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Attachment J:  Meth Lab Emergency Response Protocol

Identifying a Potential Meth Lab

Many products and equipment used in the production of meth do have legitimate uses and separately would not be cause for concern.  When certain items are found in combination and close proximity, however, staff should take notice and use extra precaution.  It is important for workers to familiarize themselves with the presence of chemicals, products, equipment or other evidence that might alert the worker to the existence of a meth lab site which is either active or has been active in the past.

Methamphetamine laboratories that produce illicit drugs operate with little or no safety precautions.  Immediate dangers include:

• Fire
• Explosion
• Inhalation of harmful fumes
• Skin contact with dangerous chemicals
• Exposure to chemicals found in meth laboratories without proper protection can cause cumulative damaging effects to the body.
• Methamphetamine laboratory seizure requires specialized training, detection and safety precautions.

Related Subject:  Section 7, Chapter 27 Methamphetamine (“METH”) Use: Clandestine Methamphetamine Laboratories; and Guidelines

Methamphetamine Emergency Response

Reports received at the county office from the Child Abuse Neglect Hotline Unit that identify the existence or potential existence of a meth lab site should be handled by contacting 9-1-1 or local law enforcement immediately to initiate an established meth lab protocol.  Children’s Division staff is not equipped to deal with the hazards associated with a meth production site and should never enter any building or suspected residence where a meth lab is suspected until clearance to do so is received from trained law enforcement personnel, DEA agents, or Drug Task Force members.

Other situations may arise when a worker discovers the existence or has reason to suspect the existence of a meth lab during an investigation/family assessment or home visit on an active FCS or FCOOHC case.  Whatever the case, when a worker becomes aware of the existence or possible existence of a meth lab the worker should take the report very seriously and without alerting or alarming the family should cease the visit immediately, leave the site and contact law enforcement.  If there is not a pending investigation, the worker should also contact the CANHU and make a hotline report.

Check CA/N History

Workers should always review the family CA/N history printed on the report, before going out on a home visit.  If the CA/N-1 coding P1---Meth Lab Exposure appears on a prior report, workers should use extreme caution.  P1---Meth Lab Exposure, under the heading Reporter’s Description/Worker’s Specific Finding is used as an investigative worker finding when an individual with care, custody or control of a child had an active lab at the child’s residence or knowingly allowed the child to be exposed to the hazardous chemicals associated with meth production.

Establishing a Multi-Disciplinary Initial Response Partnership

It is important to have an emergency meth protocol in place before the need arises.  This will require a community based multi-disciplinary approach to formulating and implementing a collaborative response.  It will require staff to assess locally what resources, agencies and protocols exist; what gaps or challenges have to be bridged; and who in the community needs to be involved.  Identify the necessary team members and form a task force to discuss the roles and responsibilities in the process.  Members may include, but not limited to:

1. Children’s Division
2. Law Enforcement
3. Fire Department/EMS
4. Prosecuting Attorney’s Office
5. Juvenile Court
6. Medical Providers
7. Foster Parents
8. Child Advocacy Center Staff
9. Addiction Treatment Providers

Identify Protocol Functions:

1. Secure the Area-Site Entry-(law enforcement) CD shall not enter a lab site until clearance to do so is received from trained law enforcement personnel, DEA agents, or Drug Task Force members.
2. Detain suspects-(law enforcement)
3. First Responders-(EMS, law enforcement, fire department)
4. Field Medical Exam-(EMS, fire department, available qualified medical personnel)
5. Decontamination of children (Health Department, fire department or medical personnel, not including Children’s Division staff)
6. Sample Collection –(Qualified personnel such as medical personnel, EMS or law enforcement, not including Children’s Division staff)
7. Full Medical Exam (medical/hospital personnel)
8. Protective Custody-(law enforcement, juvenile office or physician)
9. Transporting of children (EMS/ambulance, law enforcement, the juvenile office or Children’s Division)  Children’s Division workers shall:
   • Not transport a child who is not in CD legal custody
   • Not transport a child who is not medically stable (arrange for ambulance or EMS to take the child to the hospital)
   • Transport according to local/multi-agency task force decontamination protocol
10. Placement Arrangements or Alternative Care (Children’s Division)
11. On site evidence collection-(law enforcement, Children’s Division only after site has been cleared)
12. Hazardous waste/ collection-(law enforcement, fire department)
13. Environmental Clean Up (Department of Natural Resources (DNR), DHSS, Contracted)

Identify available resources in your community

1. Existing protocols in place or that could be enhanced
2. References/training available/cross training
3. Medical facilities/hospitals
4. Child Advocacy Centers
5. Potential decontamination facilities
6. Treatment providers/facilities
7. Foster Care Providers
8. Funding available
9. Referral of adults/parents to addiction treatment provider (Children’s Division)

Establish Protocol

1. Designate responsibilities
2. Designate locations (medical exams, decontamination, interviews)
3. Establish lines of communication between team members (Distribution of reports, Dissemination of new information)

Periodic and Ongoing Review and Revision of Protocol

1. How is it working? (review practice, specific cases or situations)
2. How can it work better? (support practice or modify)

Related Subject:  See Sample National Alliance for Drug Endangered Children (DEC) Protocol
( http://www.colodec.org/decpapers/Documents/DECNationalProtocol.pdf );
and Sample: DEC Best Practices First Response Forms
( http://colodec.org/decpapers/Documents/DECBestPracticesInitialResponseforms.pdf ).

General Meth Protocol Guidelines:

Reports received at the county office from the Child Abuse Neglect Hotline Unit that identify the existence or potential existence of a meth lab should be handled by contacting 9-1-1 or local law enforcement immediately to initiate the established meth lab protocol.  The following are suggested guidelines only and may be used as a reference in local protocol development.

