What Optometrists Should Know about Mandated Reporting

Optometrists’ role as mandated reporters

Child abuse and neglect

Parental substance abuse

1. Infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.
2. Prenatal exposure to, or abuse of, controlled substances.
3. Manufacturing a controlled substance in the presence of a child, or on premises occupied by a child.
4. Exposing a child to, or allowing a child to be present, where chemicals or equipment for manufacturing controlled substances are used or stored.
5. Selling, distributing, or giving drugs or alcohol to a child.
6. Caregiver's use a controlled substance that impairs their ability to care for a child.
7. Exposing a child to the criminal sale or distribution of drugs.²

Elder and dependent adult abuse

Dependent adult abuse

Violent injuries (non-accidental and criminal conduct)

Interpersonal violence

Domestic violence

Human trafficking

“These human trafficking definitions are additive to the current child abuse and neglect laws and allow child protective agencies to respond to trafficking in minors.”

Visual impairment, seizures, and lapses of consciousness

Professional misconduct

Infectious disease

“Because of each state’s autonomy, there are many differences as to what conditions and diseases need to be reported, persons required to report, specific time frames, and conditions for reporting.”

Reporting protocol

HIPAA

Consent

Criteria and information

1. Your name, address, telephone number, and relationship, if any, to the child.
2. Identifying information about the child, parent, or other caregivers, such as names, ages, races, and genders for adult and child subjects.
3. Addresses, contact information, and emergency contacts, if any, for all victims and perpetrators, including the current location.
4. Any information to make safe contact.
5. Information about siblings or other family members.
6. Languages spoken by the individuals involved in the incident and their families.
7. Specific information about the abusive incident, such as a description of the time and place of the incident and circumstances under which you first became aware of the injuries, including dates or time frames.
8. Documentation of the extent of the injuries, such as location, severity, patterns, and chronicity of similar injuries over time.
9. What treatment or action, if any, has been taking taken thus far to treat the child's medical condition.
10. Photographs, if any.
11. Evidence if there was an instrument used to inflict injury.
12. Any pertinent behavioral, mental, or emotional problems, developmental disabilities, physical disabilities, or special needs that may interfere with the child's ability to protect themself.
13. What the child said happened.
14. Any concerns about alcohol or drug use by the parent or caregiver.
15. Possible witnesses of the abuse or neglect.
16. Previous history of abuse or neglect.

Immunity for mandated reporters

Fines and/or penalties for non-compliance

Mandatory training

Patient education and communication

“It is the optometrist’s individual duty to have knowledge of what situations need to be reported and how to report them, observing state law reporting protocols in the process.”

State-specific mandated reporting requirements

Alabama

• Professional misconduct
  • The Alabama State Board of Optometry has a confidential program for impaired optometrists seeking assistance.
  • An optometrist who voluntarily self-reports their impairment for treatment and then successfully completes therapy recommended by the Board can continue to practice optometry without discipline.¹⁹ Information can be found at their website.

Alaska

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
• Violence-inflicted injuries/domestic violence
  • Healthcare workers are required to report certain injuries including bullet wounds, gunshot wounds, injuries apparently caused by the discharge of a firearm, non-accidental injuries caused by knives or other sharp pointed instruments, and certain burns and injuries likely to cause death.⁶

Arizona

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.
    2. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.
    3. Exposing a child to, or allowing a child to be present where, chemicals or equipment for the manufacture of controlled substances exist.
• Violence-inflicted injuries/domestic violence
  • Only physicians, surgeons, nurses, and hospital attendants are required to report gunshot wounds, knife wounds, and material injuries resulting from fights, brawls, robberies, or other illegal or unlawful acts.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
• Professional misconduct
  • The Arizona State Board of Optometry requires that an optometrist or applicant for optometric licensure who has been charged with a felony or misdemeanor involving conduct that may affect patient safety, must notify the Board in writing within 10 working days after the charge is filed.²¹

Arkansas

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.
    2. Exposing a child to, or allowing a child to be present where, chemicals or equipment for the manufacture of controlled substances are used or stored require notification.
    3. Selling, distributing, or giving drugs or alcohol to a child.²
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report knife and gunshot wounds when the wounds appear to have been intentionally inflicted.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking
• Professional misconduct
  • The Arkansas State Board of Optometry allows voluntary self-reporting by optometrists for participation in their Impaired Optometric Treatment Program.²²
  • Information regarding program participation can be found here.

California

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Caregiver use of a controlled substance that impairs their ability to care for a child.
• Elder/dependent adult abuse definitions
  • Elder abuse
  • Dependent adult abuse
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report injuries caused by assaultive or abusive conduct, as well as injuries caused by firearms.⁶
  • An optometrist is required to report to local law enforcement if they provide medical services for a physical condition to a patient who they know or reasonably suspect is suffering from any wound or other physical injury that is the result of assaultive or abusive conduct, including sexual assault, or any person suffering from any wound or other physical injury inflicted by their own act or inflicted by another where the injury is by means of a firearm.²³
  • Documentation: Patient injuries or illnesses attributable to spousal or partner abuse must be documented in the patient medical record.²³
  • Patient education: Patients who exhibit signs of spousal or partner abuse should be given information on current referral lists of private and public community agencies that provide, or arrange for, the evaluation, counseling, and care of persons experiencing spousal or partner abuse, including, but not limited to, hotlines, local battered women’s shelters, legal services, and information about temporary restraining orders.²³
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
• Visual impairment, seizures, and lapses of consciousness
  • Patients aged 14 years and older diagnosed with any disorder characterized by lapses of consciousness should be reported to the Department of Motor Vehicles (DMV).²⁴
• Professional misconduct
  • The California State Board of Optometry requires optometrists (or their attorney, if represented by counsel) to report any settlement, judgment, or arbitration award over $3,000 of a claim or action for damages for death or personal injury caused by the licensee’s negligence, error or omission in practice, or by rendering of unauthorized professional services.²⁵

