RULES AND REGULATIONS
Title 49—PROFESSIONAL AND VOCATIONAL STANDARDS
STATE BOARD OF DENTISTRY
[ 49 PA. CODE CH. 33 ]
Child Abuse Reporting Requirements
[50 Pa.B. 3854]
[Saturday, August 1, 2020]The State Board of Dentistry (Board) hereby amends §§ 33.1, 33.250—33.255 and 33.401 and adds §§ 33.256 and 33.257 (relating to child abuse recognition and reporting—mandatory training requirement; and child abuse recognition and reporting course approval process) to read as set forth in Annex A.
Effective Date
The amendments will be effective upon publication of this final-form rulemaking in the Pennsylvania Bulletin.
Statutory Authority
Section 3(o) of the Dental Law (63 P.S. § 122(o)) sets forth the Board's general rulemaking authority. Section 6383(b)(2) of the Child Protective Services Law (CPSL) (23 Pa.C.S. § 6383(b)(2) (relating to education and training)) requires the Board to promulgate regulations to implement the mandatory reporting requirements for Board-regulated practitioners.
Purpose and Explanation
Since 2014 the General Assembly has made numerous amendments to the CPSL, including the requirement imposed by the act of April 15, 2014 (P.L. 411, No. 31) (Act 31 of 2014) on all health-related Boards to require training in child abuse recognition and reporting for licensees who are considered ''mandated reporters'' under the CPSL. Section 2 of Act 31 of 2014 provided that these training requirements would apply to all persons applying for a license, or applying for renewal of a license, on or after January 1, 2015. The Board implemented the training requirements as mandated by Act 31 of 2014 at the beginning of 2015 and subsequently proposed this rulemaking to update the Board's existing regulations on the subject of child abuse reporting to be consistent with the CPSL, as amended.
The proposed rulemaking was published at 48 Pa.B. 1179 (February 24, 2018) for 30 days of public comment, but no public comments were received. The Independent Regulatory Review Commission (IRRC) submitted comments on April 25, 2018. The House Professional Licensure Committee (HPLC) and the Senate Consumer Protection and Professional Licensure Committee (SCP/PLC) did not submit comments. The following represents a summary of IRRC's comments and the Board's response, along with a description of the amendments made to this final-form rulemaking, some of which were necessitated by additional amendments made to the CPSL since publication of the proposed rulemaking.
Summary of IRRC's Comments and the Board's Response
Section 33.1 (relating to definitions)
IRRC first commented relating to definitions that the Board is adopting or amending from the CPSL that are not defined exactly as stated in the CPSL. First, IRRC noted that the Board indicated its intent to remove the definition of the term ''perpetrator'' because it is no longer used in the regulations. However, IRRC correctly pointed out that the term continues to appear in the definition of ''serious physical neglect'' as taken directly from the CPSL. IRRC suggests that the Board should either keep the defined term ''perpetrator'' or revise the definition of ''serious physical neglect'' not to include the use of that term.
The Board had intentionally deleted the definition of the term ''perpetrator'' from the regulation because the Board believed it could cause confusion when a Board regulated practitioner was unsure of who may have abused a child leading to an underreporting of suspected child abuse. The Board has added the statutory definition of ''perpetrator'' to the final-form rulemaking in response to IRRC's comment. However, this addition is being made to assure that the regulation is consistent with the CPSL, and is not intended to imply that a Board regulated practitioner has a duty to conduct an investigation to determine who abused or caused abuse to the child and then determine if they meet the statutory definition of ''perpetrator'' prior to making a report of suspected child abuse. If a Board regulated practitioner believes a child has been the subject of abuse, the Board regulated practitioner should make a report as set forth in the regulations so that the appropriate authorities may investigate.
IRRC also noted that the Board's intent is to amend the definition of ''child abuse'' to comport with amendments made to the CPSL. However, IRRC noted that the proposed definition varies from the CPSL. Specifically, section 6303(b.1)(8)(ii) of the CPSL states, ''unreasonably restraining or confining a child, based on consideration of the method, location or duration of the restraint or confinement,'' whereas the equivalent definition in the Board's regulations only states ''unreasonably restraining or confining a child.''
Initially, the qualifying phrase ''based on consideration of the method, location or duration of the restraint or confinement'' was intentionally omitted from the proposed rulemaking because the Board did not want Board regulated practitioners to be making subjective determinations about whether the method, location or duration of the restraint or confinement was or was not ''unreasonable'' resulting in an underreporting of suspected child abuse. However, upon consideration of IRRC's comment, it appears to the Board that the phrase may be helpful to Board regulated practitioners by clarifying what aspects of restraint or confinement make it unreasonable. For that reason, and to assure that the definition is consistent with the CPSL, the qualifying phrase has been added to this final-form rulemaking.
