• Search Using:


EVAWI > Resources > Best Practices > FAQs > Medical Mandated Reporting
Q Should health care professionals report a sexual assault to law enforcement, if they do not have a legal requirement to do so?
Q Is medical mandated reporting compliant with VAWA?
Q When would a health care provider be required to report a sexual assault?
Q Can mandated reports be anonymous? 
Q How do I determine the mandated reporting laws in my state?
Q What resources are available on mandated reporting?
A Should health care professionals report a sexual assault to law enforcement, if they do not have a legal requirement to do so?

Some Sexual Assault Forensic Examiner (SAFE) programs and other health care facilities have a written policy, or an unwritten rule, that they will do this. However, this practice clearly violates the spirit of the VAWA forensic compliance provisions, which were designed to increase access to medical forensic examinations for victims who are unsure about whether or not to participate in the criminal justice process.

More importantly, this practice of reporting a patient’s disclosure of sexual assault to law enforcement constitutes a violation of HIPAA unless:
  1. the report is required or expressly authorized by state law, OR
  2. the patient has consented to this report being made.
For more information, please see the template materials for non-investigative reporting policies specifically designed for SAFEs in states without medical mandated reporting. It is posted on the EVAWI website, under the tab for Non-Investigative Reports.
A Is medical mandated reporting compliant with VAWA?

The Office on Violence Against Women (OVW) has determined that states with medical mandated reporting can be compliant with VAWA, as long as victims are not required to participate in the criminal justice process. While the definition of “participation” is not explicitly defined, common sense suggests it means that victims cannot be required to personally talk with an officer – even when a mandated report has been filed with law enforcement.

In some communities, there is a policy or practice of having an officer personally meet with victims whenever a mandated report has been filed – even if the victim has not yet decided whether or not to participate in the criminal justice process. We do not believe this represents best practice, which would be to conduct the medical forensic exam first and then offer the opportunity to talk with an officer only when the victim has decided to do so.
A When would a health care provider be required to report a sexual assault?

There are two possible scenarios when it comes to mandated reporting.
  1. The law requires health care providers to report any suspected sexual assault to law enforcement. If this is the case, the report will be made regardless of whether or not the patient consents to it. However, the patient should be advised of this mandate in advance.
  2. The patient asks to talk to law enforcement. Health care providers can contact law enforcement if the victim requests it, regardless of whether or not there is medical mandated reporting.
If there is no law requiring or expressly authorizing a report to law enforcement, and the patient has not consented to it, the health care provider would be in violation of HIPAA if they reported the suspected sexual assault to law enforcement.
A Can mandated reports be anonymous?

In most of the discussion of medical mandated reporting, it is assumed that the report to law enforcement will include the victim's name and/or other identifying information. However, there is an important distinction between states that require mandated reports to include the victim’s name and other identifying information – and those that do not.

In some states, health care providers must provide the victim’s name to law enforcement, so mandated reports cannot be anonymous. It should go without saying that this must be made very clear to victims.

In other states, health care professionals may be able to meet their mandated reporting obligation without providing the victim’s name or identifying information. For example, the SAFE or other health care professional may use a standard report form, but write the phrase “declined by patient” in the space for the patient’s name, address, and telephone number. The same phrase might also be used in place of the suspect’s information. In addition, a non-identifying address may be used for the location of the assault. For example, if the assault was committed in the victim’s own home (or the victim is unsure where it happened), the address for the police department could be used. Alternatively, the 100-block of the assault location could be used to avoid listing a specific address that would identify the victim.

Any such protocol must be carefully designed with collaboration between law enforcement personnel, health care providers, victim advocates, and other community professionals. The protocol must also be supported with written documentation of a good faith agreement that law enforcement agencies will not investigate these reports, except in certain circumstances. 
A How do I determine the mandated reporting laws in my state?

All states require medical professionals to report sexual assault when the victim is a child (as defined by state law). In addition, most states require medical professionals to report sexual assault when the victim is a dependent adult. The definition of what constitutes a dependent adult is also defined in state law, but it generally includes such factors as advanced age, severe disability, or other factors. Most state laws also require mandated reporting of any sexual assault committed by a caregiver or other authority figure, although the exact provisions of these reporting requirements vary by state.

The majority of states do not require health care professionals to report sexual assault of a competent adult. However, they may still require a report if the victim presents with certain types of injuries, including those that are non-accidental, result from violent crime, or involve the use of a weapon that is either described as “deadly” or specified in some other way (e.g., firearm, knife). In states with such a requirement, health care professionals are required to notify police that a patient has presented with the specified injury, but they may not be obliged to say that the patient was also sexually assaulted. Yet it remains unclear in some states whether such laws require medical professionals to report a sexual assault against a competent adult victim that did not result in any physical injury other than the sexual assault itself.

Finally, a few states have medical mandated reporting for intimate partner violence. In these states, health care providers are required to notify law enforcement when a patient discloses that a sexual assault occurred within the context of intimate partner violence (or when the health care provider has reason to believe this is the case).
A What resources are available on mandated reporting?

To find out any laws regarding medical mandated reporting in your state, please see the document entitled, Mandatory Reporting of Domestic Violence and Sexual Assault Statutes, created by the National District Attorneys Association. It is a compilation of the laws pertaining to medical mandated reporting for all U.S. states and territories (current as of 2010).

For states with medical mandated reporting requirements, we offer a few tools that could be useful to assist with implementing alternative reporting procedures. For example, in the Forensic Compliance Resources section of our website, we provide a sample form with reporting instructions for the state of California. In California, most medical forensic exams are conducted with a victim who personally talks with law enforcement in connection with the report, so the mandated reporting requirement is met when the forensic examiner submits the standard medical forensic examination form (known as the OES-923). This form is used to document evidence from an adult victim of sexual assault. However, when a medical forensic exam is conducted with a victim who does not personally talk with law enforcement, health care providers must still meet their requirement for mandated reporting. This is accomplished by submitting a Suspicious Injury Report, which is available along with the corresponding Instructions. These materials can thus be adapted for use in other communities.

For professional in states without medical mandated reporting requirements, we offer template materials for non-investigative reporting, which include relevant procedures for health care providers. These documents are posted in the Forensic Compliance Resources, under the tab for Non-Investigative Reports
© Copyright 2018 End Violence Against Women International. Site created by Threegate Media Group