Colorado

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.
    2. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.²
• Elder/dependent adult abuse definitions
  • Elder abuse
  • Dependent adult abuse
• Violence-inflicted injuries/domestic violence
  • There is a mandatory requirement to report any “injury that the licensee has reason to believe involves a criminal act, including injuries resulting from domestic violence."
  • Every licensee has a duty to report gunshot wounds and injuries caused by knives or sharp pointed instruments that the licensee believes were intentionally inflicted.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
• Professional misconduct
  • The Colorado State Board of Optometry considers unprofessional conduct to be the failure to notify the board of the following:
    1. Any physical illness, physical condition, behavioral, mental health, or substance use disorder that renders an optometrist unable to treat with reasonable skill and safety.
    2. Final malpractice judgment or settlement.
    3. Conviction of a felony, acceptance of a plea of guilty or nolo contendere, or a plea resulting in a deferred sentence to a felony.
    4. Any optometrist engaging in unprofessional conduct.
    5. Surrender of a license or any adverse action taken by another licensing agency in another state or jurisdiction.²⁶

Connecticut

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.²
• Elder/dependent adult abuse definitions
  • Elder abuse
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report bullet wounds, gunshot wounds, and wounds arising from the discharge of a firearm.⁶
• Professional misconduct
  • Effective October 1, 2015, any healthcare professional shall file a petition if there is any information that appears to show that a healthcare professional is or may be unable to practice their profession with reasonable skill or safety due to:
    1. Physical illness or loss of motor skill, including, but not limited to, deterioration through the aging process.
    2. Abuse or excessive use of drugs, including alcohol, narcotics, or chemicals.
    3. Illegal, incompetent, or negligent conduct in the practice of the profession of the healthcare professional.
    4. Possession, use, prescription for use, or distribution of controlled substances or legend drugs, except for therapeutic or other medically proper purposes.
    5. Misrepresentation or concealment of a material fact in the obtaining or reinstatement of a license to practice the profession of the healthcare professional.²⁷

Delaware

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Caregiver use of a controlled substance that impairs their ability to care for a child.²
• Elder/dependent adult abuse
  • Delaware has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report stab wounds, gunshot wounds, bullet wounds, powder burns, injuries caused by the discharge of a firearm, and poisonings by other than accidental means.⁶
• Visual impairment, seizures, and lapses of consciousness
  • Patients with recurrent loss of consciousness due to a central nervous system disease should be reported to the DMV within 1 week.²⁸
• Professional misconduct
  • Delaware-licensed healthcare providers have the mandatory duty to report unfit practitioners or may be guilty of unprofessional conduct within 30 days of becoming aware of this information.²⁹

District of Columbia

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.
    2. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.
    3. Exposing a child to the criminal sale or distribution of drugs.²
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report injuries inflicted by a firearm or dangerous weapon sustained in the commission of a crime.⁶

Florida

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.
    2. Evidence of selling, distributing, or giving drugs or alcohol to a child.
    3. Caregiver use of a controlled substance that impairs their ability to care for a child.²
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report gunshot wounds and life-threatening injuries indicating an act of violence.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
• Professional misconduct
  • Effective January 1, 2014, certified optometrists are required to report to the Department of Health any adverse incidents in the practice of optometry. An adverse incident is defined as “any of the following events when it is reasonable to believe that the event is attributable to the prescription of an oral ocular pharmaceutical agent” by a certified optometrist.³⁰
  • Florida’s reporting procedures can be found here.
  • Adverse events that optometrists must report in:
    1. Any condition requiring a patient’s transfer to a hospital.
    2. Any condition that requires care and treatment from a physician, other than a referral or consultation.
    3. Permanent physical injury to the patient.
    4. Partial or complete permanent loss of sight by the patient.
    5. Death of the patient.³⁰

Georgia

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.²
• Elder/dependent adult abuse definitions
  • Elder abuse
  • Dependent adult abuse
• Violence-inflicted injuries/domestic violence
  • Only hospital administrators are required to report non-accidental injuries.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking

Guam

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Evidence of selling, distributing, or giving drugs or alcohol to a child.²
• Elder/dependent adult abuse definitions
  • Elder abuse
  • Dependent adult abuse

Hawaii

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Evidence of selling, distributing, or giving drugs or alcohol to a child.²
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report knife wounds, bullet wounds, and gunshot wounds.
  • Further, it is mandatory to report any injury that would seriously maim, produce death, or that has rendered the injured person unconscious, caused by the use of violence or sustained in a suspicious or unusual manner.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking

Idaho

• Violence-inflicted injuries/domestic violence
  • It is mandatory to report injuries inflicted by firearms.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking

