, DCFS Worker’s Report to the Juvenile Court of Death, Injury or Illness, to inform the Court of the emergency medical procedure.Consent for Emergency Medical Care
0600-501.15 | Revision Date: 02/25/16
Overview
This policy guide provides staff with guidelines on authorizing emergency medical, surgical, dental, or other remedial care, which if not immediately diagnosed and treated, would lead to serious disability and/or death.
TABLE OF CONTENTS
Emergency Medical Consent (EMC)
When Emergency Medical Consent (EMC) Cannot Be Authorized
Parental Consent for Emergency Medical Consent (EMC)
Parent's/Guardian's Rights to be Notified and Present for Medical Examinations
Requests for Emergency Medical Consent (EMC)
No Allegations of Abuse/Neglect
Consent for Emergency Medical Care
Version Summary
This policy guide was updated from the 07/01/14 version to clarify when DCFS can authorize an emergency medical procedure and the title and policy number (CPH: Requests for Emergency Medical Consent, 0050-503.75) were changed to reflect this. Also, a new section regarding parent's/guardian's rights was added.
An emergency situation means a child “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 is not immediately diagnosed and treated, would lead to serious disability or death,” per WIC 369(d).
Emergency medical, surgical, dental or remedial care may be provided to a child by a licensed physician without a court order and upon the authorization of a social worker when:
The social worker must make reasonable efforts to obtain the consent of, or to notify the parent, guardian, or person standing in place of a parent prior to authorizing emergency medical care. A CSW must check with the physician and determine how much time there is to contact the parent (e.g. an in-person contact, telephone call, voicemail). If time is limited due to the urgency, the CSW may give authorization for the emergency medical procedure after making one attempt to contact the parent(s).
Should the parent(s) not have legal authority to provide medical consent the CSW must make a reasonable effort to contact a person that can give medical consent, such as one of the following individuals:
As long as the child meets the criteria, an EMC must be processed in an expedited manner in consultation with SCSW. The following staff can receive an initial request for an EMC and deny or approve without court approval:
If the attending physician and surgeon determine that immediate HIV treatment is necessary to render appropriate care to a HIV positive infant 0-12 months old, it is considered emergency medical care, thereby authorizing the CSW to consent to treatment without a court order provided all the requirements for emergency medical care are met.
CPH staff can never give medical consent for the following:
A parent may not provide consent for EMC if any of the following apply:
Parental consent for EMC is not necessary in the following situations:
Parents/guardians have a right to be given notice of medical exams and procedures their children are scheduled to undergo, as well as the right to be with their children while they are receiving medical exams and procedures, or to be in a waiting room or other nearby area if there is a valid reason for excluding them while all or a part of the medical procedure is being conducted. Therefore officials (CSWs, law enforcement, etc.) cannot exclude parents from the room where their child is receiving medical attention unless there is either parental consent, a valid reason for exclusion, or an emergency requiring immediate medical attention.
A valid reason to exclude a parent from the room where their child is receiving medical attention may include circumstances where authorities have reasonable cause to believe that the parent is abusive or will interfere in the examination in a significant way, or where the non-abusive parent is so emotionally distraught that they would disrupt the examination.
If there is a valid reason to exclude family members from the examination room, a parent’s right to be present in the examination room may be limited to being near the examination (e.g. in the waiting room or another nearby area).
Parents must be notified in all instances when their child is to receive medical attention, including instances where parental consent is not obtained. Efforts to notify the parents of the medical examination or procedure should be documented.
If a CSW determines that he/she needs to exclude a parent/guardian from the medical examination, even if that medical examination was ordered by the court, the CSW should consult with his/her SCSW for guidance. The SCSW will consult with the Warrant Liaison or County Counsel as needed. Any decision to exclude a parent/guardian from the examination must be documented by the CSW in the case contact notebook.
Use the following tables and instructions (1-11) provided below to make a request for emergency medical consent (EMC). The numbers in the tables correlate with the numbers in the instruction list.
|
|
Parental Consent Given |
Parental Consent Unavailable |
Parental Consent Refused |
|
Non-court Dependent |
3, 8 |
3, 4, 8 |
1**, 5, 6, 7, 8 |
|
Court Dependent (during or after business hours) |
2, 8 |
2, 5, 6, 9, 10, 11 |
1**, 5, 6, 9, 10 |
|
|
Parental Consent Given |
Parental Consent Unavailable |
Parental Consent Refused |
|
Non-court Dependent |
1, 8 |
1, 4, 8 |
1**, 5, 6, 7 |
|
Court Dependent (during or after business hours) |
1, 8 |
1, 5, 6, 7, 9, 10, 11 |
1**, 5, 6, 7, 9, 10 |
* *If the parents refuse to consent due to religious practices, CPH staff must inquire whether the hospital staff has consulted with representatives of the parent's religion (e.g., Jehovah Witness Liaison) and the result of the consultation.
