Children Exposed to Drug Labs

0600-518.31 | Revision Date: 07/01/14

Overview

This policy guide provides guidelines for how to identify and protect children and youth who are at risk of exposure to the manufacture and distribution of drugs. It provides instructions on how to respond to referrals identified by the Drug Endangered Children program.

TABLE OF CONTENTS

Policy

Drug Endangered Children (DEC) Program and Protocol

DEC Response Team

DEC Coordinator

Unexpected Drug Labs

Procedure

Receiving a DEC Referral from the Child Protection Hotline (CPH)

ER CSW Responsibilities

Conducting the Investigation

ER CSW Responsibilities

ER SCSW Responsibilities

Receiving a DEC Case from the Multi-Agency Response Team (MART)

FM/R/G SCSW Responsibilities

Case-Carrying CSW Responsibilities

Unexpectedly Entering a Drug Lab

CSW Responsibilities

Approvals

Helpful Links

Attachments

Referenced Policy Guides

Statutes

Version Summary

This policy guide was updated from the 04/28/10 version, as part of the Policy Redesign, in accordance with the DCFS Strategic Plan. The title of this policy guide has been changed from Drug-Endangered Children (DEC) Program.

POLICY

Drug Endangered Children (DEC) Program and Protocol

Children are at extremely high risk when in locations that manufacture and distribute methamphetamine and other drugs, such as PCP and ecstasy. Children may be susceptible to chemical exposure, and there is a heightened risk of fire and/or explosions in these locations. Drug Endangered Children (DEC) programs nationally seek to ensure that the children found in these environments receive appropriate care and attention. The Los Angeles DEC program coordinates the efforts of law enforcement, medical services, prosecution entities, and child welfare agencies. The two goals of the DEC program are to:

• Break the cycle of child abuse, neglect, and endangerment caused by those who manufacture, use, and sell drugs.

• Create a collaborative, multidisciplinary response to help children discovered in illegal methamphetamine and other drug labs.

Children who are exposed to toxic chemicals should be assessed and treated immediately and on an ongoing basis as necessary. Law enforcement is required to immediately take all children into protective custody when hazardous conditions are present at a drug laboratory.

Most drug endangered or exposed children must receive ongoing care through the Multidisciplinary Assessment and Service Hub (MAS Hub), located on the campus of the King/Drew Medical Center. The Hub will assist in building a database and in identifying the long-term medical needs of drug endangered children.

• If a child is placed at a location too distant from the Hub for regular follow-up care, Hub staff will assist in referring the caregiver and the child to an appropriate medical provider.

• If chemical exposure has been ruled out medically, either at the initial or at subsequent exams, the child should receive regular medical care per Child Health and Disability Prevention (CHDP) standards and timeframes.

Case outcomes and services provided to DEC and their families are tracked by the District Attorney’s office, law enforcement, and DCFS, who are collectively responsible for gathering statistical information. DEC program protocols are supported by DCFS policies and supervision.

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DEC Response Team

The DEC Response Team is comprised of staff from the following agencies:

• California Bureau of Narcotics Enforcement

• Los Angeles County DCFS

• Los Angeles County Sheriff’s Department

• Los Angeles District Attorney’s Office

• Los Angeles Interagency Metropolitan Police Apprehension Crime Taskforce (LA IMPACT)

The DEC program utilizes the DCFS Multi-Agency Response Team (MART) staff to respond to DEC identified referrals. This team conducts DEC investigations and provides additional services that address a wide variety of high profile criminal activities where children are present.

Per Interagency DEC program protocol, Los Angeles Interagency Metropolitan Police Apprehension Crime Taskforce (LA IMPACT) and DCFS MART members will conduct initial interviews jointly with all victims at the scene, if possible. If not possible, a complete interview must take place upon completion of the exposed children’s medical examination.

When hazardous conditions exist at a drug laboratory:

• Only personnel who are trained and certified in clandestine laboratory safety operations should enter clandestine laboratory sites.

• Personnel not appropriately trained should notify the proper personnel only.

• Law enforcement and/or medical personnel at the scene will attempt to gather a urine specimen from the children.

• The Los Angeles County fire paramedics will be notified and will transport the children to the appropriate hospital.

• Medical personnel who are part of the DEC Response Team may only be involved in cases of gross chemical/drug contamination. In such situations, the DEC Response Team will remove the child’s clothing and provide clean attire prior to taking the child from the scene.

