Emergency First Responders in Ontario have a duty to report suspected child abuse and neglect that they come upon in the course of their professional duties. Other professionals dealing with children have the same duty. They all must make that report to their local children’s aid society (here is a list.) Emergency First Responders must make the report about any child they come across in their professional duties – not just a child they have been called to assist. The Ontario Ministry of Health recently updated its standards for paramedics with regard to reporting child abuse or neglect. However, the duty for paramedics and other first responders has not changed under section 72 of the Child and Family Services Act. This page answers some questions about that duty.
What is Reportable Suspected Child Abuse and Neglect?
The types of concerns that create a duty for a First Responder or other professional to report are set out in section 72 of the Child and Family Services Act of Ontario. The types of concerns are quite broad and include:
- Physical Abuse (hitting, slapping, burning, etc.) – even it may be part of a course of discipline as what is permissible under criminal law may not be for child protection law.
- Physical Harm caused by a caregiver’s failure to properly care for or supervise a child.
- Physical Harm caused by a pattern of neglect.
- Any risk that a child may suffer physical harm as described above.
- Any sexual molestation or exploitation of a child or any act or commission that may put a child at risk of being sexually molested or exploited
- Any failure of a caregiver to prevent a child from being sexually molested or exploited.
- The person with care of the child refuses, or fails, to get adequate medical treatment for a child.
- The child is at risk of serious emotional harm that is characterized by: anxiety, depression, withdrawal, self-destructive behaviour or delayed development. Note that it is not any type of emotional harm, but just emotional harm that is so serious it results in the type of damage described. Also note that one of the most common causes for this type of emotional harm is when a child is exposed to adult conflict or domestic violence.
- The refusal of a caregiver to get assistance for a child who is at risk of the type of serious emotional harm as described above.
- The child suffers a mental, emotional or developmental condition and the care giver refuses to get assistance for the child.
- A child is abandoned.
- A child less than 12 yeas old has killed or seriously injured another person or done serious damage to property and the person looking after the child fails to get services or treatment to prevent a recurrence of that behaviour, encourages that behaviour.
If a professional, including any First Responder, is not sure whether to make a report, he or she should report, then he or she should report and let the “experts in child abuse and neglect’ decide whether an investigation is warranted. Alternatively, it is possible to make an anonymous phone call to the Children’s Aid Society and ask if it is necessary to report what the First Responder has seen.
How “Sure” Does a Professional Have to Be to Make a Report?
Professionals do not have to be certain at all that child abuse or neglect is occurring to have a duty to report to the local children’s aid society. They only have to have reasonable grounds to have a concern. That concern is not even that abuse or neglect is actually occurring. All the concern has to be is that a child is at risk of suffering abuse or neglect as described above. If any professional who assists children has reasonable grounds to believe that a child is at risk of abuse or neglect, then that professional has a duty to report.
To give an example, a first responder does not need to see suspicious bruises to have a duty to report. All that is necessary is a parent threatening to hit a child to trigger that duty to report.
Where the report is based only on a suspicion of the risk of abuse or neglect, a children’s aid society may not opt to do much in response. But, if a children’s aid society receives multiple calls about similar suspicions, then it may alert the agency to a child who is in really serious danger. Children’s aid societies do not go out patrolling to look for children who are in need of protection. They rely on reports from the community, especially professionals, to alert them to children who need help. This is why making reports of any reasonable belief that a child is suffering abuse or neglect or is at risk of suffering abuse or neglect is so important.
Who Has To Report Suspected Child Abuse or Neglect?
Every professional who deals with children in the course of his or her professional duties has a duty to personally report any reasonable belief that a child is at risk of the types of harm described above.
It is a personal duty to report directly to the children’s aid society. The reporting cannot be passed on to someone else. This means that is not sufficient for a first responder to advise a supervisor of suspicions of child abuse or neglect. The first responder must personally call the children’s aid society.
What Are the Reporting Duties for Supervisors?
If the first responder also alerts his or her supervisor of the suspicion, then the supervisor also has a duty to report what he or she hears directly to the children’s aid society. The supervisor cannot rely on the first responder saying that he or she has already made the report. When calling, the supervisor may want to make it clear that he or she understands that the person who reported the concerns to the supervisor said that he or she also reported the concerns to the children’s aid society. That way the children’s aid society will know that multiple people have not made the same observations. But, if the first responder forgets to call, then supervisor making the call will avoid a child falling through the cracks.
Do You Have to Give Your Name When Reporting Child Abuse or Neglect?
