Topeka, KS— Some state lawmakers want to beef up child abuse investigations — by demanding more thorough physical examinations of potential victims.
State law already requires that investigators see any child in person who’s the subject of an abuse report. But pending legislation could insist on more thorough examinations that could last hours, sometimes requiring the use of sexual assault kits, X-rays or MRIs.
And those more exhaustive examinations, advocates of the change say, could save lives by revealing injuries that cursory checks miss.
The legislation could require a child abuse review and evaluation, or CARE, exam with greater promise of uncovering abuse and providing a legal basis to remove a child from a dangerous setting.
Last year, the Kansas Legislature approved Adrian’s Law. It requires law enforcement or the Department for Children and Families to visually observe a child during a suspected case of abuse.
Mel Hudelson, the executive director for the Kansas Chapter of the American Academy of Pediatrics, said the current bill takes additional steps in strengthening abuse investigations. She said pediatricians want the change.
“These are their patients, these are the children that they oftentimes will see anyway,” she said. “This just gives them a lot more support in doing that work.”
The legislation establishes a network where medical staff could contact people specializing in child abuse investigations if they needed help on a particular case. It also creates a triage system where child abuse specialists review case files to determine how an investigation should be handled. Those investigators could recommend a child go to an emergency room or get no further testing at all.
Child abuse pediatricians have an additional three years of training on top of their medical degrees, but the bills could offer shortened multi-day training courses.
Physicians who testified to Kansas lawmakers said more thorough examinations can also prevent misdiagnoses. One doctor told of a day care center that called the abuse hotline for unusual coloring on a child — a suspected bruise. It turned out to be a skin condition.
Fewer than a half dozen Kansans are qualified to conduct the CARE exams, Hudelson said. They practice in Wichita and the Kansas City area. Rural Kansans could be hours away from the specialists and staff at child advocacy centers across the state, which might be the only child abuse investigators for miles, lack the expertise to fill in.
Katiina Dull, executive director of the Child Advocacy Center, has workers who specialize in both forensic interviews and forensic medical exams, but she doesn’t have staff that does both. Dull operates in southern Missouri where the changes Kansas is considering were already approved.
In forensic interviews, children recount their experiences to produce responses that could stand up as evidence in a court case. Interviewing and medical evaluations require completely different skills, Dull said, and creating training and a support network for staff is crucial.
“We simply want to … prevent ongoing abuse to the child and to get them into a safe situation as soon as possible,” she said.
Rep. Susan Concannon, chair of the Children and Seniors Committee, said the legislation could bring a more consistent approach to abuse investigations.
Two bills in the Legislature propose changes already happening in some parts of Kansas, which makes Concannon more optimistic it’ll pass. Johnson and Wyandotte counties launched a pilot program six months ago trying to expand the state’s ability to conduct exams.
In the first five months of that program, around 80 cases were reviewed by specialists and roughly eight were referred for CARE exams.
That program is not available statewide, but having the blueprint available helps lawmakers, Concannon said.
“This is a priority,” she said. ”It’s going to catch some of those kids that are falling through the gaps.”
Blaise Mesa reports on criminal justice and social services for the Kansas News Service in Topeka. You can follow him on Twitter @Blaise_Mesa or email him at blaise@kcur.org.
The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy. 
Kansas News Service stories and photos may be republished by news media at no cost with proper attribution and a link to ksnewsservice.org.