Who is mandated to report?

Are all health clinicians mandated to report?

  • Yes.

Who else is a mandated reporter?

  • Physicians, medical examiners, dentists, osteopaths, optometrists, chiropractors, podiatrists, interns, nurses, hospital personnel, or Christian Science practitioners
  • Clergy members
  • School administrators, teachers, nurses, or counselors
  • Social services workers, daycare center workers, or any other child care or foster care workers
  • Mental health professionals, peace officers, or law enforcement officials
  • Commercial film and photographic print processors

For more information, refer to Mandatory Reporters of Child Abuse and Neglect at the Child Welfare Information Gateway.

When is the reporting duty triggered?

What is the standard?

  • A report is required when:
    • A reporter, who in the course of his or her employment, occupation, or professional practice comes into contact with children, has reason to suspect on the basis of his or her medical, professional, or other training and experience that a child is an abused or neglected child.
    • Any commercial film and photographic print processor has knowledge of or observes any film, photograph, videotape, negative, or slide depicting a child under age 18 engaged in an act of sexual conduct.

For more information, refer to Mandatory Reporters of Child Abuse and Neglect at the Child Welfare Information Gateway.

What must be reported?

How does state law define child abuse and neglect for reporting purposes?

  • Mandated reporters must report an “abused or neglected child” as defined by Guam Code Title 19, section 13101 and any case law and other legal guidance interpreting the statute.
    • Abused or neglected child means a child whose physical or mental health or welfare is harmed or threatened with harm by the acts or omissions of the person(s) responsible for the child’s welfare.
      • Harm to a child’s physical health or welfare occurs in a case where there exists evidence of injury, including but not limited to:
        • Any case where the child exhibits evidence of:
          • Skin bruising or any other internal bleeding,
          • Any injury to skin causing bleeding,
          • Burn or burns,
          • Poisoning,
          • Fracture of any bone,
          • Subdural hematoma,
          • Soft tissue swelling,
          • Extreme pain,
          • Death, or
          • Disfigurement or impairment of any bodily organ, and such injury is inflicted by other than accidental means, by excessive corporal punishment or where the history given concerning such condition or death is at variance with the degree or type of such condition or death; or
        • Any case where the child has been the victim of a sexual offense as defined in the Criminal and Correctional Code; or
        • Any case where there exists injury to the psychological capacity of a child such as failure to thrive, extreme mental distress, or gross emotional or verbal degradation as is evidenced by an observable and substantial impairment in the child’s ability to function within a normal range of performance with due regard to the child’s culture; or
        • Any case where the physical health of the child is adversely affected because the person responsible for the child’s welfare has not regularly provided the child, in a timely manner, with adequate food, clothing, shelter, psychological care, physical care, health care or supervision, when financially able to do so or if offered financial assistance or health care or other reasonable means to do so. “Adequate health care” includes any medical or non-medical health care permitted or authorized under territorial laws; provided, however, that a person responsible for the child’s welfare who, while legitimately practicing his or her religious beliefs, does not specify medical treatment for a child should not for that reason alone be considered as harming or threatening harm to the child; or
        • Any case where the child is provided with a controlled substance as defined by the Criminal and Correctional Code. However, this paragraph shall not apply to a child’s family who provides such drugs to the child pursuant to the direction or prescription of a practitioner as defined in § 67.12(t) of the Criminal and Correctional Code of Guam; or
        • Any case where the child is abandoned.

Are child molestation, sexual abuse, rape, statutory rape, incest, intimate partner violence, sexual exploitation and/or trafficking of a minor reportable as child abuse or neglect and if so, how are they defined and what is reportable?

Please see the statutes and definitions above as well as any related interpretative legal guidance, and please consult with legal counsel with expertise in reporting law to answer this question.

For the most current definitions of these terms, refer to the Child Protective Act at the Guam Courts website.

How to report:

What is the method of reporting?

  • Mandated reporters shall report cases of suspected abuse to child protective services (CPS) or the police immediately by telephone and follow up in writing within 48 hours. Oral reports shall be made to CPS or to the police department.

For more information, refer to Making and Screening Reports of Child Abuse and Neglect at the Child Welfare Information Gateway.

What is the timeline in which to report?

  • An oral report must be made immediately and is to be followed up in writing within 48 hours.

For more information, refer to Making and Screening Reports of Child Abuse and Neglect at the Child Welfare Information Gateway.

To whom are reports made?

  • CPS shall receive all reports, both oral and written, of suspected child abuse or neglect 7 days a week, 24 hours a day.

For more information, refer to Making and Screening Reports of Child Abuse and Neglect at the Child Welfare Information Gateway.

State/County Hotline?

  • Childhelp National Child Abuse Hotline
  • 1-800-422-4453

Confidentiality:

What federal confidentiality laws apply to health information collected during a Title X visit?

  • Title X regulations 42 CFR 59.11
  • HIPAA 45 CFR 164.502

Is there an exception in federal confidentiality law that allows a clinician to comply with mandatory child abuse reporting laws?

  • Yes.