Absolutely not. Anonymous reports are fine and they do fulfill the duty to report suspicions of child abuse or neglect under the Child and Family Services Act. Sometimes it can be better to report anonymously because you do not want a parent or other caregiver to avoid calling for help in the future. There are changes to the Child and Services Act that would prevent a children’s aid society from revealing the name of a non-anonymous informant from the family of the child. Unfortunately, those provisions are not in force yet, so the children’s aid society is required to provide the name as part of the Family Court disclosure process.
When a first responder (or other professional) reports anonymously, it is important to keep a record of the report to avoid getting in trouble (see the possibility of being prosecuted for failing to report below). When making an anonymous report, the first responder should ask the call-taker at the children’s aid society for his or her name or another way to identify and record that the call was made. Then the first responder should include that proof of the call in an incident report or similar documentation so that the first responder can show that she or he made the call if there is a question about that later.
Keep in mind that if a front-line responder provides documentation to a supervisor or other manager that the responder felt he or she had an obligation to report suspected child abuse and neglect, technically, that supervisor or manager now also has a duty to report. Just as the front-line responder cannot delegate reporting to a supervisor, a supervisor cannot delegate reporting to the front line responder. Supervisors (and other managers) must report any suspected child abuse or neglect to the children’s aid society him or herself. Hopefully, if the front line responder reported anonymously, the supervisor does not then give the responder’s name or position to the children’s aid society. Sometimes, it may be best for the front-line reconsider to keep the proof of having made the report with him or herself (in a safe place).
However, when conducting an investigation into suspected child abuse and neglect, child protection workers have a lot of powers. Section 74.1 of the Child and Services Act empowers them to get a warrant to access records in relation to a child if it will assist with the child abuse or neglect investigation. That can include a first responder’s records – especially ambulance call reports, which can form part of medical records. So if a first responder’s record of anonymously contacting a children’s aid society is attached to an ACR, or in a police officer’s notes, that responder may not be anonymous for long. Hopefully, the management will carefully review the warrant and not give out any extra information (which could be a violation of other laws). If the warrant does not specifically require the production of a specific document, it should not be produced to the child protection worker or his or her agency.
Does Patient Confidentiality Override the Duty to Report?
Section 72 of the Child and Family Services Act specifically states that it overrides all other statutory provisions, including laws regarding privacy and confidentiality. The only privacy that is protected in solicitor-client privilege for lawyers to allow them to assist people who have a “conflict” with a children’s aid society. So, all the rules about protecting patient’s health records (and the sanctions for failing to keep a patient’s health records) do not apply if there is a suspicion that a child’s welfare may be a stake. This protection does not apply if a person reports maliciously or without reasonable grounds for believing that a child might be at risk of child abuse or neglect. However, preferring patient confidentiality over the duty to report a real suspicion of child abuse or neglect can result in some serious sanctions.
Are There Sanctions/Punishments For Not Reporting Suspected Child Abuse or Neglect?
Professionals who have a duty to report suspected child abuse or neglect face serious consequences if they do not comply with their duty. At the moment, the maximum penalty for a professional who fails to report suspected child and any per incidence of failing to report, is a fine of $1000.00. However, the proposed changes to the Child and Family Services Act increase that to a maximum of fine of $50,000.00 and/or a jail term not exceeding two years. Those amounts do not include the victim fine surcharge, the cost of hiring a defense lawyer or the time missed from work to go to court.
If I Report My Suspicions About a Child Once, Have I Complied With My Duty?
Section 72(2) of the Child and Family Services Act says that a professional who has a duty to report has a duty to report every time he or she believes that a child is currently at risk of child abuse or neglect. That duty exists even if the same professional has reported concerns about the same child, or even the same abuse or neglect. Over time that a professional has a suspicion, or recurrence of a suspicion, he or she must report it. The failure to report an on-going suspicion of child abuse can be prosecuted as a separate incident of failure to report over time the professional does not report. That can result in multiple fines of up to $1000.00 (with greater sanctions coming in the future).
Is My Obligation To Report Limited to the Child I Have Been Called to Assist?
The professional’s duty to report relates to any child that the professional comes across in the course of his or her professional duties. The duty is not limited to the child to whom a first responder is providing assistance. For example, if a first responder is called to a home to assist an adult and while there, sees a child who has clearly been beaten-up, or is even acting suspiciously, the first responder still has an obligation to report the concerns regarding that child.
The general rule for emergency first responders is that if they have a real suspicion that a child is either being abused or neglected, or is a risk of being abused or neglected, that first responder must personally call the children’s aid society and report suspicions. In addition, the first responder should keep notes of his or her actions.