Who is mandated to report?

Are all health clinicians mandated to report?

  • Yes.  

Who else is a mandated reporter?

  • Persons required to report include professionals, for purposes of the reporting laws, who are licensed or certified by the State or who are an employees of facilities licensed, certified, or operated by the State and who, in the normal course of official duties or duties for which licensure or certification is required, have direct contact with children. Professionals include:
    • Teachers or daycare employees
    • Nurses, doctors, or employees of a clinic or health-care facility that provides reproductive services
    • Juvenile probation officers or juvenile detention or correctional officers

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 cause to believe that a child has been adversely affected by abuse or neglect.
  • In addition, a person or professional shall make a report if the person or professional has cause to believe that an adult was a victim of abuse or neglect as a child, and the person or professional determines in good faith that disclosure of the information is necessary to protect the health and safety of another child, an elderly person, or person with a disability.

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 or neglect as defined by Texas Family Code 261.001 and legal guidance interpreting the statute.
    • "Abuse" includes the following acts or omissions by a person:
      • mental or emotional injury to a child that results in an observable and material impairment in the child's growth, development, or psychological functioning;
      • causing or permitting the child to be in a situation in which the child sustains a mental or emotional injury that results in an observable and material impairment in the child's growth, development, or psychological functioning;
      • physical injury that results in substantial harm to the child, or the genuine threat of substantial harm from physical injury to the child, including an injury that is at variance with the history or explanation given and excluding an accident or reasonable discipline by a parent, guardian, or managing or possessory conservator that does not expose the child to a substantial risk of harm;
      • failure to make a reasonable effort to prevent an action by another person that results in physical injury that results in substantial harm to the child;
      • sexual conduct harmful to a child's mental, emotional, or physical welfare, including conduct that constitutes the offense of continuous sexual abuse of young child or children under Section 21.02, Penal Code, indecency with a child under Section 21.11, Penal Code, sexual assault under Section 22.011, Penal Code, or aggravated sexual assault under Section 22.021, Penal Code;
      • failure to make a reasonable effort to prevent sexual conduct harmful to a child;
      • compelling or encouraging the child to engage in sexual conduct as defined by Section 43.01, Penal Code, including compelling or encouraging the child in a manner that constitutes an offense of trafficking of persons under Section 20A.02(a)(7) or (8), Penal Code, prostitution under Section 43.02(b), Penal Code, or compelling prostitution under Section 43.05(a)(2), Penal Code;
      • causing, permitting, encouraging, engaging in, or allowing the photographing, filming, or depicting of the child if the person knew or should have known that the resulting photograph, film, or depiction of the child is obscene as defined by Section 43.21, Penal Code, or pornographic;
      • the current use by a person of a controlled substance as defined by Chapter 481, Health and Safety Code, in a manner or to the extent that the use results in physical, mental, or emotional injury to a child;
      • causing, expressly permitting, or encouraging a child to use a controlled substance as defined by Chapter 481, Health and Safety Code;
      • causing, permitting, encouraging, engaging in, or allowing a sexual performance by a child as defined by Section 43.25, Penal Code;
      • knowingly causing, permitting, encouraging, engaging in, or allowing a child to be trafficked in a manner punishable as an offense under Section 20A.02(a)(5), (6), (7), or (8), Penal Code, or the failure to make a reasonable effort to prevent a child from being trafficked in a manner punishable as an offense under any of those sections; or
      • forcing or coercing a child to enter into a marriage.
    • "Neglect" includes:
      • the leaving of a child in a situation where the child would be exposed to a substantial risk of physical or mental harm, without arranging for necessary care for the child, and the demonstration of an intent not to return by a parent, guardian, or managing or possessory conservator of the child;
      • the following acts or omissions by a person:
        • placing a child in or failing to remove a child from a situation that a reasonable person would realize requires judgment or actions beyond the child's level of maturity, physical condition, or mental abilities and that results in bodily injury or a substantial risk of immediate harm to the child;
        • failing to seek, obtain, or follow through with medical care for a child, with the failure resulting in or presenting a substantial risk of death, disfigurement, or bodily injury or with the failure resulting in an observable and material impairment to the growth, development, or functioning of the child;
        • the failure to provide a child with food, clothing, or shelter necessary to sustain the life or health of the child, excluding failure caused primarily by financial inability unless relief services had been offered and refused;
        • placing a child in or failing to remove the child from a situation in which the child would be exposed to a substantial risk of sexual conduct harmful to the child; or
        • placing a child in or failing to remove the child from a situation in which the child would be exposed to acts or omissions that constitute abuse under Subdivision (1)(E), (F), (G), (H), or (K) committed against another child;
      • the failure by the person responsible for a child's care, custody, or welfare to permit the child to return to the child's home without arranging for the necessary care for the child after the child has been absent from the home for any reason, including having been in residential placement or having run away; or
      • a negligent act or omission by an employee, volunteer, or other individual working under the auspices of a facility or program, including failure to comply with an individual treatment plan, plan of care, or individualized service plan, that causes or may cause substantial emotional harm or physical injury to, or the death of, a child served by the facility or program as further described by rule or policy.

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 Family Code at the Texas Constitution and Statutes website.

How to report:

What is the method of reporting?

  • An oral or written report must be made when a mandated reporter or any person has cause to believe that a child has been adversely affected by abuse or neglect.

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?

  • A professional who has cause to believe that a child has been abused or neglected or may be abused or neglected shall make a report no later than 48 hours after the professional first suspects that the child may be abused or neglected.

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 report shall be made to a law enforcement agency, the Department of Family and Protective Services, or the agency that operates or licenses the facility where the abuse or neglect occurred.
  • The report must be made to the department if the alleged or suspected abuse or neglect involves a person responsible for the care, custody, or welfare of the child.
  • A report of alleged abuse, neglect, or exploitation in any juvenile justice program or facility shall be made to the Texas Juvenile Justice Department and a local law enforcement agency for investigation.  

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

State/County Hotline?

  • Abuse Hotline (24 hours a day, 7 days a week)
  • 1-800-252-5400
  • You can also make a report online at the Texas Abuse Hotline 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.