1. Be Alert and know how to Recognize a Meth Lab Site.

   Related Subject:  Section 7, Chapter 27 Methamphetamine (“METH”) Use: Clandestine Methamphetamine Laboratories; and Guidelines

2. If staff develop reasonable suspicion of a methamphetamine operation while in the course of a home visit:
   1. Safety is the foremost consideration;
   2. Conclude the visit quickly, without causing concern of the individuals of the household.  This is extremely important due to the extreme aggressive behavior, rapid mood swings and paranoia that use of methamphetamine may elicit;
   3. Don’t alert or alarm the client;
   4. Talk slowly, clearly and continuously in non-threatening manner;
   5. Stand-still at first face-to-face contact;
   6. Keep a distance of 7 to 10 feet;
   7. Keep your hands in front of you (any movement can be interpreted as a sign of aggression);
   8. Slowly, walk backing out maintaining eye contact until you are safely away from harm;
   9. Don’t touch anything;
   10. Do not use sense of smell or touch to attempt to identify chemicals or unknown substances.
3. Leave the Site and Contact Law Enforcement Immediately:
   1. Leave the area immediately or as soon as possible.  Again, don’t alert or alarm the client;
   2. Call 911 and/or local law enforcement;
   3. Your safety is first priority;
   4. Local law enforcement agencies should have established a specific protocol for use when reports of methamphetamine laboratories are received;
   5. Staff should not enter any building until clearance to do so is received from trained law enforcement personnel, DEA agents, or Drug Task Force members;
   6. Drug Task Force, DEA personnel, or Highway Patrol Division of Drug and Crime Control (DDCC) are contacted and requested at a specific scene before any other personnel enter.
4. Children After Removed from an Active Meth Lab Site:
   1. All children should be assessed for medical stability (preferably EMS or qualified emergency response personnel should assess medical stability prior to the children is transported, though this issue should be worked out locally);
   2. All child(ren) should receive a more thorough physical examination as soon after removal as possible;
   3. Children not showing signs of chemical toxicity should be taken to medical facility within the first 24 hours;
   4. Children demonstrating symptoms of acute chemical toxicity are to be immediately decontaminated and taken to nearest emergency hospital;
   5. Children with open wounds should receive immediate medical attention;
   6. If protective custody is taken of the child(ren), workers should not transport the child(ren) if he or she has not been determined medically stable;
   7. Medical professionals need to be informed immediately of the situation and to what possible chemicals the children might have been exposed;
   8. The child(ren) should have a lead screening when they receive the physical examination, as high levels of lead have been detected in children removed from homes that contained a methamphetamine laboratory;
   9. Immediately following the removal of the child(ren) from the home, he/she should be observed closely for labored breathing and headaches, for at least 48 hours;
   10. If labored breathing or headaches do occur, the child(ren) should be taken immediately to a physician or an emergency room;
   11. There may have been children in the family or home who were not present at the time of the seizure.  All children who have lived in the home will need to be examined within 72 hours;
   12. All children at the lab site should be decontaminated according to local decontamination protocols;
   13. Personal items, clothing, toys should not be removed from the lab site.
   14. The lab site is a crime scene and should not be disturbed;
   15. If there is knowledge that the child(ren) had direct exposure (i.e., he/she was in the same room when the “cooking” process was taking place) to any chemical, the clothing, shoes, etc., should be thrown away;
   16. All clothing, shoes, and toys that are removed from the home with the child(ren) should be thoroughly washed with soap and water;
   17. Bleach should be used to clean the washing machine and area where the washing occurred;
   18. The child(ren) and any adults that have had physical contact with him/her should wash all skin surfaces thoroughly with soap and water except when injuries have occurred.
5. Transporting children in protective custody:
   1. Law enforcement, Juvenile Office or a physician must take protective custody prior to Children’s Division transporting any child exposed to a meth lab.
   2. Children’s Division staff shall not transport a child who does not appear to be medically stable.  Arrange for EMS or an ambulance to take the child to a hospital;
   3. A Children’s Division Worker shall not transport a child who has not been decontaminated to a foster or kinship placement.
   4. If a child is not decontaminated on the site, a protocol for transporting children to decontamination sites must be worked out locally (EMS, the Fire Department, Law Enforcement, preferably not Children’s Division staff, may transport the child to a designated site for decontamination);
6. Interviewing the victim:
   1. The multi-disciplinary investigative team should agree on a case-by-case basis, who should interview victims.  Because meth cases are all investigations, interviews should not be conducted without law enforcement’s involvement;
   2. Interviews should take place only after the child is decontaminated and assessed for medical stability;
   3. The interviewer should:
      • Build rapport with the child;
      • Allow the child to use drawing or dolls;
      • Ask specific questions;
      • Avoid repeating questions;
      • Avoid leading questions;
      • Not suggest that the interviewer knows what happened;
      • Not confront the child on prior statements;
   4. Include questions such as:
      • Have you ever smelled or seen anything strange or weird in your house?
      • Do you know what drugs are?
      • What do they look like?
      • Are there ever times when you feel sick?
      • Do you get headaches?
      • Does your nose ever hurt?
      • Ask the child whether there are weapons or guns in the house?
7. Make complete assessment (child abuse/neglect/domestic violence and forensic evaluations of the dangers the lab posed to the child):
   1. Physical condition of the children
   2. Child’s access to drugs or chemicals
   3. Living conditions
   4. Play area
   5. Food supply
   6. Children’s bedroom or sleeping arrangements
   7. Bathroom conditions

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