10. Special State of California Requirements
Subject’s
Bill of Rights
All investigators are required to inform prospective subjects
of their rights as research subjects. In addition, the State of
California requires that all subjects enrolled in medical
research receive a copy of the Research Subject’s Bill of
Rights. UCLA Investigators are responsible for ensuring that
subjects recruited in medical research are provided with the UCLA
"Rights of Human Subjects in Medical
Experiments" document in addition to the HSPC approved
informed consent form.
Reporting
Suspected Abuse of Children, Elderly Individuals, and Others
Under California law, health practitioners (among others) are
required to report to appropriate authorities when there is good
reason to believe that a child or an elderly or dependent adult
has been abused. They are required to also report an injury that
indicates possible abuse of an elder or dependent child or if
they have personally treated a patient with injuries from an
apparent assault [Child Abuse and Neglect Reporting Act, Cal. Penal Code,
Section 11165 et seq.; Elder Abuse and Dependent Adult Civil
Protection Act, Cal. Welfare. & Inst. Code, Section 15601 et
seq.; Reports of Injuries, Cal. Penal Code,
Section 11160 et seq.]. (Please see Chapter
4, "Informed Consent Requirements:
Confidentiality", Chapter 7,
"Responsibilities of Principal Investigators:
Confidentiality", for more information, and the Appendix for the
appropriate California
Penal Code.)
The state law differentiates between required reporting of
physical abuse or injury of elders and dependent adults and the
endangering of "emotional well-being." Investigators
are reminded that state law periodically changes and does vary
from state to state. Investigators conducting research outside of
California should familiarize themselves with the applicable
local reporting requirements.
Health practitioners required to report include:
physicians, surgeons, psychiatrists, psychologists, dentists,
residents, interns, podiatrists, chiropractors, licensed nurses,
dental hygienists, optometrists, and any other person who is
currently licensed under Division 2 of the Business and
Professions Code. They also include marriage, family and child
counselors, emergency medical technicians, paramedics, and others
certified under Division 2.5 of the Health and Safety Code,
psychological assistants, marriage, family and child counselor
trainees and interns, county public health employees who treat
children for venereal disease or any other condition, and
coroners, medical examiners, and others who perform autopsies (Section 11165.8).
Child Abuse
Any person who is employed as a child care custodian, medical
practitioner, or non-medical child care practitioner, or employee
of a child protective agency who has knowledge of or observes a
child who has been abused or reasonably suspects has been the
victim of child abuse is required to report "the
known or suspected instance of child abuse to a child protective
agency immediately or as soon as possible by telephone and to
prepare and send a written report thereof within 36 hours of
receiving the information concerning the incident." [Section
11166 of the Penal
Code]
Child abuse reports are confidential though reports of
suspected abuse are disclosed under special conditions as
described in Penal Code Section 1167.5. Disclosure may be made to
a hospital Suspected Child Abuse and/or Neglect (SCAN) team. The
purpose of disclosing reports to SCAN teams is to prevent child
abusers from attempting to hide the pattern abuse by taking the
child to different hospitals for treatment. You can contact the
UCLA SCAN team at 57171.
Elder Abuse
Investigators are required to report instances of known
physical abuse, reasonable appearance of physical abuse, or when
they are told by an elderly person or dependent adult that abuse
has occurred.
Physical
Abuse of an Elder:
"Any elder or dependent adult care custodian, health
practitioner, or employee of a county adult protective services
agency or a local law enforcement agency, who in the scope of his
or her employment, either has observed an incident that
reasonably appears to be physical abuse, as observed a physical
injury where the nature of the injury, its location on the body,
or the repetition of the injury, clearly indicates that physical
abuse has occurred, or is told by an elder or dependent adult
that he or she has experienced behavior constituting physical
abuse, shall report the known or suspected instance of
physical abuse either to the long-term care ombudsman
coordinator or to a local law enforcement agency when the
physical abuse is alleged to have occurred in a long-term care
facility, or to either the county adult protective services
agency or to a local law enforcement agency when the physical
abuse is alleged to have occurred anywhere else, immediately or
as soon as possible by telephone, and shall prepare and send a
written report thereof within 36 hours." [Section
15630(a) of the Penal Code]
Other Forms
of Elder Abuse:
Other forms of abuse inflicted upon an elder or dependent
adult that endangers the person’s well being "...in any
other way, may report such known or suspected instance of
abuse either to a long-term care ombudsman coordinator or to
a local law enforcement agency when the abuse is alleged to have
occurred in a long-term care facility, or to either the county
adult protective services agency or to a local law enforcement
agency when the abuse is alleged to have occurred anywhere
else." [Section 15630(b) of the Penal Code]
Other persons may report child or elder abuse, even if
they are not required to do so. The HSPC expects all
investigators, including their staff, who become aware of
possible abuse of a child or an elder or dependent adult to
report the matter even if they are not a licensed health
practitioners. No supervisor or administrator may impede or
inhibit reporting, nor may a person making a report be subject to
any sanction.
