This case involves a child who did not receive an appropriate medical screening when taken into custody by the state. Her birth mother tested positive for opioids at delivery and the baby tested positive for opioids after birth. A judge promptly signed the child to the care of the state, but a comprehensive medical record was not completed before the child was entrusted to the state. The child developed an infection by age 8 and was found to have AIDS. Original paperwork revealed that the mother had been HIV positive. It was alleged that if the child had been treated within the first six weeks, she would not have contracted AIDS. A licensed social worker was sought to discuss the responsibility to ensure children receive appropriate medical screening, especially when birth mothers present with complicated medical issues.
Question(s) For Expert Witness
- 1. Please describe your experience as a social worker.
- 2. What is the responsibility of social workers to ensure that children have appropriate medical screening?
Expert Witness Response E-010166
I have been the chair of the department of social work and human services at a state university for 16 years. I have also served as a senior faculty member for master and Ph.D. programs in social work. I also opened a private child services practice in 1994 and received a substantial number of referrals from pediatricians and the local school system. A professional social worker has an ethical mandate to provide a comprehensive bio-psycho-social and spiritual assessment as an integral part of the treatment and disposition planning process. If the social worker is the case manager, this responsibility is clearly required. This responsibility becomes even more critical if there are birth or any other presenting medical issues that require assessment. The mother’s social and medical history, as well as the newborn’s positive drug test, clearly indicated a need for further medical screening. Although caseworkers have large caseloads and rigorous deadlines established by the court, this situation required a social worker to slow the process to ensure that the child had an adequate medical work up. The case managers involved should have at least raised a question about the issues surrounding the birth of this child.
Expert Witness Response E-009359
I have worked in child welfare 20 years and I have broad, ample knowledge, expertise, and exposure to child protective services nationally. I have a Ph.D. in social work and I am a licensed clinical social worker in 2 northeastern states. My experience includes removal expectations and procedures, placement, adoptions, high-risk medical issues, and general health concerns. I have been an expert witness in many state and federal cases. I have also worked with the child welfare system from the perspective of a child welfare worker, investigator, foster parent, consultant, and board member and chair of a committee. A completed comprehensive medical assessment is required prior to the child’s initial placement as well as all subsequent placements. One of the most important placements considerations for the social worker is the comprehensive medical exam that occurs immediately after removal.