IRRC also noted that the phrase ''provided that the violation is being investigated by law enforcement'' was not carried over from section 6303(b.1)(8)(iv) of the CPSL to the Board's definition of ''child abuse.'' This provision of the CPSL defines ''child abuse'' to include the act of ''causing a child to be present at a location while a violation of 18 Pa.C.S. § 7508.2 (related to operation of methamphetamine laboratory) is occurring, provided that the violation is being investigated by law enforcement.'' In response to IRRC's comment, the Board has inserted the missing clause. Originally, the Board did not want to include the proviso at the end because it might imply that the Board regulated practitioner would have a duty to determine if the methamphetamine laboratory was being investigated by law enforcement, which was not the Board's intent. Again, the insertion of the proviso in the final-form rulemaking is being made to assure that the definition in the Board's regulation is consistent with the CPSL. It is not intended to imply that a Board regulated practitioner has such a duty. If a Board regulated practitioner believes that a child has been present at a methamphetamine laboratory, it should be reported as set forth in the regulation.
Additionally, IRRC noted that section 6303(b.1)(8)(vii)(D) of the CPSL was not included at all in the proposed rulemaking. This provision is related to leaving a child unsupervised with an individual, other than the child's parent, who has been determined to be a sexually violent predator under 42 Pa.C.S. § 9799.58 (relating to assessments) or has to register for life under 42 Pa.C.S. § 9799.55(b) (relating to registration). In response, the Board notes that section 6303(b.1)(8)(vii)(D) was added by the act of February 21, 2018 (P.L. 27, No. 10) (Act 10 of 2018), while the Board delivered the proposed rulemaking to IRRC and the standing committees of the House and Senate on February 9, 2018. Therefore, the Board could not have included it in the proposed rulemaking because it did exist as a requirement of the CPSL at the time of delivery. However, it has been added to the final-form rulemaking.
IRRC also noted that since it is the Board's intent to amend the regulations to be consistent with the CPSL to benefit licensees and so as to avoid confusion as to their responsibilities in this area, the Board should ensure that the final-form rulemaking is consistent with the CPSL. The final-form rulemaking has been reviewed and revised so that it comports with the CPSL, including more recent amendments that occurred after the proposed rulemaking was published. In addition, the Board will endeavor to keep up with future changes to the CPSL and to amend the regulations as needed.
Section 33.401 (relating to credit-hour requirements)
IRRC raised a concern that the proposed rulemaking does not provide direct notice that if the continuing education requirement for child abuse recognition and reporting is not met, a license or certificate cannot be renewed. IRRC suggests that direct and clear notice in the wording of the regulation will benefit both the Board and the regulated community in obtaining compliance. In response, the Board has added a clear notice to § 33.401(h) indicating that the Board will not renew a license or certificate unless the Bureau has received an electronic report from an approved provider documenting the attendance/participation of the licensee or certificate holder. Instead, the licensee or certificate holder will receive a ''discrepancy notice'' through the Pennsylvania Licensing System informing them that the Bureau/Board has not received an electronic report evidencing completion of the mandatory child abuse training and that their license or certificate cannot be renewed until such a report is received.
Description of Amendments to the Final-form Rulemaking
The definition of ''child abuse'' has been amended in response to IRRC's comments to be consistent with the definition in the CPSL as discussed previously. Additionally, the definition of ''perpetrator'' has been included in this final-form rulemaking.
In the proposed rulemaking, the Board had planned to add a new section, § 33.252a (relating to mandatory reporting of children under 1 year of age) as a result of amendments to section 6386 of the CPSL, which had required mandatory reporting when a health care provider is involved in the care of a child under 1 year of age who is born and identified as being affected by illegal substance abuse by the child's mother, withdrawal symptoms resulting from prenatal drug exposure, or a Fetal Alcohol Spectrum Disorder. However, section 6386 of the CPSL was amended in June of 2018, to change this requirement to a ''notification'' and to clarify that this ''notification'' does not constitute a child abuse report. Therefore, the Board determined that this section was no longer needed in this final-form rulemaking and it has been deleted. This, of course, does not relieve health care providers from the duty to make such notifications under the CPSL, but simply reflects the fact that the Board is not required to enforce this requirement by regulation. In addition, all cross references to proposed § 33.252a have been removed from this final-form rulemaking.
