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Mandatory Reporting for Minors. PPNEO Health Services Training February 2011. From your PPNEO Orientation Day or previous PP experience you may remember….
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Mandatory Reporting for Minors PPNEO Health Services Training February 2011
From your PPNEO Orientation Day or previous PP experience you may remember….. Under Ohio law, any physician, nurse, other health care professional or social worker having “reason to believe” that a child under 18 years of age has suffered any abuse, shall immediately report or cause report to be made of such information to the Children’s Service Board (CSB) or the County Department of Welfare. Or in other words: PPNEO Health Center staff are mandatory reporters of child abuse.
Also, Life Dynamics PPNEO staff have always had guidelines for reporting abuse of minors. The issue gained attention throughout PPFA several years ago due to phone calls made by an anti-choice organization, Life Dynamics
Also, Life Dynamics This group’s callers presented situations on the phone to try to trap PPH staff into coaching young women to lie about their sexual partners, similar to the Lila Rose attacks. These calls were recorded but national media never really took on the story as legitimate.
Now, Live Action Now we have Lila Rose and her group Live Action, who have vowed to ruin Planned Parenthood’s reputation. Their carefully edited videos posted on YouTube are evidence of their intent.
Be Prepared! As PPNEO staff, our best defense against anti-choice attacks: • Understand Ohio’s laws regarding sexual abuse of minors • Know what to do if you suspect abuse is occurring
FAQ • If a report is made, won’t that be a breach of confidentiality and harm the patients’ trust in Planned Parenthood? • Protecting confidentiality is a crucial, core concept for all Planned Parenthoods. However, there is a limit and that limit is when the patient potentially is not safe. • Exceptions to confidentiality rule per HIPAA: • Reporting positive STI’s to health dept • Reporting suspected abuse of minors
FAQ • Where do we call to report? • Reports are made to local authorities such as Cuyahoga County Job and Family Services, and Summit County Children’s Services. • You can check your center’s Medical Manual for the reporting agency in your service area • Generally we are not reporting to law enforcement.
FAQ • Who makes the report? • the Health Center staff member who learns of the situation, or • any staff member the team in the Health Center decides is appropriate. Could be your Manager, Clinician, etc. • How is the report made? • Follow the Medical Standards and Guidelines (Section 1-C-2) for how to make the report, e.g., report is confidential.
Quick Reference Table This table alerts us about when, as medical providers, we must make a report; and should be easily accessible in your center so you have it when you need it.
Making Sexual Assault Reports for Minors Reporting minors who have been raped requires our best client centered service. It may remind them of the assault, bringing up feelings. But remember, it is important to assure that their parent/guardian and authorities know about the assault. Note, we must report, even if the minor says she/he has informed parents/guardian, and/or reported to authorities, or that the assault occurred long ago. If your service area has a rape crisis service or hotline, make the appropriate referral for the client, as well as making the report.
Use Your Judgment While the Quick Reference Table is very clear, use your judgment, too. For example, if a 12 year old is in your Health Center for a pregnancy test, you will almost always make a report. If she is concerned she could be pregnant, and it is clear she has had sex - you have to report. But what if her mother has brought her in and the client says she has never had sex? --You would not automatically report. Use your judgment and/or ask for help from your clinician or manager.
What is “sex” or a “sexual partner”? • Does oral sex count? What about “just touching?” • What if both people are female? • What if the victim is male? --Oral, anal and vaginal sex all “count.” So does touching of “erogenous areas.” The gender of the partners do not matter, only their age and relationship.
Should we inform the patient we will be making the report? Client Centered Service is our standard, so yes, we inform the patient. (A Manager or Clinician may decide not to in rare circumstances.) Patients are sometimes initially upset by this news, but expressing our concern for their safety and assisting them with this process should help comfort them. Patients often are not upset, as authorities already have been to the home. They may also be relieved that we’re helping them.
Be clear and direct when informing the patient Anti-Planned Parenthood groups (like Life Dynamics) have made accusations that we coach patients when making appointments. They have accused PPH of informing the client before her visit that if she discloses the partner’s age during the visit, we will have to make a report --thereby “coaching” the patient not to mention it. We do not coach the patient. During a patient’s visit, if we learn reportable information, a report is made. If we learn reportable information before the patient is registered, including on the phone, we encourage the patient to make the appointment. We want the patient to come in for services because they need our services and we want to make the appropriate report when they do come in.
What if the patient asks this directly on the phone while making an appointment? Again, Client Centered Service is our standard, and we answer the question accurately and honestly, clearly and directly. E.g., “Yes, that would be reportable information.” But don’t dwell on this - encourage the patient to come in. Note, if caller asks “What is your procedure” for this, forward the call to Sue Hirt. (Center staff provide patient care, not administrative duties like answering questions about routine policies).
Avoid Entrapment If you believe you are being entrapped by an individual with less than legitimate intentions, end the conversation quickly and politely. Refer the call or individual to your manager or clinician. Avoid getting into a situation where you may be off guard and then fall off message or off procedure.
Red Flags! These are some situations that would alert you to be cautious – this could be a trap: • You have been given information that is very unusual or unfamiliar to you, i.e.: “I’m a pimp” or “I’m involved with sex trafficking” • The client has no appointment – “just wants to talk with someone.” • The same client is reluctant to sign in or complete a registration form/ has no ID
Red Flags! Whether or not the situation is legitimate, • If you are uncomfortable with the information the client is giving you… • If you are not sure how to proceed… Get Help!
Helpful Tips Some statements to use in a “red flag” situation: • “Let me get someone who can better answer your questions” • “I’m not sure I can answer all your questions – let me get my manager.” • “What you are telling me is a reportable offense. Let me get someone to help us.”
Helpful Tips Remember: you are a health care provider and should remain professional at all times. • You are not the patient’s “buddy” • You are not there to help them “get around the system” • You are there to assure that the patient gets the medical care she/he needs and that minor patients are in safe, non-abusive situations
That’s All! Please open the quiz for this module and complete the quiz. Then E-mail, scan or fax your completed quiz to Sheryl Stebbins, Health Services Training Coordinator, so you can officially complete this training module.
