KMA Model Health Care Protocol on Abuse, Neglect & Exploitation Child, Spouse/Partner, Adult & Elder

I. PROTOCOL: STATEMENT, PURPOSE & DEFINITIONS

This model policy and protocol information is provided:

• to facilitate, simplify, and standardize quality health care intervention for patients at risk of abuse, neglect or exploitation;
• to assist physicians to comply with standards, regulations and laws related to adult and child abuse, neglect and exploitation.

These materials are to be used as guidelines to assist physicians to develop policies and procedures related to the needs of these patients. Every physician and facility administrator should have a mechanism established in which initial patient contact assesses for current and historical identification of abuse, neglect or exploitation.

A. Policy Statement

1. Physicians should consider assessment of their patients for the possibility of adult or child abuse, neglect or exploitation. When maltreatment is suspected or indicated, appropriate treatment, reports and referrals must be rendered.
2. All personnel should treat adult and child victims of maltreatment with respect, dignity and discretion.
3. Where a patient has been determined to be in need of emergency care by the physician, no such person shall be denied admission by reason only of his inability to pay for services to be rendered by the hospital. (EMTALA)
4. Every Kentucky hospital which offers emergency services is required by law to provide a physician or sexual assault nurse examiner, available on call 24 hours each day, for the examination of persons reported to any law enforcement agency to be victims of sexual offenses (including sexual abuse). The physician or sexual assault nurse examiner shall, upon request of any peace officer or prosecuting attorney, and with the consent of the reported victim, examine the patient for the gathering of physical evidence. (KRS 216B.400)
5. Physicians should assist in all possible ways to provide appropriate treatment, protection (if indicated), information and referrals.
6. In accordance with state law and professional /ethical standards of practice, all physicians are required to report all known or suspected acts of child, spouse, adult abuse, neglect or exploitation to the Cabinet for Health and Family Services, Department for Community Based Services (DCBS) for protection/support services, if indicated. Cooperation with DCBS is essential.
7. In-service training should be provided at regular intervals. Training and written materials should: a) enhance the quality of physician response to these patients; and, b) increase knowledge of and compliance with the law, policy and protocol.

B. Purpose of Protocol

The primary purpose of medical policy and protocol is to assist physicians to:

• identify cases of adult and child abuse, neglect and exploitation;
• minimize the physical and psychological trauma to the adult or child victim of abuse, neglect or exploitation;
• clarify the role of physicians related to these types of maltreatment;
• maximize proper medical record documentation and the collection/preservation of physical evidence for potential use in the delivery of protective services and in legal proceedings;
• clarify statutory responsibilities for proper reporting of all known or suspected adult, spouse/partner, child abuse, neglect and exploitation to designated authorities;
• facilitate the provision of protection and support services in order to remedy or prevent the abuse, neglect or exploitation;
• aid to use in the facilitation of guidelines which address and facilitate compliance with medical-legal standards of care for adult and child victims of abuse, neglect and exploitation;
• reduce the risk of criminal and civil liability which may be incurred in these cases;
• develop and implement on-going professional education on these issues for physicians.
  
  C. Key Definitions

The definitions in this section are intended to serve as functional (NOT legal) definitions for the identification of possible victims and the types of maltreatment which may have occurred.

Definition of Domestic Violence
A pattern of coercive behaviors that may include repeated battering and injury, psychological abuse, sexual assault, progressive social isolation, deprivation, and intimidation. Someone who is or was involved in an intimate relationship with victim perpetrates these behaviors.

Definition of sexual assault
Any unwanted sexual contact against your will that can include fondling, incest, molestation, sexual abuse, rape, and sodomy. Perpetrators of sexual assault can be anyone or any gender: an acquaintance, date, relative, stranger, friend, spouse, etc.

Back to Table of Contents