NO. No school system entity, public or private, may refer a child victim to a Child Advocacy Center for a CME.
All school faculty and staff are NC Mandated Reporters for suspected, observed or disclosed incidents of child physical/sexual abuse and/or neglect, and are required by law to report to either their local DSS and/or 9-1-1 or law enforcement.
Who can refer for a CME?
Only Departments of Social Services and Law Enforcement agencies with an open investigation for child physical/sexual abuse and/or neglect are able to schedule a CME at a Child Advocacy Center, like Carousel Center. Anyone may refer child survivors and their parents/adult caregivers for access to evidence-based child trauma therapy services at Carousel Center, regardless of a family’s ability to pay, documentation status, and/or insurance coverage status.
What is a CME?
A CME is a Child Medical Evaluation (CME) is a forensic-medical process that allows experts to observe, document, and collect evidence for the basis of a DSS and/or criminal child abuse investigation. A CME includes a child forensic interview and head-to-toe wellness exam conducted by forensic experts in child abuse, when a report of abuse/neglect is made to a local department of social services and/or law enforcement agency.
The NC Child Medical Examiners Program (CMEP) staff has developed a statewide network of local providers who perform medical and psychological assessments of children referred by DSS agencies to help determine the presence or extent of abuse and neglect. Established in 1976, the Child Medical Evaluation Program (CMEP) is a cooperative effort of the UNC School of Medicine’s Department of Pediatrics, the N.C. State Division of Social Services, the N.C. Legislature, local Departments of Social Services, and local medical and mental health providers. Payment for the services is provided through a contract with the State Office of Social Services. There are approximately 100 medical providers and 50 psychological providers in the state as well as referral clinics at the major medical centers. The CMEP of North Carolina has served as a model for the development of similar programs in other states in efforts to identify, treat, and prevent maltreatment of children.
What happens at the Child Advocacy Center?
The Carousel Center Child Advocacy Center (TCC) is a safe, child friendly location for children to come speak with trained interviewers or one of our medical providers. We know this can be an anxious time for you and your family. When we are able, one of our child advocates will be calling you before the interview or medical evaluation to answer any of your questions. But you don’t have to wait. If you have questions and need answers, please call and ask to talk to the advocate assigned to your child’s case. We would rather you call than worry.
At the Carousel Center we work with a team of professionals from law enforcement and the Department of Health and Human Services. When you come to the TCC , you will be able to meet the professionals working on your child’s case and ask them further questions.
While you’re talking to the team, one of our advocates will be showing your child(ren) around the Center. They will get to see the room where they will be talking, play and check out the cool artwork. If they have questions or worries, they can ask their advocate anything.
Will I be able to watch my child’s interview?
No. Only professionals directly involved in the investigation are allowed to observe the interview. This is done to reduce the possible stress that can be placed on a child and to provide a neutral setting for the child and the investigation.
Most of us working at TCC are parents just like you. We understand how being in the same room with our child may influence what the child says or doesn’t say. If our child doesn’t answer quickly enough, we may answer for them. Whenever we have made exceptions to the rule, it just doesn’t work. It’s hard for us as moms and dads to sit quietly or not influence the interview with a concerned look or an emotional reaction.
Parents are also not allowed in the observation room during their child’s interview. We have two different interview rooms and to ensure confidentiality, only professionals are allowed in the observation room.
All of the interviews at the Child Advocacy Center are recorded to minimize the number of times your child will have to talk about what happened. The DVD recording of the interview is turned over to law enforcement as part of evidence in a potential criminal case. North Carolina Statue Cites Release parameters of CME Reports and/or Child Advocacy Center records (because they are confidential and/or privileged):
DSS Records:
N.C.G.S. 7B-302(a1)(3) – CME and/or FI received by DSS for an investigation of child abuse, neglect or dependency are strictly confidential and cannot be released except in certain circumstances (i.e. with court order).
N.C.G.S. 7B-505.1(d) – CME cannot be shared, except pursuant to N.C.G.S. 7B-700
N.C.G.S. 7B-700 and N.C.G.S. 7B-3100 – allow us to share information with community partners named in the administrative order (signed by the Chief District Court Judge) for protection of the child.
Privileged Information (CME and FIs):
N.C.G.S. 8-53 – physician/patient privilege; court order required
N.C.G.S. 8-53.7 – social worker privilege; court order required
N.C.G.S. 8-53.8 – LPC/counselor privilege; court order required
Law Enforcement Records (CME and/or FI):
N.C.G.S. 132-1.4(l) – Records of investigations of alleged child abuse shall be governed by Article 29 of Chapter 7B of the General Statutes.
N.C.G.S. 7B-2901 – Court order required
What do I tell my child about coming to the Child Advocacy Center?
