CPS call?

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Specializes in IMC, school nursing.

Our school has a family that appears to be practicing a bit of Munchausen. This child has not been in school for three weeks straight due to severe anxiety. This child came to me one day and begged to call mom to pick him up, crying before call and instant smile when she said yes. According to counselors I have discussed with, this is manipulation, not anxiety. The mother constantly posts on social media how she has a disabled son, it is how she identifies herself, despite the lack of any documented disability. The school has requested medical records of same so we may assist him in any way we can. Is this a CPS issue? He has essentially missed 75% of school days this year. I have brought up truancy issues to admin because we don't really have a medical reason for the absences.

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I wouldn't call CPS. I would have an emergency meeting with the mom and students present as well as Admin, as many teachers as possible, guidance, etc.

These counselors that don't know the child CANNOT assess whether or not it is anxiety or manipulation.

I know you are stuck as you don't have a counselor on staff. I think that's a sin, personally, and a HUGE disservice to your kids.

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Specializes in Pediatrics, Community Health, School Health.

I would think they can open a case based on truancy, right? What a frustrating case. I would hope that once they request medical records and see no documented reasons for the child missing school, they can start a case and follow them. We had a patient like this in my old practice years ago where the parents were just letting him stay home from school. The school finally called us (pediatricians office) b/c the kid had missed a ton of school and mom was saying her was really sick. They wanted us to see if he had come b/c she said he was at the doctor's office "all the time". This was all pre HIPAA...

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Specializes in school nursing, ortho, trauma.

I have a student in a similar sitch. I feel like the litany of ailments and diseases that the parent tells us that this student has is not necessarily factual until it is backed up by medical documentation. I have yet to get anything and I have been asking for a long long time.

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Specializes in School Nursing.

We had a similar issue and, because there was medical neglect, did file a report with CPS. That particular county said it didn't fit the criteria of an investigation by CPS but we could take steps via the truancy process because this child was missing to much school. So that's what we did. It hasn't been resolved yet so we're still in the process.

Our elementary school process is a bit tricky but at our middle school we have the parents, student, nurse, counselor and principal meet and the kid and parent sign in an In School Contract basically agreeing to come to school. We also put some of our kids with attendance problems on a Doctor's Note Only which means their absence from school is only excused if they bring in a doctor's note or are excused by the health office during the school day. If they still have excessive absences that are not covered by a doctor's note then we move on through the county truancy program.

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I have a student in a similar sitch. I feel like the litany of ailments and diseases that the parent tells us that this student has is not necessarily factual until it is backed up by medical documentation. I have yet to get anything and I have been asking for a long long time.

This.

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Specializes in Med-surg, school nursing..

See if by some miracle mom would sign a release of information paper. That way you could call the doctors office yourself and see what's going on, if he's really coming in when she says he is, and if he has an actual diagnosis.

As for missing so much school, I agree that a meeting needs to happen ASAP. I know once I had a kiddo with recurrent lice and neglectful/hateful parents. Even though our policy says to send home kids with live lice, we sometimes break the rules and keep the ones we know are better off in school (without telling admin of course ;)) Anywho, my district health coordinator said to send her home every time, that way when she became truant we could report and state educational neglect.

Best of luck Mr.

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Specializes in Pediatrics Retired.

In Texas unexcused absenteeism is considered neglect and is investigated by CPS, so we would report in such an instance if a truancy meeting wasn't successful.

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OD, how long would you try to get a note?

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Specializes in Pediatrics Retired.
OD, how long would you try to get a note?

I'd probably tell them to provide the absenteeism documentation by the end of the next school week but actually give them 2 weeks before I'd report. The documentation, however, would have to be pretty convincing.

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Specializes in School Nurse.

More than 10 days absent in Texas = a date with family court. Try that route.

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Specializes in Med-surg, school nursing..

Our district passed a new policy that you can only have 10 medical notes (on top of the 7 parent notes). This is to try and discourage parents from doctor shopping and just taking their kids in to the doctor for the note pretty much. These are usually the parents that don't have to pay for insurance, and I mean no disrespect by that. But my kids have to be pretty darn sick before going in. $25 co-pay for three kids gets expensive when they all share their germs.

Of course our kiddos with chronic conditions have a special exempt form the doctor can fill out to prevent them from becoming truant.

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