Child Advocacy and Protection Program

The Child Advocacy and Protection Program (CAPP) is a multidisciplinary program within CHaD. It was established to evaluate and advocate for and provide integrative care to suspected victims of child maltreatment. We do this by psychosocial evaluation of the entire family, medical evaluation and treatment, and referral for services.

CAPP team members include physicians, advanced practice registered nurses, social workers, nurses, child life specialists, and medical assistants. Together, we conduct inpatient and outpatient consultations, urgent and routine evaluations of children who are suspected victims of physical abuse, psychological/emotional abuse, sexual abuse, and/or neglect in addition to other less common forms of child maltreatment.

We conduct these evaluations at the request of various professionals: Medical professionals within and outside of DH Health System, Department of Children, Youth and Families (DCYF)/DCF social workers, child advocacy centers (CAC), or police investigators. We provide evidence-based medical information to all members of the larger county-based interagency-multidisciplinary team (MDT).

The main CAPP office is in Lebanon, NH. CAPP clinics are located at Dartmouth-Hitchcock (DH) Medical Center in Lebanon, DH Clinic in Manchester and at Elliott Hospital.

CAPP is a multi-site program with three essential, distinct, but collaborative branches serving NH statewide and southeast and southern Vermont:

  • One of these branches is located within CHaD, in Lebanon, NH. This branch provides outpatient clinical services, inpatient consultation services, record review services.
  • Second branch is located at DH Clinic in Manchester, NH. This branch provides outpatient clinical services. Elliott Hospital is in close affiliation with this clinic to provide both inpatient and outpatient services to child victims in Southern NH.
  • Third branch is Grafton-Sullivan Counties CAC, which is located in Lebanon, NH and is governed under ChaD organizational umbrella. This team also provides outpatient clinical services with a focus on forensic interview and child advocacy services.

Other CAPP activities include:

  • Organizing and sustaining a 24/7 call schedule for both the state of NH and southeast and southern VT. This service employs a team of medical providers specializing in child abuse pediatrics. They collectively provide:
    • guidance and real time brief consultation to professionals such as primary care providers, Emergency Room staff, DCYF/DCF staff, police investigators, and attorneys
    • triage cases to the most appropriate health facility to obtain urgent/emergent and routine specialized medical services
  • Participating in county/community based case review MDT meetings as medical representatives
  • Leading and organizing hospital based MDT meetings for high profile cases to assure DCYF/DCF, police, and county attorneys have access to specialists providing care to victims of abuse and neglect
  • Peer review of high profile or uncertain cases with all medical providers in NH
  • Peer review of high profile cases with medical providers from multiple New England states’ CAPPs
  • Performing case/peer review on all acute sexual assault evaluations conducted by Sexual Assault Nurse Examiner (SANE) Program at DHMC on children under 18 years of age
  • Medical-legal case/record reviews at the request of DCYF/DCF staff, police investigators, and attorneys
  • Fact witness and expert testimony services and depositions when required
  • Leading and participating in the state and regional coordination of specialized medical and multidisciplinary services for abused and neglected children

In addition to these activities directly affecting the trajectory of victims of abuse and neglect, CAPP leadership and team members also engage in, organize, and lead the following activities serving the best interest of children and families at multiple levels of prevention.

  • Representing CAPP at NH Child Fatality Review Committee, Attorney General’s Child Abuse Task Force and multiple legislative activities
  • Community and ChaD based child abuse prevention activities
  • Organization of an annual regional child abuse conference: Shield Our Children from Harm
  • Child maltreatment training to multiple audiences in collaboration with Granite State Children’s Alliance, NH DCYF/VT DCF, Attorney General’s Office, Children’s Trust, Office of the Child Advocate, among others. Professionals benefiting from these activities include teachers and school staff, health care professionals, CACs, prosecutors, police investigators, attorneys, judges, and DCYF/DCF social workers among others
  • Child abuse research
  • Evidence based medical guidance to relevant governmental and non-governmental agencies such as Child Advocacy Centers, DCYF/DCF, police departments, county attorney’s offices, courts, domestic violence and sexual assault prevention organizations, Children’s Trust, The Office of the Child Advocate among others in New Hampshire and Vermont