The Virtual Hospital: The Iowa Child Abuse Resource: Conferences and Symposiums

Iowa Child Abse Resource: Resources from the State of Iowa

Child Abuse: A Guide for Mandatory Reporters

The University of Iowa
Peer Review Status: Externally Reviewed

Child Abuse:

Application of the Law

The Child Abuse Reporting Law, Iowa Code Section 232.67 through Section 232.68 was initially enacted in 1978 and has been amended several times since then. The intent of the law is to identify children who are victims of abuse. The law also provides for a professional investigation to determine if abuse has occurred. Accompanying the investigation are protective services designed to protect, treat, and prevent further maltreatment.

The Child Abuse Reporting Law is only one type of Iowa statute designed to deal with child abuse. Juvenile Court laws authorize the court to provide protection for children through supervision in their own homes or in substitute care. Criminal laws are separate from the Reporting and Juvenile Court laws. Criminal laws provide for prosecution of alleged perpetrators in cases where a criminal act has been committed.

According to Iowa statute, the Department of Human Services (DHS) has responsibility to assess and investigate suspected child abuse. DHS is the agency designated by law to receive reports of suspected child abuse and neglect.

Iowa's Child Abuse Reporting Law

A Social Overview

Child abuse is recognized as a problem of epidemic proportions. Each year Department of Human Services Investigators conduct about 20,000 investigations involving about 30,000 children. Each year about 9,000 lowa children are determined to be victims of child abuse. In 1993, twelve Iowa children died as the result of child abuse. National studies continue to indicate that only about one-third of maltreated children are reported to child protection agencies. Significant numbers of victims remain unidentified without protection and treatment.

Child abuse has serious consequences which may remain as indelible pain throughout the victim's lifetime. The violence and negligence of parents and caretakers serve as a model for children as they grow up. The child victims of today, without protection and treatment, may become the child abusers of tomorrow.

As with any social issue, child abuse is a problem for the entire community. Achieving the goals of protective services requires the coordination of many resources. Each professional group and agency involved with a family assumes responsibility for specific elements of the Child Protective Service (CPS) process. The Department of Human Services works closely with physicians, nurses, educators, mental health practitioners, law enforcement agencies, and the judiciary. These parties are involved in the identification, reporting, investigation, ssRrrsment and treatment of cases of child maltreatment.

Protective services are provided by the Department of Human Services to abused and neglected children and their families without regard to income. Special rehabilitative services for prevention and treatment of child abuse are provided by D.H.S. and other community resources to children and families such as: homemaker services, parenting classes, respite day care, foster care, financial assistance, psychological and psychiatric services, and sexual abuse treatment.

Purpose of the Child Abuse Reporting Law

The purpose of the lowa law is to provide the greatest possible protection to children by encouraging the reporting of suspected child abuse. The state respects the bond between parent and child. However, the State does assert the right to intervene for the general welfare of the child when there is a clear and present danger to the child's health, welfare or safety. The state does not intend to interfere with reasonable parental discipline and childrearing practices that are not injurious to the child. Certain persons or groups of persons having frequent contact with children are required by state law to report suspected cases of child abuse to the Department of Human Services. Those persons are designated to be "Mandatory Reporters" and typically are employed in one of the following fields:

1. Medicine
2. Social Work
3. Child Care
4. Mental Health
5. Education
6. Law Enforcement

Those designated persons are in a position to identify children who are at risk from abuse. Consequently, they are required to report such cases.

It is the intent of the law that a professional investigation of reports of suspected abuse be initiated and that comprehensive protective services be provided for abused and neglected children in lowa.

Recognizing Child Abuse

Victims and Perpetrators

The victim of child abuse is a person under the age of 18 who has suffered one or more of the six categories of child abuse as defined in the lowa Code (Physical Abuse, Mental Injury, Sexual Abuse, Denial of Critical Care, Child Prostitution, or Presence of illegal Drugs).

Perpetrators of child abuse come from all walks of life, races, religions and nationalities. They come from all professions and represent all levels of intelligence and standards of living. There is no single social strata free from incidents of child abuse.

Some perpetrators of child abuse may have social or psychological problems such as depression or low self-esteem. Some may have alcohol or drug-related problems. Others lack basic information about normal child development and parenting. Some have expectations of the child that the child cannot possibly meet. Lack of parenting skills, coupled with the child's inability to meet unreasonable demands, can sometimes lead to child abuse. Stress (including financial stress) is also a frequent contributing factor.

Abusive parents may show disregard for the child's own needs, limited abilities, and feelings. Many abusive parents believe that children exist to satisfy parental needs and that the child's needs are unimportant. Children who don't satisfy the parent's needs may become victims of child abuse. Sexual abusers may have deviant personality traits and behaviors which can result in sexual contact with a child. Sexual abuse perpetrators sometimes use threats, bribery, coercion or force to engage a child in sexual activity. They violate the trust that a child inherently places in them for care and protection, and exploit the power and authority of their position as a trusted caretaker in order to sexually misuse a child. Often the child is threatened or warned "not to tell", creating a conspiracy of silence about the abuse.

