Frequently Asked Questions
1. What is Child Protective Services?
Child Protective Services, CPS, is part of the division of Family and Community Services under the Idaho Department of Health and Welfare. Their services are designed to help protect children while providing supports to strengthen families to prevent abuse and neglect. If a child needs to be removed from his or her family for safety, CPS will work with the family to lower the safety concerns so the child can be returned home as soon as it is safe. For additional information, please see the Idaho Department of Health and Welfare’s website at www.healthandwelfare.idaho.gov.
2. Who is involved in making decisions about child protection and regulations?
Laws are issued by state and federal authorities. They are enforced by local, state and federal law enforcement. They are followed by many organizations and individuals who work with children including health care providers, schools, childcare providers and child protective services.
3. When do Idaho hospitals contact Child Protective Services?
Idaho State law deems all physicians, nurses and other hospital workers mandatory reporters. The term “mandatory reporter” is a legal term outlined in Idaho State law (Idaho Code sec. 16-1605). This means these employees are legally required to report when they observe a child being subjected to conditions or circumstances that would reasonably result in abuse, abandonment, or neglect. The definition of “neglected” includes a child who is without proper medical or other care or control necessary for his well-being because of the conduct or omission of his parents (Idaho Code sec. 16-1602).
4. What is “leaving the hospital against medical advice” (AMA) with a pediatric patient?
When it is deemed clinically important by a health care provider to continue treatment and the parent or legal guardian chooses to leave the hospital without treatment, this is considered leaving against medical advice or AMA.
5. In Idaho, if a parent wants to leave the hospital against medical advice with their child, what criteria do hospitals use to determine when to contact Child Protective Services?
As health care providers hospitals play a key role in caring for and advocating for patients, including pediatric patients. We value the safety, security, and health of these patients, and care for patients with the utmost sense of responsibility.
When making the determination to contact additional resources, we categorize patients into one of three scenarios:
- Scenario 1: The child is at risk of imminent harm or death and cannot leave the hospital.
- In this scenario, staff members contact law enforcement and Child Protective Services
- Scenario 2: The child is at uncertain risk of lesser harm
- In this scenario, staff members contact law enforcement and Child Protective Services
- Scenario 3: Minimal or no risk of harm
- In this scenario no outside resources are contacted. Situation is documented in the medical record.
When a child’s life, safety, or well-being is in question, we will always err on the side of caution. It is our legal responsibility to notify Child Protective Services in cases that fall into Scenarios 1 and 2, above. If we do not contact Child Protective Services, we can be legally responsible (Idaho Code sec. 16-1605).
6. What happens when a health care provider and a parent disagree on treatment?
When a patient is at the hospital, the care team (including physicians and nurses) works to stabilize and diagnose conditions, some of which can be urgently life threatening.
Diagnosis of diseases and conditions occurs through assessment, interview, testing, imaging, examination, and observation. Procedures and policies within the hospital setting help identify the main causes for concern/admission as well as secondary issues which may be impacting a patient’s health.
Once issues are thoroughly identified, evaluated, and documented, the care team will create a care plan that includes therapy, medication, interventions, and supportive care.
We do our absolute best to create a care plan that both parent and health care provider feel good about. Health care providers work with parents to discuss options, risks, benefits, and provide professional recommendations.
In very rare circumstances, there are times when a parent and health care provider cannot come to an agreement about a recommended treatment, test, therapy, or intervention while admitted at the hospital.
If the health care provider deems this treatment or intervention necessary for patient care and the parent decides to leave the hospital with their child, the hospital will follow its criteria for notifying Child Protective Services based on Idaho State law and perceived risk of harm if the child leaves the hospital.
It is important to note that a parent can choose to take risks that we, as health care providers and mandatory reporters, legally cannot take.
7. How do Idaho hospitals define medical neglect?
Neglect is an emotionally charged term that has different classifications/definitions based on circumstances. In accordance with Idaho state law, medical neglect is defined as: a child who is without proper medical or other care necessary for his well-being because of the conduct or omission of his parents (Idaho Code sec. 16-1602(31)). More simply: if there is a risk of harm, or an uncertain risk of harm without medical treatment or follow up.
8. Do hospitals follow up on cases/families after referral to Child Protective Services?
No. Child Protective Services protects the confidentiality of children and families referred. After a referral is placed, Child Protective Services does not provide any information to people or organizations that made referrals.
The outcome of an investigation is not disclosed and therefore is not included in the medical record. Hospitals only maintain records of patients while in the hospital.
9. What is a hospital’s involvement in cases of abuse, abandonment and neglect?
Hospitals do not make determinations or judgments about child abuse, neglect, or abandonment. Hospitals report their concerns to the appropriate outside entities, whose obligation it is to investigate and make the determination. The State of Idaho has processes and procedures in place to investigate and determine necessary interventions.
10 Can a hospital “hold” a child against a parent’s wishes?
Hospitals do not make the determination to shelter a child. Law enforcement makes that determination after evaluating information provided from a variety of sources, including an Idaho Department of Health and Welfare case worker.
If you have further general concerns about when and why children are sheltered in the State of Idaho, please see the Idaho Department of Health and Welfare’s website at www.healthandwelfare.idaho.gov.
11. Can I amend my child’s medical record?
Under Health Insurance Portability and Accountability Act of 1996 (HIPAA), patients have a right to amend to their medical records. Patients can submit a Request for Amendment of Health Information Form to Kootenai Health’s Medical Records department that details how the medical record is incorrect or incomplete. Once the form is completed, the facility/provider can either grant or deny the amendment based on criteria outlined in hospital policy. Please note, information cannot be deleted from a medical record. If amendments are granted or denied, the request and information about the request will be added and referenced in the medical record.
If a provider amendments a person’s medical record, the new amendment to the medical record will be viewable whenever the original document is accessed. The amendment will also be released any time the original document is released.
12. If my family has been referred to Child Protective Services in the past, will I be discriminated against if I seek care at Kootenai Health in the future?
No. Kootenai Health does not discriminate against any patients.
13. What oversight does Kootenai Health have over the CPS referral process?
While legally, mandatory reporters can submit referrals to Child Protective Services anonymously, Kootenai Health’s policy is for employees to inform our Risk Management, Hospital Supervisor, and Patient Advocacy departments whenever a referral is made to Child Protective Services for a current patient.
14. What is Kootenai Health’s philosophy of care?
Health care is incredibly complex and at times can be emotionally charged.
Kootenai Health employees come to work every day dedicated to provide the best possible care to all patients. With every patient and every interaction we strive to be respectful and compassionate in our care.
As health care providers, we play a key role in caring for and advocating for patients, including pediatric patients. We value the safety, security, and health of these patients, and care for patients with the utmost sense of responsibility.
Please see our vaccination policy and philosophy of care here.
Please see information on involuntary detention here.