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2. Filing a 51A on cases of medical neglect

What should I consider when reporting medical neglect to DSS?

According to BMC Policy, the following situations are reportable:

1.  Five or more consecutive, failed, previously scheduled health care appointments:
   • despite two verbal or written contacts with the caretaker, to arrange follow up; and
   • with inadequate reasons offered by the caretaker for the appointment failure.
2. Delay (greater than 24 hours for highly symptomatic conditions or greater than 72 hours for less symptomatic conditions) in seeking treatment for an injury or illness with inadequate or implausible explanation.
3. One major or three minor illnesses that could have been prevented by parental supervision or which occurred while the caretaker was impaired by alcohol or substance abuse.

 What do I do if the situation does not meet any of the previously mentioned criteria, but I am still concerned?

•  While some patients may have missed less than five health care appointments, his or her illness could be of high risk, and a 51A may still be warranted. Please consult the Child Protection Team (# 7336) if help is needed to make this decision.
• Examples of high risk cases may involve the following illnesses: Failure to Thrive, Asthma, sickle cell anemia, diabetes, cancer, cardiac issues, seizure disorder, child with psychotic features and no mental health intervention, etc.

***Ensure that the medical staff is arranging appointments with consideration of the family’s scheduling. For example, have several appointments been scheduled at BMC on different days of the same week? Is there a way that the medical team can make the appointments more convenient for the family to attend? Has the team collaborated with the family and discussed with them the obstacles that are preventing them from attending appointments?