UTSW/BioTel EMS System

October 2015

EMS TB 15-006 Child/Elderly/Disabled Abuse & Neglect Reporting Procedure   PDF Here


  1. To set forth for UTSW/BioTel EMS Providers the reporting procedure for the suspected abuse, neglect or exploitation of children, the elderly or the disabled.


  1. Texas ranks in the top 3 states with the highest number of reported child abuse cases.
  2. Similar to reporting requirements for physicians, Texas Family Code defines the duty and obligation of non-physician "professionals" to report to a proper, state-designated authority any suspected child abuse or neglect:
    1. "Professional" is defined as a person "licensed or certified by the state…who, in the normal course of official duties or duties for which a license of certification is required, has direct contact with children”.
    2. This clearly encompasses EMS Providers in the field. 
    3. The duty cannot be delegated to others or waived, based on legal “privilege”.
  3. These reporting requirements also apply to suspected cases of abuse, neglect or exploitation of the elderly and the mentally or physically disabled (see below).
  4. A person who reports abuse/neglect/exploitation in good faith is immune from civil or criminal liability.

WHAT is the UTSW/BioTel reporting procedure for suspected abuse or neglect?

  1. UTSW/BioTel EMS Providers shall evaluate and transport to an appropriate receiving hospital Emergency Department ANY patient for whom abuse or neglect is suspected:
    1. Details of the patient’s history, physical examination, environmental factors at the scene, and other relevant observations and evidence shall be clearly and objectively documented in the ePCR (more documentation information here: http://www.emsworld.com/article/10319863/prehospital-documentation).
  2. EMS Providers shall convey directly to hospital E.D. personnel their concern about possible abuse, neglect or exploitation.
  3. EMS Providers ALSO shall directly report as soon as possible ANY suspected child/elderly/disabled abuse/neglect to the following state-designated authorities:
    1. Texas Department of Family and Protective Services (DFPS), 24 hours a day, 7 days a week, via secure website online: https://www.txabusehotline.org/Login/Default.aspx (preferred) or 1-800-252-5400; OR
    2. Local Law Enforcement agency; OR
    3. The agency with regulatory oversight over a facility suspected of abuse*; OR
    4. Any agency designated by a court to handle abuse.
  4. The TX state report must include the following minimum information:
    1. The patient’s name and address; AND
    2. The name and address of the person(s) responsible for the care, custody or welfare of the patient; AND
    3. Any other information regarding the possible abuse, neglect or exploitation, especially all available medical or other evidence; AND
    4. The names of all EMS Providers participating in the EMS incident.

What are “Red Flags” for possible child, elderly, or disabled abuse/neglect/exploitation?

  1. EMS Providers Can Identify Child Abuse – Adapted from JEMS October 2011
  2. What Is Child Abuse and Neglect? Recognizing the Signs and Symptoms
  3. Guide to Reporting Suspected Abuse, Neglect or Financial Exploitation of Adults

What other persons are protected by these reporting requirements?

  1. Elderly persons at least 65 years of age;
  2. Physically disabled persons;
  3. *Mentally ill and mentally disabled persons, including adults and children living in state facilities or who are being helped by programs for people with mental illness or intellectual disabilities.


  1. Everyone – including EMS Providers – is bound by Texas law to report to an appropriate state-designated authority any case of suspected child/elderly/disabled abuse, neglect or exploitation. The report should be made as soon as possible to:
    1. Texas Department of Family and Protective Services, 24 hours a day, 7 days a week (secure website online: https://www.txabusehotline.org/Login/Default.aspx or 1-800-252-5400); OR local Law Enforcement.
  2. EMS Providers should not assume that the hospital staff or “someone else” will do it.
  3. Persons submitting good-faith reports are immune from criminal or civil liability.
  4. Reporting suspected abuse or neglect makes it possible for a family to get help.
  5. Failure to report could mean the difference between life and death for the patient.

Resources (verified/accessed 16 September 2015):

  1. Texas Department of Family and Protective Services (DFPS)
    1. DFPS Web Site to Report Abuse, Neglect or Exploitation
    2. DFPS Secure Online Reporting Form
  2. *Abuse Reports/Complaints for Facilities:
    1. Nursing homes, assisted living facilities, private ICF/MR, and adult day care:
      1. Texas Department of Aging and Disability Services (DADS): 1-800-458-9858
    2. Hospitals, psychiatric hospitals (including private psychiatric facilities), and various other medical facilities:
      1. Texas Department of State Health Services (DSHS): 1-888-973-0022
  3. EMS Providers Can Identify Child Abuse – Adapted from JEMS October 2011
  4. US DHHS What Is Child Abuse and Neglect? Recognizing the Signs and Symptoms
  5. Guide to Reporting Suspected Abuse, Neglect or Financial Exploitation of Adults
  6. Abuse/Neglect EMS Documentation: Describing What Happened (EMS World 2010)
  7. Texas Family Code, Section 261
  8. UTSW/BioTel EMS Guidelines for Therapy, especially: Pediatric Treatment Overview and Destination Policy