Physical Indicators of Child Abuse

Unexplained (or multiple history for) bruises, burns or fractures
Bruises and welts on the face, lips, mouth, torso, back, buttocks, or thighs in various stages of healing,
Bruises and welts in unusual patterns reflecting the shape of the article used (i.e. electric cord, belt buckle or in clusters (indicating repeated contact) )
Bruises on an infant, especially facial bruises
Cigarette burns, especially on the soles, palms, backs or buttocks
Immersion burns (sock-like, glove-like, doughnut-shaped on buttocks or genitalia)
Burns - patterned like an electric element, iron or utensil
Rope burns on arms, legs, neck or torso
Bite marks and/or loss of hair
Lacerations or abrasions to the mouth, frenum, lips, gums, eyes, or external genitalia
Fractures of the skull, nose, ribs or facial structure in various stages of healing; multiple or spiral fracture
Subdural hematomas, retinal hemorrhages, internal injuries
Consistent hunger, poor hygiene, inappropriate dress
Consistent lack of supervision; abandonment
Unattended physical/emotional problems or medical needs
Speech disorders, lags in physical development, ulcers,
Asthma, severe allergies and/or failure-to-thrive
Difficulty in walking or sitting
Torn, stained or bloody underclothing
Pain or itching in the genital are
Bruises, bleeding or infection in the external genitalia, vaginal or anal areas
Venereal disease, especially in pre-teens
Frequent urinary or yeast infections
Pregnancy
Substance abuse - alcohol or drugs
Positive test for presence of illegal drugs in the child's body

Behavioral Indicators of Child Abuse

Wary of adult contacts, lack of trust, uncomfortable with or threatened by physical contact or closeness
Apprehensive when children cry, overly concerned for siblings
Behavioral extremes such as aggressiveness or withdrawal
Overly compliant, passive, undemanding behavior; apathy
Extreme aggression, rage, or hyperactivity
Poor self-esteem, self-devaluation, lack of confidence or self-destructive behavior
Complaints of soreness, uncomfortable movement
Inappropriate clothing for the weather or massive weight change
Afraid to go home; frightened of parents
Destructive, antisocial or neurotic traits, habit disorders
Multiple or inconsistent histories for a given injury
Delay in securing or failure to secure medical care
Begging, stealing or hoarding food
Extended stays at school (early arrival and late departure)
Constant fatigue, listlessness or falling asleep in class
Alcohol or drug abuse
Role-reversal behavior or overly dependent behavior
Lags in growth or development
Delinquent, runaway or truant behaviors
Frequently absent or tardy from school or drops out of school or sudden school difficulties
States there is no caretaker
Shunned by peers; poor peer relationships
Lack of emotional control, withdrawal, chronic depression, hysteria, fantasy or infantile behavior
Indirect allusions to problems at home such as, "I want to live with you".
Fear of a person or an intense dislike of being left with some one
Unusual interest in or knowledge of sexual matters, expressing affection in inappropriate way
Excessive seductiveness or promiscuity
Developmental and/or language delays
Suicide attempts
History of abuse/neglect provided by the child

Basic Information and Definitions

The Department of Human Services has legal authority to conduct investigations of child abuse when it is alleged that:

a. The victim is a child
b. The child is subjected to one or more of the six categories of child abuse
c. The abuse is the result of the acts or omissions of the person responsible for the care of the child.

Child is defined in the Code of Iowa 232.68(1) as being:

"any person under the age of eighteen years."

Person Responsible for the Care of a Child is defined in the Code of Iowa 232.68(7) as being:

a. A parent, guardian, or foster parent.
b. A relative or any other person with whom the child resides, and who assumes care or supervision of the child, without refer ence to the length of time or continuity of such residence.
c. An employee or agent of any public or private facility provid ing care for a child, including an institution, hospital, health care facility, group home, mental health center, residential treatment center, shelter care facility, detention center, or child care facility.
d. Any person providing care for a child, but with whom the child does not reside, without reference to the duration of the care.

Six Categories of Child Abuse

Child Abuse is defined in the Code of Iowa 232.68 as being the following six categories:

Physical Abuse
Mental Injury
Sexual Abuse
Denial of Critical Care
Child Prostitution
Presence of Illegal Drugs

Physical Abuse:

Any non-accidental physical injury, or injury which is at variance with the history given of it, suffered by a child as the result of the acts or omissions of a person responsible for the care of the child

Mental Injury:

Any mental injury to a child's intellectual or psychological capacity as evidenced by an observable and substantial impairment in the child's ability to function within the child's normal range of performance and behavior as the result of the acts or omissions of a person responsible for the care of the child, if the impairment is diagnosed and confirmed by a licensed physician or qualified mental health professional as defined in section 622.10.