Illinois

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • Prenatal substance exposure/and or abuse is required to be reported in order that the pregnant mother can be referred for treatment.²
  • State civil definitions of child abuse or neglect include:
    1. Evidence of selling, distributing, or giving drugs or alcohol to a child.
• Violence-inflicted injuries/domestic violence
  • It is required to report injuries resulting from the discharge of a firearm.⁶
  • Patient education: Optometrists shall offer to a person suspected to be a victim of abuse immediate and adequate information regarding services available to victims of abuse.²³
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking

Indiana

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.
    2. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.²
• Elder/dependent adult abuse
  • Indiana has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • There is a duty to report injuries from guns, firearms, knives, ice picks, and other sharp-pointed instruments, as well as certain burns and injuries caused by the manufacture or use of destructive devices.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking

Iowa

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Caregiver use of a controlled substance that impairs their ability to care for a child.
    2. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.
    3. Exposing a child to, or allowing a child to be present where, chemicals or equipment for the manufacture of controlled substances are used or stored.
    4. Evidence of selling, distributing, or giving drugs or alcohol to a child.
    5. Exposure of a child to the criminal sale or distribution of drugs.²
• Violence-inflicted injuries/domestic violence
  • Iowa law requires medical providers to treat gunshots, stab wounds, or other serious injuries which appear to have been received in connection with the commission of a criminal offense, and to report the injuries to law enforcement.⁶
• Professional misconduct
  • Licensed optometrists who self-report are eligible for the Impaired Practitioner Program which is designed to assist licensees with successful recovery from alcohol and drug dependence, mental health impairments, and physical impairments, so that they may continue to safely practice their profession.³¹
  • Information about the program and the necessary forms can be found here.
• Continuing Education (CE)
  • Optometrists are mandated reporters in the state of Iowa and as such, must complete 2 hours of training within 6 months of employment or self-employment, and require 1 hour of additional training every 3 years.
  • The child and dependent adult abuse training can no longer be combined into a 2-hour course. Both the child and dependent adult abuse core training will be 2 hours each.³²
  • All mandatory reporters are required to take the core (2 hours long) training initially, but will be allowed to take a 1-hour recertification training every 3 years thereafter, so long as they do so prior to the 3-year expiration period.³²
  • Note: All valid mandatory reporter training certificates issued prior to July 1, 2019 remain effective for 5 years.

Kansas

• Violence-inflicted injuries/domestic violence
  • It is mandatory to report bullet wounds, gunshot wounds, powder burns, and other injuries caused by the discharge of a firearm, and wounds which are likely to, or may result in, death that are apparently inflicted by a knife, ice pick, or other pointed instrument.⁶
  • The statute requires certain professionals to make reports if they suspect that an adult is being abused, but employees of domestic violence centers are exempt from this requirement.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking

Kentucky

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Caregiver use of a controlled substance that impairs their ability to care for a child.²
• Elder/dependent adult abuse
  • Kentucky has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • As of June 29, 2017, Kentucky’s mandatory reporting law for victims of DV changed to a mandatory information and referral provision.³³
  • Patient education: The revised law requires professionals to provide educational material to victims of domestic and dating violence with whom they have had a professional interaction.
  • This law also requires these same professionals to make a report to police if requested to by the victim and to report to police if they believe that the death of a victim may be related to domestic or dating violence.

Louisiana

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.²
• Elder/dependent adult abuse
  • Louisiana has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • Healthcare providers are required to report suspected abuse to the State Department of Hospitals or local law enforcement.⁶
  • It is mandatory to report gunshot wounds and certain burns.⁶
  • A statute under the adult protective services chapter requires reporting of abuse, neglect, or exploitation. ”Adult” is defined as a person, without regard to age, who is the victim of abuse or neglect inflicted by a spouse.²³
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking
  • Human trafficking reporting laws:
    1. The state of Louisiana requires a mandatory reporter “who has cause to believe that a minor or adult female who presents at an outpatient abortion facility is a victim of human trafficking, trafficking of children for sexual purposes, rape, incest, or coerced abortion [to] report such crime immediately, or no later than the end of the business day, to the sheriff’s department in the parish or local police department where the outpatient abortion facility is located.”³⁴
• Professional misconduct
  • Unprofessional conduct includes failing to report to the Louisiana State Board of Optometry any adverse action taken by another licensing jurisdiction, government agency, law enforcement agency, or court.
  • Any other act, event, or occurrence that would constitute grounds for disciplinary action should be in writing and submitted within 30 days of such adverse action, act, event, or occurrence.³⁵

Maine

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report gunshot wounds within 24 hours of treatment.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking

Maryland

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.²
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report gunshot wounds, and in some counties, injuries sustained by an automobile or lethal weapon.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
• Professional misconduct
  • The Maryland State Board of Optometry requires optometrists to report the following:
    1. Any incident of adverse reaction to the administration of diagnostic pharmaceutical agents.
    2. Unethical conduct by a licensed optometrist.
    3. Any individual who is not licensed but represents themself to be an optometrist and is practicing, attempting to practice, or offering to practice optometry.³⁶

