Multidisciplinary Teams: Elements of Success

A coordinated multidisciplinary response to children found at clandestine meth lab sites will help ensure that all the needs of each child are met and that evidence is gathered to support the management and prosecution of each case. Personnel who respond to seizures of illegal drug laboratories and conduct investigations may be from any of the law enforcement, social services, prosecution, environmental health, and medical disciplines. These personnel usually respond according to their own agency’s protocols and, in most instances where multidisciplinary teams have not been established, operate independently. When jurisdictions do not coordinate their responses to these complicated scenes, personnel often overlook children’s needs or assume another agency will address these needs, fail to remove children from conditions of endangerment, or fail to gather adequate evidence to substantiate appropriate endangerment and other legal charges. Coordinated multidisciplinary investigations enhance information gathering, evidence integrity, interventions, and comprehensive treatment services for children and their families.

The Methamphetamine Interagency Task Force, cochaired by the Attorney General and the Director of the Office of National Drug Control Policy, gives several recommendations to improve interagency cooperation. The task force suggests that jurisdictions

• Increase information sharing and promote multidisciplinary approaches and partnerships among prevention, education, treatment, and law enforcement agencies at the federal, state, and local levels.
  
  
• Expand collaborations among social services agencies and public health officials.
  
  
• Conduct research on the hazards to which children found in meth labs are exposed.¹⁴

Although coordination among child welfare services, law enforcement, medical services, and other agencies may vary across jurisdictions, interagency protocols developed to support drug-endangered children should generally address

• Staff training, including safety and cross training.
  
  
• Roles and responsibilities of intervening agencies.
  
  
• Appropriate reporting, cross reporting, and information sharing.
  
  
• Confidentiality.
  
  
• Safety procedures for children, families, and responding personnel.
  
  
• Interviewing procedures.
  
  
• Evidence collection and preservation procedures.
  
  
• Medical care procedures.
  
  
• Community resource development.¹⁵

Team Composition

To adequately meet children’s needs, a multidisciplinary response team should include personnel from the following agencies or disciplines.

Medical and mental health services. A medical professional who has been trained in diagnosing and treating children exposed to neglect and abuse, possible chemical hazards, and trauma should be a member of the multidisciplinary team. Before any seizure of a meth lab, operational agreements should be established with appropriate medical professionals to ensure that personnel are included who can help identify the children who have been harmed, determine the extent of harm, and provide treatment, support services, and monitoring. Frequently, public health nurses assigned to child protective services agencies will respond to the scene of a meth lab seizure when children are present.

Toxicology testing and a physical examination should occur as soon as possible after a child is found living at or visiting a methamphetamine production site. A medical protocol should instruct that search warrants served at methamphetamine manufacturing sites require the collection of children’s urine within 12 hours. Medical personnel must document each child’s physical and mental condition, using photographs as appropriate. They also must document any relevant injuries or exposures that occurred before lab seizure and provide diagnosis and treatment for drug exposures resulting from the manufacturing process, ingestion of drugs and hazardous substances, and physical injuries and abuse.¹⁶ Results of these medical evaluations and testimony of the examining physician, toxicologist, or other specialists may be required in child endangerment cases.

To address the complex behavioral and emotional problems experienced by these children, a psychologist, clinical social worker, or other mental health professional should participate on the team. Crisis intervention may be needed when children are removed from their families. Referrals for therapeutic services are often necessary for children coping with the effects of long-term neglect and abuse. The mental health professional should be consulted throughout the prosecution of a case, working closely with child protective services, law enforcement, and prosecutors to consider the emotional state of the child.

Child protective services. Child protective services (CPS) typically operate under local county offices of social services, and, when necessary, intervene on behalf of children at the direction of the juvenile court. When parents who are illegally manufacturing or abusing drugs are suspected of child endangerment, child welfare workers determine the course of the child welfare investigation and share information with law enforcement officers, district attorneys’ offices, and health care and mental health agencies. Investigations by CPS and/or adult protective services (who become involved when vulnerable adults are found at the scene) may involve law enforcement assistance when necessary for the safety of children or other vulnerable family members.

