Provider Manual


Participating providers must comply with all applicable state and federal child/elder abuse and other reporting laws.

The duty to warn a potential victim of possible harm from a patient may override the usual right to confidentiality of which an individual is assured when speaking to a clinician. This applies to any Carelon participating provider who receives information during assessment or treatment. In any threatening situation, relevant clinical data or history may be released to authorities. If a provider believes that a patient represents a threat to self or others, the provider may be required to attempt to protect the patient and to warn the potential victim(s) in a timely manner. It is preferable to contact the police, but the provider should warn the intended victim by telephone if that is the best way to assure the potential victim’s safety. It is the provider’s responsibility to be thoroughly familiar with the duty-to-warn rules of the state(s) in which they practice. Carelon should also be made aware of any such situation. Carelon may contact the provider when we are notified first of a potential situation. The provider will be called upon to exercise their duty-to-warn obligations in such a situation.

Members receiving Drug and Alcohol treatment cannot be identified as receiving these services. Providers may not identify themselves as being a behavioral health professional when reporting a threat made by a member receiving Drug and Alcohol services.

Mandated Reporters

What is the Child Protective Services Law (CPSL)?

The PA Child Protective Services Act was signed into law in 1975. It was enacted to protect children from abuse, allow the opportunity for healthy growth and development and, whenever possible, preserve and stabilize the family.

What is child abuse?

According to the CPSL, child abuse includes:

  • any act or failure to act by a perpetrator which causes non-accidental serious physical injury;
  • non-accidental serious mental injury to a child under 18 years of age;
  • sexual abuse or sexual exploitation to a child under 18 years of age;
  • serious neglect.

Child abuse also includes any recent act, failure to act, or series of acts or failures to act by a perpetrator that creates an imminent risk of serious physical injury to, or sexual abuse or exploitation of, a child under 18 years of age.

Who is Mandated to Report?

Individuals who, in the course of their employment, occupation or practice of a profession, come into contact with children and have reasonable cause to suspect that a child under the care, supervision, guidance, or training of that person or of an agency, institution, organization or other entity with which that person is affiliated, is a victim of child abuse.

Please keep in mind:

  • The victim child does not need to come directly before the mandated reporter in order for the reporter to be obligated to make a report. The mandated reporting requirements require persons who have a reasonable cause to suspect—on the basis of medical, professional or other training and experience—that a child under the care, supervision, guidance or training of that person or of an agency, institution, organization or other entity with which the person in affiliated, is a victim of child abuse.
  • Mandated reporters are obligated to report suspected child abuse without regard for the relationship between the alleged perpetrator, or abuser, and the child.
  • Penalties for failing to report suspected child abuse are a misdemeanor of the third degree for the first violation and a misdemeanor of the second degree for subsequent violations.
  • Confidential communications to clergy and to an attorney are exempted.

How do I report?

Call ChildLine at 1-800-932-0313. ChildLine is the 24-hour toll-free telephone reporting system operated by the Department of Public Welfare to receive reports of suspected child abuse. ChildLine forwards the report of suspected child abuse to the local county children and youth agency, which investigates the report to determine if the allegations can be substantiated as child abuse/neglect and also arranges for, or provides the services that are needed, to prevent the further maltreatment of the child and to preserve the family unity. If the alleged perpetrator named in the report does not meet the definition of perpetrator under the CPSL, but does suggest the need for investigation, ChildLine will forward the information to the District Attorney’s Office in the respective county. ChildLine also maintains a statewide Central Register, which contains the names and vital information about children who have been abused in PA since 1976. This information can be accessed by county children and youth agencies when investigating new reports of suspected child abuse.