Legal Mandates for Health Care Providers

Child Protective Services

• Child abuse is defined at both state and federal levels, although the mechanisms by which suspected cases are evaluated are guided by state and local jurisdiction. Child protective services (CPS) are responsible for investigating suspected maltreatment and ensuring the ongoing safety of abused and neglected children.

• Only a small percentage of reports to CPS result in children entering foster care. Understanding the local process and terminology to facilitate clear communication to families is helpful.

Mandated Reporting

• Physicians and health care providers are mandatory reporters of suspected child abuse in all 50 states. Mandatory reporters are legally required to report suspicion of abuse to child protective services. Failure to do so can result in criminal and civil liabilities for providers and result in a child returning to an environment where they may be further injured or killed.

• Reporting mechanisms vary by state. Physicians should familiarize themselves with local reporting procedures. Most jurisdictions have telephone hotlines available 24 hours per day, 7 days per week. Additionally, many jurisdictions have or are developing online portals for reporting.

• Although it is appropriate to collaborate with social workers or other care team members to file a report, any mandated reporter can and should report when indicated. If a team is involved, communication is necessary to ensure that a report is completed when indicated. Reports should include history provided for injuries and clear language, with minimal medical jargon, describing injuries.

Law Enforcement

In some cases (child sexual abuse, significant physical abuse, and severe neglect), police investigation of a potential crime committed against a child is warranted. Regulations regarding police notification and involvement in investigation vary by state. In many jurisdictions, law enforcement and child protective services coordinate efforts to protect children, though the purpose of law enforcement investigations is different from that of child protective services.