Section 33.255 (relating to noncompliance) has been amended in this final-form rulemaking to reflect recent amendments made to the CPSL by the act of November 26, 2019 (P.L. 648, No. 88), which were effective as of January 25, 2020, with regard to the criminal penalties related to the willful failure to report suspected child abuse.
Finally, the Board has amended § 33.401(h) to provide clear notice that the Board will not renew a license or certificate unless the Bureau has received an electronic report from an approved child abuse course provider documenting the attendance/participation by the licensee or certificateholder of the required 2 hours of continuing education in child abuse recognition and reporting requirements.
Fiscal Impact and Paperwork Requirements
The Board does not anticipate any significant fiscal impact or paperwork requirements relating to these amendments. Because licensees and certificateholders are already required to complete mandatory continuing education, and the 2 hours in child abuse recognition and reporting are incorporated in the existing requirement, there would be no increased burden. Only applicants for licensure or certification incur an additional requirement, and as there are many low-cost and free options available to complete the training, the Board anticipates this impact to also be minimal. Because all approved Act 31 training providers are required to report attendance/participation electronically, there are no additional paperwork requirements imposed on licensees. In addition, the implementation of an electronic reporting system for mandatory reporters of child abuse under the CPSL by the Department of Human Services has decreased the paperwork requirements related to the mandatory reporting requirements.
Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P.S. § 745.5(a)), on February 9, 2018, the Board submitted a copy of the notice of proposed rulemaking, published at 48 Pa.B. 1179, to IRRC and to the Chairpersons of the HPLC and SCP/PLC for review and comment.
Under section 5(c) of the Regulatory Review Act, IRRC, the HPLC and the SCP/PLC were provided with copies of the comments received during the public comment period, as well as other documents when requested. In preparing this final-form rulemaking, the Board has considered all comments from IRRC. No public comments were received. The Board also received no comments from the HPLC or the SCP/PLC.
Under section 5.1(j.2) of the Regulatory Review Act (71 P.S. § 745.5a(j.2)), on February 13, 2020, the Board delivered this final-form rulemaking to IRRC, the HPLC and the SCP/PLC. Under section 5.1(j.2) of the Regulatory Review Act (71 P.S. § 745.5a(j.2)), on June 17, 2020, the final-form rulemaking was deemed approved by the HPLC and the SCP/PLC. Under section 5.1(e) of the Regulatory Review Act, IRRC met on June 18, 2020, and approved the final-form rulemaking.
Additional Information
Individuals who need information about this final-form rulemaking may contact Lisa Burns, Board Administrator, State Board of Dentistry, at P.O. Box 2649, Harrisburg, PA 17105-2649, RA-DENTISTRY@pa.gov.
Findings
The Board finds that:
(1) Public notice of proposed rulemaking was given under sections 201 and 202 of the act of July 31, 1968 (P.L. 769, No. 240) (45 P.S. §§ 1201 and 1202), known as the Commonwealth Documents Law and the regulations promulgated thereunder, 1 Pa. Code §§ 7.1 and 7.2 (relating to relating to notice of proposed rulemaking required; and adoption of regulations).
(2) A public comment period was provided as required by law, but no comments were received.
(3) The amendments to this final-form rulemaking do not enlarge the original purpose of the proposed rulemaking published at 48 Pa.B. 1179.
(4) This final-form rulemaking is necessary and appropriate for the administration of the amendments to the Child Protective Services Law (23 Pa.C.S. §§ 6301—6387).
Order
The Board, therefore, orders that:
(a) The regulations of the Board at 49 Pa. Code Chapter 33, are amended by amending §§ 33.1, 33.250—33.255 and 33.401 and adding §§ 33.256 and 33.257 to read as set forth in Annex A, with ellipses referring to the existing text of the regulations.
(Editor's Note: Proposed § 33.252a in the proposed rulemaking published at 48 Pa.B. 1179, is not being adopted.)
(b) The Board shall submit this Order and Annex A to the Office of Attorney General and the Office of General Counsel for approval as required by law.
(c) The Board shall submit this order and Annex A to IRRC, the HPLC and the SCP/PLC as required by law.
(d) The Board shall certify this Order and Annex A and deposit them with the Legislative Reference Bureau as required by law.
(e) This final-form rulemaking shall take effect upon publication in the Pennsylvania Bulletin.
IVAN R. LUGO, DMD,
Chairperson(Editor's Note: See 50 Pa.B. 3355 (July 4, 2020) for IRRC's approval order.)
Fiscal Note: Fiscal Note 16A-4626 remains valid for the final adoption of the subject regulations.
