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2.2.12 Sexually transmitted infection notifications

Last Modified: 16-Aug-2019 Review Date: 02-Jan-2017

Purpose

To guide child protection workers on how to assess and respond to sexually transmitted infection (STI) notifications.

Note:  CEO refers to the Chief Executive Officer of the Department of Communities (the Department).

Practice Requirements
  
  • The Department must automatically intake all cases referred by the Department of Health for children aged under 14 years with a diagnosed STI.

  • The practice requirements relating to our response to an STI notification are of the same standards as those for assessments and investigations of other types of notifications.

  • Child protection workers must comply with the legal requirements outlined in Division 9A - Reporting sexual abuse of children, Children and Community Services Act 2004 (the Act).

  • Once the outcome of a child safety investigation (CSI) has been finalised, child protection workers must provide the referring health practitioner with feedback and relevant information that includes our responses and outcomes.

Process Maps

Dual Reporting by Medical and Health Staff Flowchart

Local Department District Office Referral Flowchart

Procedures

  • Overview
  • STI Definition
  • Protocols for children diagnosed with an STI
  • Interface with the Mandatory Reporting Service (MRS)
  • Notifications received by the MRS
  • Notifications received at local Department district offices
  • Assessments at local Department district offices
  • The STI Interagency Meeting
  • STI notifications in relation to a child in the CEO's Care
  • Overview

    In response to recommendation 1987 of the Gordon Inquiry, protocols between the Department for Child Protection and Family Support, the Department of Health, Communicable Disease Control Directorate (CDCD) and the Western Australia Police Service (WA Police) Child Protection Squad, have been in operation since 1 July 2004.

    Under the protocol Operational Directive 21 Interagency Management of Children Under 14 Years Diagnosed with a Sexually Transmitted Infection (STI) the Department of Health advises the Department and WA Police of children under 14 years of age diagnosed with a sexually acquired STI.

    The protocol involves parallel reporting:

    • firstly, from CDCD to the Mandatory Reporting Service (MRS) and the Child Abuse Squad (WA Police), and
    • secondly, through independent referral by local health staff to our local district offices and/or WA Police.

    Notification is made upon clinical diagnosis or on receipt of laboratory confirmation.  The independent referral from the local health staff to the local district office prevents a delay in initiating and conducting a CSI.

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    STI Definition

    STIs are defined as:

    •  Gonorrhoea
    •  Syphilis
    •  Soft chancre (chancroid)
    •  Granuloma (donovanosis), or 
    •  Genital chlamydia.

    For more information about these infections please refer to Department of Health - Sexually Transmitted Infections and Bloodborne Viruses (in related resources). 

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    Protocols for children diagnosed with an STI

    Protocol for children aged under 14 years 

    The MRS and WA Police must be notified by the CDCD of all cases where a child aged less than 14 years has been diagnosed with an STI. The child's name, nature of the STI, and the details of the notifying local practitioner will be provided to the local district office and WA Police for assessment/investigation and follow up.

    Children aged 14 and over

    Children aged 14 and over are not covered by the Protocol for Children Diagnosed with an STI.   

    However, mandatory reporters who know of a child aged 14 years and over with a diagnosed  STI, and who form a belief that sexual abuse has occurred or is occurring to the child, are required to submit a mandatory report under Division 9A of the Act.  For further information refer to Chapter 2.2 Mandatory reports of child sexual abuse.

    Notifications may be received by both:

    • the MRS and/or
    • local district offices (as per the STI protocol).
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    Interface with the Mandatory Reporting Service (MRS)

    Notifications of STIs from the CDCD are made to the MRS and are recorded as a concern for a child unless accompanied by a separate mandatory report received from a doctor or a nurse who has formed a belief, on reasonable grounds, that sexual abuse has occurred.

    On receipt of a mandatory report from a doctor or a nurse regarding an STI the MRS records this as a mandatory report.

    If the STI notification from the CDCD is not accompanied by a mandatory report it must be intaked for a CSI.

    Each STI notification that has not been intaked at the district office must be opened for assessment.

