Chapter 6: Reporting Requirements and Issues

Child Abuse & Neglect

The most common types of abuse are physical, sexual, and neglect. Healthcare practitioners are required to know the symptoms of child abuse and are mandated to report any suspicion of such abuse by the California Penal Code. For a complete listing and link to California codes click here: http://www.leginfo.ca.gov/calaw.html.

The following is a list of mandatory reporters of child abuse in the state of California. (Bold Font added)

• As used in this article, "mandated reporter" is defined as any of the following:
  • A teacher.
  • An instructional aide.
  • A teacher's aide or teacher's assistant employed by any public or private school.
  • A classified employee of any public school.
  • An administrative officer or supervisor of child welfare and attendance, or a certificated pupil personnel employee of any public orprivate school.
  • An administrator of a public or private day camp.
  • An administrator or employee of a public or private youth center, youth recreation program, or youth organization.
  • An administrator or employee of a public or private organization whose duties require direct contact and supervision of children.
  • Any employee of a county office of education or the California Department of Education, whose duties bring the employee into contactwith children on a regular basis.
  • A licensee, an administrator, or an employee of a licensed community care or child day care facility.
  • A Head Start program teacher.
  • A licensing worker or licensing evaluator employed by a licensingagency.
  • A public assistance worker.
  • An employee of a child care institution, including, but not limited to,foster parents, group home personnel, and personnel ofresidential care facilities.
  • A social worker, probation officer, or parole officer.
  • An employee of a school district police or security department.
  • Any person who is an administrator or presenter of, or a counselor in, a child abuse prevention program in any public orprivate school.
  • A district attorney investigator, inspector, or local child support agency caseworker unless the investigator, inspector, or caseworker is working with an attorney appointed to represent a minor.
  • A peace officer,
  • A firefighter, except for volunteer firefighters.
  • A physician, surgeon, psychiatrist, psychologist, dentist, resident,intern,podiatrist, chiropractor, licensed nurse, dental hygienist,optometrist,marriage, family and child counselor, clinical socialworker, or any other person who is currently licensed
  • Any emergency medical technician I or II, paramedic
  • A psychological assistant registered
  • A marriage, family, and child therapist trainee,
  • An unlicensed marriage, family, and child therapist intern
  • A state or county public health employee who treats a minor forvenereal disease or any other condition.
  • A coroner.
  • A medical examiner, or any other person who performs autopsies.
  • A commercial film and photographic print processor,
  • A child visitation monitor.
  • An animal control officer or humane society officer
  • A clergy member
  • Any custodian of records of a clergy member,
  • Any employee of any police department, county sheriff's department,county probation department, or county welfaredepartment.
  • An employee or volunteer of a Court Appointed Special Advocate program
  • A custodial officer
  • Any person providing services to a minor child under Section 12300 or 12300.1 of the Welfare and Institutions Code.
• Except as provided in paragraph (35) of subdivision (a), volunteers of public or private organizations whose duties require direct contact with and supervision of children are not mandated reporters but are encouraged to obtain training in the identification and reporting of child abuse and neglect and are further encouraged to report known or suspected instances of child abuse or neglect to an agency specified in Section 11165.9.
• Employers are strongly encouraged to provide their employees who are mandated reporters with training in the duties imposed by this article. This training shall include training in child abuse and neglect identification and training in child abuse and neglect reporting. Whether or not employers provide their employees with training in child abuse and neglect identification and reporting, the employers shall provide their employees who are mandated reporters with the statement required pursuant to subdivision (a) of Section 11166.5.
• School districts that do not train their employees specified in subdivision (a) in the duties of mandated reporters under the child abuse reporting laws shall report to the State Department of Education the reasons why this training is not provided.
• Unless otherwise specifically provided, the absence oftraining shall not excuse a mandated reporter from the duties imposed by this article.
• Public and private organizations are encouraged to provide their volunteers whose duties require direct contact with and supervision of children with training in the identification and reporting of child abuse and neglect. (CA Penal Code, 11165.7.)

To whom should the report be made?

Make sure that you have access to child abuse hotlines.Regardless of the information you have, you must make a report if you have a reasonable suspicion of the abuse. Reports must be made to those designated by law to take such reports.These include the police, probation department if designated to receive such reports, or county welfare department.

The code reads as follows:

"Reports of suspected child abuse or neglect shall be made by mandated reporters to any police department or sheriff's department, not including a school district police or security department, county probation department, if designated by the county to receive mandated reports, or the county welfare department.Any of those agencies shall accept a report of suspected child abuse or neglect whether offered by a mandated reporter or another person, or referred by another agency, even if the agency to whom the report is being made lacks subject matter or geographical jurisdiction to investigate the reported case, unless the agency can immediately electronically transfer the call to an agency with proper jurisdiction.When an agency takes a report about a case of suspected child abuse or neglect in which that agency lacks jurisdiction, the agency shall immediately refer the case by telephone, fax, or electronic transmission to an agency with proper jurisdiction. (CA Penal Code, 11165.9)?

What does a reasonable suspicion mean?

"A "reasonable suspicion" means that it is objectively reasonable for a person to entertain a suspicion, based upon facts that could cause a reasonable person in a like position, drawing, when appropriate, on his or her training and experience, to suspect child abuse or neglect." (CA Penal Code, 11166)

What is the reporting timetable?

