Treatment of Minors and Defining Abuse

Question 1

Can minors provide consent?

Answer 1

Usually, the parent or legal guardian must consent to the minor’s treatment, and the minor generally must give assent.

Question 2

Can a parent without legal custody consent to treatment?

Answer 2

Only a parent with legal custody may consent to treatment, but best practice is to have consent from both

Question 3

Can a parent without legal custody have access to medical files for treatment?

Answer 3

Yes, per California Family Code Section 3025, a parent without legal custody can access their child’s medical records

Question 4

What are the exceptions for a minor’s parent providing consent?

Answer 4

Emancipated Minor
Self-sufficient Minor
At risk or in which parental consent might discourage necessary treatment

Question 5

Can an emancipated minor provide consent?

Answer 5

Emancipated minors are treated as adults in terms of confidentiality, privilege, and consent to treatment.

Question 6

How can a minor become emancipated?

Answer 6

1. Marrying Legally
2. Enlisting in the Military
3. Declaration of Emancipation:
   Must be 14 or over, live separately from their parents with consent, and manage their own finances with income that is not derived from criminal activity.

Question 7

Can a self-sufficient minor provide consent?

Answer 7

Self-sufficient minors may legally consent to medical and dental treatment.

Question 8

How can a minor become a self sufficient minor?

Answer 8

1. 15 years of age or older.
2. Living apart from the parent or guardian, whether with or without consent of the parent or guardian.
3. Managing his or her own finances, regardless of the source of the minor’s income.

Question 9

What are examples of at-risk situations that are grounds for an exception for adult consent?

Answer 9

1. Outpatient mental health treatment/residential services
2. Pregnancy
3. Communicable disease
4. Sexual Assault/Rape Victims
5. Intimate Partner Violence
6. Drug or Alcohol Treatment

Question 10

In CA, under what circumstance does a mandated reporter have to report an incident of child abuse?

Answer 10

Whenever a reasonable suspicion of child abuse exists

Question 11

What are the different types of child abuse?

Answer 11

Physical abuse
Sexual abuse
Neglect
Emotional Abuse
Willfull Cruelty

PS, NEW

Question 12

Define physical abuse

Answer 12

Report if bruises or marks are left, or involves using an object on bare skin (e.g. belt or coat hanger on bare skin, or hitting with a closed fist).

Question 13

Can parents use corporal punishment in the state of CA?

Answer 13

Yes. Okay if it’s an open hand, on the butt, that does not leave a mark

Question 14

Define sexual abuse

Answer 14

Sexual assault: rape, statutory rape, incest, sodomy, oral copulation, penetration by a foreign object, child molestation, and lewd or lascivious acts.

Sexual exploitation: selling/distributing child porn, promoting or encouraging a child to engage in prostitution/pose for film, depicting a child engaged in an act of obscene sexual conduct

Question 15

What are the two different types of neglect?

Answer 15

Severe neglect and general neglect

Question 16

Severe Neglect

Answer 16

Failure of the caretaker to protect the child from severe harm. Involves physical injury

Example:
Food (malnutrition), clothing, shelter or medical care

Question 17

General Neglect

Answer 17

Failure of the caretaker to provide adequate food, clothing, shelter, medical care, or supervision.

DOES NOT involve physical injury

Question 18

What is willful cruelty?

Answer 18

Willfully causing/permitting a child to suffer

Example: a child witnessing domestic violence

Question 19

What is emotional abuse?

Answer 19

Serious emotional damage resulting in severe anxiety, depression, withdrawal, or untoward aggressive behavior toward self or others

Question 20

In CA, what age is the minimum age for sexual consent?

Answer 20

The age of 14.

It is statutory rape is if they are having intercourse under 14 years of age

Question 21

How soon must someone report abuse?

Answer 21

Report abuse immediately or as soon as is practically possible by telephone to DCFS.

Typically, within 24 hours.

Question 22

How soon must a written report for abuse be submitted?

Answer 22

Within 36 hours a mandated reported must submit a written report either online through SCAR (Suspected Child Abuse Reporting System) or by fax

Question 23

Can you breach confidentiality when making a report?

Answer 23

You can breach confidentiality to the minimum extent necessary

Question 24

What are the two types of reports?

Answer 24

Urgent report and historical report

Question 25

How do you make an urgent report?

Answer 25

If urgent or unsure, call DCFS to consult and/or make a report

Question 26

How do you make a historical report?