Annex A
TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS
PART I. DEPARTMENT OF STATE
Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS
CHAPTER 33. STATE BOARD OF DENTISTRY
Subchapter A. GENERAL PROVISIONS § 33.1 Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
* * * * * Board regulated practitioner—A dentist, restricted faculty license holder, dental hygienist, public health dental hygiene practitioner or expanded function dental assistant.
Bodily injury—Impairment of physical condition or substantial pain.
Bureau—The Bureau of Professional and Occupational Affairs of the Commonwealth.
Child—An individual under 18 years of age.
Child abuse—Intentionally, knowingly or recklessly doing any of the following:
(i) Causing bodily injury to a child through any recent act or failure to act.
(ii) Fabricating, feigning or intentionally exaggerating or inducing a medical symptom or disease which results in a potentially harmful medical evaluation or treatment to the child through any recent act.
(iii) Causing or substantially contributing to serious mental injury to a child through any act or failure to act or a series of such acts or failures to act.
(iv) Causing sexual abuse or exploitation of a child through any act or failure to act.
(v) Creating a reasonable likelihood of bodily injury to a child through any recent act or failure to act.
(vi) Creating a likelihood of sexual abuse or exploitation of a child through any recent act or failure to act.
(vii) Causing serious physical neglect of a child.
(viii) Engaging in any of the following recent acts:
(A) Kicking, biting, throwing, burning, stabbing or cutting a child in a manner that endangers the child.
(B) Unreasonably restraining or confining a child, based on consideration of the method, location or duration of the restraint or confinement.
(C) Forcefully shaking a child under 1 year of age.
(D) Forcefully slapping or otherwise striking a child under 1 year of age.
(E) Interfering with the breathing of a child.
(F) Causing a child to be present at a location while a violation of 18 Pa.C.S. § 7508.2 (relating to operation of methamphetamine laboratory) is occurring, provided that the violation is being investigated by law enforcement.
(G) Leaving a child unsupervised with an individual, other than the child's parent, who the actor knows or reasonably should have known:
(I) Is required to register as a Tier II or Tier III sexual offender under 42 Pa.C.S. Chapter 97, Subchapter H (relating to registration of sexual offenders), where the victim of the sexual offense was under 18 years of age when the crime was committed.
(II) Has been determined to be a sexually violent predator under 42 Pa.C.S. § 9799.24 (relating to assessments) or any of its predecessors.
(III) Has been determined to be a sexually violent delinquent child as defined in 42 Pa.C.S. § 9799.12 (relating to definitions).
(IV) Has been determined to be a sexually violent predator under 42 Pa.C.S. § 9799.58 (relating to assessments) or has to register for life under 42 Pa.C.S. § 9799.55(b) (relating to registration).
(H) Causing the death of the child through any act or failure to act.
(I) Engaging a child in a severe form of trafficking in persons or sex trafficking, as those terms are defined under section 103 of the Trafficking Victims Protection Act of 2000 (22 U.S.C.A. § 7102).
ChildLine—An organizational unit of the Department of Human Services, which operates a 24-hour a day Statewide toll free telephone system for receiving reports of suspected child abuse, referring reports for investigation and maintaining the reports in the appropriate file.
* * * * * General supervision—In a dental facility, supervision by a dentist who examines the patient, develops a treatment plan, authorizes the performance of dental hygiene services to be performed within 1 year of the examination, and takes full professional responsibility for the performance of the dental hygienist. In facilities identified in § 33.205(c)(2) and (3) (relating to practice as a dental hygienist), general supervision is defined in § 33.205(d)(2).
Individual study—A course of continuing education offered by an approved program sponsor, which permits the participant to learn without interacting with an instructor or interactive learning methodologies and which requires a passing grade on a written examination or workbook.
Local anesthesia—The elimination of sensations, especially pain, in one part of the body by regional injection of an anesthetic agent.
Mandated reporter—A person who is required under 23 Pa.C.S. § 6311 (relating to persons required to report suspected child abuse) to make a report of suspected child abuse. For purposes of this chapter, the term includes all Board regulated practitioners.
Parent—A biological parent, adoptive parent or legal guardian.
Perpetrator—A person who has committed child abuse as defined in this section.
(i) This term includes only the following:
(A) A parent of the child.
(B) A spouse or former spouse of the child's parent.
(C) A paramour or former paramour of the child's parent.
(D) A person 14 years of age or older and responsible for the child's welfare or having direct contact with children as an employee of child-care services, a school or through a program, activity or service.
