firearm. Such injuries inevitably include instances of intimate partner violence.7 In addition to these laws that address the issue indirectly, three states—California, Colorado, and Rhode Island—explicitly require the reporting of intimate partner abuse, and one—Kentucky—requires the reporting of abuse, neglect, or exploitation of any adult

California and Colorado require that reports be made to law enforcement agencies. Kentucky and Rhode Island, in contrast, require reporting solely for the purpose of documenting the incidence of family violence. As a result, it requires health professionals to report to monitoring agencies, rather than to law enforcement.

The typical legal standard that triggers these reporting requirements is “reasonable cause to suspect” or “reasonable cause to believe.” Kentucky requires physicians, dentists, mental health professionals, nurses, social workers, and some allied health workers to report intimate partner violence. California and Rhode Island do not apply this requirement to mental health professionals or social workers. Colorado requires only physicians to report intimate partner violence.

Elder Maltreatment. In all, 43 states and the District of Columbia mandate the reporting of elder maltreatment by health professionals. (The exceptions are: Colorado, New Jersey, New York, North Dakota, Pennsylvania, South Dakota, and Wisconsin.) These states vary in terms of the types of injury that must be reported. Most states require reporting of “abuse, neglect, or exploitation.” Others also require reporting of “mistreatment” (Minnesota); the “need [for] protective services” (Delaware, District of Columbia., Kansas, North Carolina, Missouri, and Pennsylvania); “isolation” (Nevada); “abandonment” (Alaska, California, Connecticut, Rhode Island, and Wyoming); or “financial exploitation” (California, Illinois, and Washington).

Some states have built in special exceptions to their elder maltreatment reporting requirements. For example, a California health professional need not report evidence of elder abuse if he or she “reasonably believes” that abuse did not occur in his or her “best clinical judgment.”

The legal standard that triggers the reporting requirement also varies. In all, 39 states have adopted a “reasonable cause to believe” or “reasonable cause to suspect” standard. Other states dictate that a health professional “know,” “observe,” or “suspect” abuse before a report is required.

Just over half the states require reporting directly to the local department of health and human services or protective services agency. An additional 15 states also permit reporting to law enforcement officials. Two states—Alaska and


New Hampshire has enacted such a law, but it includes a statutory exception that limits the mandatory reporting of intimate partner violence. Specifically, the law exempts reporting when a patient is the victim of sexual assault or domestic violence, is at least 18 years old, and objects to having the information reported to law enforcement. This exemption does not apply, however, if the victim is being treated for a gunshot wound or other “serious” injury.

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