Sexual Abuse:

The commission of a sexual offense with or to a child pursuant to chapter 709, section 726.2, or section 728.12, subsection 1, as a result of the acts or omissions of the person responsible for the care of the child. Notwithstanding section 702.5, the commission of a sexual offense under this paragraph includes any sexual offense referred to in this paragraph with or to a person under the age of eighteen years.

This includes the following 12 sub-categorizes:

First Degree Sexual Abuse,
Second Degree Sexual Abuse,
Third Degree Sexual Abuse,
Detention in a Brothel,
Lascivious Acts with a Child,
Indecent Exposure,
Assault with Intent to Commit Sexual Abuse,
Indecent Contact with a Child,
Lascivious Conduct with a Minor,
Incest,
Sexual Exploitation by a Counselor or Therapist, and
Sexual Exploitation of a Minor.

Denial of Critical Care:

The failure on the part of a person responsible for the care of a child to provide for the adequate food, shelter, clothing or other care necessary for the child's health and welfare when financially able to do so or when offered financial or other reasonable means to do so. A parent or guardian legitimately practicing religious beliefs who does not provide specified medical treatment for a child for that reason alone shall not be considered abusing the child, however this provision shall not preclude a court from ordering that medical service be provided to the child where the child's health requires it.

This includes the following 8 sub-categories:

Failure to provide adequate food and nutrition to such an extent that there is danger of the child suffering harm, injury or death.

Failure to provide adequate shelter to such an extent that there is danger of the child suffering harm, injury or death.

Failure to provide adequate clothing to such an extent that there is danger of the child suffering harm, injury or death.

Failure to provide adequate health care to such an extent that there is danger of the child suffering serious harm, injury or death. A parent or guardian legitimately practicing religious beliefs who does not provide specified medical treatment for a child for that reason alone shall not be considered abusing the child. However, a court may order that medical service be provided where the child's health requires it.

Failure to provide the mental health care necessary to adequately treat an observable and substantial impairment in the child's ability to function.

Gross failure to meet emotional needs of the child necessary for normal development.

Failure to provide proper supervision of the child to such an extent that there is danger of the child suffering harm, injury or death, and which a reasonable and prudent person would exercise under similar facts and circumstances.

Failure to respond to the infant's life-threatening conditions (also known as withholding of medically indicated treatment) by providing treatment (including appropriate nutrition, hydration and medication) which in the treating physician's reasonable judgment will be most likely to be effective in ameliorating or correcting all conditions, except that the term does not include the failure to provide treatment (other than appropriate nutrition, hydration or medication) to an infant when, in the treating physician's reasonable medical judgment any of the following circumstances apply: the infant is chronically and irreversibly comatose; the provision of treatment would merely prolong dying, not be effective in ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be futile in terms of the survival of the infant; the provision of the treatment would be virtually futile in terms of the survival of the infant and the treatment itself under the circumstances would be inhumane.

Child Prostitution:

The acts or omissions of a person responsible for the care of a child which allow, permit, or encourage the child to engage in acts prohibited pursuant to section 725.1. Notwithstanding section 702.5, acts or omissions under this paragraph include an act or omission referred to in this paragraph with or to a person under the age of eighteen years.

Note: Prostitution is defined as follows: A person who sells or offers for sale the person's services as a partner in a sex act, or who purchases or offers to purchase such services.

Presence of Illegal Drugs:

An illegal drug is present in a child's body as a direct and foreseeable consequence of the acts or omissions of the person responsible for the care of the child.

Note: Illegal drugs are defined as cocaine, heroin, amphetamine, methamphetamine, other illegal drugs, (including marijuana), or combinations or derivatives of illegal drugs which were not prescribed by a health practitioner

The Investigative Process

The process of investigating reports of child abuse is as follows:

1. Intake
2. Investigation

a. Observation and ensuring child safety
b. Interviews with subjects of the report and other relevant collateral sources
c. Gathering of physical and documentary evidence
d. Assessment of the home environment and the relationships of household members
e. Evaluation of information

3. Service recommendations and referrals
4. Documentation of investigation through completion of reports
5. Completion of required correspondence to subjects and mandatory reporters

Report Conclusions

The conclusion of the investigation is based on an evaluation of all of the information gathered during the investigation, including:

a. Physical evidence
b. Documentary evidence
c. Observations
d. Interviews of the victim, perpetrator and others

There are three possible outcomes in a Child Abuse Investigation:

Founded: It has been determined by a preponderance of evidence (51 % or greater) that abuse has occurred

Undetermined:It cannot be determined by a preponderance of evidence (51% or greater) that child abuse has or has not occurred. To found or unfound is equally compelling.