Massachusetts

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
• Elder/dependent adult abuse definitions
  • Elder abuse
• Violence-inflicted injuries/domestic violence
  • Massachusetts has mandatory reporting for bullet wounds, gunshot wounds, and other injuries caused by firearms, certain burns, and injuries caused by a knife or sharp pointed instrument if, in the physician's opinion, a criminal act was involved.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
• Continuing education (CE)
  • In Massachusetts, optometrists are required to complete 18 hours of CE, of which, no more than 6 hours are credited for any combination taken in the subject areas below, provided however that no more than 2 CE hours per renewal period will be credited for CE courses in cardiopulmonary resuscitation (CPR).³⁷
  • Continuing education subject area limitations:
    1. CPR
    2. Child abuse recognition
    3. Infection control
    4. Practice management
    5. Office procedures
    6. Recordkeeping
    7. Legislation
    8. Optometric statutes and regulations

Michigan

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report wounds or other injuries inflicted by means of a knife, gun, pistol, other deadly weapon or other means of violence.⁶
• Continuing education (CE)
  • Beginning in 2019 and all renewal cycles thereafter, licensees must have completed training in identifying victims of human trafficking.
  • Beginning December 21, 2021, individuals seeking licensure must have completed human trafficking training prior to obtaining a license as an optometrist.³⁸
  • This is a one-time training that is separate from CE. Information and the link to the free training course are here.

Minnesota

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • Prenatal substance exposure/and or abuse is required to be reported so that the pregnant mother can be referred for treatment.
  • State civil definitions of child abuse or neglect include:
    1. Caregiver use of a controlled substance that impairs their ability to care for a child.
    2. Evidence of selling, distributing, or giving drugs or alcohol to a child.²
• Violence-inflicted injuries/domestic violence
  • Healthcare providers are required to report gunshot wounds, burns, and other injuries the medical provider has reasonable cause to believe have been inflicted by a perpetrator of a crime by a dangerous weapon other than a firearm.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
• Professional misconduct
  • A licensed optometrist shall report to the Minnesota State Board of Optometry knowledge of any conduct by any optometrist, including reporting oneself, any incompetency, unprofessional conduct, or physical disability that would require disciplinary action.³⁹

Mississippi

• Elder/dependent adult abuse
  • Mississippi has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report injuries caused by gunshot or knifing.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking

Missouri

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
• Violence-inflicted injuries/domestic violence
  • Gunshot wounds are required to be reported.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking

Montana

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.
    2. Exposing a child to the criminal sale or distribution of drugs.²
• Elder/dependent adult abuse definitions
  • Elder abuse
  • Dependent adult abuse
• Violence-inflicted injuries/domestic violence
  • There is a duty to report that a victim has been stabbed or shot.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking

Nebraska

• Violence-inflicted injuries/domestic violence
  • It is mandatory to report wounds or injuries of violence that appear to have been received in connection with the commission of a criminal offense.⁶
• Human trafficking definitions written into state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking
• Professional misconduct
  • All healthcare professionals must report oneself within 30 days of the occurrence of any of the following:
    1. Loss of hospital or healthcare facility privileges due to incompetence, negligence, unprofessional conduct, or physical, mental, or chemical impairment.
    2. Professional liability claim that resulted in an adverse judgment, settlement, or award.
    3. Conviction of any misdemeanor or felony in Nebraska or any other state, territory, or jurisdiction, including any federal or military jurisdiction.⁴⁰
  • Every healthcare professional must report firsthand knowledge of any person in the same profession that has committed acts indicative of gross incompetence, a pattern of negligent or unprofessional conduct, or any impairment by alcohol, controlled substances, narcotic drugs, or physical, mental, or emotional disability.

Nevada

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
• Elder/dependent adult abuse definitions
  • Elder abuse
  • Dependent adult abuse
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report knife and gunshot wounds not inflicted under accidental circumstances, as well as certain burns.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
• Visual impairment, seizures, and lapses of consciousness
  • Nevada mandates DMV notification, within 30 days, after diagnosing a blind, night blind, or severely visually impaired patient.⁴¹
  • The state of Nebraska defines these as:
    1. “Blind person” means any person whose visual acuity with correcting lenses does not exceed 20/200 in the better eye, or whose vision in the better eye is restricted to a field which subtends an angle of not greater than 20 degrees.
    2. “Night-blind person” means a person afflicted with nyctalopia.
    3. “Severely visually impaired person” means any person whose visual acuity with correcting lenses does not exceed 20/70 in the better eye, or whose vision in the better eye is restricted to a field which subtends an angle of not greater than 30 degrees, or whose vision is impaired to such an extent that it contributes to limiting the individual’s activities of functioning.
  • In addition, patients with physical or mental conditions must be communicated to the DMV, such as:
    1. Lapses of consciousness.
    2. Severe dizziness
    3. Fainting spells
    4. Head injuries
    5. Seizures
    6. Epilepsy
    7. Lapses of consciousness disorders associated with diabetes
    8. Any other injuries or ailments resulting in lapses of consciousness
• Professional misconduct
  • A licensee or applicant for a license shall report to the Board no later than 30 days after the situations below occur in Nevada, any other state, the District of Columbia, Puerto Rico, the US Virgin Islands, any territory subject to the jurisdiction of the US or a foreign country or by the Federal Government or a branch of the Armed Forces of the US.⁴²
  • The situations this applies to include:
    1. Being charged with or convicted of a crime, other than a minor traffic violation.
    2. Any disciplinary action is taken against the licensee by a licensing authority.
    3. A civil action relating to the practice of optometry is filed against the licensee.
    4. An extended order for protection against domestic violence is issued against the licensee.⁴²