(E) An individual 14 years of age or older who resides in the same home as the child.
(F) An individual 18 years of age or older who does not reside in the same home of the child but is related within the third degree of consanguinity or affinity by birth or adoption of the child.
(G) An individual 18 years of age or older who engages a child in severe forms of trafficking in persons or sex trafficking, as those terms are defined under section 103 of the Trafficking Victims Protection Act of 2000 (22 U.S.C.A. § 7102).
(ii) Only the following may be considered a perpetrator for failing to act, as provided in this section:
(A) A parent of the child.
(B) A spouse or former spouse of the child's parent.
(C) A paramour or former paramour of the child's parent.
(D) A person 18 years of age or older and responsible for the child's welfare.
(E) A person 18 years of age or older who resides in the same home as the child.
Person responsible for the child's welfare—A person who provides permanent or temporary care, supervision, mental health diagnosis or treatment, training or control of a child in lieu of parental care, supervision and control.
Program, activity or service—Any of the following in which children participate and which is sponsored by a school or a public or private organization:
(i) A youth camp or program.
(ii) A recreational camp or program.
(iii) A sports or athletic program.
(iv) A community or social outreach program.
(v) An enrichment or educational program.
(vi) A troop, club or similar organization.
Program sponsor—The party approved by the Board who is responsible for the development and presentation of the continuing dental education program.
Public health dental hygiene practitioner—A licensed dental hygienist who is certified by the Board as having met the requirements of section 11.9 of the act (63 P.S. § 130j), and who is authorized to perform dental hygiene services in accordance with § 33.205b (relating to practice as a public health dental hygiene practitioner) without the authorization, assignment or examination of a dentist.
Recent act or failure to act—An act or failure to act committed within 2 years of the date of the report to the Department of Human Services or county agency.
Serious mental injury—A psychological condition, as diagnosed by a physician or licensed psychologist, including the refusal of appropriate treatment, that does one or more of the following:
(i) Renders a child chronically and severely anxious, agitated, depressed, socially withdrawn, psychotic or in reasonable fear that the child's life or safety is threatened.
(ii) Seriously interferes with a child's ability to accomplish age-appropriate developmental and social tasks.
Serious physical neglect—Any of the following when committed by a perpetrator that endangers a child's life or health, threatens a child's well-being, causes bodily injury or impairs a child's health, development or functioning:
(i) A repeated, prolonged or egregious failure to supervise a child in a manner that is appropriate considering the child's developmental age and abilities.
(ii) The failure to provide a child with adequate essentials of life, including food, shelter or medical care.
Sexual abuse or exploitation—Any of the following:
(i) The employment, use, persuasion, inducement, enticement or coercion of a child to engage in or assist another individual to engage in sexually explicit conduct, which includes the following:
(A) Looking at the sexual or other intimate parts of a child or another individual for the purpose of arousing or gratifying sexual desire in any individual.
(B) Participating in sexually explicit conversation either in person, by telephone, by computer or by a computer-aided device for the purpose of sexual stimulation or gratification of any individual.
(C) Actual or simulated sexual activity or nudity for the purpose of sexual stimulation or gratification of any individual.
(D) Actual or simulated sexual activity for the purpose of producing visual depiction, including photographing, videotaping, computer depicting or filming.
(ii) Any of the following offenses committed against a child:
(A) Rape as defined in 18 Pa.C.S. § 3121 (relating to rape).
(B) Statutory sexual assault as defined in 18 Pa.C.S. § 3122.1 (relating to statutory sexual assault).
(C) Involuntary deviate sexual intercourse as defined in 18 Pa.C.S. § 3123 (relating to involuntary deviate sexual intercourse).
(D) Sexual assault as defined in 18 Pa.C.S. § 3124.1 (relating to sexual assault).
(E) Institutional sexual assault as defined in 18 Pa.C.S. 3124.2 (relating to institutional sexual assault).
(F) Aggravated indecent assault as defined in 18 Pa.C.S. § 3125 (relating to aggravated indecent assault).
(G) Indecent assault as defined in 18 Pa.C.S. § 3126 (relating to indecent assault).
(H) Indecent exposure as defined in 18 Pa.C.S. § 3127 (relating to indecent exposure).
(I) Incest as defined in 18 Pa.C.S. § 4302 (relating to incest).
(J) Prostitution as defined in 18 Pa.C.S. § 5902 (relating to prostitution and related offenses).
(K) Sexual abuse as defined in 18 Pa.C.S. § 6312 (relating to sexual abuse of children).