** If the refusal to obtain or consent to medical treatment amounts to medical neglect, create an allegation of general neglect.
Instructions (1-11):
When the CPH or Court Liaison consents to a medical emergency procedure/surgery, the Case-Carrying CSW will notify the Court and the child’s attorney and forward the DCFS 4158-A, 4158-2, and 4334 forms to the Case-Carrying CSW.
The following procedures apply to the CSW who is completing the emergency medical consent:
, DCFS Worker’s Report to the Juvenile Court of Death, Injury or Illness, to inform the Court of the emergency medical procedure.
Info to CSW/Consultation Call form
DCFS 1688-1, DCFS Worker’s Report to the Juvenile Court of Death, Injury, or Illness
DCFS 4158-A, Authorization for After-Hours Emergency Medical Care for a Child
DCFS 4158-2, Physician Questionnaire
DCFS 4334, Court Medical Consent-Medical Emergency Worksheet
DCFS 5402, Notice to Child’s Attorney Re: Child’s Case Status
0300-303.06, Hospital Holds
0600-501.10, Consent for Routine Medical Care
0600-502.20, HIV/AIDS Testing and Disclosure of HIV/AIDS Information'
0600-514.10, Psychotropic Medication: Authorization, Review and Monitoring for DCFS Supervised Child
0600-505.20, Hospitalization of and Discharge Planning for DCFS-Supervised Children
for DCFS Supervised Children
Business and Professional Code (BPC) Section 2397 – States, in part, that a licensed medical professional will not be “liable for civil damages for injury or death caused in an emergency situation occurring in the licensee’s office or in a hospital on account of a failure to inform a patient of the possible consequences of a medical procedure.”
Family Code (FC) Section 6922 – Details, in part, when a minor may consent for medical and/or dental care without parental consent. Also states, in part, that a licensed professional may advise a minor’s parent/guardian of treatment given/needed on both the basis of the information provided by the minor and the whereabouts of the parent/guardian.
FC 6925 – States, in part, that a minor may consent to medical care related to the prevention or treatment of pregnancy. It does not authorize a minor to be sterilized without the consent of the minor's parent or guardian.
FC 69256(a) – States, in part, that a minor may who may have come into contact with an infectious, contagious, or communicable disease may consent to medical care related to the diagnosis or treatment of the disease, if it is one that is required by law … to be reported to the local health officer, or is a related sexually transmitted disease...
FC 6927 – States, in part, that a minor who is 12 years of age or older and who is alleged to have been raped may consent to medical care related to the diagnosis or treatment of the condition and the collection of medical evidence with regard to the alleged rape.
FC 6928(b) – States, in part, that a minor who is alleged to have been sexually assaulted may consent to medical care related to the diagnosis and treatment of the condition, and the collection of medical evidence with regard to the alleged sexual assault.
FC 6929 – States, in part, that a minor who is 12 years of age or older may consent to medical care and counseling relating to the diagnosis and treatment of a drug or alcohol related problem.
Health and Safety Code 1607.5 – Details, in part, when and how a minor may and may not donate blood.
Health and Safety Code 121020 (d) – States in part that HIV treatment for a HIV positive infant 0-12 months of age is considered emergency medical care.
Juvenile Court Rule 7.4 (c) – States, in part, a social worker or probation officer, after making reasonable efforts to obtain parental consent, has the authority to grant "emergency medical treatment" for any minor who "requires immediate treatment for the alleviation of severe pain or an immediate diagnosis and treatment of an unforeseeable medical, surgical or dental, or other remedial condition or contagious disease which, if not immediately diagnosed and treated, would lead to serious disability or death."
WIC Section 366.27(a) – States that the court may authorize the relative of a child to provide the same legal consent for the minor’s medical, surgical, and dental care as the custodial parent of the minor if the placement of the child in a planned permanent living arrangement with a relative is ordered.
WIC Section 369 – States, in part, that a social worker may authorize the performance of medical, surgical, dental, or other remedial care for a child who is taken into temporary custody, in need of care, and who has obtained the recommendation of a licensed medical professional. Also states, in part, that the court, upon both written recommendation of a licensed medical professional and due notice to the parent/guardian, may authorize the performance of the necessary medical, surgical, dental, or other remedial care for that person. This includes a dependent child placed, by court order, under the custody and/or supervision of a social worker and for whom no parent/guardian is willing to authorize necessary medical treatment for the child.
WIC 369(d) – Provides a definition of an emergency medical condition.
WIC 5326.6 – Details the circumstances under which psychosurgery may be administered.
WIC 5326.8 – States the circumstances under which convalescent therapy may and may not be administered.
WIC 5326.95 – States, in part, that the “Director of State Hospitals shall adopt regulations to carry out the provisions of this chapter, including standards defining excessive use of convulsive treatment.”