New Hampshire

• Elder/dependent adult abuse
  • New Hampshire has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • There is a requirement that gunshot wounds be reported; however, the exception to this is for sexual assault victims 18 years and older not also suffering from a gunshot wound or other serious bodily injury.⁶
• Human trafficking definitions written into state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking

New Jersey

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.²
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report gunshot wounds, stab wounds, and wounds caused by destructive devices, explosives, or weapons, as well as certain burns.⁶
• Visual impairment, seizures, and lapses of consciousness
  • New Jersey law requires informing the Motor Vehicle Commission within 24 hours of patients with any of the following:
    1. Recurrent convulsive seizures.
    2. Recurrent periods of unconsciousness or impairment.
    3. Loss of motor coordination.
    4. Epilepsy, in any of its forms, which persist or recur despite medical treatment.
    5. A driver that does not meet vision standards.⁴³
  • New Jersey visual acuity test standards:
    1. A minimum of 20/50 in each eye, with or without corrective lenses as measured by Snellen chart.
    2. When the vision in either eye is less than 20/50 and cannot be improved by means of corrective lenses, a certificate adequately explaining the deficiency signed by a physician, ophthalmologist, or an optometrist must be presented.
    3. When the vision in either eye is less than 20/50 and corrective lenses will improve the vision, the corrective lenses will be required to be worn while driving; except where corrective lenses show an improvement but wearing lenses would be detrimental to the applicant’s well-being. A statement to this effect signed by a physician, ophthalmologist, or optometrist must be presented.
    4. When there is no vision in one eye, the good eye must meet the minimum standard of 20/50 with or without corrective lenses.
    5. In the event that any special device or equipment is used or needed to meet the minimum requirements outlined in this section, the matter may be referred to the Safety Standards Driver Testing for final determination.⁴³
• Professional misconduct
  • Healthcare professionals are required by state law to report other healthcare professionals to the New Jersey Division of Consumer Affairs if they possess information that reasonably indicates that the other healthcare professional has demonstrated unprofessional conduct, including sexual misconduct, which makes the other healthcare professional imminently dangerous to an individual patient or the public.⁴⁴

New Mexico

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Exposing a child to, or allowing a child to be present where, chemicals or equipment for the manufacture of controlled substances are used or stored.²
• Elder/dependent adult abuse
  • New Mexico has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • Patient referral and education required: In New Mexico, medical personnel who treat a patient believed to be a victim of DV, must give the patient a referral to, and information on, victim services.
  • Documentation required: If the patient reports the abuse, documentation of the name of the perpetrator and nature of the abuse in the patient's file is required.²³

New York

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Caregiver use of a controlled substance that impairs their ability to care for a child.²
• Elder/dependent adult abuse
  • New York has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report bullet wounds, gunshot wounds, and wounds that are actually or apparently inflicted by a knife, icepick, or other sharp or pointed instruments that are likely to or may result in death. In addition, certain burn injuries must be reported.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking
• Continuing education (CE)
  • Mandated training:
    1. Child abuse: Effective January 1, 1989, Education Law requires optometrists, when applying initially for licensure, to provide documentation of having completed 2 hours of coursework or training regarding the identification and reporting of child abuse and maltreatment.⁴ This is a one-time requirement and once taken does not need to be completed again. Documentation in the form of an authorized Certification of Completion must be submitted to the State Education Department at the time of re-registration or initial application for licensure.⁴⁵
    2. Infection control: All optometrists must complete course work or training appropriate to their practice regarding infection control and barrier precautions, including engineering and work controls to prevent the transmission of human immunodeficiency virus (HIV) and the hepatitis b virus (HBV) in the course of professional practice, every 4 years.⁴⁶ Attestation of completion is required to the State Education Department on first licensure and at every subsequent registration.⁴⁶

North Carolina

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.²
• Elder/dependent adult abuse
  • Dependent adult abuse
  • North Carolina has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report bullet wounds, gunshot wounds, or injuries that appear to be caused by the discharge of a gun or firearm, illnesses apparently caused by poisoning, wounds or injuries caused or apparently caused by knives or sharp pointed instruments if it appears that a criminal act was involved and wounds.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking
• Professional misconduct
  • All optometrists shall self-report to the North Carolina Board of Optometry any of the following:
    1. Felony arrest or indictment.
    2. Arrest for driving while impaired or driving under the influence.
    3. Arrest or indictment for the possession, use, or sale of any controlled substance.
    4. Medical malpractice judgments or awards.
    5. Settlements in the amount or aggregate amount of $75,000 or more related to an incident of alleged medical malpractice.⁴⁷

North Dakota

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.
  • Prenatal substance exposure/and or abuse is required to be reported in order that the pregnant mother can be referred for treatment.²
  • State civil definitions of child abuse or neglect include:
    1. Exposing a child to, or allowing a child to be present where, chemicals or equipment for the manufacture of controlled substances are used or stored.²
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report injuries inflicted by a knife, gun, or pistol.
  • Patient information or referral required: North Dakota statute requires medical personnel providing treatment, to give the patient information regarding DV or a referral to a DV sexual abuse organization.²³
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
• Continuing education (CE)
  • Although not required, mandatory reporters may receive 1 CE unit hour for completing the state’s online training.⁴⁸

