Medical Response

The Washington State Governor’s Methamphetamine Coordinating Committee appointed a Drug Endangered Children’s (DEC) subcommittee to examine existing national and local DEC programs, research pertinent legal issues and identify best practices that address the children’s needs. The subcommittee’s work resulted in the development of the We Care Plan, a tool to assist counties in responding to the needs of drug-endangered children.

Following are the procedures for medical personnel:

• Child is placed in protective custody by responding law enforcement officers.
• Child with obvious injury, illness, or respiratory distress is immediately transported to medical facility by calling 9-1-1.
• Child with suspected illness receives medical exam within 24 hours of assuming custody. However, a urine sample is collected, whenever possible within four hours of assuming custody.
• Medical exam is performed by the child’s primary medical provider.
• Child, who does not exhibit illness, receives medical exam within 7 to 14 days after assuming custody. However, a urine sample is collected, whenever possible within four hours of assuming custody.
• Medical exam is performed by the child’s primary medical provider.
• Medical exam consists of:
• Medical History: Child Protective Services (CPS) assists by obtaining medical records and history from parents
• Physical Exam: Attention to nutrition, dental decay, respiratory distress, brief developmental screen
• Lab Tests as Needed: Consider Complete Blood Count (CBC)
• Urine sample:
• Collected, whenever possible within four hours of being placed in protective custody, at either a medical facility or in the field by specially trained professionals.
• Obtained for either:
  • Child protection, safety and health reasons: No warrant required.
  • Legal prosecution of caregivers: Warrant required, WSP forensic laboratory collection protocols and Police Evidence System adhered to. Analysis conducted at the WSP forensic laboratory.
• Analyzed to detect and report the presence of illicit drugs at any level.
• Early Periodic Screening, Detection and Treatment (EPSDT) exam conducted within one month of placement, as required by DSHS. Follow-up medical exams conducted as needed.

Urine Collection Procedures

Persons who collect urine samples should be trained in the proper collection procedures and maintain sensitivity towards the child’s situation.

• For urine collection from an infant, place four 4 X 4 gauze pads in the diaper. Remove when wet and place in clean leak proof urine container. Cover, label, and seal in a biohazard container.
• For urine collection from a child who is potty trained but too young to use a urine collection cup, use a clean urine collection “hat.” Place the hat in the toilet and have the child urinate into the collection hat. Transfer the urine to a clean leak proof urine container. Cover, label, and seal in a biohazard container.
• For older child and adolescent, give the clean urine collection cup to the child and instruct them to urinate into the cup. Cover, label, and seal in a biohazard container.

Hair Samples

At this time it is recommended not to collect hair samples. Additional research is underway to determine the need for this practice.