Unfounded: It has been determined by a preponderance of evidence (51 % or greater) that abuse has not occurred.

Upon completion of the report, all subjects and mandatory reporters are notified in writing of the conclusions of the report.

Mandatory Reporters of Child Abuse

Code of Iowa 232.69
The following classes of persons shall make a report within twenty-four hours and as provided in section 232.70, of cases of child abuse:

Every health practitioner (a licensed physician and surgeon, osteopath, osteopathic physician and surgeon, dentist, optometrist, podiatrist or chiropractor; a resident or intern in any of such professions; a licensed dental hygienist, a registered nurse or licensed practical nurse; and a basic emergency medical care provider certified under section 147.161 or an advanced emergency medical care provider certified under section 147A.6) who in the scope of professional practice, examines, attends, or treats a child and who reasonably believes the child has been abused. Notwithstanding section 140.3, this provision applies to a health practitioner who receives information confirming that a child is infected with a sexually transmitted disease.

Any of the following persons who, in the scope of professional practice or in their employment responsibilities, examines, attends, counsels, or treats a child and reasonably believes a child has suffered abuse:
A self-employed social worker,
A social worker under the jurisdiction of the D.H.S.
A social worker employed by a public or private agency or institution,
An employee or operator of a public or private health care facility as defined in section 135C.1,
A certified psychologist,
A licensed school employee,
An employee or operator of a licensed child care center, registered group day care home or registered family day care home,
An employee or operator of a substance abuse program or facility licensed under chapter 125,
An employee of a Department of Human Services institution listed in section 218.1
An employee or operator of a juvenile detention or juvenile shelter care facility approved under section 232.142,
An employee or operator of a foster care facility licensed or approved under chapter 237,
An employee or operator of a mental health center,
A peace officer,
A dental hygienist,
A counselor, or mental health professional.

Note: lowa Administrative Code 441-175.3(2) mandates certified adoption investigators to report suspected abuse.

Iowa D.H.S. policy (Manual IV-B) also mandates Income Maintenance Workers to report suspected abuse.

Training for Mandatory Reporters

Iowa Code 232.69(3) provides that:
"A person required to make a report under subsection 1, other than a physician whose professional practice does not regularly involve providing primary health care to children, shall complete two hours of training relating to the identification and reporting of child abuse within six months of initial employment or self-employment. Within one month of initial employment or self-employment the person shall obtain a statement of the abuse reporting requirements from the person's employer or, if self-employed, from the department. The person shall complete at least two hours of additional child abuse identification and reporting training every five years. If the person is an employee of a hospital or similar institution, or of a public or private institution, agency, or facility, the employer shall be responsible for obtaining the child abuse identification and reporting training. The person may complete the initial or additional training as part of a continuing education program required under chapter 258A or may complete the training as part of a training program offered by the department of human services, the department of education, an area education agency, a school district, the Iowa law enforcement academy, or a similar public agency.

Reporting Procedures

1. Each report made by a mandatory reporter, as defined in section 232.69, subsection 1, shall be made both orally and in writing. Each report made by a permissive reporter, as defined in section 232.69, subsection 2, may be oral, written, or both.

2. The oral report shall be made within 24 hours by telephone or otherwise to the Department of Human Services. If the person making the report has reason to believe that immediate protection for the child is advisable, that person shall also make an oral report to an appropriate law enforcement agency.

3. The written report shall be made to the Department of Human Services within forty-eight hours after such oral report. (Form SS-1705-0 may be used to fulfill this requirement.)

4. The Department of Human Services shall:

a. Immediately, upon receipt of an oral report, make a determination as to whether the report constitutes an allegation of child abuse as defined in Section 232.68;
b. Make a report to the central registry if the oral report has been determined to constitute a child abuse allegation;
c. Forward a copy of the written report to the registry, and;
d. Notify the appropriate county attorney of the receipt of any report.

5. The oral and written reports shall contain the following information, or as much thereof as the person making the report is able to furnish:

a. The names and home address, (current location or residence) of the child and the child's parents or other persons believed to be responsible for the child's care;
b. The child's present whereabouts, if not the same as the parent's or other person's home address.
c. The child's age;
d. The nature and extent of the child's injuries, including any evidence of previous injuries;
e. The name, age and condition of other children in the same household;
f. Any other information which the person making the report believes might be helpful in establishing the cause of the injury to the child, the identity of the person or persons responsible for the injury, or in providing assistance to the child.
g. The name and address of the person making the report.

6. A report made by a permissive reporter, as defined in Section 232.69, subsection 2, shall be regarded as a report pursuant to this Chapter whether or not the report contains all of the information required by this Section and may be made to the Department of Human Services, county attorney, or law enforcement agency. If the report is made to any agency other than the Department of Human Services, such agency shall promptly refer the report to the Department of Human Services.
Note: Any other person who believes that a child has suffered abuse may make a report of the suspected abuse to the Department of Human Services. Mandatory reporters, outside the scope of their professional practive, may also report suspected abuse, but as permissive reporters.

