Reporting Sexual Assault

Sexual assaults committed against any of the following individuals are required to be reported:

• Adults who fall under the legal definition of “vulnerable adult,” meaning an adult who lacks the capacity to care for her or his daily needs,
• Adults with mental illness who by reason of their mental or physical condition are unable to authorize disclosure and have no legal guardian or legal representative to authorize disclosure for them or who are under guardianship of the State
• Adults who are developmentally disabled
• Residents of nursing homes and similar institutions (including some small private homes where unrelated adults are cared for); and/or
• Residents of homes for emotionally disturbed children or adolescents.
• Injuries caused in certain ways also must be reported. These are generally unrelated to sexual offenses but could occur simultaneously with a sexual assault. They are (in all counties): gunshot wounds; certain burn injuries; and injury by moving vessel [boat].
• Additionally, injuries by automobile or lethal weapon (other than a gun) are only reportable in certain jurisdictions. These jurisdictions do not include Baltimore City, Baltimore County, and Carroll County.
• Sexual abuse of children is discussed in the Child Abuse and Neglect section.

Reporting of sexual assault without the victim’s consent may be a violation of HIPAA.

Reporting against the adult victim’s wishes:

• Eliminates the competent victim’s right to make personal decisions
• Violates the victim’s privacy
• May violate HIPAA
• Might lead to a reluctance to confide in health care providers in the future
• Could put the victim in more danger since the abuse has been exposed

Confidentiality and Reporting – Child Victims of Sexual Assault

There are complicated rules governing when confidentiality may be breached and when the assault or abuse must be reported to law enforcement or Child Protective Services.

Sexual offenses by a parent; a household member or family member; a person who has permanent or temporary care or custody of the child; a person who has responsibility for supervision of the child; or a person who, because of the person’s position or occupation, exercises authority over the child MUST be reported to civil authorities. This is the mandated reporter law. This does not mean reporting is forbidden but it does mean informed consent is required before a report can be made in cases of a child sexual assault.

If a parent is acting as the personal representative of a minor child (for instance, when a mother brings her daughter to the hospital because of suspected child sexual abuse by a stranger), then the parent may consent to reporting to the police. However, there are three situations where a parent would not have the authority to consent to reporting:

1. When the minor is the one who consents to care and the consent of the parent is not required under Maryland law (see further discussion, below);
2. When the minor obtains care at the direction of a court, or a person appointed by the court; and/or
3. When the parent has agreed that the minor and health care practitioner may have a confidential relationship.

The Minor Consent Act permits, but does not require, health care practitioners to inform parents, stepparents, guardians, and custodians of information about treatment needed or consented to by the minor. HIPAA does not change this. Confidential information about a minor may still be disclosed to these caretakers, even over the minor’s objections. Disclosure is not required. If disclosure to the parent/guardian is made, the parent/guardian may choose to report the crime – parents/guardians are not required to maintain confidentiality.

At Center for Hope, we believe in a victim-centered, trauma-informed approach. In cases of sexual assault, we will not inform the parents, stepparents, guardians, or custodians without the permission of the child. We will encourage the child to tell a trusted adult and will provide resources to the child. Children 12 and older may consent to mental health therapy without the knowledge or consent of the parent or guardian.

Reporting Intimate Partner Violence

In Maryland, there is no general requirement to report all intimate partner violence. However, the sexual abuse of children and certain categories of adults must be reported as explained in the Sexual Assault section.

There are special circumstances that require reporting:

• Injuries caused in certain ways also must be reported. They are (in all counties): gunshot wounds; certain burn injuries; and injury by moving vessel [boat].
• Additionally, injuries by automobile or lethal weapon (other than a gun) are only reportable in certain jurisdictions. These jurisdictions do not include Baltimore City, Baltimore County, and Carroll County.
• Intimate partner violence that involves child abuse or neglect must be reported. A child witnessing intimate partner violence alone is not reportable; unless there is observable, identifiable, and substantial impairment to the child’s functioning.