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Expert Social Work Consultation for CPS: Safety and Medical Consultation Findings
Molly C Berkoff1, Meghan E Shanahan2
1Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Child Maltreatment
|July 31, 2026
Summary
The Regional Abuse and Medical Specialist (RAMS) team improves communication between Child Protective Services (CPS) and healthcare providers. RAMS consultations help clarify injury concerns and support child welfare policy adherence.
Area of Science:
- Pediatrics
- Child Abuse and Neglect
- Medical Toxicology
Background:
- Child Protective Services (CPS) investigations rely on suspicion of maltreatment, potentially leading to unclear concerns.
- Healthcare providers reporting injuries require expert medical consultation for CPS, but these are often delayed.
- The Regional Abuse and Medical Specialist (RAMS) team in North Carolina aims to enhance CPS-healthcare communication and child welfare policy compliance.
Purpose of the Study:
- To evaluate the effectiveness of the RAMS team in assisting CPS investigations involving young children with reported injuries.
- To assess the impact of RAMS consultations on clarifying injury concerns and supporting safety plans.
Main Methods:
- Secondary data analysis of RAMS consultations for children aged 3 years and younger with injuries reported to CPS.
- Review of consultation outcomes, including injury explanation clarity and adherence to policy-supported safety plans.
Main Results:
- After RAMS consultation and CPS-healthcare communication, 13.8% of cases showed no concern for poorly explained or unexplained injuries.
- RAMS provided educational support on policy-supported safety plans in 19.4% of cases.
- Expert medical consultation policy was followed in 79.3% of eligible cases.
Conclusions:
- The RAMS team serves as a valuable model for supporting CPS investigations.
- RAMS enhances communication and clarifies medical concerns, aiding in child protection decisions.
- The program shows promise in improving the efficiency and accuracy of child maltreatment investigations.
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