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EVAWI > Resources > Best Practices > FAQs > Medical Mandated Reporting
Q If a sexual assault victim comes in with injuries, should the health care provider report it to law enforcement?
A If a sexual assault victim comes in with injuries, should the health care provider report it to law enforcement?

The answer to this question depends on whether or not the health care provider works in a state or territory with medical mandated reporting. The phrase “medical mandated reporting” refers to any legal requirement that health care professionals may have to report to law enforcement when a patient discloses that they have been the victim of a certain crime – or they otherwise have a reasonable basis to believe that a patient has been the victim of a certain crime (e.g., they observe indicators that a sexual act has been committed against a child). All U.S. states mandate 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 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 injury 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 obliged to notify police that a patient has presented to them with the specified injury, but they may not be obliged to say that the patient was also sexually assaulted.

Finally, a few states have medical mandated reporting for intimate partner violence. In these states, if a patient discloses that a sexual assault occurred within the context of intimate partner violence then the responding medical professional will be obliged to report the assault to law enforcement.

The amount of information required in a mandated report also varies by state. Some states do not require that the victim’s name or other identifying information be provided, while other states require not only the victim’s name but also detailed information about the suspect if available (e.g., name, age, location) and the nature of the sexual assault (e.g., date, location, basic description).

To learn about the laws in your state or territory, you can consult one of two statutory compilations. One was prepared in 2010 by the National District Attorneys Association, entitled Mandatory Reporting of Domestic Violence and Sexual Assault Statutes. A second statutory compilation was also completed in 2010 by AEquitas: The Prosecutors' Resource on Violence Against Women, entitled, Reporting Requirements for Competent Adult Victims of Domestic Violence. While it pertains exclusively to domestic violence, this will of course cover sexual assault that is perpetrated within the context of intimate partner violence.

Clearly, health care professionals must provide the information that is legally mandated. In some states, however, health care providers may be able to meet their legally mandated duty to report a sexual assault disclosure to law enforcement without providing identifying information for the victim (i.e., anonymously. In either case, victims must be provided with accurate information about what information will be reported and what may happen next. As summarized in the National Protocol for Sexual Assault Medical Forensic Examinations (Adolescent/Adults) (2nd edition, 2013):

In jurisdictions in which mandatory reporting by health care personnel is required, patients should be informed of the legal obligations of health care personnel, what triggers a mandatory report, that a report is being made, and the contents of the report. Patients should understand that even if health care personnel make a mandatory report, they are not obligated to talk with law enforcement officials (p. 51).

To be clear, however, just because a medical professional is mandated by state law to report a sexual assault it does not mean that the victim is required to personally talk with law enforcement. This would certainly be inconsistent with VAWA forensic compliance provisions – and in fact it would violate the law, because victims cannot be detained against their will unless there is probable cause that they have committed a criminal offense. These issues are discussed in detail in an article published in the Journal of Forensic Nursing and sample language for developing a community protocol on medical mandated reporting can be found in the template materials for Anonymous Reporting within the Forensic Compliance Resources section of the EVAWI website.

Another point that is worth making is that health care providers should NOT be reporting sexual assault disclosed by a patient to law enforcement in the absence of any legal requirement. 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 important, 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 anonymous reporting policies specifically designed for Sexual Assault Forensic Examiners in states without medical mandated reporting. Information is also available in the OnLine Training Institute (OLTI) module entitled, The Earthquake in Sexual Assault Response: Implementing VAWA Forensic Compliance.

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