(L) Unlawful contact with a minor as defined in 18 Pa.C.S. § 6318 (relating to unlawful contact with minor).
(M) Sexual exploitation as defined in 18 Pa.C.S. § 6320 (relating to sexual exploitation of children).
(iii) For the purposes of subparagraph (i), the term does not include consensual activities between a child who is 14 years of age or older and another person who is 14 years of age or older and whose age is within 4 years of the child's age.
Sexual misconduct—Any conduct with a current patient, including words, gestures or expressions, actions or any combination thereof, which is sexual in nature, or which may be construed by a reasonable person as sexual in nature.
Subgingival agents—Therapeutic agents, including antimicrobials, antibiotics, antiseptics or anesthetics, placed below the free margin of the gingiva by a local delivery system or device, including injectable systems for ointments, gels or pastes, and degradable or nondegradable devices, such as fibers, films, strips, slaps, spheres, discs or chips.
Subchapter C. MINIMUM STANDARDS OF CONDUCT AND PRACTICE § 33.250. Suspected child abuse—mandated reporting requirements.
(a) General rule. Under 23 Pa.C.S. § 6311 (relating to persons required to report suspected child abuse), all Board regulated practitioners are considered mandated reporters. A mandated reporter shall make a report of suspected child abuse in accordance with this section if the mandated reporter has reasonable cause to suspect that a child is a victim of child abuse under any of the following circumstances:
(1) The mandated reporter comes into contact with the child in the course of employment, occupation and practice of the profession or through a regularly scheduled program, activity or service.
(2) The mandated reporter is directly responsible for the care, supervision, guidance or training of the child, or is affiliated with an agency, institution, organization, school, regularly established church or religious organization or other entity that is directly responsible for the care, supervision, guidance or training of the child.
(3) A person makes a specific disclosure to the mandated reporter that an identifiable child is the victim of child abuse.
(4) An individual 14 years of age or older makes a specific disclosure to the mandated reporter that the individual has committed child abuse.
(b) Staff members of public or private agencies, institutions and facilities. Whenever a Board regulated practitioner is required to make a report under subsection (a) in the capacity as a member of the staff of a medical, dental or other public or private institution, school, facility or agency, that Board regulated practitioner shall report immediately in accordance with subsection (c) and shall immediately thereafter notify the person in charge of the institution, school, facility or agency or the designated agent of the person in charge.
(c) Reporting procedure. A mandated reporter shall immediately make a report of suspected child abuse to the Department of Human Services by either:
(1) Making an oral report of suspected child abuse by telephone to ChildLine at (800) 932-0313, followed by a written report within 48 hours to the Department of Human Services or the county agency assigned to the case in a manner and format prescribed by the Department of Human Services. The written report submitted under this subparagraph may be submitted electronically.
(2) Making an electronic report of suspected child abuse in accordance with 23 Pa.C.S. § 6305 (related to electronic reporting) through the Department of Human Service's Child Welfare Information Solution self-service portal at www.compass.state.pa.us/cwis. A confirmation by the Department of Human Services of the receipt of a report of suspected child abuse submitted electronically relieves the mandated reporter of the duty to make an additional oral or written report.
(d) Written or electronic reports. A written or electronic report of suspected child abuse, shall include the following information, if known:
(1) The names and addresses of the child, the child's parents and any other person responsible for the child's welfare.
(2) Where the suspected child abuse occurred.
(3) The age and sex of the subject or subjects of the report.
(4) The nature and extent of the suspected child abuse, including any evidence of prior abuse to the child or sibling of the child.
(5) The name and relationship of the person or persons responsible for causing the suspected abuse and any evidence of prior abuse by those persons.
(6) Family composition.
(7) The source of the report.
(8) The name, telephone number and e-mail address of the person making the report.
(9) The actions taken by the person making the report, including actions taken under 23 Pa.C.S. §§ 6314—6317.
(10) Other information required by Federal law or regulation.
(11) Other information that the Department of Human Services may require by regulation.
§ 33.251. Photographs, medical tests and X-rays of child subject to report.
A Board regulated practitioner may take or cause to be taken photographs of the child who is subject to a report and, if clinically indicated, cause to be performed a radiological examination and other medical tests on the child. Medical summaries or reports of the photographs, X-rays and relevant medical tests taken shall be sent to the county children and youth social service agency at the time the written report is sent, or within 48 hours after an electronic report is made under § 33.250(c)(2) (relating to suspected child abuse—mandated reporting requirements), or as soon thereafter as possible. The county children and youth social service agency shall have access to actual photographs or duplicates and X-rays and may obtain them or duplicates of them upon request.