Ohio

• Violence-inflicted injuries/domestic violence
  • It is a misdemeanor for any person having knowledge that a felony has been committed to knowingly fail to report it.
  • Gunshot wounds, stab wounds, serious physical harm where there is reason to believe it resulted from an offense of violence, and second-degree burns or higher, must be reported.²³
  • Documentation required: Ohio requires recording knowledge or reasonable suspicion of domestic violence in the patient's record and is not subject to doctor-patient privilege.
  • Domestic violence must be noted in the patient’s record but not reported.²³
• Professional misconduct
  • Ohio optometrists have a duty to report another doctor of optometry who is engaged in unprofessional conduct or has an addiction subject to board action.
  • Clinically significant drug-induced side effects in a patient resulting from the optometrist administering, employing, applying, or furnishing a topical ocular or therapeutic pharmaceutical agent must be reported within 72 hours.
  • The Ohio Board of Optometry offers a one-time program to optometrists experiencing substance abuse issues. The optometrist must initiate the action and self-report to the Board before any involvement of the Board occurs, otherwise, the program is not available to the optometrist.⁴⁹
  • Details on exact reporting procedures can be found here.

Oklahoma

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Caregiver use of a controlled substance that impairs their ability to care for a child.
    2. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.
    3. Exposing a child to, or allowing a child to be present where, chemicals or equipment for the manufacture of controlled substances are used or stored.
    4. Exposing a child to the criminal sale or distribution of drugs.²
• Elder/dependent adult abuse
  • Oklakoma has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • Reporting required: In Oklahoma, domestic abuse does not have to be reported if the victim is over the age of 18, unless the victim requests them to do so orally or in writing.
  • Documentation and referral required: In all cases of domestic violence, doctors are required to record the incident and injuries observed as well as any treatment provided or prescribed, in the medical chart clearly and legibly.
  • Also, referral to services for domestic violence and victim services, including the number of the Oklahoma statewide hotline must be given to the patient.²³
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking

Oregon

• Parental substance abuse
  • Prenatal substance exposure/and or abuse is required to be reported in order that the pregnant mother can be referred for treatment.
  • State civil definitions of child abuse or neglect include:
    1. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.
    2. Exposing a child to, or allowing a child to be present where chemicals or equipment for the manufacture of controlled substances are used or stored.²
• Elder/dependent adult abuse definitions
  • Elder abuse
• Violence-inflicted injuries/domestic violence
  • Injuries inflicted by a knife, gun, pistol, or other deadly weapons by anything other than accidental means must be reported.⁶
• Visual impairment, seizures, and lapses of consciousness
  • Optometrists are required to report to the DMV, patients, age 14 years and older, who have severe and uncontrollable functional or cognitive impairments that cannot be controlled by medication, therapy, surgery or adaptive devices.⁵⁰
  • Reportable situations can be due to an underlying medical diagnosis or condition related to:
    1. Loss of consciousness or control due to a cardiovascular accident, cardiac event, alcohol, cannabis, controlled substance, inhalant use, or relapse.⁵⁰
    2. Medication prescribed that may interfere with safe driving behaviors.⁵⁰
    3. Functional impairments of:
       • Visual acuity and/or field of vision not meeting DMV standards below
       • Strength
       • Peripheral sensation
       • Flexibility
       • Motor planning and coordination
    4. Cognitive impairments of:
       • Attention
       • Judgment and problem-solving
       • Reaction time
       • Planning and sequencing
       • Impulsivity
       • Visuospatial
       • Memory
       • Loss of consciousness or control
  • Oregon DMV vision and visual field standards
    • Acuity: The person must have a visual acuity level of 20/70 or better when looking through both eyes (or one eye if the person has usable vision in only one eye).
    • A person with usable vision in both eyes will meet the standard if the visual acuity level in one eye is worse than 20/70 so long as the visual acuity level in the other eye is 20/70 or better.
    • Field of vision: The person must have a field of vision of at least 110 degrees.
    • The DMV will restrict the person’s driving privileges to daylight driving only, if the person’s best eye is worse than 20/40 and no worse than 20/70, unless in the written opinion of a licensed vision specialist (ophthalmologist or optometrist), the person’s driving should not be restricted.
    • The DMV will not restrict a person whose vision is 20/40 or better to daylight driving only unless in the written opinion of a licensed vision specialist, such restriction is warranted.
• Professional misconduct
  • Optometrists must self-report to the Oregon Board of Optometry within 10 days if convicted of a misdemeanor, felony, or if arrested for a felony crime.⁵¹
  • Further, optometrists who have reasonable cause to believe another healthcare professional has engaged in prohibited or unprofessional conduct must report the conduct to the Oregon Board of Optometry.⁵¹

