MANDATORY REPORTING 09/01/2015

Purpose of mandatory reports Mandatory reporting is intended to protect those who cannot protect themselves. Mentally Ill persons (ORS ) Developmentally Disabled persons (ORS ) Seniors (ORS ) Children (ORS 419B B.017) Adult patients with non-accidental injuries (ORS ) Applies to RN, LPN, MD

Mandatory Reporting All Marion County Health Department staff (paid & non-paid) are mandatory reporters by Oregon Law You must make a report if while in your official capacity, you come into contact with an adult (or abuser of person) who is mentally ill, or developmentally disabled and you reasonably believe abuse has occurred You must make mandatory report if you examine a patient with non- accidental, serious physical injury or injury caused by a weapon Mandatory reporting for children and seniors (65 or older) is a 24-7 responsibility A report is a request for assessment into the safety and condition of a vulnerable person based on a reasonable concern Failure to report may be subject to prosecution and possible fine

Definitions of Abuse For Mentally Ill or Developmentally Disabled (18+) Abandonment Physical injury caused by other than accidental means Willful infliction of physical pain or injury Sexual abuse Neglect Verbal abuse Financial exploitation Involuntary seclusion A wrongful use of a physical or chemical restraint An act that constitutes a crime (rape, sodomy, etc.) Any death caused by other than accidental or natural means

Reporting Suspected Abuse Mentally Ill If you, while in your official capacity, suspect abuse of a mental health client (18+): Report the suspected abuse immediately to: MH Abuse Report Line at AND Your supervisor (if reporting suspected abuse of a MCHD client) If a client, document the report in the client record

Definitions of Abuse for Seniors (65) Physical injury by other than accidental means or that does not match explanation Neglect Abandonment Willful infliction of physical pain or injury An act constituting a crime such as rape, sodomy, unlawful sexual penetration, Verbal abuse Non-consensual sexual contact Financial exploitation Involuntary seclusion Wrongful use of a physical or chemical restraint

Reporting Suspected Abuse Seniors and Developmentally Disabled If you, while in your official capacity, suspect abuse of a senior or person with developmental disabilities: Report the suspected abuse immediately to: DD Abuse Report Line at OR Seniors and Persons with Disabilities (Seniors) at AND Your supervisor (if reporting suspected abuse of a MCHD client) If a client, document the report in the client record

Definitions of Child Abuse (Unmarried under 18) Assault Physical injury which has been caused by other than accidental means Mental injury Rape, sodomy, unlawful sexual penetration and incest Sexual abuse Sexual exploitation Contributing to the sexual delinquency of a minor Allowing, permitting, encouraging or hiring a child to engage in prostitution Negligent treatment or maltreatment Threatened harm Buying or selling a person under 18 years of age Permitting a child to enter or remain in or upon premises where methamphetamines are being manufactured Unlawful exposure to a controlled substance ORS 419B B.950

Child Abuse Physical Assault Injury which has been caused by other than accidental means Includes injury which doesn’t appear to match the explanation provided

Child Abuse Mental Injury Rejecting, abandoning or extensive ridiculing Terrorizing with threats of extreme punishment against child’s pets or possessions Ignoring a child over time by refusing to talk or show interest in their daily activities Isolating a child by teaching to avoid social contact beyond parent-child relationship Corrupting by teaching inappropriate aggressive, sexual or substance abuse behavior Exposing child to violence

Child Abuse Sexual When a person uses, or attempts to use, a child for their own sexual gratification Incest Rape Sodomy Unlawful sexual penetration Fondling Voyeurism Sexual harassment ORS 419.B005 C-D; ORS 163

Child Abuse Sexual Exploitation Using children in a sexually explicit way for personal gain Using children in prostitution Using children to create child pornography Allowing, or encouraging child to patronize a prostitute Contributing to the sexual delinquency of a minor, including when the minor’s sexual partner is 18 years or older (ORS 163)

Child Abuse Sexual activity of a minor must be reported Under Oregon reporting law, minor may not consent so sexual activity must be reported A report is not a conclusion that abuse has occurred Sexual activity may indicate there is sexual abuse You should disclose any of the following factors for reviewer’s consideration: Force was used Drug/alcohol use Power differential Age difference (3+ years) Impaired mentally or emotionally Coercion or intimidation Minor’s partner is 18 or older

Child Abuse Neglect Failure to provide: Adequate food, clothing, shelter, Supervision and guidance to protect the child from physical or mental harm Medical, dental or mental health care Exposing a child to illegal activities such as drug sales/manufacturing, theft, parental drug abuse (ORS ) Encouraging a child to use drugs or alcohol

Child Abuse Neglect (continued) Leaving a child alone in a position of authority beyond his ability to handle Each child must be looked at individually to make sure he or she is physically and emotionally able to handle the given responsibility The law does not specify the age at which a child can be left alone. However, a child younger than age 10 cannot be left unattended for such a period of time as may likely endanger the child’s health or welfare (ORS ).

