Asking tough questions about mandatory abuse reporting

When Nicole gave birth to her daughter at an Arkansas hospital, she and her husband didn’t expect a weekslong encounter with Child Protective Services. During the delivery, Nicole, who is also a nurse, declined antibiotics for group B streptococcus because she had not been tested for the infection and did not have any of the risk factors, she said. Some women are given antibiotics for the infection during labor as a precaution even if they are not tested first.

When the couple decided to check out of the hospital, the nurse told Nicole that the pediatrician planned to report them to CPS for medical neglect because she declined the antibiotics.

“We got home at 10 p.m. that night with our newborn,” Nicole said. WORLD agreed to withhold the family’s last name to protect their children's privacy. A social worker arrived at the family’s house the next morning. “She called my husband to say, ‘I’m a social worker. I’ve been reported to inspect your baby, to interview all your other children, and inspect your home,” Nicole said.

The majority of referrals made to child welfare agencies each year are made by mandatory reporters—individuals who have regular contact with children as part of their job and are legally required to notify authorities if they suspect a child is being abused or neglected, according to the U.S. Department of Health and Human Services. Educators, medical professionals, and law enforcement officers made nearly 50 percent of reports in 2021.

Federal and state laws define child abuse and neglect. While some types of maltreatment such as physical or sexual abuse are easier to identify, neglect is less clearly defined. For example, state laws differ on when leaving a child at home alone or allowing a child to travel to school unaccompanied is considered neglect.

According to the Centers for Disease Control and Prevention, about 1 in 7 U.S. children are abused or neglected each year. In 2020, 1,750 children died because of that abuse or neglect. Stress caused by abuse can stunt brain growth, and adults who were abused as children are more likely to commit crimes or abuse others.

Though adults who regularly interact with children play a key role in identifying signs of maltreatment, some lawmakers and child safety advocates say mandatory reporting laws do not always accomplish that goal. State laws have increased the number of people who are legally obligated to document their suspicions. But the laws often do not strictly outline what constitutes abuse and neglect, allowing personal bias and judgments to influence how and when reports are made. Just over three-fourths of all 2021 reports raised concerns of neglect.

In 2021, just 51.5 percent of calls made to child welfare agencies alleging maltreatment warranted a response, according to the U.S. Department of Health and Human Services. Agencies investigated more than 3 million children, and 600,000 were found to be the victims of abuse or neglect, the lowest number in the last five years.

In 1963, Colorado became the first U.S. state to pass a mandatory reporting law. Since then, state lawmakers have expanded requirements to include almost 40 professions as mandated reporters.

“Nobody has ever taken a look at whether the law is even effective in keeping children and families safe,” said Colorado Child Protection Ombudsman Stephanie Villafuerte. “We assume it is because we were told that it does.”

In 2022, the Colorado General Assembly created the Mandatory Reporter Task Force to analyze the effectiveness of the state’s reporting law. The group held its first meeting in December and will meet 13 times over the course of two years.

Massachusetts assembled a similar commission that met from 2020 to 2021 to discuss who should be required to report suspected child abuse. The commission did not make any recommendations to the state, according to the final report. Panel Chair Maria Mossaides wrote in the report summary that a system that relies on the judgment of reporters could allow individual bias to inform reports.

Child welfare laws order mandatory reporters to alert the appropriate agency if they have any belief that a child is in danger, said Herbie Newell, president and executive director of Lifeline Children’s Services. In an effort to protect children from more extreme, life-threatening abuse or neglect, nearly every state imposes criminal penalties on mandatory reporters who fail to report suspected cases.

“Certainly what we’re seeing happening around the country is a lot of social workers, hospitals, teachers, school counselors, that are being over hypervigilant and reporting anything that they see and anything that they hear,” Newell said.

More reports mean more investigations for state social workers. In 2015, Colorado launched a statewide child abuse hotline and an advertising campaign to encourage residents to report suspected cases. Villafuerte said that the number of calls nearly doubled in the first 18 months of the campaign. Caseworkers’ workloads increased in response to the higher number of calls, but authorities did not substantiate a higher number of abuse cases.

In many states, caseworkers already work with overwhelming caseloads. Jacob Huereca, CEO of Connections Individual and Family Services, said the Texas child welfare system is overburdened. “In Texas, you have a system that is, by everyone’s account, broken. [CPS workers] already are overwhelmed and have the inability to perform their jobs. So if you flood them with more work … they’re going to do a worse job,” said Huereca.

Huereca and Villafuerte say that mandatory reporting laws disproportionately affect minority children and those whose families are experiencing poverty. According to a 2016 Washington University in St. Louis study, 37 percent of children in the U.S. experience one child welfare investigation by the time they turn 18. Among black children, that number is 53 percent.

Because mandatory reporters are not all trained on what constitutes abuse and neglect, Villafuerte said many reports happen because a family needs financial assistance or access to other public resources. But the fear of an investigation or the state removing children from a home often prevents parents from getting help, she said. As of early 2019, 29 states carried criminal penalties for intentionally making false reports.

In Pennsylvania, data showed that in the five years after the state expanded its child protection laws in 2014, 80 percent of calls to the state’s child abuse hotline were allegations of neglect tied to poverty. Most of the cases were later dismissed.

Newell and many other experts say they don’t want to completely throw out mandatory reporting, but they believe it has expanded to include too many people without needed clarity about what should or shouldn’t be reported.

“Yes, we want children to be protected, but we really need to make sure that there’s a lot of good, solid accountability for what that looks like,” Newell said. “We believe that the family is the sole unit for human flourishing, a family that’s committed to the Lord [and] that loves the Lord.”

When a social worker arrived to see Nicole’s daughter, Nicole and her husband told the caseworker she could not enter their property because she did not have a warrant and there was no immediate risk to their daughter. By law, child protection workers may only enter a home if they have a court order or have been given permission by the occupant.

The family called a lawyer and eventually asked a state senator to help. WORLD verified portions of Nicole’s story with the state senator who assisted her and her family. About three weeks after the baby’s birth, the caseworker agreed to drop the case after the family allowed her to see the baby but not interview the other children.

“It was intensely stressful for me and for my children, even though it wasn’t founded,” Nicole said. Since then, Nicole has met more families who have been the subject of false or unfounded reports of abuse or neglect.

Regardless of the reason for a call, an investigation from a state agency often results in trauma for the whole family, Nicole said. As a nurse, she was a mandated reporter. She worries that the child welfare system overlooks legitimate cases due to bias against certain groups: “What we should be doing instead is focusing on holding mandatory reporters accountable to follow a set of guidelines or give specific cause for their reporting.”