The CPS worker participating on a multidisciplinary response team often coordinates medical examinations, including transportation to and from appointments, and coordinates communication between the criminal and dependency and/or family law courts. CPS workers interview children and parents, take children into emergency custody, assess the need for both short- and long-term protective custody, arrange for timely medical and mental health evaluations and followup care, and gather information for the juvenile court. They coordinate these activities with law enforcement to ensure that child endangerment issues are adequately evaluated. CPS workers also must provide records of any relevant current and past investigations. The responding CPS worker also may be required to testify in child endangerment cases.¹⁷

Law enforcement. Law enforcement organizations that may be involved in both planned and unplanned seizures of illegal methamphetamine laboratories include city police departments, county sheriffs’ departments, state departments of justice or bureaus of narcotics enforcement, and federal law enforcement agencies.¹⁸ Law enforcement personnel at all levels of jurisdiction who find children living at illegal drug manufacturing sites must act to ensure the immediate safety of the children present, ensure that children are placed in a safe environment with a responsible caretaker (not relatives with similar substance abuse problems, which commonly occurs), contact CPS at the local level, and file child endangerment charges against endangering adults when appropriate. Close coordination and communication with CPS can help the officer carry out these responsibilities.

To minimize trauma to children and ensure consistency between the CPS and criminal investigations, CPS workers and law enforcement officers should jointly interview children found living at clandestine meth lab sites and children known to have been present during meth lab operation. Neighbors and witnesses should also be interviewed. Officers must document any present or potential danger, assess the level of danger and the likelihood of harm, and assess any intentional aspects of endangerment. The clothing and other belongings of children found at meth labs may be saved as evidence and tested for chemical contamination.¹⁹

State statutes vary with regard to the circumstances that warrant endangerment charges. To prove child endangerment, law enforcement officers must use photographs, diagrams, and careful descriptions to document children’s physical injuries or access to dangers. Photographs, diagrams, and careful descriptions also are critical in documenting the proximity of the methamphetamine laboratory and its hazards (such as booby traps, weapons, exposed wiring, chemical contaminants, waste products, and other unsafe matter) to the areas where children live, play, and sleep.²⁰ All materials must be filed in a timely manner for both the CPS and criminal proceedings to progress. The testimony of investigating officers and results from the forensic chemists’ findings will be required to prove child endangerment. Their descriptions must be specific to codified rules of evidence.

Public safety. Fire department personnel and hazardous materials professionals, including toxics control specialists and cleanup personnel, also play a key role in documenting conditions of child endangerment, including the potential for fire or explosion, presence of hazardous materials, improper storage of chemicals, and poor ventilation. Their training should address policies, responsibilities, processes, documentation, and procedures related to the examination, transportation, immediate treatment, and referrals of drug-endangered children living at illegal meth labs. A specialist in hazardous materials involved in the investigation should list all the chemicals found at an illegal drug manufacturing site to help medical personnel assess the physical condition of children found there. The reports or testimony of hazardous materials specialists who respond to the site and other experts will be required in court.²¹

Prosecution. Criminal prosecutors are responsible for filing and supporting charges of child endangerment, and the short- and long-term interests of the child must be an important consideration in the criminal drug prosecution. By reviewing all the evidence gathered, charging the drug violations as appropriate, and filing child endangerment charges against the appropriate parties, the prosecutor strengthens the multidisciplinary team’s efforts to achieve favorable child protection outcomes. Communication between CPS workers, probation officers, health care personnel, police officers, and attorneys should continue throughout the period of prosecution. Communication between the criminal and dependency and/or family law courts is crucial to avoid creating conflicts or jeopardizing either case outcome. Based on the nature of the crime and the jurisdiction in which it occurred, prosecution may take place in local, state, or federal courts. At the sentencing phase, the court establishes sanctions and activities considered necessary for rehabilitation. Even if charges of child endangerment are dismissed, the prosecutor can ask that the court consider conditions relating to the child endangerment charge in sentencing.²²

In cases in which one parent or caregiver is not charged with endangerment but lesser charges are levied, the prosecutor can play an important role in safeguarding the child’s welfare by influencing the terms of probation. These terms often include drug treatment, parenting classes, and other rehabilitative measures such as parent-child counseling to help the parent change his or her lifestyle and focus on the child’s welfare. Compliance with all terms of family reunification care plans or other dependency/family court orders also should be included in probation terms.