Child Abuse Threat Of Harm Putting child in situations that pose a significant risk to their health or welfare For example: Living with, or cared for, by person with prior conviction of child abuse or neglect Living with a person involved in child pornography Caregiver behaviors that may endanger the child (substance abuse, mental health or physical problems)

Child Abuse Threat Of Harm (continued) A report should be made when there is current domestic violence or the alleged abuser has a history of domestic violence; and: There is a reason to believe the child has, or will, intervene in a violent situation The child is likely to be harmed during the violence The alleged abuser is not allowing the adult caregiver and child access to basic needs, impacting their health or safety The alleged abuser has killed, inflicted substantial harm, or is making a believable threat to do so to others, including pets Child is witnessing repeated or serious domestic violence

Child Abuse Selling or Trading Buying, selling, or trading legal or physical custody of a child Does not apply to legitimate adoptions or domestic relations planning (ORS )

Good Faith Report You do not have to prove that abuse occurred before making a report in good faith You must simply have a reasonable belief that abuse has occurred When in doubt, call the appropriate Child Welfare Agency or Law Enforcement Agency to seek a consultation ORS

Immunity of Person Making Report In Good Faith (Children) Anyone participating in good faith in the making of a report of child abuse and who has reasonable grounds for the making thereof shall have immunity from any liability, civil or criminal, that might otherwise be incurred or imposed with respect to the making or content of such report. Any such participant shall have the same immunity with respect to participating in any judicial proceeding resulting from such report (ORS 419B.025)

Reporting Suspected Abuse Children If you have reasonable cause to believe that: Any child you come in contact with has suffered abuse, or Any person with whom you have contact with has abused a child “Contact” is not just physical contact (phone, , letter) You must make a “good faith” report immediately to: Oregon Department of Human Services, Child Welfare at After hours and/or emergency reports, call law enforcement office or 911 Notify your supervisor (if MCHD client) Document the report in the client record (if MCHD client) Reporting suspected child abuse is a 24/7 hour responsibility!

Non-accidental injuries- Adults (18+) RN’s, LPN’s, MD’s are mandatory reporters Applies if a person examined by you has a non- accidental injury that is: A serious physical injury (risk of death, serious disfigurement, protracted health impairment), or A physical injury caused by a knife, gun or other dangerous weapon ORS

Reporting Suspected Non- Accidental Injuries In Adults (18+) If you suspect a patient under your care has a non-accidental injury that is serious or caused by a weapon, you must make a verbal report to law enforcement immediately: Within city limits – Report to city police Outside city limits – Report to Marion Co. Sheriff at (503) AND Your supervisor (if involves MCHD client) If a client, document the report in the client record In consultation with supervisor, submit a written follow-up report to law enforcement ASAP See guidance posted on MCHD Policy & Procedure page for more information ORS

Contact Numbers for Mandatory Abuse Reporting CHILDREN (Age 0-18) Oregon Department of Human Services (Child Welfare) SENIORS (MC Clients 65+) Senior and Disabled Services Division or Mentally Ill (MC Clients 18+) MH Adult Abuse Report Line or Developmentally Disabled (MC Clients 18+) DD Adult Abuse Report Line or Non-Accidental Injury (MC Patients/Clients 18+) Call City Police or for Rural Areas call MC Sheriff Mandatory Reporting Responsibility Children – 24/7 Mentally Ill, Seniors, Developmentally Disabled, Non-Accidental Injuries – When in official capacity

Conclusion This Mandatory Reporting training was updated and reviewed by the Marion County Legal Department in October If you have questions about information presented in this training, or need clarification of your mandatory reporting responsibilities, please contact your supervisor.

References “What you can do about child abuse”, DHS Oregon Dept of Human Services. Revised 10/

Quiz time You have completed Mandatory Reporting Training. To complete this training and receive credit, you must pass the quiz with 100%. Please click here and then click on ‘Health Deptclick here Mandatory Reporting Quiz’ to take the Mandatory Reporting quiz. Your results will be electronically submitted.