Answer 26

If historical, file a report through CARES

Question 27

How do you determine whether it is an urgent or historical report?

Answer 27

If they are a minor, probably more urgent

Use clinical judgment and consult

Question 28

What must you do after making a report?

Answer 28

Document that you consulted/filed a report

Question 29

Do you need to notify a family if you made an abuse report?

Answer 29

Generally, no

Question 30

What the the consequences of not reporting abuse?

Answer 30

Failure to report child abuse is a misdemeanor, punishable by a jail term of up to six months, or a fine of up to $1,000, or both.

Failure to report child abuse where that abuse or neglect results in death or great bodily injury, will be punished by up to one year in a county jail, or a fine up to $5,000, or both.

Question 31

Who is considered an elder?

Answer 31

Any person 60 years of age or older

Question 32

Who is considered a dependent?

Answer 32

Any person residing in the state of California, between the ages of 18 and 59, “who has physical or mental limitations that restrict their ability to carry out normal activities to protect their rights, including, but not limited to, persons who have physical or developmental disabilities, who have traumatic brain injuries or cognitive impairments, or whose physical or mental abilities have diminished because of age.”

Question 33

What are the requirements for reporting potential adult abuse?

Answer 33

Observation or Knowledge of Abuse: When a mandated reporter has observed or has knowledge of an incident that reasonably appears to be abuse.

Patient Reveals Abuse: When a mandated reporter is told by the elder or dependent adult of an instance of abuse.

Question 34

What are grounds for reporting abuse in adults?

Answer 34

Physical harm

Pain or mental suffering (e.g., fear, agitation, severe depression)d

Deprivation by a care custodian of the goods or services that are necessary to avoid physical harm or mental suffering

Question 35

Is emotional abuse reportable in adults?

Answer 35

No

Question 36

When might you not be required to report abuse?

Answer 36

If the reporter is not aware of any corroborating evidence

The elder has been diagnosed with a mental illness or dementia

The reporter reasonably believes the abuse did not occur

Question 37

Is reporting required if it occurs in a long term care facility?

Answer 37

Reporting is not required when a physical, mental or medical injury occurs in a long-term care facility, and there is a proper plan of care, properly provided and executed, and the reporter believes the injury was not the result of abuse.

Question 38

What are the types of adult abuse?

Answer 38

Financial Abuse
Physical Abuse
Abandonment
Isolation
Neglect

Question 39

Define adult physical abuse

Answer 39

Assault, battery, unreasonable physical restraint, or prolonged or continual deprivation of food or water, sexual assault, or abuse of a chemical restraint or psychotropic medication

Question 40

Define adult neglect

Answer 40

Failure of the person in charge of the care of the elder or dependent adult to exercise a sufficient degree of care

Question 41

Define adult abandonment

Answer 41

A situation in which the elder or dependent person has been deserted.

Question 42

Define adult isolation

Answer 42

Keeping the elder or dependent adult from having contact with others.

Question 43

Define adult financial abuse

Answer 43

When a person takes an elder or dependent adult’s finances or property wrongfully or with intent to defraud, resulting in harm.

Financial abuse also occurs when another party holds control of the elder or dependent person’s finances and does not allow the elder or dependent person access.

Question 44

What is the most common type of elder abuse?

Answer 44

Financial abuse

Question 45

What is the reporting process if the abuse occurred at home?

Answer 45

Report to adult protective services (APS) agency OR local law enforcement agency

Reports must be made immediately or as soon as possible and a written report must be made within two working days.

Question 46

What is the reporting process if the abuse occurred at a Long Term Care Facility

Answer 46

Report should be made to the local ombudsman AND to a local law enforcement agency.

Reports must be made immediately, or as soon as possible and a written report must be sent within two hours if serious bodily injury occurred, or within 24 hours in the absence of serious bodily injury.

Question 47

What is the reporting process if the abuse occurred at a State Mental Hospital or Developmental Center

Answer 47

The report should be made to the investigator of the State Department of State Hospitals or the State Department of Developmental Services AND also to the local law enforcement agency.
Reports must be made immediately, or as soon as possible and a written report must be sent within two hours.

Question 48

If a client reports abusing someone, do you have permission to make a report?

Answer 48

Providers of mental health services are not mandated to report assault, nor even permitted to report assault, unless the patient gives explicit written consent.

Question 49

Are mental health providers permitted to report HIV status to a client’s sexual partner?

Answer 49

Mental health providers may never breach a patient’s confidentiality with regard to HIV status.