Mandatory Reporting of Domestic Violence in Healthcare

 Reports must be made to a local law enforcement agency, child protective services, or adult protective services.

Mandatory reporting of suspected child abuse and elder abuse developed with the understanding that these are vulnerable victim populations. Child abuse victims and elder abuse victims may not be able to self-report their abuse. They are often dependent on caregivers. Sometimes those caregivers are also the abusers.

In contrast, mandatory reporting for domestic or intimate partner violence is less common. States often only require reports by medical professionals instead of a wide array of professions. The approach may be different based on societal expectations. Many believe that adult victims of domestic abuse can self-report and take steps to move away from an abuser.

So, what does mandatory reporting on domestic violence look like in practice?

Example of Mandatory Reporting Law

In California, the mandatory reporting law requires that healthcare practitioners report suspected domestic abuse to local law enforcement. The health care practitioner must know or suspect on reasonable grounds that a wound or physical injury occurred as a result of abuse from a spouse or cohabitant. Healthcare practitioners must report to law enforcement other types of injuries as well. This includes injuries caused by firearms, incest, battery, stabbing, sexual assault, or torture. Likewise, medical treatment for a serious bodily injury may also require a report to law enforcement.

Upon learning of these types of injuries, the healthcare provider is required to call local law enforcement. They must report the suspected abuse as soon as possible. They must send a written report within 48 hours. Failure to report such abusive conduct can bring consequences. Failure to report is a misdemeanor crime.

Who Has to Make a Report Varies Depends on State Law

Who must report varies by state. But in California, for example, healthcare "practitioners" must report domestic violence when they provide medical services to a victim for a physical condition. This can be confusing. Patients may not know whether a counselor or social worker is considered a healthcare provider.

For example, a domestic violence victim may see a counselor. She may describe the emotional abuse she has experienced from her spouse. The medical care provided by the counselor is not for a physical condition.

Are all healthcare providers subject to the mandatory reporting requirement? In some states, no, and in other states, yes. If you're a health care provider or work with health care providers, be aware of your state's particular mandatory reporting laws.

In California, the definition of health practitioner is in California Penal Code section 11165.7 (paragraphs 21-28). It includes physicians and nurses. It also includes mental health professionals like:

• Psychologists
• Marriage and family counselors
• Coroners

California requires the provision of "medical services for a physical condition." So, potential reporters must review the situation. Are they a health practitioner under the law? Did they provide medical services for a physical condition?

In Pennsylvania, requirements for mandatory reporting of domestic violence apply to physicians, interns, and managers of a healthcare facility. But the law gives a well-defined exception in the case of domestic abuse. Mandated healthcare providers or managers are not required to report suspected domestic violence if the victim:

• Is an adult suffering bodily injury as a result of domestic violence
• Is informed of the reporting requirement
• Does not consent to reporting
• Is provided with a referral to a victim services agency

The mandatory reporting exception in Pennsylvania takes into account the privacy concerns of victims of domestic violence. It relies on victim advocates to work with victims on their next steps. Patients, of course, can always choose to report on their own.

What Does the Report Include?

In most states, the report on suspected abuse must include the following:

• name of the patient
• the patient's location
• a description of the patient's injuries
• the name or identity of the abuser, if the abuser's identity is known

Keep in mind that these are minimum requirements. The report can go into more detail about the suspected abuse if the healthcare provider feels that further description will help.

Many healthcare providers ask whether they must tell the patient about the report. Not all state laws require that the healthcare provider tell the patient about the report, although it is encouraged, if possible.

What Is the Impact of Federal Law Under HIPAA?

Healthcare providers must comply with the federal patient privacy rules under the Health Insurance Portability and Accountability Act (HIPAA). The release of a patient's medical records must be carefully reviewed.

Healthcare providers may ask themselves whether HIPAA requires them to notify the patient or limits what they can report. Whether a healthcare provider can report protected health information to law enforcement depends upon several factors. The Department of Health and Human Services has summarized key provisions related to mandatory reporting as follows:

Child Abuse or Neglect

Healthcare providers may make reports to law enforcement without notifying the patient under HIPAA.

Adult Abuse, Neglect, or Domestic Violence

Healthcare providers may make reports to law enforcement under HIPAA when one of the following happens:

1. When the patient/victim consents to the report
2. When the report is required by law
3. When the law permits, and in the healthcare provider's exercise of their professional judgment, reporting is necessary to avoid serious harm to the patient/victim or others or when other emergencies are present
4. Notice to the patient/victim may be required depending on the circumstances

What Should Happen After the Report?

Sending a report to local law enforcement may cause new problems for the patient/victim experiencing family violence. Such reports may cause law enforcement to show up at the patient's house and question the well-being of family members. They may investigate for abuse. They may make an arrest or issue charges.

When the behavior of an abuser is questioned, criticized, and potentially investigated, then this can create a dangerous environment for the victim. The abuser may accuse the victim of "betraying" the abuser's trust. This may happen even though the healthcare provider made the report and not the victim.

So, what can you do to help? Healthcare providers and others can and should try to guarantee the victim's safety. Contact security at the healthcare center or contact the local police if there's a real possibility that the patient won't be safe upon going home. Healthcare providers can also encourage the victim to get counseling. They can give information on violence prevention.

Resources are available through most hospitals and outside of hospitals, including domestic violence hotlines. Social service agencies also offer information on shelters and safety planning.

Get Legal Help with Mandatory Reporting of Domestic Violence

An accusation of failure to report domestic violence can have a significant impact on your professional reputation. Not only that, it is a criminal offense.

If you are a healthcare professional in a position to report domestic violence, it's critical to take action as soon as possible. In many instances, domestic violence incidents recur and can get much worse. You could face criminal charges for failing to report the abuse if you fail to make a report required by law. If you want to learn more about your legal responsibilities as a mandated reporter, contact a local family law attorney. An experienced attorney can explain how the law applies to your work and any specific situations that concern you.

If you've been accused of failure to report domestic abuse, contact a criminal defense attorney. Your attorney will review the circumstances of your situation to determine your defenses and options. If you are facing a criminal charge, you will want an attorney by your side who can protect your rights and build a strong defense strategy.