1. (a) The FSW Investigator will:

   1. (1) Confer with the supervisor concerning a complete examination/evaluation by a mental health professional if a child has one (1) of the following:

      1. (A) Impairment of the intellectual, emotional, or psychological development as evidenced by observable and substantial reduction in the child’s ability to function within a normal range of performance and behavior; or
      2. (B) Suffered a substantial impairment in the ability to function as a result of a specific, nonaccidental action or interaction committed by a parent or caretaker;

   2. (2) Refer for a medical examination or consultation with a physician in the following cases unless the Area Director allows an exception:

      1. (A) Burns, fractures, or dislocations in children under three (3) years of age;
      2. (B) Burns, fractures, or dislocations in children of any age if unexplained or implausibly explained;
      3. (C) Burns, bruises, or fractures in nonambulatory children;
      4. (D) Reasonable suspicion that vaginal or oral penetration has occurred;
      5. (E) Cases involving sexually transmitted diseases in prepubescent children;
      6. (F) Cases of malnutrition and failure to thrive;
      7. (G) Cases of serious medical neglect;
      8. (H) Cases of alleged head and abdominal injuries (regardless of presence of visible injury); and
      9. (I) Reports in which the child has an observable injury, the caretaker admits responsibility for the injury, and there is reason to believe that there are internal injuries or other injuries which have occurred in the past;
   3. (3) Involve the parent, legal guardian, or legal custodian of the child whenever possible if during the investigation a medical examination is needed to determine the existence of abuse or neglect;
   4. (4) Verify that the parent, legal guardian, or legal custodian has exhausted all other resources before requesting Department of Human Services funds for payment; and

   5. (5) Consider the following, listed in order of preference, in all cases in which a medical examination is required:

      1. (A) Have the child examined at a child safety center when available and appropriate (i.e., consider distance of child safety center, whether nearest child safety center has medical services on site, and if the investigation is regarding a report of alleged sexual abuse or alleged severe maltreatment);
      2. (B) Have the child examined by the child’s Primary Care Physician (PCP);
      3. (C)

2. (i) Have the child examined by a pediatrician if the PCP is unavailable.

   1. (ii) The investigator must advise the pediatrician whether the PCP, although not physically available, is available by telephone for consultation; or

      1. (D) Take the child to the emergency room of the nearest hospital.
3. (b) The physical examination of children alleged to be sexually abused must be conducted by a physician or other medical personnel, not the investigator.

Codification Notes: This section as promulgated prior to codification into the Code of Arkansas Rules provided as follows: "08/2013"