0300-303.06 | Revision Date: 02/25/16
This policy guide provides information on determining whether a hospital hold is necessary and how to place a hospital hold.
TABLE OF CONTENTS
Evaluating/Placing a Hospital Hold
Removing a Hospital Hold
Referenced Policy Guides
This policy guide was updated from the 07/01/14 version to clarify when it is appropriate to place a hospital hold.
Placing a child on a hospital hold has the same effect as taking a child into temporary custody. Therefore, a CSW must have one of the following before placing a hospital hold:
- Exigent Circumstances – A CSW may detain a child without a court order if the CSW determines that a child is in immediate danger of suffering serious physical injury and there is no less intrusive means of protecting the child.
- If exigent circumstances exist, a hospital hold may be placed on the child immediately, regardless of face-to-face contact with the family by the ER CSW.
- Consent – A parent/guardian may consent to the removal of their child.
- Court Order – If the CSW does not have either consent or exigent circumstances, a CSW must obtain a court order to detain a child from the custody of his or her parent or guardian.
Hospital holds may be used at any time and are in effect until the Detention Hearing unless removed prior to the hearing. The date and time of the hospital hold becomes the date and time of the detention. If the hospital hold was placed in error, the CSW must consult with their SCSW and/or the Warrant Desk on how to proceed. A hospital hold may be used when there is reason to believe a child is at immediate risk of serious physical harm, sexual abuse or physical abuse. In other words, there is no time to get a warrant because, in the time it would take to get a warrant, it is likely the child will suffer serious disability or death, or continue to suffer severe pain, or the child will likely suffer serious physical harm if discharged to the parent. For example:
- When the parent refuses to authorize treatment of an emergency medical condition that requires immediate treatment for the alleviation of severe pain or an immediate diagnosis and treatment of an unforeseeable medical, surgical, dental, or other remedial condition or contagious disease which if not immediately diagnosed and treated would likely lead to serious disability or death or continue to suffer severe pain, in the time it would take to get a warrant. In this case, parental refusal may amount to medical neglect.
- When the medical condition of the child is due to the conduct of parents, guardians, a member of the household, or other caretakers who have custody and control of the child and the child is going to be immediately released from the hospital and it is likely the child will suffer serious disability or death, or continue to suffer severe pain, in the time it would take to get a warrant.
- When there is a reasonable belief that the parent may remove the child or infant from the hospital against medical advice and it is likely the child will suffer serious physical harm, disability or death, in the time it would take to get a warrant.
- The child is due to be released to the perpetrator and it's likely the child will suffer serious physical harm, severe pain, disability or death while in the custody of the perpetrator.
- The child is due to be released to a parent who is unable or unwilling to protect the child from the perpetrator and it's likely the child will suffer serious physical harm while in the custody of that parent.
Do not place a hospital hold when there is no risk that the parent/legal guardian will take the child against medical advice or harm the child while in the hospital. Rather than place a hospital hold in this situation, obtain a removal order instead to protect the child from abuse or neglect. Once the CSW has obtained a removal order, the CSW may place the hospital hold.
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Evaluating/Placing a Hospital Hold
- Discuss with the hospital representative the risk factors of the case and evaluate the potential danger to the child.
- Request the hospital complete the DCFS 4158-2, Physician Questionnaire if emergency medical consent is necessary and the DCFS 410, Hospital Medical Summary and Newborn Risk Assessment if appropriate.
- Discuss the following with the SCSW and the Public Health Nurse (if available) to determine if a hospital hold is necessary:
- The safety factors of the case
- The potential danger to the child and any other children who may be in the home, utilizing the SDM Safety Assessment tool and all other pertinent information
- DCFS 4158-2
- DCFS 410
- Newborn Risk Assessment
- If a hospital hold is necessary, determine if exigent circumstances exist. If not, obtain parental consent or a court order that supports the removal of a child at risk of abuse or neglect.
- Complete and sign Part 1 of the DCFS 164, Hospital Hold and obtain the SCSW’s signature.
- In emergency situations, fax the DCFS 164 to the medical facility. Inform the medical facility that the child is in temporary custody pending either a court hearing, or removal from the medical facility when acute care is no longer necessary. Request that the hospital hold be placed in the child’s hospital chart.
- Within two hours of initiating the hospital hold, contact IDC during business hours at (323) 881-1303, and notify them that a child has been taken into temporary custody and a Detention Report is being prepared. IDC will inform the CSW of the time frame for submitting a Detention Report. After business hours, report the hospital hold to the ERCP SCSW at 213-639-4500.
- If the decision is not to place a hospital hold on the child, notify the hospital and, if needed, provide community resource referrals, and any additional services to the child and his/her family.
- Document all contacts with the SCSW, PHN, hospital, parents, etc., in the Contact Notebook.
- If after consultation with CSW and the PHN, a hospital hold is necessary, review and sign the 164. If not approved, return to CSW for any modification.
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Removing the Hospital Hold
- If the child is medically cleared to leave the hospital continued detention is not necessary, and the child is being released to his or her parents/legal guardians, complete Part II of the DCFS 164 used to place the Hospital Hold.
- If a child 0-59 months old is being released to a parent/legal guardian, obtain the signature of the ARA when the allegations were physical or sexual abuse, failure to thrive, or parental substance abuse.
- In all other cases, only SCSW approval is required.
- Contact the medical facility’s representative, notify them of the decision, and fax the DCFS 164 to the medical facility.
- Notify the Dependency Investigator (DI), if assigned, that the hospital hold is removed.
- Indicate the discharge date and the child’s placement location.
- If the hospital hold was removed prior to the Detention Hearing, call Intake and Detention Control at (323) 881-1303, and inform the IDC CSW that the child will be released to the parent/legal guardian.
- Document all contacts in the Contact Notebook.
- Review and sign the 164.
- If not approved, return to CSW for any modification.
- Review and sign the 164 when releasing a child between 0-59 months old to parents.
- If not approved, return to SCSW for any modification.
Back to Procedure
- DCFS 164, When releasing a child 0-59 months old to parents
DCFS 164, Hospital Hold
DCFS 410, Hospital Medical Summary
DCFS 4158-2, Physician’s Questionnaire
Referenced Policy Guides
0600-501.15, Consent for Emergency Medical Care
0070-548.20, Taking Children into Temporary Custody
0070-570.10, Obtaining Warrants and/or Removal Orders
WIC Section 306 (a) – Describes the legal conditions when a CSW can place a child who has an immediate medical need in temporary custody without a warrant.
WIC Section 309(b) – Describes the condition when a CSW can place a child into temporary custody when that child who is under the care of a physician, surgeon or hospital care and cannot be immediately moved into temporary custody.
WIC Section 319 – Describes reasonable efforts and services that should be made available to the parents and legal guardian in order to eliminate the need to remove the child from the custody of the parents or guardians.
WIC Section 369 – Describes the circumstances when a social worker may authorize emergency medical or dental consent for a child placed in protective custody.
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