Who is mandated to report?

Are all health clinicians mandated to report?

  • Yes.

Who else is a mandated reporter?

  • Physicians in training
  • Psychologists
  • Dentists
  • Nurses
  • Chiropractors
  • Other health-related professionals
  • Child care employees

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, in his or her professional or official capacity, a reporter has reason to believe that child abuse or neglect has occurred or that there exists a substantial risk that child abuse or neglect may occur in the reasonably foreseeable future.

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 child abuse or neglect as defined by Hawaii Statute 350-1 and any case law and other legal guidance interpreting this statute.
  • “Child abuse or neglect” means:
    • The acts or omissions of any person that have resulted in sex trafficking or severe forms of trafficking in persons; provided that no finding by the department pursuant to this chapter shall be used as conclusive evidence that a person has committed an offense under part VIII of chapter 707 or section 712-1202. "Sex trafficking" has the same meaning as provided in title 22 United States Code Annotated section 7102(10). [L 1982, c 77, §1; am L 1983, c 171, §5; am L 1987, c 204, §3 and c 339, §4; am L 1988, c 141, §29; am L 2013, c 246, §3; am L 2017, c 16, §2]
    • The acts or omissions of any person who, or legal entity which, is in any manner or degree related to the child, is residing with the child, or is otherwise responsible for the child's care, that have resulted in the physical or psychological health or welfare of the child, who is under the age of eighteen, to be harmed, or to be subject to any reasonably foreseeable, substantial risk of being harmed. The acts or omissions are indicated for the purposes of reports by circumstances that include but are not limited to:
      • When the child exhibits evidence of:
        • Substantial or multiple skin bruising or any other internal bleeding;
        • Any injury to skin causing substantial bleeding;
        • Malnutrition;
        • Failure to thrive;
        • Burn or burns;
        • Poisoning;
        • Fracture of any bone;
        • Subdural hematoma;
        • Soft tissue swelling;
        • Extreme pain;
        • Extreme mental distress;
        • Gross degradation; or
        • Death; and such injury is not justifiably explained, or when the history given concerning such condition or death is at variance with the degree or type of such condition or death, or circumstances indicate that such condition or death may not be the product of an accidental occurrence;
      • When the child has been the victim of sexual contact or conduct, including but not limited to sexual assault as defined in the Penal Code, molestation, sexual fondling, incest, or prostitution; obscene or pornographic photographing, filming, or depiction; or other similar forms of sexual exploitation, including but not limited to acts that constitute an offense pursuant to section 712-1202(1)(b);
      • When there exists injury to the psychological capacity of a child as is evidenced by an observable and substantial impairment in the child's ability to function;
      • When the child is not provided in a timely manner with adequate food, clothing, shelter, psychological care, physical care, medical care, or supervision;
      • When the child is provided with dangerous, harmful, or detrimental drugs as defined by section 712-1240; provided that this subparagraph shall not apply when such drugs are provided to the child pursuant to the direction or prescription of a practitioner, as defined in section 712-1240; or
      • When the child has been the victim of labor trafficking under chapter 707.

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?

For the most current definitions of these terms, refer to the Hawaii State Legislature website.

How to report:

What is the method of reporting?

  • A mandated reporter who has reason to believe that child abuse or neglect has occurred shall immediately report the matter orally to the Department of Human Services or the police department. The initial oral report shall be followed as soon as possible by a report in writing to the 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?

  • Immediately. The initial oral report shall be followed by a written report as soon as possible.

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?

  • The Department of Human Services shall receive reports concerning child abuse or neglect. The department shall inform the appropriate police department or office of the prosecuting attorney of the relevant information concerning a case of child abuse or neglect when the information is required for the investigation or prosecution of that case.

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

State/County Hotline?

  • Department of Human Services
  • Child Abuse: 1-808-832-5300
  • Child Abuse Reporting from neighboring islands: 1-888-380-3088

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.