What are the possible legal penalties for failing to report?

Suspected child abuse must be reported immediately by telephone and followed up by a written report within 36 hours. Failure to do so can result in a $1000 fine and./or six months of incarceration or both for each instance.

Elder Abuse

The National Center on Elder Abuse is a comprehensive resource for issues of Elder Abuse. Here is a link to their site: http://www.elderabusecenter.org HIssues

The following from the California Welfare and Institutions Code regarding mandated reporters and penalties inked to from the NCEA website:

CALIFORNIA WELFARE AND INSTITUTIONS CODE
SECTION 15630


Who is a mandate reporter of Elder Abuse?

Anybody who has assumed care for an elderly person is a mandated reporter:

"15630. (a) Any person who has assumed full or intermittent responsibility for care or custody of an elder or dependent adult, whether or not he or she receives compensation, including administrators, supervisors, and any licensed staff of a public or private facility that provides care or services for elder or dependent adults, or any elder or dependent adult care custodian, health practitioner, clergy member, or employee of a county adult protective services agency or a local law enforcement agency, is a mandated reporter.

(b) (1) Any mandated reporter who, in his or her professional capacity, or within the scope of his or her employment, has observed or has knowledge of an incident that reasonably appears to be physical abuse, as defined in Section 15610.63 of the Welfare and Institutions Code, abandonment, abduction, isolation, financial abuse, or neglect, or is told by an elder or dependent adult that he or she has experienced behavior, including an act or omission, constituting physical abuse, as defined in Section 15610.63 of the Welfare and Institutions Code, abandonment, abduction, isolation, financial abuse, or neglect, or reasonably suspects that abuse, shall report the known or suspected instance of abuse by telephone immediately or as soon as practicably possible, and by written report sent within two working days, as follows:

(A) If the abuse has occurred in a long-term care facility, except a state mental health hospital or a state developmental center, the report shall be made to the local ombudsperson or the local law enforcement agency."

What are the penalties for failure to report?

Penalties for failing to report become more severe if it is determined that, as a result of the failure to report, the elderly person is injured or killed:

"(h) Failure to report physical abuse,as defined in Section 15610.63 of the Welfare and Institutions Code, abandonment, abduction, isolation, financial abuse, or neglect of an elder or dependent adult, in violation of this section, is a misdemeanor, punishable by not more than six months in the county jail, by a fine of not more than one thousand dollars ($1,000), or by both that fine and imprisonment. Any mandated reporter who willfully fails to report physical abuse,as defined in Section 15610.63 of the Welfare and Institutions Code, abandonment, abduction, isolation, financial abuse, or neglect of an elder or dependent adult, in violation of this section, where that abuse results in death or great bodily injury, shall be punished by not more than one year in a county jail, by a fine of not more than five thousand dollars ($5,000), or by both that fine and imprisonment.If a mandated reporter intentionally conceals his or her failure to report an incident known by the mandated reporter to be abuse or severe neglect under this section, the failure to report is a continuing offense until a law enforcement agency specified in paragraph (1) of subdivision (b) of Section 15630 of the Welfare and Institutions Code discovers the offense." (Bolding of font added)

Domestic Violence

The clients of healthcare practitioners may be victims of domestic/family violence. These may not be child abuse or Elder abuse, but between a husband and wife or another type of adult on adult violence.The safety of the client is the primary concern.It is important for the healthcare practitioners to discuss with the victim of domestic violence the resources available and to assist them to obtain those resources.This includes medical attention if needed, the involvement of law enforcement and shelters.There should also be an awareness of children in the home and their emotional health under such a situation, which can be abusive in itself.

There are many complex biopsychosocial issues surrounding abuse and violence.The purpose of this section has been to clarify the legal and ethical responsibilities of the licensed healthcare professional surrounding abuse.

Confidentiality vs. Need to Report: Tarasoff

The case of Tarasoff vs. Regents of the University of California established the duty of therapists to warn the public if the client or another identifiable person is in clear or imminent danger.The Tarasoff case concerns a University of California student, Prosenjit Poddar who was seeing a psychiatrist at the student healthcare center. Tatiana Tarasoff was a young woman who Mr. Poddar had feelings for, but she did not have the same for him.

Mr. Poddar had expressed his intention to the psychiatrist to buy a gun and as a result of their sessions together the psychiatrist felt that Mr. Poddar meant to do Ms. Tarasoff harm and informed the police.The police questioned Mr. Poddar, felt that he would not harm Ms. Tarasoff and made him commit to staying away from her. A couple of months later, Mr. Poddar killed Ms Tarasoff.

As a result of the killing, the parents of Ms Tarasoff sued the University, the healthcare center staff and the police, but the courts dismissed the case.In a later appeal to the California State Supreme Court it was ruled that the psychiatrist had responsibility to inform Ms. Tarasoff of the imminent danger she was in. As a result of this case, it is the legal duty of healthcare practitioners to breach confidentiality if a client or an identifiable person is in danger.If it is another identifiable person that is in danger, the practitioner must warn them directly of the threat.Just calling the police does not fulfill the obligation of the "duty to warn.