§ 33.252. Suspected death as a result of child abuse—mandated reporting requirement.
A Board regulated practitioner who has reasonable cause to suspect that a child died as a result of child abuse shall report that suspicion to the coroner or medical examiner of the county where death occurred or, in the case where the child is transported to another county for medical treatment, to the coroner or medical examiner of the county where the injuries were sustained.
§ 33.253. Immunity from liability.
Under 23 Pa.C.S. § 6318 (relating to immunity from liability) a Board regulated practitioner who participates in good faith in the making of a report of suspected child abuse, making a referral for general protective services, cooperating or consulting with an investigation including providing information to a child fatality or near fatality review team, testifying in a proceeding arising out of an instance of suspected child abuse or general protective services or engaging in any action authorized under 23 Pa.C.S. §§ 6314—6317, shall have immunity from civil and criminal liability that might otherwise result by reason of the Board regulated practitioner's actions. For the purpose of any civil or criminal proceeding, the good faith of the Board regulated practitioner shall be presumed. The Board will uphold the same good faith presumption in any disciplinary proceeding that might result by reason of a Board regulated practitioner's actions under §§ 33.250—33.252 (relating to suspected child abuse—mandatory reporting requirements; photographs, medical tests and x-rays of child subject to report; and suspected death as a result of child abuse—mandated reporting requirement).
§ 33.254. Confidentiality—waived.
To protect children from abuse, the reporting requirements of §§ 33.250—33.252 (relating to suspected child abuse—mandated reporting requirements; photographs, medical tests and X-rays of child subject to report; and suspected death as a result of child abuse—mandated reporting requirement) take precedence over the provisions of any client confidentiality, ethical principle or professional standard that might otherwise apply. In accordance with 23 Pa.C.S. § 6311.1 (relating to privileged communications), privileged communications between a mandated reporter and a patient does not apply to a situation involving child abuse and does not relieve the mandated reporter of the duty to make a report of suspected child abuse.
§ 33.255. Noncompliance.
(a) Disciplinary action. A Board regulated practitioner who willfully fails to comply with the reporting requirements in §§ 33.250—33.252 (relating to suspected child abuse—mandated reporting requirements; photographs, medical tests and X-rays of child subject to report; and suspected death as a result of child abuse—mandated reporting requirement) will be subject to disciplinary action under section 4.1 of the act (63 P.S. § 123.1).
(b) Criminal penalties. Under 23 Pa.C.S. § 6319 (relating to penalties), a Board regulated practitioner who is required to report a case of suspected child abuse or to make a referral to the appropriate authorities and who willfully fails to do so commits a criminal offense, as follows:
(1) An offense not otherwise specified in paragraphs (2), (3) or (4) is a misdemeanor of the second degree.
(2) An offense is a felony of the third degree if all of the following apply:
(i) The mandated reporter willfully fails to report.
(ii) The child abuse constitutes a felony of the first degree or higher.
(iii) The mandated reporter has direct knowledge of the nature of the abuse.
(3) If the willful failure to report continues while the mandated reporter knows or has reasonable cause to suspect a child is being subjected to child abuse by the same individual, or while the mandated reporter knows or has reasonable cause to suspect that the same individual continues to have direct contact with children through the individual's employment, program, activity or service, the mandated reporter commits a felony of the third degree, except that if the child abuse constitutes a felony of the first degree or higher, the mandated reporter commits a felony of the second degree.
(4) A mandated reporter who, at the time of sentencing for an offense under 23 Pa.C.S. § 6319, has been convicted of a prior offense under § 6319, commits a felony of the third degree, except that if the child abuse constitutes a felony of the first degree or higher, the penalty for the second or subsequent offense is a felony of the second degree.
§ 33.256. Child abuse recognition and reporting—mandatory training requirement.
(a) Except as provided in subsection (c), individuals applying to the Board for an initial license or certificate shall submit proof of completion of 3 hours of training in child abuse recognition and reporting requirements which has been approved by the Department of Human Services.
(b) Except as provided in subsection (c), licensees and certificate holders seeking renewal of a license or certificate issued by the Board shall complete, as a condition of biennial renewal of the license or certificate, 2 hours of approved continuing education in child abuse recognition and reporting requirements, as a portion of the total continuing education required for biennial renewal. For credit to be granted, the continuing education course or program must be approved by the Bureau, in consultation with the Department of Human Services, as set forth in § 33.257 (relating to child abuse recognition and reporting course approval process).