Pennsylvania

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.²
• Violence-inflicted injuries/domestic violence
  • Injuries caused by firearms must be reported unless they were caused by domestic violence.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking
• Visual impairment, seizures, and lapses of consciousness
  • Doctors and others authorized to diagnose or treat disorders characterized by lapses of consciousness are required to report patients with such disorders who are over the age of 15 years, within 10 days to the Pennsylvania Department of Transportation.⁵²
  • The provider should inform the patient of the prohibition against driving due to the functional impairment. The provider shall inform the Department in writing of the impairment if the condition has lasted or is expected to last longer than 90 days.⁵²
  • Visual criteria:
    1. Visual acuity of less than 20/100: A person with visual acuity of less than 20/100 combined vision with best correction will not be qualified to drive.
    2. Visual acuity and field of vision requirements: A person shall have a combined field of vision of at least 120 degrees in the horizontal meridian, excepting the normal blind spots.
    3. Sight in one eye: A person may be adequately sighted in only one eye and still meet the requirements of this section. The person’s driving privilege will be restricted to vehicles having mirrors so located as to reflect to the person a view of the highway for a distance of at least 200 feet to the rear.
    4. Telescopic lenses: Correction through the use of telescopic lenses is not acceptable for purposes of meeting acuity requirements.
  • Physical criteria:
    1. Unstable diabetes mellitus leading to severe hypoglycemic reactions or symptomatic hyperglycemia.
    2. Cerebral vascular insufficiency or cardiovascular disease.
    3. Syncopal attack or loss of consciousness.
    4. Vertigo, paralysis, or loss of qualifying visual fields.
    5. Periodic episodes of loss of consciousness and/or awareness, dyspnea upon mild exertion, or any other sign or symptom which impairs the ability to control and safely perform motor functions necessary to operate a motor vehicle.
    6. Loss or impairment of a joint or extremity as a functional defect or limitation.
    7. Rheumatic, arthritic, orthopedic, muscular, vascular, or neuromuscular disease expected to last longer than 90 days.
  • Mental criteria:
    1. Cognitive impairments.
    2. Mental disorder, whether organic or without known organic cause, as described in the current Diagnostic and Statistical Manual of Mental Disorders (DSM).
    3. Inattentiveness to the task of driving because of, for example, preoccupation, hallucination, or delusion.
    4. Contemplation of suicide, as may be present in acute or chronic depression, or in other disorders.
    5. Excessive aggressiveness or disregard for the safety of self, others or both, presenting a clear and present danger, regardless of cause.
    6. Periodic episodes of loss of attention or awareness which are of unknown etiology or not otherwise categorized.
    7. Use of any drug or substance, including alcohol, known to impair skill or functions, regardless of whether the drug or substance is medically prescribed.
    8. Other conditions which, in the opinion of a provider, are likely to impair the ability to control and safely operate a motor vehicle.
• Professional misconduct
  • The Pennsylvania Board of Optometry requires self-reporting of misconduct by optometrists, in writing, within 90 days of the following:
    1. A criminal conviction, which includes a verdict, a finding of guilt, or a plea of guilty or nolo contendere, to a felony or to a misdemeanor relating to or arising out of the practice of optometry.⁵³
    2. Disciplinary action taken by a licensing authority in another state, territory, or country.⁵³
    3. In-patient admission to a facility for treatment of mental disease or disability, or for treatment arising out of the use of alcohol or controlled substances.⁵³
• Continuing education (CE)
  • Pennsylvania requires optometrists, as mandatory reporters, to complete at least 2 hours of board-approved CE in child abuse recognition and reporting for renewal or reactivation of a license.
  • A certificate for a 3-hour training on child abuse is required before initial licensure. All hours count toward the total number of CE.
  • Note that human trafficking of minors is considered child abuse, so these trainings extend to human trafficking education.
  • Verification of completion must be sent electronically and directly from the course provider.⁵⁴

Puerto Rico

• Elder/dependent adult abuse definitions
  • Elder abuse
  • Puerto Rico has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • There was a set of statutes governing “Medical Protocol to Manage Victims of Domestic Violence,” but it expired in 1999, and the statutes were omitted.⁶

Rhode Island

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • In Rhode Island, a report of substance use by a pregnant woman may be made, but an investigation will be conducted only if there is an allegation of abuse and/or neglect of the newborn or other children in the home.²
  • State civil definitions of child abuse or neglect include:
    1. Caregiver use of a controlled substance that impairs their ability to care for a child.²
• Elder/dependent adult abuse definitions
  • Elder abuse
  • Rhode Island has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.
• Violence-inflicted injuries/domestic violence
  • There is a requirement that gunshot wounds be reported.⁶
  • Rhode Island requires optometrists who have knowledge of, or reasonable cause to believe that a patient or resident in a facility has been abused, mistreated, or neglected, either while in the facility or prior to being admitted, within 24 hours or by the end of the next business day, to make a report via telephone.
  • This report must include the following: name, address, telephone number, occupation, employer’s address, and phone number of the person reporting. Also, the name and address of the patient who is believed to be the victim of abuse, mistreatment, or neglect; the details, observations, and beliefs concerning the incident, any statements regarding the incident made by the patient or resident and to whom they were made, the date, time, and place of the incident.
  • On top of that, optometrists should report: the individuals believed to have knowledge of the incident, the name of the individual's caregiver if known, any medical treatment being received, any other information the reporter believes relevant, and the name and address of the reporter and where the reporter can be contacted.
  • The definition of abuse includes “any conduct which harms or is likely to physically harm the patient or resident.”³⁴

South Carolina

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.²
• Violence-inflicted injuries/domestic violence
  • There is a requirement that gunshot wounds be reported.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking

South Dakota

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.
    2. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.
    3. Exposing a child to the criminal sale or distribution of drugs.²
• Elder/dependent adult abuse definitions
  • Elder abuse
  • Dependent adult abuse
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report bullet wounds, gunshot wounds, and injuries arising from the discharge of a firearm.⁶
• Professional misconduct
  • According to the South Dakota Board of Optometry, unprofessional conduct includes:
    1. Not reporting discipline by a licensing board of another state or territory under U.S. jurisdiction to the board.⁵⁵
    2. Not reporting a conviction of a criminal offense arising out of the practice of optometry to the board.⁵⁵