Confidentiality is Waived

Confidentiality is Waived in the Iowa Code as follows:

The Code of Iowa 232.74
Sections 622.9 and 622.10 and any other statute or rule of evidence which excludes or makes privileged the testimony of a husband or wife against the other or the testimony of a health practitioner or mental health professional as to confidential communications do not apply to evidence regarding a child's injuries or the cause of the injuries in any judicial proceeding, civil or criminal, resulting from a report pursuant to this Chapter or relating to the subject matter of such a report.

Sanctions for failure to report child abuse

The Code of Iowa 232.75 sanctions:
1. Any person, official, agency or institution, required by this chapter to report a suspected case of child abuse who knowingly and willfully fails to do so is guilty of a simple misdemeanor.

2. Any person, official, agency or institution, required by Section� 232.69 to report a suspected case of child abuse who knowingly fails to do so is civilly liable for the damages proximately caused by such failure.

3. A person who reports or causes to be reported to the Department of Human Services false information regarding an alleged act of child abuse, knowing that the information is false or that the act did not occur, commits a simple misdemeanor.

Immunity From Liability

The Code of Iowa 232.73 provides for:
A person participating in good faith in the making of a report, or photographs, or X-rays, or in the performance of a medically relevant test pursuant to this Chapter, or aiding and assisting in an investigation of a child abuse report pursuant to section 232.71, shall have immunity from any liability, civil or criminal, which might otherwise be incurred or imposed. The person shall have the same immunity with respect to participation in good faith in any judicial proceeding resulting from the report or relating to the subject matter of the report. As used in this section and Section 232.77, "medically relevant test" means a test that produces reliable results of exposure to cocaine, heroine, amphetamine, methamphetamine, or other illegal drugs, or combinations or derivatives thereof, including a drug urine screen test.

Investigation and Agency Response

Procedure Following A Report

The duties of the department upon receipt of a report are outlined in the Code of Iowa 232.71 as follows:
1. If a report is determined to constitute a child abuse allegation, the department of human services shall promptly commence an appropriate investigation. The primary purpose of this investigation shall be the protection of the child named in the report. The department, within five working days of commencing the investigation, shall provide written notification of the investigation to the child's parents. However, if the department shows the court to the court's satisfaction that notification is likely to endanger the child or other persons, the court shall orally direct the department to withhold notification. Within one working day of issuing an oral directive, the court shall issue a written order restraining the notification. If a report is determined to not constitute a child abuse allegation, but a criminal act harming a child is alleged, the department shall immediately refer the matter to the appropriate law enforcement agency.

2. The investigation shall include:

a. Identification of the nature, extent and cause of the injuries, if any, to the child named in the report;
b. The identification of the person or persons responsible therefor;
c. The name, age and condition of other children in the same home as the child named in the report;
d. An evaluation of the home environment and relationship of the child named in the report and any other children in the same home as the parents or other persons responsible for their care;
e. An interview of the person alleged to have committed the child abuse, if the person's identity and location are known, to afford the person the opportunity to address the allegations of the child abuse report. The interview shall be conducted, or an opportunity for an interview shall be provided, prior to a determination of child abuse being made. The court may waive the requirement of the interview for good cause.

3. The investigation may, with the consent of the parent or guardian, include a visit to the home of the child named in the report and an interview or observation of the child may be conducted. If permission to enter the home or observe the child is refused, the juvenile court or district court upon showing of probable cause may authorize the person making the investigation to enter the home and interview or observe the child. The department may utilize a multidisciplinary team in investigations of child abuse.

4. Based on an investigation of alleged child abuse by an employee of a facility providing care to a child, the department shall notify the licensing authority for the facility, the governing body of the facility, and the administrator in charge of the facility of any of the following:

a. A violation of facility policy noted in the investigation.
b. An instance in which facility policy or lack of facility policy may have contributed to the alleged child abuse.
c. An instance in which general practice in the facility appears to differ from the facility's written policy. The licensing authority, the governing body, and the administrator in charge of the facility shall take any lawful action which may be necessary or advisable to protect children residing in the facility.

5. The department of human services may request information from any person believed to have knowledge of a child abuse case. The county attorney, any law enforcement or social services agency in the state, and any mandatory reporter, whether or not the reporter made the specific child abuse report, shall cooperate and assist in the investigation upon the request of the department of human services. The county attorney and appropriate law enforcement agencies shall also take any other lawful action which may be necessary or advisable for the protection of the child.