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    Notifications received by the MRS

    On receipt of an STI notification from the CDCD, the MRS must record the notification as follows:

    • intake the notification on Assist if it is not already the reason for an existing assessment of concern
    • the subject child of the report is selected as “child of concern”
    • the detail reflects either non familial or familial circumstances
    • “Sexual Harm” is recorded as the “Primary Issue”
    • the “Director of Communicable Disease Control” is noted as the source of the referral
    • the code “CDA” (Communicable Disease Control Directorate) is recorded under “Protocol”
    • “Child Protection” is selected under “Outcome”, and
    • “Next Action” is recorded as “Intake”

    The following conditions will apply to the recording processes:

    • If the STI notification has already been referred to a local district office by the local health practitioner and intaked by the district office, then the MRS will complete an MR Component record in Assist and an Objective electronic file note reference number. These records will be sent to the managed 'CPFrontdesk' email box for the district office and to the case manager

    • If MRS receives a mandatory report related to an STI notification which has already been actioned at the local district office, MRS will update the client file, complete an MRS recommendation form and forward it to childFIRST, CAIT and WA Police, and save the documents in Objective, and

    • If MRS receives a mandatory report in relation to an STI before an STI notification from the CDCD has been received, MRS will complete an intake (unless the district office has already intaked the information), follow the recording pathway and update Assist on receipt of the STI Notification from CDCD.

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    Notifications received at local Department district offices

    When notification of an STI is made by the local health practitioner to the local district office, the duty officer must intake the concern as sexual harm and commence a CSI.

    STI notifications received by local district offices should be recorded as follows:

    • the notification is intaked on Assist if it is not already the reason for an existing assessment of concern

    • the subject child of the report is selected as “child of concern”

    • the detail reflects either non familial or familial circumstances

    • “Sexual Harm” is recorded as the “Primary Issue”

    • the “Director of Communicable Disease Control” is noted as the source of referral

    • the code “CDA” (Communicable Disease Control Directorate) is recorded under “Protocol”

    • “Child Protection” is selected under “Outcome”, and

    • “Next Action” is recorded as “Intake”.

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    Assessments at local Department district offices

    When conducting an investigation following an STI notification district child protection workers, in consultation with their team leader and designated senior officer or senior practice development officer, should convene a joint strategy meeting (face-to-face or via telephone) with WA Police and the local public health worker to coordinate planning and conduct of an investigation. Refer to the Operational Directive 21 Interagency Management of Children Under 14 Years Diagnosed with a Sexually Transmitted Infection for more information.

    Conducting a CSI for an STI notification

    Where an STI notification is received and it is determined that we have an ongoing role, a CSI must be conducted with sexual harm documented as the primary concern. The following should be noted when completing the CSI Outcome Report for an STI notification:

    • the Joint Strategy Meeting including the date and the outcome

    • treatment for the STI, including contact made with health or medical practitioners involved

    • the Child Assessment Interview and the outcome

    • if applicable, the Child Specialist Interview (forensic interview) including the date and the outcome

    • contact tracing details (information provided to the Health Department about persons in sexual contact with the child for the purposes of population health treatment and medical records)

    • if applicable, WA Police involvement with persons of interest and the outcome

    • Our engagement with the parents or caregivers, including consideration of their level of protectiveness, and

    • follow up services for the child (and parents or caregivers if necessary) including sexual health education, counselling and other interventions assessed as necessary.

    Where a child has been diagnosed with an STI, it is likely that we will substantiate significant harm based on the medical evidence. The decision on whether someone is responsible for the harm is a separate assessment decision.  

    Previous STI infections

    Two or more STI infections would indicate a pattern of regular unprotected sexual activity. It may also highlight concerns about the level of supervision and sexual health education received by the child.

    Completing CSIs for STI notifications

    Child protection workers should refer to Chapter 2.2 Conducting a Child Safety Investigation for specific procedures about undertaking a CSI.  Child protection workers must forward a copy of the CSI Outcome Report to MRS for quality assurance, research and statistical purposes. The report should be sent via email to mrs@dcp.wa.gov.au or faxed to 1800 610 614, attention to the STI Project Officer.

    Any issues that cannot be resolved at a local level should be referred to the senior practice development officer in the district office, to the director or to the senior practice development officers in Professional Practice Unit: ProfessionalPracticeUnit_GeneralEnquiries@cpfs.wa.gov.au

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    The STI Interagency Meeting

    The STI Interagency Meeting is a quarterly meeting held by the Department, the Department of Health and the WA Police, as per the STI Protocol. Child safety investigations for STI notifications are discussed at the meeting.

    The Department, the Department of Health and the WA Police are accountable for medical, psychosocial and any relevant legal follow up in relation to children diagnosed with STIs. 

    We are represented at the meetings by the Director, CCU and the STI project officer. The STI project officer gathers information from local district staff and the completed CSIs before the meeting and presents a report on our behalf. Following the meeting, the STI project officer follows up on unresolved issues with district staff.

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    STI notifications in relation to a child in the CEO's Care

    If the STI notification relates to a child in the CEO’s care, the child protection worker must commence a Duty of Care Notification as soon as practicable. Please refer to Chapter 4.2 Notification of death, serious injury or critical incident for details.

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