You might tell your child:
“We are going to the Carousel Center. It is a special place where kids go to talk about important stuff. The person you will be talking to talks to lots of kids about what might have happened to them. It’s okay to tell them everything. You are not in any trouble.”
Who will my child talk to?
Your child will be talking to one of our trained forensic interviewers. They have attended basic and advanced training on how to talk to children about difficult subjects. It’s important that any details about the alleged abuse be coming from the child. Our interviewers are trained to not ask suggestive questions and to move at a pace that is comfortable for your child. They never force a child to talk to them.
What will I be doing while my child is talking to someone?
You will be meeting with your child advocate. They want to answer any questions you have. If they don’t know the answer, it is their job to find out. They will listen to your worries and concerns and provide resources to help you through a difficult time. Our advocates are not therapists, but they can listen and get you the help you need.
Your other children are welcome to play in our lobby area so you can talk privately to your advocate. Our staff assistant or one of our interns will keep an eye on them. Before they find our snacks in our kitchen, be sure to let us know if your child(ren) has any food allergies or diet restrictions.
What happens after the interview?
You will be able to talk to members of the investigation team. They will tell you in general terms what they learned from the interview. You will have an opportunity to ask questions and voice your concerns.
Remember, your child’s interview is just the first step in the investigative process. There may be other witnesses that need to be interviewed. There may be physical evidence that needs to be photographed or collected. The alleged offender will be interviewed. So, at this point in the process it’s often difficult to predict what will happen. All of the information will be turned over to the county attorney who will decide whether or not to prosecute. Your advocate will keep in regular contact to let you know what is happening on the case. If you have questions at any point during the investigation or prosecution of your child’s case, please feel free to contact your advocate.
Parents and children are often worried about whether they will have to testify in court. It’s really way too early to know. If this happens, our advocate will be with you every step of the way and will even provide a special Court School to help your child feel more comfortable.
Will my child need a medical exam?
Based on the allegation or the interview, the members of the investigative team may decide a medical evaluation is needed. For many children, knowing their bodies are okay is a huge relief and if seeing one of our medical providers will make them less worried or anxious then be sure to let us know. That is always an option.
We have medical providers with specialized training in child abuse who conduct the medical evaluations at TCC . They will want to spend some time with you to collect important medical history, but they will also want to talk to your child one-on-one to answer any of their questions. When it comes time for the actual medical evaluation, we leave it up to the child who they want in the room. Some children want their parent(s) in the room and some don’t.
Our medical providers use a tool to help them see the genital area more clearly. This tool is called a colposcope and it is a magnification device with a camera. The medical provider can take a picture of what they are seeing. If they need a second opinion, your child doesn’t have to have another exam. They can consult with a medical peer utilizing the photographs taken during the evaluation.
When the medical evaluation is over, the medical provider will be able to tell you what he or she has learned. It’s important to realize that in at least 95% of all cases of child sexual abuse, there are no medical findings and the medical provider can help explain this to you more fully.
Will my child need counseling?
Some children do and some don’t. Every child is unique in how they cope. Some may not need counseling now, but will need counseling down the road. Maybe you need counseling more than your child to help you cope with everything that has happened. Your advocate will listen and provide referral information. What we do know is that children who are believed and protected from continued abuse are able to do quite well.
It is very important to your child’s recovery that you work with a therapist specifically trained and experienced in trauma and abuse. This is a field with special expertise.
In most instances, it is important to provide your child with an opportunity to talk with a professional. Too often parents just want their child to “forget” about the abuse and “move on.” That’s easier said than done. Counseling can help your child and family through this very difficult time. It’s best to address issues and concerns now, rather than years later. We have therapists available at the Carousel Center either or we can also provide you with referrals to therapists in the community. Just let us know.
Certified medical professionals perform a complete medical examination in a nurturing and supportive environment on children who are victims of physical or sexual abuse. The medical exam takes place at the Carousel Center in a child friendly examination room receiving a thorough head to toe exam similar to a well-child exam. Our medical staff has been specifically trained to gather the essential physical, medical evidence, all while being extremely sensitive to the victim. The medical exam is conducted by a trained medical provider, assuring that evidence is neither missed nor compromised while it is recorded for later reference and prosecution.
Beyond the physical component of the exam, our medical providers help assure parents that their child is healthy and that if abuse has occurred, it will not be visible to others. Our providers offer extensive, one-on-one consultation not received during a regular doctor’s visit and take as much time as necessary to help the children by explaining each step of the check-up and finding ways to put the child at ease. Although there are very rarely physical signs of sexual abuse, many families find reassurance knowing that no permanent physical damage has been done.