6. The investigation may include a visit to a facility providing care to the child named in the report or to any public or private school subject to the authority of the department of education where the child named in the report is located. The administrator of a facility, or a public or private school shall cooperate with the investigator by providing confidential access to the child named in the report for the purpose of interviewing the child, and shall allow the investigator confidential access to other children for the purpose of conducting interviews in order to obtain relevant information. The investigator may observe a child named in a report in accordance with the provisions of section 232.68, subsection 3, paragraph "b". A witness shall be present during an observation of a child. Any child age ten years or older can terminate contact with the investigator by stating or indicating the child's wish to discontinue the contact. The immunity granted by section 232.73 applies to acts or omissions in good faith of such administrators and their facilities or school districts for cooperating in an investigation and allowing confidential access to a child. The department may utilize a multidisciplinary team to conduct investigations of child abuse involving employees or agents of a facility providing care for a child.

7. The department, upon completion of its investigation, shall make a preliminary report of its investigation as required by sub-section 2. A copy of this report shall be transmitted to juvenile court within four regular working days after the department initially receives the abuse report unless the juvenile court grants an extension of time for good cause shown. If the preliminary report is not a complete report, a complete report shall be filed within ten working days of the receipt of the abuse report, unless the juvenile court grants an extension of time for good cause shown. The department shall notify a subject of the report of the result of the investigation, of the subject's right to correct the information pursuant to section 235A.19, and of the procedures to correct the information. The juvenile court shall notify the registry of any action it takes with respect to a suspected case of child abuse.

8. The department of human services shall transmit a copy of the report of its investigation, including actions taken or contemplated, to the registry. The department of human services shall make periodic follow-up reports thereafter in a manner prescribed by the registry so that the registry is kept up-to-date and fully informed concerning the handling of a suspected case of child abuse.

9. The department of human services shall also transmit a copy of the report of its investigation to the county attorney. The county attorney shall notify the registry of any actions or contemplated actions with respect to a suspected case of child abuse so that the registry is kept up-to-date and fully informed concerning the handling of such a case.

10. Based on the investigation conducted pursuant to this section, the department shall offer to the family of any child believed to be the victim of abuse such services as are available and appear appropriate for either the child, the family, or both, if it is explained that the department has no legal authority to compel the family to accept the services.

11. If, upon completion of the investigation, the department of human services determines that the best interests of the child require juvenile court action, the department shall take the appropriate action to initiate such action under this chapter. The county attorney shall assist the county department of human services as provided under section 232.90, subsection 2.

12. The department of human services shall assist the juvenile court or district court during all stages of court proceedings involving a suspected child abuse case in accordance with the provisions of this chapter.

13. The department of human services shall provide for or arrange for and monitor services for abused children and their families on a voluntary basis or under a final or intermediate order of the juvenile court. The department shall adopt rules defining services which the local planning groups authorized to develop plans may recommend.

14. In every case involving child abuse which results in a child protective judicial proceeding, whether or not the proceeding arises under this chapter, a guardian ad litem shall be appointed by the court to represent the child in the proceedings. Before a guardian ad litem is appointed pursuant to this section, the court shall require the person responsible for the care of the child to complete under oath a detailed financial statement. If, on the basis of that financial statement, the court deems that the person responsible for the care of the child is able to bear the cost of the guardian ad litem, the court shall so order. In cases where the person responsible for the care of the child is unable to bear the cost of the guardian ad litem, the expense shall be paid out of the county treasury.

15. If a fourth report is received from the same person who made three earlier unfounded reports which identified the same child as the abused child and the same person responsible for the child as the alleged abuser, the department may determine that the report is again unfounded due to the report's spurious or frivolous nature and may in its discretion terminate its investigation.

16. The department may request criminal history data from the department of public safety on any person believed to be responsible for an injury to a child which, if confirmed, would constitute child abuse. The department shall establish procedures for determining when a criminal history records check under this subsection is necessary.

17. In each county or multicounty area in which more than fifty child abuse reports are made per year, the department shall establish a multidisciplinary team, as defined in section 235A.13, subsection 7. Upon the department's request, a multidisciplinary team shall assist the department in the assessment, diagnosis, and disposition of a child abuse report.

Protective Custody

The Code of Iowa 232.78 (paraphrased) provides for a juvenile court to enter an ex parte order directing a peace officer to take custody of a child before or after the filing of a petition provided all of the following apply:

a. The person responsible for the care of the child is absent, or though present, was asked and refused to consent to the removal of the child and was informed of an intent for an order under this section, or there is reasonable cause to believe that a request for consent would further endanger the child, or there is reasonable cause to believe that a request for consent will cause the parent, guardian, or legal custodian to take flight with the child.
b. It appears that the child's immediate removal is necessary to avoid imminent danger to the child's life or health.
c. There is not enough time to file a petition and hold a hearing under Section 232.95
The order shall specify the facility to which the child is to be brought. Except for good cause shown or unless the child is sooner returned to the place where the child was residing or permitted to return to the child day care facility, a petition shall be filed under this chapter within three days of the issuance of the order.