Tennessee

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.
    2. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.
    3. Caregiver use of a controlled substance that impairs their ability to care for a child.²
• Elder/dependent adult abuse
  • Tennessee has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • There is a requirement to report injuries caused by a knife, pistol, gun, or deadly weapon or suffering from the effects of poison or suffocation.⁶
  • The state of Tennessee requires any healthcare practitioner who knows, or has reasonable cause to suspect, that a patient’s injuries are the result of DV or domestic abuse, shall report to the department of health, office of health statistics on a monthly basis without identifying information.²³
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking

Texas

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.
    2. Caregiver use of a controlled substance that impairs their ability to care for a child.
    3. Evidence of selling, distributing, or giving drugs or alcohol to a child.²
• Elder/dependent adult abuse
  • Elder abuse
  • Dependent adult abuse
  • Texas has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report bullet and gunshot wounds.⁶
  • Documentation and referral required: The state of Texas requires medical professionals who treat a person with injuries that they have reason to believe to have been caused by family violence to immediately provide them with information regarding the nearest family violence shelter.
  • The provider should document in the patient’s medical chart the reasons the injuries were caused by family violence and that the victim was given such information, with a written notice, provided in the statute, regarding their rights.²³
  • Note that DV must be documented in the patient's medical chart but must not be reported to law enforcement.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking
• Continuing education (CE)
  • For each biennial renewal of an optometric license, Texas requires the completion of a 1-hour training course on identifying and assisting victims of human trafficking.
  • Licensees will receive 1 general credit hour upon submission of written proof of completion of the approved course.⁵⁶

Utah

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.²
• Elder/dependent adult abuse
  • Utah has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴
• Violence-inflicted injuries/domestic violence
  • There is a requirement that injuries caused by a knife, gun, pistol, explosive, infernal device, or deadly weapon be reported.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking

Vermont

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances
    2. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.
    3. Caregiver use of a controlled substance that impairs their ability to care for a child.²
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report gunshot wounds and injuries caused by the discharge of a firearm.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking

US Virgin Islands

• Elder/dependent adult abuse
  • Elder abuse
  • Dependent adult abuse
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report gunshot wounds and injuries caused by the discharge of a firearm.⁶

Virginia

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.
    2. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.
    3. Exposing a child to the criminal sale or distribution of drugs.²
• Elder/dependent adult abuse
  • Elder abuse
  • Dependent adult abus
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report injuries caused by guns, knives, and similar weapons.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking

Washington

• Elder/dependent adult abuse
  • Elder abuse
  • Dependent adult abuse
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report bullet wounds, gunshot wounds, and stab wounds.⁶
• Professional misconduct
  • The Washington legislature directed the Department of Health to adopt rules about mandatory reporting of healthcare practitioners who commit unprofessional conduct or are unable to practice safely, and mandatory reporting requirements were added in 2008.⁵⁷
  • Every optometrist must self-report:
    1. Any conviction, determination, or finding that he or she has committed unprofessional conduct.
    2. Information that he or she is unable to practice with reasonable skill and safety due to a mental or physical condition
    3. Any disqualification from participation in the federal medicare or Medicaid program.⁵⁷
  • Optometrists must report other optometrists if there is actual knowledge of the following:
    1. Any conviction, determination, or finding that another license holder has committed an act that constitutes unprofessional conduct.
    2. Mental or physical conditions hindering the practice of optometry with reasonable skill and safety.
  • Note that the optometrist does not have to report if:
    1. The optometrist is a member of a professional review organization.
    2. Providing healthcare to the other license holder and the other license holder does not pose a clear and present danger to patients.
    3. The other optometrist is part of a federally funded substance abuse program, approved impaired practitioner, or voluntary substance abuse program and does not pose a clear and present danger to patients.

West Virginia

• Parental substance abuse
  • State civil definitions of child abuse or neglect include:
    1. Prenatal exposure to controlled substances.²
    2. Caregiver use of a controlled substance that impairs their ability to care for a child.²
• Elder/dependent adult abuse
  • Dependent adult abuse
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report gunshot and stab wounds that a reasonable person would believe resulted from a violation of the criminal laws of the state.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
  • Labor trafficking

Wisconsin

• Parental substance abuse
  • Healthcare providers must report when they treat infants who show evidence at birth of having been exposed to drugs, alcohol, or other controlled substances.²
  • Prenatal substance exposure and/or abuse is required to be reported in order that the pregnant mother can be referred for treatment.
  • State civil definitions of child abuse or neglect include:
    1. Manufacturing a controlled substance in the presence of a child or on premises occupied by a child.²
• Elder/dependent adult abuse
  • Elder abuse
• Violence-inflicted injuries/domestic violence
  • It is mandatory to report gunshot wounds and certain burns.⁶
• Human trafficking definitions written into the state’s civil child abuse laws
  • Sex trafficking
• School violence
  • Wisconsin law requires that any mandated reporter who believes in good faith, based on a threat made by an individual seen in the course of professional duties regarding violence in or targeted at a school, that there is a serious and imminent threat to the health or safety of a student or school employee or the public make a report to law enforcement.⁵⁸

Wyoming

• Elder/dependent adult abuse
  • Wyoming has a universal mandatory reporting requirement: Any person, regardless of their occupation, is required to report elder or dependent adult abuse.⁴