Mandatory reporting duties vary by state, and a telehealth session can involve more than one. Start with the law of the state where the client and any victim are located, since that is where you are practicing and where the agency can act. Know each relevant state's rules and hotline before a disclosure, and consult an attorney on conflicts.
Mandatory reporting is familiar territory for most MFTs. The unfamiliar part is geography. When you are in one state, your client is in another, and the child or older adult at risk may be in a third, the question of which law applies stops being simple.
Which state's law is in play
For telehealth, the client's physical location during the session determines which state's practice law applies. That points to the client's state as the starting place for reporting duties. The location of the potential victim matters too, because child protective and adult protective agencies act within their own jurisdictions.
Your own state may also matter. Some reporting laws attach to the licensee rather than the location of the session, and your home board may expect compliance with its reporting rules regardless of where the client sits. Because these laws vary by state, a clinician serving clients in several states should get attorney input on how the rules interact for their specific combination.
Differences to expect
Reporting laws differ in several ways that affect practice. They vary in who counts as a mandated reporter, which forms of abuse and neglect are covered, whether the duty extends to vulnerable adults, what level of suspicion triggers a report, how quickly a report must be made, and whether a written follow-up is required. Do not assume the rules you learned in your first state carry over.
Preparing before a disclosure
Keep a short reference sheet for each state where you see clients. List the hotline numbers for child and adult protective services, the reporting standard in plain terms, the required timeline, and whether written reports follow. Confirm the entries with the agency or an attorney and date the sheet.
Record the client's location at the start of every session. If a disclosure happens, you will need that information immediately, and the note also shows which law you were working under.
Tell clients about reporting limits during informed consent, in language that is accurate for the states where you serve them. Families in couples and family therapy should hear this before any disclosure, not after.
Supervisees and group practices
In a group practice, agree in writing on who makes the report when a supervisee hears a disclosure, and make sure supervisees know that consulting a supervisor does not transfer or delay their own duty where the law places it on them. Keep the state reference sheets in a shared location so every clinician uses the same current version.
During and after the call
When a disclosure occurs, focus first on immediate safety. Then make the report to the appropriate agency, explaining that you are an out-of-state clinician providing telehealth if that applies. Agencies can often route a report or tell you where it belongs. Record the date, time, agency, the name of the person who took the report, and any reference number. If you are uncertain whether a second state's agency should also be notified, ask the hotline and consult an attorney or your carrier's risk management service.
Common questions
- Do I report to my state or the client's state?
- Usually the report goes to the agency where the child or vulnerable adult is, because that agency can respond. Your home state's law may also impose its own duty. When in doubt, contacting both hotlines and documenting the calls is a common conservative approach, but confirm your obligations with an attorney.
- What if the victim lives in a third state?
- That happens with divorced parents, visiting relatives, and adult children caring for parents elsewhere. The agency where the victim lives is generally the one that can act, and the hotline you call can often help route the report. Document every call, including the time and the person you spoke with.
- Are the definitions of reportable abuse the same everywhere?
- No. States differ on who is a mandated reporter, which kinds of abuse or neglect must be reported, the standard of suspicion required, and reporting timelines. Check each state's current law rather than relying on your training in one state.
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