Case Study 4 Instructions: Spend 5-10 minutes reviewing the case below and considering the questions that follow.
Spend 5 minutes considering the following questions in light of the information provided earlier in this learning activity: 1. What signs suggest that Sayura might be a victim of human trafficking? What signs argue against that hypothesis? Although Sayura tests negative for HIV, she has multiple other sexually transmitted diseases. When asked if she uses protection during sex, she shrugs and says ‘sometimes they don’t want to.’ When you ask who ‘they’ are, Sayura says that sometimes she has sex with other men, but won’t say how many. She grows quiet and refuses to answer further questions about her sexual behavior or relationship with her boyfriend. Sayura comes to your clinic for an HIV screening. Although she says she is 19, she appears physically and developmentally much younger. Sayura says she’s mature for her age and very experienced. During the exam she constantly receives texts on her cell phone. She answers the phone and says ‘Daddy, don’t worry, I’ll be done soon.’ She tells the nurse her boyfriend, who is 30, is so in love he can’t be away from her for even one minute.
2. What steps might a clinician take to probe the situation further or obtain more information?
Questions for case study:
3. What services might a clinician suggest to give Sayura support in the event that she is a victim of human trafficking?
Commentary: The persistent and frequent contact by the person Sayura refers to as “Daddy” (a commonly-used phrase for men using or trafficking in women for prostitution) as well as Sayura’s reluctance to discuss her sexual behavior strongly suggest she may be a victim of human trafficking. In this case, if the clinician initially meeting with Sayura is male, he should ask if Sayura would like to talk with a female clinician (who might be able to elicit more information about Sayura’s situation). If Sayura continues to be uncommunicative, the clinician should avoid a judgmental or presumptive tone and, instead, empathetically remind Sayura of the risks of her current behaviors and of the availability of support services for young women like her. She could be given the number and/or URL for the National Human Trafficking Resource Center, for example, or of services provided through the PA Family Support Alliance.
• A foster parent. • An adult family member who is a person responsible for the child’s welfare and provides services to a child in a family living home, community home for individuals with an intellectual disability or host home for children which are subject to supervision or licensure by the department under Articles IX and X of the Public Welfare Code. I mportant Note: Act 54 of 2018 Update Mandatory Notification of Substance Exposed Infants by Health Care Providers A health care provider shall immediately give notice or cause notice to be given to the Department if the provider is involved in the delivery or care of a child under one year of age and the health care provider has determined, based on standards of professional practice, the child was born affected by: • Substance use or withdrawal symptoms resulting from prenatal drug exposure; or • A Fetal Alcohol Spectrum Disorder. Notification to the Department can be made to ChildLine, electronically through the Child Welfare Portal or at 1-800-932-0313. This notification is for the purpose of assessing a child and the child’s family for a Plan of Safe Care and shall not constitute a child abuse report.
After notification of a child born affected by substance use or withdrawal symptoms resulting from prenatal drug exposure or a fetal alcohol spectrum disorder: A multidisciplinary team meeting must be held prior to the child’s discharge from the health care facility. • The meeting will inform an assessment of the needs of the child and the child’s parents and immediate caregivers to determine the most appropriate lead agency for developing, implementing, and monitoring a Plan of Safe Care. • The child’s parents and immediate caregivers must be engaged to identify the need for access to treatment for any substance use disorder or other physical or behavioral health condition that may impact the safety, early childhood development and well-being of the child. • Depending upon the needs of the child and parent(s)/caregiver(s), ongoing involvement of the county agency may not be required.
including a physician, podiatrist, optometrist, psychologist, physical therapist, certified nurse practitioner, registered nurse, nurse midwife, physician’s assistant, chiropractor, dentist, pharmacist or an individual accredited or certified to provide behavioral health services. Department – The Department of Human Services of the Commonwealth Multidisciplinary Team – for the purpose of informing the Plan of Safe Care may include: Public health agencies; Maternal and child health agencies; Home visitation programs; Substance use disorder prevention and treatment providers; Mental Health providers; Public and private children and youth agencies; Early intervention and developmental services; Courts; Local education agencies Managed care organizations and private insurers; and Hospitals and medical providers.
Attorneys As Mandated Reporters
Note: The amended CPSL includes attorneys under persons required to report suspected child abuse. Specifically: • Attorneys affiliated with an agency, institution, organization or other entity, including a school or regularly established religious organization that is responsible for the care, supervision, guidance, or control of children.
Supplementary Definitions:
Health care provider – a licensed hospital or health care facility or person who is licensed, certified or otherwise regulated to provide health care services under the laws of this Commonwealth,
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