The Neuropsychiatric Institute and Hospital (NPI&H) Policy
Manual includes specific instructions for reporting domestic
violence/spousal/partner abuse (Policy #2048), suspected child
abuse and/or neglect (SCAN) case reporting responsibilities
(#2020), suspected elder abuse (#2025), and suspected dependent
adult abuse reporting (#2026). Please contact the NPI&H for
more information.
Definitions
Abuse: intentionally or recklessly causing or
attempting to cause bodily injury or causing reasonable
apprehension of imminent serious bodily injury to himself,
herself, or another
Child: a person under the age of 18 years
Child abuse or neglect includes: sexual abuse, sexual
exploitation, other physical or emotional abuse, severe or
general neglect of the child’s needs (food, clothing,
shelter, medical care, and willful cruelty or unjustifiable
punishment of a child).
Child care custodian: includes teachers, administrative
officers, supervisors of child welfare or attendance, or
certified pupil personnel employees of any public or private
school; administrators of a public or private day camp; licensed
day care workers; administrators of community care facilities
licensed to care for children; headstart teachers; licensing
workers or licensing evaluators; public assistance workers;
employees of a child care institution including, but not limited
to, foster parents, group home personnel, and personnel of
residential care facilities; and social workers or probation
officers.
Dependent adult: any person between the ages of 18 and
64 years, who has physical or mental limitations that restrict
his or her ability to carry out normal activities or to protect
his or her rights including, but not limited to, persons who have
physical or developmental disabilities or whose physical or
mental abilities have diminished because of age. It includes all
such persons admitted to a 24-hour health facility.
Elder: any person residing in California who is 65
years of age or older.
Abuse of an elder or a dependent adult means: physical
abuse, neglect, fiduciary abuse, abandonment, isolation, or other
treatment with resulting physical harm or pain or mental
suffering, or the deprivation by a care custodian of goods or
services that are necessary to avoid physical harm or mental
suffering.
Medical practitioner: includes physicians and surgeons,
psychiatrists, psychologists, dentists, residents, interns,
podiatrists, chiropractors, coroner, licensed nurses, dental
hygienists, or any other person who is licensed under Division 2
(commencing with Section 500) of the Business and Professions
Code.
Non-medical practitioner: includes state or county
public health employees who treat minors for venereal disease or
any other condition; coroners; paramedics; marriage, family, or
child counselors; and religious practitioners who diagnose,
examine, or treat children.
Neglect of an elder or dependent adult means: the
negligent failure of any person having the care or custody of an
elder or a dependent adult to exercise that degree of care which
a reasonable person in a like position would exercise. Neglect
includes, but is not limited to:
- failure to assist in personal hygiene, or in the
provision of food, clothing or shelter;
- failure to provide medical care for physical and mental
health needs;
- failure to protect from health and safety hazards; and
- failure to prevent malnutrition.
Reasonable suspicion: an objectively reasonable
suspicion that a person would entertain, based upon facts that
could cause a reasonable person in a like position, drawing when
appropriate upon his or her training and experience, to suspect
abuse.
Reporting Abuse or Neglect of a Child: Reports of known
or suspected child abuse or neglect should be reported
immediately, by telephone, to a child protective agency and be
followed by a written report within 36 hours.
Confidentiality: The identity of persons filing reports
is confidential, but may be made known to appropriate licensing,
law enforcement, and protective service agencies.
Protection from liability: No health professional or
other mandated report will be subject to civil or criminal
liability for filing a report of known or suspected abuse.
Nonmandated reporters are protected as well, unless it is
shown that the person knowingly filed a false report.
Immunity from liability and legal fees: Reports of
child or elder abuse/neglect are confidential. In addition,
health professionals are immune from civil or criminal liability
for making required reports. Other individuals who file reports
(but who are not required to do so) are immune if they acted in
good faith. Health professionals who are sued for filing a
required report of child or elder abuse/neglect will be
reimbursed up to $50,000 for legal expenses incurred while
defending the suit, if the judge dismisses the action or if they
prevail at trial. The billing rate reimbursed may not exceed the
hourly rate charged by the state Attorney General.
| Failure of a health professional to file a
required report is a misdemeanor, punishable by a fine of
up to $1,000, or confinement in the county jail for up to
six months, or both. |
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October 29, 2004
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