What is a Child Medical Evaluation (CME)?

When Child Protective Services (CPS) becomes involved in a family’s life, it can be an overwhelming and confusing experience. One tool that CPS may utilize during an investigation is a Child Medical Evaluation (CME). Understanding what a CME is—and whether a parent or guardian must consent to one—is critical for any family facing a child welfare investigation.

What is a Child Medical Evaluation (CME)?

A Child Medical Evaluation is a specialized medical assessment performed by healthcare providers who are trained in identifying and documenting signs of abuse, neglect, or other maltreatment in children. These providers are usually part of a hospital-based child protection team or a designated CME provider network.

The purpose of a CME is to:

• Assess a child’s physical and mental health in the context of suspected maltreatment.

• Document findings that may support or refute allegations of abuse or neglect.

• Make recommendations for the child’s medical, mental health, and safety needs.

A CME often includes a full physical examination, developmental screening, psychological screening, and interviews with the child, caregivers, and sometimes other involved individuals. The evaluation is thorough and trauma-informed, aiming to support the child’s well-being while informing the CPS investigation.

Who Can Request a CME?

In North Carolina and many other states, a CME can be requested by the County Departments of Social Services (DSS) or via court order. In most cases, DSS initiates the request when there is concern about a child’s safety, especially when physical abuse, sexual abuse, or severe neglect is alleged. The results of a CME are not only used in child welfare cases, but they can also play a significant role in criminal investigations or custody disputes.

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Must a Parent Consent to a CME?

This is a crucial question for many parents under CPS investigation: Do I have to allow this evaluation?

The answer depends on the specific circumstances:

1. With Parental Consent:

Ordinarily, medical treatment—including a CME—requires the consent of a parent or legal guardian. DSS will often ask the parent to voluntarily consent to the evaluation.

2. Without Parental Consent:

In cases where DSS believes there is an imminent risk to the child or when a parent refuses to consent, DSS may seek a court order authorizing the CME without parental approval. Judges may grant these requests if DSS can show that the evaluation is necessary to ensure the child’s safety or further the investigation.

Additionally, North Carolina law (N.C. Gen. Stat. § 7B-505(a)) allows for temporary custody orders or nonsecure custody placements in emergencies, during which DSS may arrange for medical evaluations, including a CME, even over parental objections. They may also seek to remove custody from parents in severe cases.

3. In Temporary Custody or Foster Care:

If DSS already has legal custody of the child (for example, the child is in foster care), they can consent to a CME without parental involvement.

What Should Parents Know?

If CPS is requesting or has conducted a CME, it is essential for parents or guardians to:

• Seek legal advice immediately. An attorney can help you understand your rights and obligations, review the evaluation findings, and advocate for your family.

• Request a copy of the CME report. These reports are typically shared with the investigating agency, and they may be introduced in juvenile court proceedings.

• Understand that CMEs are not neutral. While conducted by professionals, the purpose is investigatory. The findings can carry significant weight in custody, dependency, and criminal proceedings.

Conclusion

A Child Medical Evaluation is a powerful tool used in CPS investigations, designed to assess and protect a child’s well-being. However, it also represents a serious intrusion into a family’s private life and parental rights. If you are being asked to consent to a CME—or if one has been conducted without your consent—it is vital to seek legal counsel as soon as possible.

At Batch, Poore & Williams, PC, our experienced family law attorneys are here to help you navigate these sensitive situations and protect your rights as a parent. Contact us today to schedule a consultation and get the support your family needs.