Many children’s hospitals now include an internal child abuse pediatrician specialist (CAPS) or even a whole CAPS team. They include a specifically trained doctor who consults on child abuse/neglect cases. These teams are embedded in hospitals and may also include a social worker, child protective services representatives, along with at least one child abuse pediatrician, among other health, mental health, and child welfare professionals. The team is tasked with determining whether certain injuries or medical presentation of symptoms are caused by abuse, neglect, accident, or for medical reasons. These teams are usually investigating a parent long before that parent becomes aware of the investigation and often before a parent has a chance to clear up misunderstandings. Sometimes these teams get involved when a parent is at odds with a certain doctor, has asked for a second opinion, or a misunderstanding between parents and doctors or even disagreements between doctors takes place; thus, the doctor decides to ask for a CAPS consultation for clarification or even in retaliation. This more nefarious use of a CAPS team is difficult even for parents to accept, much less the general public or legislators. As long as these CAPS systems have no accountability, we have no way of knowing how often this is happening in doctors offices, specialty clinics and especially Children’s Hospitals all over the country. In Texas, there is an entire network of Specialists, including CAPS doctors, called Forensic Assessment Center Network (FACN) and a doctor or CPS Investigator need not be working at a children’s hospital to request a consultation from one of these teams. The state of Texas set up a program called MEDCARES (Medical Child Abuse Resources and Education System) to fund the the FACN and CAPS teams in children’s hospitals.
When these teams are secretly investigating parents for possible abuse and/or neglect without their knowledge, a parent is deprived of due process and parents are often denied access to their own records when they suddenly become aware of such a covert investigation and request their child’s records. These are clear violations of due process. Parents should be told immediately when they are under any sort of investigation, be it from secret CAPS teams embedded in hospitals, or if the call to CPS has already been made (see Full Disclosure). Parents have a right to know and seek counsel from attorneys, parent advocates, medical advocates, or anyone else they think may help them during an investigation before they are shocked with the removal of their child by a court order or forced to leave a hospital where their child is a patient. Parents also have a right to their child’s FULL medical record without delay (see Medical Records) so they can see what has been said about themselves or their child by treating professionals. Sometimes these teams are used to coerce and threaten parents into certain treatments before making an official report to CPS which violates a myriad of state and federal laws.
Additionally, Mental Health is starting to have increased implications for families. When doctors decide that a child’s medical issues originate from psychological issues rather than organic medical issues, families have been forced under threat of CPS involvement into eating disorder clinics, mental health services, or psychiatric hospitals while medical treatments are stopped or postponed even when parents disagree. The “psycho-social model” is being implemented into healthcare models thus forcing healthcare professionals to look for psychological issues first rather than just treating a child’s medical issues even when parents do not want or even consent to this type of treatment for their child. Often social workers are sent to a child’s hospital room to do psychological screenings and/or psycho-social interviews of parents. The parents may not even know what is really happening or that this is an OPTIONAL part of their child’s healthcare treatment. This is a violation of INFORMED CONSENT requirements in healthcare settings and is a growing problem in hospitals, clinics, and doctor’s offices. Then, the information gleaned from an seemingly informal discussion with a seemingly well-meaning social worker is added to the child’s medical record. Later this information is used against the parent without their knowledge as part of the covert, internal abuse/neglect investigation. This practice needs to be stopped immediately and the doctors, clinics, and hospitals that enact it need to be held responsible for their actions.