(c) An applicant, licensee or certificate holder may apply in writing for an exemption from the training/continuing education requirements set forth in subsections (a) and (b) provided the applicant, licensee or certificate holder meets one of the following:
(1) The applicant, licensee or certificate holder submits documentation demonstrating that:
(i) The applicant, licensee or certificate holder has already completed child abuse recognition training as required by section 1205.6 of the Public School Code of 1949 (24 P.S. § 12-1205.6).
(ii) The training was approved by the Department of Education in consultation with the Department of Human Services.
(iii) The amount of training received equals or exceeds the amount of training or continuing education required under subsection (a) or (b), as applicable.
(2) The applicant, licensee or certificate holder submits documentation demonstrating all of the following:
(i) The applicant, licensee or certificate holder has already completed child abuse recognition training required under 23 Pa.C.S. § 6383(c) (relating to education and training).
(ii) The training was approved by the Department of Human Services.
(iii) The amount of training received equals or exceeds the amount of training or continuing education required under subsection (a) or (b), as applicable.
(3) The applicant, licensee or certificate holder submits documentation demonstrating that the applicant, licensee or certificate holder should not be subject to the training or continuing education requirement. Each request for an exemption under this paragraph will be considered on a case-by-case basis.
§ 33.257. Child abuse recognition and reporting course approval process.
(a) An individual, entity or organization may apply for approval to provide mandated reporter training as required under 23 Pa.C.S. § 6383(b) (relating to education and training) by submitting the course materials set forth in subsection (b) simultaneously to the Department of Human Services (DHS), Office of Children, Youth and Families, and to the Bureau at the following addresses:
(1) Department of Human Services, Office of Children, Youth and Families, Health and Welfare Building, 625 Forster Street, Harrisburg, PA 17120 or electronically at RA-PWOCYFCPSL@pa.gov.
(2) Bureau of Professional and Occupational Affairs, 2601 North Third Street, P.O. Box 2649, Harrisburg, PA 17105-2649 or electronically at RA-stcpsl_course_app@pa.gov.
(b) Submissions must include all of the following:
(1) Contact information (mailing address, e-mail address and telephone number) for the agency/course administrator.
(2) General description of the training and course delivery method.
(3) Title of the course.
(4) Timed agenda and estimated hours of training.
(5) Learning objectives.
(6) Intended audience.
(7) All course related materials, including as applicable:
(i) Handouts.
(ii) Narrated script or talking points.
(iii) Interactive activities or exercises.
(iv) Videos and audio/visual content.
(v) Knowledge checks, quizzes or other means of assessing participant's understanding of the material.
(vi) For online courses, a transcript or recording of audio training.
(8) Citation of sources, including written permission to use copyrighted material, if applicable.
(9) Anticipated credentials or experience of the presenter, or biography of presenter, if known.
(10) Printed materials used to market the training.
(11) Evaluation used to assess participants' satisfaction with the training.
(12) Sample certificate of attendance/participation, which shall include:
(i) Name of participant.
(ii) Title of training.
(iii) Date of training.
(iv) Length of training (2 or 3 hours).
(v) Name and signature of the authorized representative of the provider. The signature may be an electronic signature.
(vi) Statement affirming the participant attended the entire course.
(13) Verification of ability to report participation/attendance electronically to the Bureau in a format prescribed by the Bureau.
(c) The Bureau will notify the applicant in writing upon approval of the course and will post a list of approved courses on the Bureau's web site and the Board's web site.
Subchapter F. CONTINUING DENTAL EDUCATION § 33.401. Credit-hour requirements.
* * * * * (b) Except as provided in subsection (h), the required hours shall be taken in subject areas listed in § 33.402 (relating to continuing education subject areas) from a program sponsor listed in § 33.403 (relating to program sponsors).
* * * * * (g) Exceptions are as follows:
(1) An applicant is exempt from the continuing education requirement in subsection (a) for only the biennial period during which the applicant passed the licensure or certification examination.
(2) An applicant who cannot meet the continuing education requirement due to illness, emergency or hardship may apply to the Board in writing for a waiver. The request must explain why compliance is impossible. Waiver requests will be evaluated on a case-by-case basis.
(h) All licensees and certificate holders shall complete 2 of the required hours of continuing education in approved courses on child abuse recognition and reporting as set forth in § 33.256 (relating to child abuse recognition and reporting—mandatory training requirement). The Board will not renew a license or certificate unless the bureau has received an electronic report from an approved course provider documenting the attendance/participation by the licensee or certificateholder.
[Pa.B. Doc. No. 20-1028. Filed for public inspection July 31, 2020, 9:00 a.m.]
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