By Alessandra Suuberg, Decency LLC
Last week, NPR and KFF Health News published a story on states’ seeking a better balance with respect to mandated reporting.
Mandated reporting is legally required reporting of suspected or known abuse, generally where the victim is a child, disabled, or elderly.
The rules that determine who is a “mandated reporter”—i.e., who must report abuse—and what, when, and how they must report, are a matter of state law and vary from state to state.
For example, some states may say that only certain categories of professionals, such as doctors, teachers, or therapists, are mandated reporters. Others may not limit the requirement in this way.
Some states may require a report when abuse is only suspected, and others may require a report when abuse is believed to be happening.
As explained last week on NPR, mandated reporting rules have long reflected an early-intervention approach. But now, states including New York, California, and Colorado are considering “roll[ing] back these laws” for various reasons.
The reasons cited include “too many unfounded reports” of abuse and disproportionate harm to “families that are poor, Black, or Indigenous, or have members with disabilities.”
Conflicts in Mandated Reporting
The challenges inherent in mandated reporting systems have long been a topic of interest for Decency. This is because they exemplify the controversies that can arise when well-intentioned rules collide with reality in everyday practice, potentially resulting in unintended harms.
In my own professional life pre-Decency, discussions about mandated reporting arose in a few different contexts.
For example, taking calls on a crisis line, I learned that staff or volunteers might receive calls suggesting or disclosing abuse. Because crisis lines often emphasize caller confidentiality, how should they handle these disclosures?
In another example, working pro bono on Social Security disability appeals in Boston, I learned that law offices might keep individuals with dual law-and-healthcare or law-and-social work backgrounds off of certain cases where the client is a child or has children.
The reason for this type of policy: Depending on state laws, even if a lawyer is not a mandated reporter in their legal role, they may be a mandated reporter by virtue of a second role or background in healthcare or social work.
Taking a look for example at Massachusetts’ mandated reporting rules and lawyers’ professional duty of confidentiality, a lawyer with a dual background could need to reconcile conflicting duties to legal clients and the state. How would their clients feel about that conflict?
Recent State Reform Efforts
Looking beyond these conflicts, last week’s coverage also noted that, when “the only way to report concerns about a child is with a formal report to a hotline,” individuals often end up calling in to look for resources, rather than to report abuse.
The outlet also relayed statistics from Colorado, showing a 42% increase in child abuse and neglect reports over the last decade. They attributed the increase “to a policy of encouraging a broad array of professionals . . . to call a hotline whenever they have a concern.” However, despite the increasing numbers of reports, the number of substantiated cases of abuse had not risen.
With these challenges in mind, Colorado has considered changes including better screening, a warmline to connect families with services, clarification of the definitions of abuse and neglect, and better training and help for mandatory reporters.
Disclaimer: The information and opinions on this site do not include legal advice or the advice of a licensed healthcare provider.