The juvenile court may enter an order authorizing a physician or hospital to provide emergency medical or surgical procedures.
The juvenile court may enter an order authorizing a physician or hospital to conduct an outpatient physical examination or authorizing a physician, psychologist or community mental health center to conduct an outpatient mental examination of a child.
Every reasonable effort shall be made to inform the parent or other person legally responsible for the child's care of the application.

The Code of Iowa 232.79 (paraphrased) provides for a peace officer to take a child into custody or a physician treating a child may keep the child in custody without a court order and without the consent of a parent, guardian, or custodian provided that both of the following apply:

a. The child is in a circumstance or condition.that presents an imminent danger to the child's life or health. b. There is not enough time to apply for an order under section 232.78.

The child is to be brought immediately to a place designated by the rules of the court for this purpose unless the child is or will be hospitalized.
Every reasonable effort shall be made to inform the parent or custodian of the whereabouts of the child.
The court is to be immediately orally informed of the emergency removal and the circumstances.
The court is to be informed in writing within twenty-four hours of the emergency removal and the circumstances.
Any person, agency, or institution acting in good faith in the removal or keeping of a child pursuant to this section. . . shall have immunity from any civil or criminal liability that might otherwise be incurred or imposed as the result of such removal or keeping.
The court will direct D.H.S. or juvenile probation to make every reasonable effort to communicate immediately with the child's parent or parents or other person legally responsible for the child's care. The court shall be notified both orally and in writing upon locating such parties. The court shall authorize D.H.S. or juvenile probation to cause a child to be returned if it concludes there is not an imminent risk to the child's life and health in so doing. D.H.S. or Juvenile probation shall communicate orally and in writing any information which could affect the court's decision. If the child is not returned D.H.S. or juvenile probation shall cause a petition to be filed within three days after the removal.
When there has been an emergency removal of a child without a court order, a physical examination of the child by a licensed medical practitioner shall be performed within twentyfour hours of such removal unless the child is returned to the child's home within twenty-four hours of the removal.

Juvenile Court Hearings

(Child in Need of Assistance)

Juvenile Court hearings are held when children are removed from their parent's custody or when treatment or Department of Human Services supervision of abused or neglected children is necessary because the parents are unwilling or unable to provide such treatment or supervision. Parents are notified immediately if their child is placed in shelter care. A petition for a hearing must be filed with the Juvenile Court within three days of the removal of a child from a parent's care. A Juvenile Court hearing is held promptly in order to review the need for continued protection of the child through shelter care. Parents are provided the opportunity at the shelter care hearing to present evidence that their child can be returned home without danger of injury or harm. The Court ensures that the parent's and the children's rights will be protected. The parents have a right to legal counsel and, if they cannot afford an attorney, one will be appointed by the court. An attorney will be appointed to represent the child's best interest in these cases. The attorney representing the child is called the Guardian ad litem. An attorney will be appointed by the court to represent parents who are unable to afford one. Additional hearings are held if the Court determines that the child needs its protection. At each hearing, the Court reviews the efforts of the parents to remedy problems and the services arranged for or provided by the Department of Human Services to help the parents and child(ren).

Child in Need of Assistance

Code of Iowa 232.2 (6) Child in Need of Assistance means an unmarried child:

a. Whose parent, guardian or other custodian has abandoned or deserted the child.
b. Whose parent, guardian, other custodian, or other member of the household in which the child resides has physically abused or neglected the child, or is imminently likely to abuse or neglect the child.
c. Who has suffered or is imminently likely to suffer harmful effects as a result of either of the following:
(1 ) Mental injury caused by the acts of the child's parent, guardian or custodian.
(2) The failure of the child's parent, guardian, custodian, or other member of the household in which the child resides to exercise a reasonable degree of care in supervising the child.
d. Who has been, or is imminently likely to be, sexually abused by the child's parent, guardian, custodian or other member of the household in which the child resides.
e. Who is in need of medical treatment to cure, alleviate, or prevent serious injury or illness and whose parent, guardian or custodian is unwilling or unable to provide such treatment.
f. Who is in need of treatment to cure or alleviate serious mental illness or disorder, or emotional damage as evidenced by severe anxiety, depression, withdrawal or untoward aggressive behavior toward self or others and whose parent, guardian, or custodian is unwilling or unable to provide such treatment.
g. Whose parent, guardian, or custodian fails to exercise a minimal degree of care in supplying the child with adequate food, clothing or shelter and refuses other means made available to provide such essentials.
h. Who has committed a delinquent act as a result of pressure, guidance, or approval from a parent, guardian, custodian, or other member of the household in which the child resides.
i. Who has been the subject of or a party to sexual activities for hire or who poses for live display or for photographic or other means of pictorial reproduction or display which is designed to appeal to the prurient interest and is patently offensive; and taken as a whole, lacks serious literary, scientific, political or artistic value.
j. Who is without a parent, guardian or other custodian.
k. Whose parent, guardian, or other custodian for good cause desires to be relieved of the child's care and custody.
l. Who for good cause desires to have the child's parents relieved of the child's care and custody.
m. Who is in need of treatment to cure or alleviate chemical dependency and whose parent, guardian or custodian is unwilling or unable to provide such treatment.
n. Whose parent's or guardian's mental capacity or condition, imprisonment, or drug or alcohol abuse results in the child not receiving adequate care.
o. In whose body there is an illegal drug present as a direct and foreseeable consequence of the acts or omissions of the child's parent, guardian or custodian.

