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KMA Model Health Care Protocol on Abuse, Neglect & Exploitation
Child, Spouse/Partner, Adult & Elder |
Table of Contents
Violence Fact Sheet
Signs of Possible Abuse, Neglect, & Exploitation
I. Protocol: Statement, Purpose & Definitions
A. Policy Statement
B. Purpose of Protocol
C. Key Definitions
II. Screening & Identification of Possible Victims
A. Universal Screening
B. Neonatal/Prenatal Screening Process
C. Prenatal Factors Influencing Neonatal Outcome During the Screening Process
D. Triage
E. High Risk Indicators
III. Consent Issues
A. Adults
B. Children
C. Advocates / Support Persons
D. Alleged Perpetrators
E. Photographic Documentation.
F. Emergency Services / Protection
IV. Assessment, Examination & Documentation
A. General Information
B. Physical Abuse & Neglect
C. Sexual Abuse & Assault Examination
D. Documentation (Chart, Photographic)
E. Evidence Collection, Preservation & Release Procedures
V. Reporting Responsibilities & Medical Records
A. Cabinet for Families and Children, Dept. for Social Services-
B. Law Enforcement Agency, County or Commonwealth’s Attorney
C. Duty to Warn
D. Coroner
E. Records
VI. Model Policy & Assessment Forms
A. Interviewing the Family/Caretaker
B. Interviewing and History Taking - Adult
C. Interviewing and History Taking - Child
D. Assessment and Documentation Checklist: Adult/Child Sexual Abuse
VII. Health Insurance & Reimbursement Issues
A. General Information
B. Adult Maltreatment Syndrome & Related Cases
C. Sexual Assault Examination
D. Crime Victim Compensation Board
VIII. Legal Issues
A. Legal System
B. Role of Physician in Court
C. Court Appearance
D. Authority for Investigative Access to Health Care Facilities, Private Premises, and
Medical Records/Information
E. Reporting from Substance Abuse Programs
IX. Patient Education & Referrals to Community Resources
A. Kentucky & National Toll-Free Help Numbers
B. Department for Social Services: County Offices
C. Spouse Abuse Centers; Map of Locations
D. Rape Victim Services Programs; Map of Locations
E. Community Mental Health Centers
F. Children's Advocacy Centers
G. Child Abuse/Safe Place Shelters
Physician Education - Child Abuse
Patient Brochure
Patient Poster
Patient Poster - Spanish Web Links
References
Credits
Whether in private practice, a hospital or residential facility, most physicians will treat some patients who are victims of abuse, neglect or exploitation. This document serves to provide guidance to Kentucky’s physicians on how to effectively identify, treat and reduce the risk of further victimization for these adult and child victims.
The Kentucky Medical Association has historically been in the forefront of addressing adult and child abuse, neglect and exploitation. KMA has demonstrated commitment to educating physicians on the issues of domestic violence through development of a comprehensive educational packet on child, adult and elderly abuse, as well as sponsorship of training programs, and public awareness campaigns. These initiatives were developed through the Subcommittee on Domestic Violence, established in 1993 and composed of a multidisciplinary group representing government and private sector agencies. The Model Health Care Protocol on Abuse, Neglect & Exploitation, initially developed by the Subcommittee in March 1997, received approval by the Governor’s Council on Domestic Violence and the Kentucky Board of Medical Licensure as the official curriculum for training of physicians in domestic violence.
The original goal of the Subcommittee was to develop a model protocol to facilitate quality health care intervention for these patients and to assist Kentucky’s physicians to comply with standards, regulations and laws related to adult and child maltreatment. With a number of changes in law and procedural matters, the Subcommittee has reviewed and revised portions of the protocol to reflect these changes.
These guidelines are not intended to be construed or to serve as a standard of medical care. Standards of medical care are determined on the basis of all the facts and circumstances involved in an individual case and are subject to change as scientific knowledge and technology advance and patterns of practice evolve. These guidelines reflect the views of scientific, legal, and social science experts and reports available in the scientific, legal, and social science literature as of August 2004.
The original work of the Subcommittee on the model protocol was developed through four working groups as follows:
Fact Sheet Kathy Frederich and Travis Fritsch
Protocol Systems Michael Moore, MD; Terry Faragher; Travis Fritsch; and Kathy Frederich
Interview & History Taking Lana Grandon; Kim Bunnell; Kaye Bowman-Kile; and Linda Murray
Documentation Form & Check List George R. Nichols, MD; Jerry Bowles; Lana Grandon; Beth Jurek; Linda Murray and Kim Bunnell
Updates for 2004 were provided by: Mary Pauline Fox, MD; Lana Grandon; James Grace; Donna Hunsaker, MD; Eileen Recktenwald, MSW; Christy-Burch Epperson.
The Kentucky Medical Association is committed to educating physicians on caring for patients who have suffered abuse. The KMA will continue to update physicians on timely information related to domestic violence as needed.
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Hon. Jerry Bowles
Family Court Judge
Louisville, KY
James L. Coorsen, MD
Internal Medicine
Louisville, KY Charles A. Eckerline, MD
Emergency Medicine
Lexington, KY Susan Ely
Jefferson County Attorney’s Office
Louisville, KY
Mary P. Fox, MD
General Practice
Pikeville, KY Hon. Lana Grandon
Assistant Attorney General
Frankfort, KY Nancy Horrar
Family Services Program
Louisville, KY Ardis D. Hoven, M.D.
Infectious Diseases
Lexington, KY Donna M. Hunsaker, MD
Pathology
Louisville, KY Karen W. Krigger, MD
Family Practice
Louisville, KY
Hon. Ray Larson
Fayette County Commonwealth’s Attorney
Lexington, KY
| Susan F. Melton, MD
Family Practice Resident
Louisville, KY
J. Michael Moore, MD
Plastic Surgeon
Lexington, KY
George R. Nichols, MD
Pathology
Louisville, KY William S. Smock, MD
Emergency Medicine
Louisville, KY Nagma Zafar, MD
Pediatrics
Somerset, KY Medical Students
Fred Foshee, Pikeville
Carrie Huber, Louisville
Kimberly Jones, Louisville
Carrie Morgan, Lexington
Kara O’Brien, Lexington
Chris Warner, Lexington
Emily Wolff, Lexington
Ex Officio
Eileen Recktenwald, MSW
Executive Director
KY Association of Sexual Assault Programs, Inc
Frankfort, KY Christy Burch-Epperson
Advocacy Program Administrator
Kentucky Domestic Violence Association
Frankfort, KY
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