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DEC Coordinator

The responsibilities of the DEC Coordinator includes but is not limited to:

• Coordination of the DEC Response Team and DCFS Multi-Agency Response; Team (MART) response to clandestine drug laboratory investigations where children are present;

• Interdepartmental substance abuse awareness training;

• Statistical data collection and analysis;

• Research design;

• Development of evidence-based best practice standards for DEC response; and

• Policy development on safety awareness and other emerging DEC related issues.

Unexpected Drug Labs

Per California Code of Regulations Title 8, Section 5144, only personnel trained and certified in laboratory safety operations should enter clandestine laboratory sites. Personnel not appropriately trained should take no action other than to notify the proper personnel.

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PROCEDURE

Receiving a DEC Referral from the Child Protection Hotline (CPH)

ER CSW Responsibilities

1. If a DEC referral is received in an out-of-home care placement, follow the procedure set forth in Emergency Response Referrals Alleging Abuse in Out-of-Home Care.

2. Review the DEC referral to verify that the Child Protection Hotline (CPH) has identified a situation where there are drug endangered children.

• If the referral involves a clandestine drug laboratory but the referral source was not law enforcement or the DEC Coordinator, immediately notify the DEC Coordinator at (323) 869-6895 or (310) 838-2856 and/or the law enforcement agency with jurisdiction over the site.

3. Prior to responding to the DEC referral, contact the DEC Coordinator and/or the law enforcement agency involved to:

1. Ensure a response within two (2) hours.

2. Confirm the location, as the following may have occurred:

• The parent/caregiver may have already been placed in custody

• The residence may have been quarantined

• A child may have already been removed from the scene by law enforcement to a safe location

4. If responding to the laboratory site, remain in the designated safety zone until otherwise advised by law enforcement that it is safe to proceed.

Conducting the Investigation

ER CSW Responsibilities

1. If drugs are unexpectedly found being manufactured at a site during a child abuse investigation or during a routine home visit, exit immediately and call law enforcement.

2. When clearance from law enforcement has been given to enter a clandestine drug laboratory, assess all children at the location for the following:

• Obvious illness or injury

• In such cases, obtain medical assistance by immediately informing any law enforcement at the location or by calling 911.

• Physical symptoms of exposure to the chemicals in the drug laboratory. These may include:

• Watery eyes, discharge from or burn of the eyes, blurred vision

• Drying, irritation, and redness of the skin and/or mild to severe burns

• Sneezing, coughing, difficult and labored breathing, congestion of the voice box, chest pain

• Nausea, vomiting, and abdominal pain

3. If immediate medical treatment and/or examination are indicated as needed for a child, accompany him/her to the nearest emergency room.

4. When assessing the home environment, look for, or ask the investigating law enforcement officer to look for, possible environmental indicators of a clandestine drug laboratory. The presence of these items should especially be looked for in areas of the house or garage that are accessible to children:

• Funnels, flasks, plastic tubing, large plastic containers, beakers

• Drano, iodine crystals, Red Devil Lye, cold medications such as Actifed or Sudafed, rock salt

• A large variety of chemicals and particularly those stored in food preparation areas or the refrigerator in unlabeled or inappropriately labeled food or drink containers.

5. While in the home, do not:

• Smoke

• Touch, move, lift, carry, push, or slide anything

• Shut off/turn on anything such as electrical appliances

• Open the refrigerator. Ask the investigating law enforcement officer to check the refrigerator.

6. Leave the child’s personal possessions at the laboratory scene to avoid possible chemical/drug contamination in other settings.

7. Document all findings in the Contact Healthy Notebooks.

8. If the child is not being taken into temporary custody, inform the parent/caregiver that the child must be examined within twenty-four (24) to seventy-two (72) hours to rule out methamphetamine or other drug exposure.

1. Provide the parent/caregiver with the appropriate medical referrals and timeframes for the medical examination.

2. If the parent/caregiver fails or refuses to have the child medically examined, consult with the SCSW to determine what the next course of action should be.

9. If the child is taken into temporary custody, follow existing procedures to complete the detention process.

1. On the DCFS 709, Foster Child Needs and Case Plan Summary, under Section III. E., “Other Comments,” enter “Drug Exposed Status; child may be drug exposed and must be medically examined within 24 hours.”

2. If the child has not already been examined at a Medical Hub, inform the parent/caregiver of the child’s DEC status and the need for the initial medical exam to be completed.

• If the child was taken into temporary custody on Monday – Thursday, the exam must be completed within twenty-four (24) hours.

• If the child was taken into temporary custody on Friday, Saturday, Sunday, or on a holiday, the exam must be completed within the next business day.

