Who is mandated to report?

Are all health clinicians mandated to report?

  • Yes.  

Who else is a mandated reporter?

  • Hospital personnel
  • Health or mental health professionals
  • Professional child care, foster care, residential, or institutional workers
  • Social workers
  • Neighbors, relatives, or friends

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 person has knowledge that a child has been harmed by abuse or neglect.
    • A person is called upon to render aid to any child who is suffering from an injury that reasonably appears to have been caused by brutality, abuse or neglect.
    • A person knows or has reasonable cause to suspect that a child has been sexually abused.
    • Every physician or other person who makes a diagnosis of, or treats, or prescribes for any sexually transmitted disease set out in § 68-10-112, or venereal herpes and chlamydia, in children thirteen (13) years of age or younger, and every superintendent or manager of a clinic, dispensary or charitable or penal institution, in which there is a case of any of the diseases, as set out in this subsection (f), in children thirteen (13) years of age or younger shall report the case immediately, in writing on a form supplied by the department of health to that department. If the reported cases are confirmed and if sexual abuse is suspected, the department of health will report the case to the department of children's services. The department of children's services will be responsible for any necessary follow-up
    • Every physician or other person who makes an initial diagnosis of pregnancy to an unemancipated minor, and every superintendent or manager of a clinic, dispensary or charitable or penal institution in which there is a case of an unemancipated minor who is determined to be pregnant, shall provide to the minor's parent, if the parent is present, and the minor consents, any readily available written information on how to report to the department of children's services an occurrence of sex abuse that may have resulted in the minor's pregnancy, unless disclosure to the parent would violate the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), 42 U.S.C. § 1320d et seq., or the regulations promulgated pursuant to the act.
    • Any school official, personnel, employee, or member of the board of education who is aware of a report or investigation of employee misconduct on the part of any employee of the school system that in any way involves known or alleged child abuse, including, but not limited to, child physical or sexual abuse or neglect, shall immediately upon knowledge of such information notify the Department of Children’s Services or law enforcement official of the abuse or alleged abuse.

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 abuse, neglect, brutality and child sexual abuse as defined by Tennessee statutes 37-1-102 and 37-1-602 and legal guidance interpreting the statutes.
    • "Abuse" exists when a person under the age of eighteen (18) is suffering from, has sustained, or may be in immediate danger of suffering from or sustaining a wound, injury, disability or physical or mental condition caused by brutality, neglect or other actions or inactions of a parent, relative, guardian or caretaker;
    • "Child sexual abuse" means the commission of any act involving the unlawful sexual abuse, molestation, fondling or carnal knowledge of a child under thirteen (13) years of age that prior to November 1, 1989, constituted the criminal offense of:
      • Aggravated rape under § 39-2-603 [repealed];
      • Aggravated sexual battery under § 39-2-606 [repealed];
      • Assault with intent to commit rape or attempt to commit rape or sexual battery under § 39-2-608 [repealed];
      • Begetting child on wife's sister under § 39-4-307 [repealed];
      • Crimes against nature under § 39-2-612 [repealed];
      • Incest under § 39-4-306 [repealed];
      • Promotion of performance including sexual conduct by minor under § 39-6-1138 [repealed];
      • Rape under § 39-2-604 [repealed];
      • Sexual battery under § 39-2-607 [repealed]; or
      • Use of minor for obscene purposes under § 39-6-1137 [repealed];
    • "Child sexual abuse" also means the commission of any act involving the unlawful sexual abuse, molestation, fondling or carnal knowledge of a child under thirteen (13) years of age that on or after November 1, 1989, constituted the criminal offense of:
      • Aggravated rape under § 39-13-502;
      • Aggravated sexual battery under § 39-13-504;
      • Aggravated sexual exploitation of a minor under § 39-17-1004;
      • Criminal attempt as provided in § 39-12-101 for any of the offenses in (a)(3)(B)(i)-(iii);
      • Especially aggravated sexual exploitation of a minor under § 39-17-1005;
      • Incest under § 39-15-302;
      • Rape under § 39-13-503;
      • Sexual battery under § 39-13-505; or
      • Sexual exploitation of a minor under § 39-17-1003;
    • "Child sexual abuse" also means one (1) or more of the following acts:
      • Any penetration, however slight, of the vagina or anal opening of one (1) person by the penis of another person, whether or not there is the emission of semen;
      • Any contact between the genitals or anal opening of one (1) person and the mouth or tongue of another person;
      • Any intrusion by one (1) person into the genitals or anal opening of another person, including the use of any object for this purpose, except that it shall not include acts intended for a valid medical purpose;
      • The intentional touching of the genitals or intimate parts, including the breasts, genital area, groin, inner thighs, and buttocks, or the clothing covering them, of either the child or the perpetrator, except that it shall not include:
        • Acts that may reasonably be construed to be normal caretaker responsibilities, interactions with, or affection for a child; or
        • Acts intended for a valid medical purpose;
      • The intentional exposure of the perpetrator's genitals in the presence of a child, or any other sexual act intentionally perpetrated in the presence of a child, if such exposure or sexual act is for the purpose of sexual arousal or gratification, aggression, degradation, or other similar purpose;
      • The sexual exploitation of a child, which includes allowing, encouraging, or forcing a child to:
        • Solicit for or engage in prostitution; or
        • Engage in an act prohibited by § 39-17-1003;
      • The commission of any act towards the child prohibited by § 39-13-309; and
    • For the purposes of the reporting, investigation, and treatment provisions of §§ 37-1-603 -- 37-1-615 "child sexual abuse" also means the commission of any act specified in subdivisions (a)(3)(A)-(C) against a child thirteen (13) years of age through seventeen (17) years of age if such act is committed against the child by a parent, guardian, relative, person residing in the child's home, or other person responsible for the care and custody of the child;

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 Tennessee Statutes at the Lexis website and the Tennessee Child Abuse Hotline FAQ website.

How to report:

What is the method of reporting?

  • If there is reason to suspect that a child has been subject to child abuse or neglect a report must be made orally.

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?

  • When there is knowledge that a child has been subjected to child abuse or neglect.

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 county office of the department shall investigate an oral or written report of harm. If the report of child abuse alleges physical abuse, it shall be in the best interests of the child that the child be referred to a child advocacy center or that the investigation be conducted by a child protective services investigator who is adequately trained in investigating physical abuse reports. Under no circumstances shall the investigation be performed by a probation officer previously assigned to the child.
  • In cases involving child sexual abuse, the investigation shall be conducted by a child protective investigation team. Each team shall be composed of one person from the department, one representative from the office of the district attorney general, one juvenile court officer or investigator from a court of competent jurisdiction, and one properly trained law enforcement officer with countywide jurisdiction from the county where the child resides or where the alleged offense occurred. The team also may include a representative from one of the mental health disciplines. It is in the best interests of the child that, whenever possible, an initial investigation shall not be commenced unless all four disciplines are represented. An initial investigation may, however, be commenced if at least two of the team members are present at the initial investigation.
  • It is the intent of the general assembly that the child protective investigations be conducted by the team members in a manner that not only protects the child but that also preserves any evidence for future criminal prosecutions.

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

State/County Hotline?

  • Child Abuse Hotline
  • 1-877-237-0004
  • You can also make an online report at the Tennessee Department of Children’s Services’ secure website.  

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.