Risk Management

Last reviewed: July 2026. This page is reviewed periodically. Members should consult their professional liability carrier or a licensed Maryland attorney for guidance on specific situations.

Reporting Child Abuse


When to Report


Question: How do I know when I am required to report suspected child abuse?


Answer: The general rules can be found in the statute. Please see Family Law Article § 5-701, § 5-702, and § 5-704. If you have reason to believe that abuse has taken place, it is critical to recognize that reporting is not discretionary.


Psychologists are mandated reporters under Maryland law. The reporting obligation is triggered by a reasonable professional belief — definitive proof is not required.


Maryland law requires a two-step reporting process:

  • Oral report: Contact the local Department of Social Services or appropriate law enforcement agency in the jurisdiction where the abuse occurred immediately upon having reason to believe abuse or neglect has occurred.
  • Written report: Complete and submit DHS/SSA Form 180 within 48 hours of the contact or event that revealed the suspected abuse or neglect. A copy must also be provided to the local State's Attorney's Office. (See Family Law § 5-705 and COMAR 07.02.07.04.)


If you work within an institutional setting (hospital, school, child care facility, or similar organization), you must also immediately notify the head of your institution or their designee — though this institutional notification does not substitute for your personal obligation to contact the local department of social services.


Deceased Perpetrator


Question: Must I report if the alleged perpetrator is deceased?


Answer: If you work for the State of Maryland, you are bound by the opinion of the Attorney General, which requires reporting in such an instance. Members are encouraged to consult their professional liability carrier for guidance specific to their practice setting.


Adult Abused Out-of-State


Question: If I am treating an adult who was abused as a child outside the state of Maryland, am I obligated to report?


Answer: Generally, if your patient is a current adult and the abuse occurred in another state during their childhood, Maryland's mandatory reporting statute does not require you to report under that specific circumstance.


However, an important distinction applies: if the abuse involves a child who currently resides in Maryland — regardless of where the abuse took place — Maryland law does require a report to be made to the local department of social services, which is then responsible for forwarding the report to other jurisdictions as appropriate. (See Family Law § 5-705.1 and COMAR 07.02.07.04.) If any current child is potentially at risk, the reporting obligation applies.


When in doubt, consult your professional liability carrier before declining to report.

Subpoenas


Question: I've just received a subpoena. What do I do?


Answer: A subpoena is a court document sent by a lawyer that requires a response; however, it does not mean that the psychologist immediately turns over records. Although it is not a judicial order, failure to respond can theoretically result in a bench warrant for "failing to appear."


The subpoena should be accompanied by a notice to the patient that they have 30 days within which to file a motion to quash or for a protective order. No records should be produced until the issuing attorney or party provides assurances that no objection has been made.


The psychologist may contact the patient about the matter. With an appropriate release from the patient, the psychologist may also speak to the patient's lawyer.


The psychologist should advise the lawyer issuing the subpoena that records can only be provided in compliance with the requirements of the Maryland Medical Records Confidentiality Act (Health-General § 4-307, which applies specifically to mental health records). The psychologist may ask the lawyer for the basis for the release and make arrangements for expenses and fees (if the psychologist's appearance is requested, they are considered an expert witness). This communication should be documented by letter, with copies to the patient and the patient's lawyer. A formal Motion may need to be filed, but a letter will usually suffice.


If the subpoena is from the spouse of a patient: There is no exception to confidentiality in a divorce or custody case that allows a spouse to obtain the records of the other spouse.

If the subpoena is from one member of a couple seen for couples' therapy: Releases for records from couples' or family therapy require that all patients sign a release.



In all cases, it is recommended that you contact your professional liability carrier for advice and potential coverage of legal expenses.

Records


Retention of Records


Question: How long do I need to retain records?


Answer: Current Maryland law requires retention of records for five years from the date of the record for adults. For minors, records must be kept until the former patient reaches age 21, or for five years from the last date of the record, whichever is later (i.e., three years after reaching the age of majority at 18).


For psychologists who are required to follow HIPAA, the retention period increases from five to six years from the date of creation or the date the record was last in effect, whichever is later.


Release of Records to Non-custodial Parents


Question: I have received a request for records from a parent who does not have custody of the child I am seeing in therapy. Do I have to send my records?



Answer: Maryland law (Family Law Article § 9-104, quoted below) prohibits denial of access based on non-custodial status, unless a court orders otherwise. A denial to disclose the record can be based on other legal grounds — primarily the refusal to disclose a portion of a record that may be "injurious to the health of a patient" — but there is a process that must be followed per Health-General § 4-303 and § 4-304. Consult an attorney familiar with this law before declining to release records.

§ 9-104: Unless otherwise ordered by a court, access to medical, dental, and educational records concerning the child may not be denied to a parent because the parent does not have physical custody of the child.

Professional Wills


Question: What is a professional will and do I need one?


Answer: A professional will is a document that provides for the care of your practice in the event of your sudden death or disability. Generally, it identifies another professional who will be responsible for closing your practice, including the care and destruction of records, contact with patients, and other administrative matters. Developing a professional will can help avoid confusion and stress for families and clients in the event of an emergency.


You may wish to consult an attorney familiar with Maryland laws when developing your professional will. In general, a professional will should include: identification of an executor; location of client records; location of billing and financial records; patient contact information; email and voicemail access codes; provision for patient notification; provision for notification of liability insurance carrier; and compensation for the executor. The executor should have a copy of the document and should also have the name of the executor of the psychologist's personal will.


Maryland law (Health-General § 4-403(e)) provides guidance for the maintenance of records and the conditions under which medical records can be destroyed upon the death, retirement, surrender of license, or discontinuance of practice of the provider.


APA Resources: Professional Will — A Responsible Thing to Do | Why You Need a Professional Will Today | Sample Professional Will | Information for Professional Executor

Copying Fees


Question: Are psychologists allowed to charge patients and/or their personal representatives a fee for copying medical records?


Answer: Maryland law and HIPAA allow psychologists to charge patients and/or their personal representatives a fee for copying medical records. These charges are adjusted annually for inflation in accordance with the Consumer Price Index. See Health-General § 4-304 for the full statutory framework.


Current allowable fees in Maryland are as follows:

  • Paper copies: Up to $0.76 per page, plus the actual cost of postage and handling.
  • Electronic copies: Up to $0.57 per page (75% of the paper rate), not to exceed $80 total, plus the actual cost of postage and handling.
  • Preparation fee: Up to $22.88 is permitted when records are sent to someone other than the patient or their personal representative. HIPAA regulations do not allow this fee when records are released directly to the patient.


No fee may be charged when records are requested for the purpose of filing or appealing a Social Security Disability Income or Social Security Benefits claim under Title II or Title XVI of the Social Security Act, when requested by the patient, their personal representative, or an employee or representative of a nonprofit legal services entity or volunteer program representing the patient (Health-General § 4-304(c)(5)).


Fees are subject to annual CPI adjustment; verify current rates at health.maryland.gov.

Titles


Question: What title can I use on business cards and stationery?


Answer: If you are licensed by the Maryland Board of Examiners of Psychologists, you may call yourself "Licensed Psychologist" and/or list yourself by your specialty (e.g., "Clinical Psychologist," "Counseling Psychologist").


You may not use the title "Licensed Clinical Psychologist," because the Maryland license is generic — you are licensed as a psychologist, not as a clinical psychologist or any other specialty. (Health Occupations Article § 18-101)

Note: This page provides general information only and does not constitute legal advice. Laws and regulations change; members should consult a licensed Maryland attorney or their professional liability carrier for guidance on specific situations.