10. To complete the investigation, follow established procedures.

ER SCSW Responsibilities

1. Review each document and all supporting reports for compliance with DCFS policy, legal, and regulatory requirements.

2. If not approved, return the case to the CSW for corrective action.

3. If approved, complete the online approval and transfer the case to the FM/R/G CSW.

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Receiving a DEC Case from the Multi-Agency Response Team (MART)

FM/R/G SCSW Responsibilities

1. Receive and review the case including all documents and supporting reports for compliance with DCFS policy and legal and regulatory requirements.

2. If the case is incomplete, consult with the sending SCSW to ensure corrective action.

Case-Carrying CSW Responsibilities

1. Continue to provide case management services.

2. Complete the following additional following tasks:

1. With the assistance of the PHN and the parent/caregiver, if possible, obtain the child’s previous medical history and records and forward to the initial medical provider.

2. Instruct the child’s current caregiver to take the child for a follow-up exam with the initial service provider within thirty (30) days of the initial medical exam in order to:

1. Reevaluate the comprehensive health status of the child

2. Identify any latent symptoms

3. Ensure any needed appropriate and timely follow-up services

3. If it is medically determined that the child has serious physical disabilities, work with the PHN to see if the child qualifies for a Specialized Care Increment (SCI) F-rate and whether to transfer the child’s case to the Medical Case Management Services (MCMS) Unit.

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Unexpectedly Entering a Drug Lab

CSW Responsibilities

1. If CSWs discover a clandestine laboratory site:

1. Discretely and immediately leave the premises.

2. Notify law enforcement.

3. Notify the DEC Coordinator at (323) 838-2856 or (310) 668-6511.

4. Seek immediate medical attention if experiencing any symptoms associated with exposure to chemicals.

5. Follow procedures for conducting an investigation.

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APPROVALS

SCSW Approval

• To transfer a case

HELPFUL LINKS

Attachments

Instruction Sheet for Caregivers of Children Exposed to Methamphetamine Laboratories

Referenced Policy Guides

0070-548.05, Emergency Response Referrals Alleging Abuse In Out-of-Home Care Regarding Children Who Are Under DCFS Supervision

0070-548.09, Multi-Agency Response Team (MART) Referrals

0070-548.10, Disposition of Allegations and Closure of Emergency Response Referrals

0070-548.20, Taking Children into Temporary CustodyThe removal of a child from the home of a parent or legal guardian and placement or facilitation of placement of the child in the home of a non-offending parent, relative, foster caregiver; group home or institutional setting.Temporary custody also includes: placing hospital holds on children; situations in which the CSW interrupts an established Family Law Court custody or visitation orders when the CSW believes that if the order is carried out, the child would be placed in immediate risk of abuse, neglect or exploitation and the child is allowed to remain in the home of the non-offending parent; situations in which DCFS requests that law enforcement remove a child from the home of his or her parent/legal guardian and the CSW places the child with a relative or unrelated caregiver; and situations in which the child is living with a relative or an unrelated caregiver and all of the following conditions exist: child’s parent is asking for the child to be returned home, CSW believes that the return of the child to his or her parent would place the child at risk of abuse, neglect or exploitation, CSW does not allow the child to be returned to his or her parent; and, the child remains in the home of the relative or is placed in out-of-home care.

0400-503.10, Contact Requirements and Exceptions

0600-500.00, Medical Hubs

0600-506.10, Child Health and Disability Prevention (CHDP) ProgramCalifornia’s version of the federal health care program called Early and Periodic Screening, Diagnosis and Treatment (EPSDT). It provides comprehensive medical, mental health and dental diagnostic and treatment services for all Medi-Cal eligible persons aged newborn to 21 years who request them. States are required to inform the families of eligible children about CHDP; assist with referral and transportation to providers; and, follow-up to ensure that necessary diagnostic and treatment services are provided.

1000-504.10, Case Transfer Criteria and Procedures

0900-522.11, Specialized Care Increment (SCI)A rate paid in addition to the basic care rate for the care of children/youth with special needs. – F-Rate

Statutes

California Code of Regulations (CCR), Title 8, Sections 5144, 5192, and 5198 – States, in part, that only personnel trained and certified in clandestine laboratory safety operations should enter clandestine laboratory sites.

Welfare and Institutions Code (WIC) Section 300 – States, in part, that the children described in this section are within the jurisdiction of the juvenile court and may be declared dependents of the juvenile court. Drug abuse cases are typically categorized under neglect in WIC Section 300(b).

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