DeVos Hospital Wants To Develop Child Protection Pilot Program at St. Ignace
By Ellen Paquin

Apilot program to better identify and treat abused and neglected children in Mackinac County is being proposed by DeVos Children's Hospital of Grand Rapids, which wants to work with Mackinac Straits Hospital in St. Ignace.

DeVos is building a communication and referral network of specialized pediatric care givers at hospitals across the state and has asked the St. Ignace hospital to become its first satellite site, primarily because of a previously established connection with pediatrician Cynthia Statler, a two-days-a-week staff physician at Mackinac Straits. Dr. Statler said she believes there is a need for better identification of child abuse and neglect cases here.

The pilot program's success would rely heavily on participation by local social workers, police, and court staff, as well as hospital workers. The prospect drew representatives of these community agencies to a meeting at Mackinac Straits Hospital Friday, November 27. Those attending included representatives of the Department of Human Services, the prosecuting attorney's office, Michigan State Police, St. Ignatius Loyola Catholic Church and Project Hope, Diane Peppler Resource Center, district court, Mackinac County Sheriff's Department, Sault Ste. Marie Tribe of Chippewa Indians social services, probate court, Strong Families Safe Children, and hospital administrators.

Dr. Debra Simms and social worker Tracy Cyrus of the Child Protection Team at DeVos attended the St. Ignace meeting to offer around-the-clock telephone access to DeVos Children's Hospital experts in the areas of identifying, diagnosing, and treating abused children. Using the DeVos "Triage" phone hotline, local police, hospital staff, or social workers can ask questions of on-call, specially trained pediatric physicians or master's level social workers about suspected child abuse cases at any time. DeVos can serve as a network to connect callers to experts across Michigan. Under the proposed pilot program, the Child Protection Team also would offer expert medical evaluations and documentation, case reviews and second opinion reviews, coordination of medical resources for abused children, local training programs for hospital staff, case workers, attorneys, and police, and community parenting programs.

DeVos will not charge Mackinac Straits Hospital for these services, and hopes to develop future links with more under-served hospitals in the state to build a network of expert resources.

In return, Dr. Statler and LPN Jeanne Litzner, a nurse in Dr. Statler's office, would be trained by the DeVos experts to perform specialized pediatric exams in cases where physical or sexual abuse is suspected, and to properly collect medical data needed to prosecute abuse in court. They would serve as an "information hub" in this area, and suspected child abuse cases in the county or in the Eastern Upper Peninsula would be directed to them for examination.

"According to national statistics, I believe we are missing kids in this community who need help," Dr. Statler said. "We have got to start working together to fix it in this community, because I am fearful there are kids slipping through the cracks."

Having 24-hour access to the experts at DeVos can be helpful to medical workers, social workers, and police, Dr. Simms said, in situations where abuse may be suspected and the care givers need to know how to proceed.

"Call us when you need information, you need a second opinion, or you are a law enforcement officer facing a situation when two doctors do not agree" about a diagnosis of abuse or whether medical information needs to be collected, Dr. Simms said. A highly credentialled expert on forensic pediatrics, she is a pediatrician, the director of the Child Protection Team, and has worked with child abuse and neglect cases in Ottawa, Allegan, and Kent counties.

Pediatricians in Cheboygan and Mount Pleasant pursued the opportunity to serve as test communities for the DeVos program, Dr. Simms said, but it was the willingness of the hospital and so many community agencies to come together to consider the idea that drew the Child Protection Team to St. Ignace. Mackinac Straits Hospital will be the first in the state to test this program.

While no decisions were reached Friday about implementing the pilot program in St. Ignace, Dr. Simms encouraged those attending the meeting to discuss the idea further and determine how they believe the DeVos experts could best serve Mackinac County. Local support issues to be determined, she said, include funding, hospital payment of staff time to work on child abuse cases, and acquiring a digital camera and a recording colposcope. A colposcope is a camera that takes pictures of tiny scars, cuts, bruises, or tears in the rectal and genital areas.

Pointing out that Mackinac Straits Hospital already has the $12,000 colposcope needed to participate in the program, but that it will need to be upgraded to record data, Emergency Department Director Tamie Hartwig suggested that Mackinac Straits Hospital may explore the idea of working cooperatively with War Memorial Hospital in Sault Ste. Marie and Helen Newberry Joy Hospital in Newberry.

Mackinac Straits CEO Rod Nelson was unable to attend the entire meeting, but pointed out that although Mackinac Straits will be the program's pilot site, hospital planners will invite War Memorial, Helen Newberry Joy, and tribal health services to participate.

Dr. Statler works at Mackinac Straits Hospital only two days a week, raising the question of whether she will have time to

devote to the project. Dr. Statler, who said she is currently not able to work more than two days per week, said she may be able to work another half day some weeks if that time can be devoted to this program only.

"DeVos can contribute time, energy, expertise, but not dollars," Dr. Simms said, pointing out that the program's cost in the community cannot be determined until local agencies set specific goals for the program. "We are talking with community partners to build a medical program that fits your needs. Most of the cost will be in physician time blocks. We have to [decide whether] we want to cast a small net or a big net, and does our net have holes in it. A lot will depend on what your needs are."

About 85 suspected abuse or neglect cases were investigated by the Department of Human Services (DHS) in Mackinac County last year, said Terri Bush of DHS. The figure does not include tribal cases. The majority of the cases dealt with neglect, rather than physical or sexual abuse, she said, such as "a dirty house, or improper parental supervision." Roughly 10 of those cases were filed into the court system.

Future meetings are planned at the hospital to discuss the DeVos proposal among key local agencies, said Mrs. Hartwig, with an in-house discussion set for Monday, November 6. Mrs. Hartwig will chair the meetings, and can be reached at 643-0425 for questions or suggestions from the community.

"The worst feeling you can have, as a nurse, is the feeling that 'maybe I missed something,'" Mrs. Hartwig said, referring to possible abuse cases. "I think this program will be a good opportunity for our community."