Criminal Prosecution

Law enforcement agencies are obligated to investigate reported crimes. Criminal prosecution of parents in cases of abuse is at the discretion of the County Attorney. A child abuse investigation is not a criminal investigation. It is a civil procedure. However, there are times when a child abuse investigation is conducted simultaneously by D.H.S. and Law Enforcement working as a team.

Central Abuse Registry

When it is determined that a child is a victim of abuse, the child's name is entered into the Central Registry. The names of the child's parents and the name of the perpetrator of the abuse are also entered into the Central Registry. The purpose of the Registry is to gather data on the incidence and nature of child abuse in Iowa. It is also used as a resource for identifying repeated cases of abuse. The Central Registry was established by Iowa law and is maintained by the Department of Human Services. The Central Registry also serves as a quality assurance function, reviewing reports whose content is contested by a subject of the report. Another function of the Central Registry is approval of the dissemination of child abuse information to persons authorized to receive this information.

Access to Child Abuse Information

Iowa Code 235A(15) (paraphrased) provides that:
Confidentiality of child abuse information shall be maintained, except as specifically authorized.

Note: The Department shall withhold the name of the person who made the report of suspected child abuse. Only the court or the central registry may allow the release of that person's name.

Access to child abuse information (founded, undetermined or unfounded) is authorized to Subjects of a Report (child, parent, guardian or legal custodian, alleged perpetrator) or to the attorney for any subject, as well as an employee or agent of the Department of Human Services responsible for investigating a child abuse report, D.H.S. registry and department personnel when necessary for the performance of their official duties and functions, and to the mandatory reporter who reported the abuse.

Access to child abuse information (other than unfounded) is also authorized to persons involved in an investigation of child abuse. (A health practitioner or mental health professional, a law enforcement officer, a multidisciplinary team)

Access to certain child abuse information (other than unfounded) is authorized to individuals, agencies, or facilities providing care to a child named in a report under some circumstances. (Facility licensing authority, a person or agency responsible for the care of a child victim or perpetrator, a D.H.S. registration or licensing employee, a D.H.S. adoption worker, a certified adoption worker, a licensed child placing agency, administrator of a psychiatric medical institution, administrator of a child foster care facility, administrator of a registered or licensed child day care facility, superintendent of the Iowa Braille and sight-saving school, superintendent of the school for the deaf, administrator of a community mental health center.)

Access to child abuse information (other than unfounded) is also authorized under some circumstances as it relates to judicial and administrative proceedings. (Juvenile Court, District Court, a court or agency hearing an appeal for correction of child abuse information, an expert witness at any stage of an appeal hearing, a probation or parole officer, juvenile court officer, adult correctional officer)

Access to certain child abuse information (other than unfounded) is also authorized to others under certain circumstances as follows: To a person conducting bona fide child abuse research, the Department of Public Safety, a child protection agency from another state for investigative, treatment or adoptive, and other purposes, the attorney for D.H.S., foster care review boards, a D.H.S. employee responsible for licensing or registering a child day care facility, the board of educational examiners, a legally authorized protection and advocacy agency.

Request for Correctionof Child Abuse Information and Appeals

A person who is the subject of a child abuse report may receive a copy of that report by submitting a request to the D.H.S. using either form SS-1606-0 (Request for Child Abuse Information) or by using form 470-0686 (Child Abuse Notification). All other requesters must use form SS-1606-0. Upon receipt of a copy of the report, a subject of that report may, if they feel there is incorrect or erroneous information contained in the report, or if they disagree with the conclusions of the report, request correction of the report by writing within six months of the completion of the report to the:

Central Abuse Registry - 5th Floor
Hoover State Office Building
Des Moines, Iowa 50319-0114.

Registry personnel will review the request for correction along with any additional information that the requester provides, and may uphold, modify or overturn the original finding. If the requester is not satisfied with the Registry decision they may file for an evidentiary hearing at which time the matter will be heard before an Administrative Law Judge. The Administrative Law Judge may also uphold, modify or overturn the finding. If the requester is not satisfied with the decision of the Administrative Law Judge, the matter may be appealed to the District Court.

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