Risk Management GEM (Volume I): Ask MPIE: When are Physicians Required to Report Suspected Child Abuse or Neglect?

Recently a call came into MPIE’s risk management hotline about mandatory reporting requirements for suspected child abuse in Michigan. After reviewing the physician’s situation, we advised the physician and provided resources and links to help meet legal requirements. As a service to all MPIE providers, we take this opportunity to review aspects of mandatory reporting requirements.

Reporting requirements vary by state but, generally, state child welfare laws impose an obligation on licensed healthcare providers to recognize and report instances of suspected abuse to Centralized Intake (CI) at the Department of Health and Human Services (DHHS). In many states, including Michigan, these persons are referred to as “mandated reporters.” Other mandated reporters include counselors, therapists, social workers, teachers, and school administrators.

It is important to note that these requirements do not state that providers have absolute certainty before a report is required. Instead, mandatory reporters with a good-faith basis to suspect abuse are obligated to report. Typically, physicians with a good-faith basis of suspected abuse are shielded from repercussions by the patient or the caretaker. In addition, the reporter’s identity is generally kept confidential. In Michigan, confidentiality is provided in the Child Protection Law, and the reporter’s identity will be disclosed only with consent or by judicial process.[i]

The obligation to report a child’s suspected physical or sexual abuse typically includes a requirement that the report be made in a specific amount of time. Most state agencies involved have a 24-hour reporting hotline or an online reporting option. Many states also require a written follow-up to be completed within a specified time. Michigan, for example, requires an immediate notification by phone or through an online reporting system and a written report following within 72 hours.[ii] Failure to report suspected abuse can lead to both civil and criminal liability and disciplinary actions. Physicians (and others considered mandatory reporters) who fail to follow state reporting requirements when abuse is suspected may open themselves to various professional liability implications, including lawsuits. For example, a physician treating a very young child for an arm fracture finds indications of prior healed fractures and observes a history of recent care for other suspicious injuries. The physician suspects abuse but does not report it and, instead discharges the child to the parent. Shortly after, the child dies due to further abuse. Attorneys for the child’s estate may be able to pursue the physician for failure to protect the child on the basis that the physician did not report the suspected abuse.

To assist providers in knowing and following their mandated reporting requirements, MPIE provides the following information.

Risk Management Recommendations

  1. Be familiar with state-specific mandatory reporting requirements (some resources listed below).
  2. Be familiar with the signs and residual effects of physical or sexual abuse.
  3. Establish protocols for responding to suspected abuse.
  4. Educate staff on requirements, including making sure any suspected abuse is immediately made known to the physician or healthcare provider and where to report.
  5. Ensure thorough and accurate charting that illustrates why the provider suspects abuse or neglect.
  6. Be prepared to answer questions from state investigators and possibly testify in court proceedings. Please contact MPIE Claims for assistance if you believe the reporting of issues may result in criticism of medical care provided or if other professional liability concerns may be implicated.

Resources and More Information

If you have additional questions about mandatory reporting requirements or would like to discuss further, do not hesitate to contact MPIE Risk Management at risk@mpie.org.

[i] http://www.legislature.mi.gov/(S(0vvbip3lmikhlu5vmmyitchg))/mileg.aspx?page=getObject&objectName=mcl-722-625

[ii] https://www.michigan.gov/mdhhs/0,5885,7-339-73971_7119_50648_44443-157836–,00.html

Disclaimer: This information is provided as a risk management resource and should not be construed as legal, compliance, technical, or clinical advice. This information may refer to specific local regulatory or legal issues that may not be relevant to your organization. Consult your professional advisors or legal counsel for guidance on issues specific to your organization. Medical or clinical information presented is offered for educational and informational purposes only and does not replace independent professional judgment. The information is intended to guide the clinician in patient care management and is not intended to establish a standard of care. The clinician shall defer to applicable prevailing medical authority. This material may not be reproduced or distributed without the express, written permission of MPIE.