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abuse or dictate what agencies must be consulted to develop the curriculum.30 Others simply call for the dissemination of educational materials and programs to increase awareness of trafficking and services.31 From this general framework, three approaches merit closer consideration. New Jersey’s standalone human-trafficking statute offers the most concrete guidance.32 For all employees of “a licensed health care facility,” education is mandatory. “Licensed health care facility” is comprehensively defined, including entities such as general hospitals, mental hospitals, public health centers, diagnostic centers, rehabilitation centers, extended-care facilities, nursing homes, intermediate-care facilities, maternity hospitals, outpatient clinics, dispensaries, and home health care agencies.33 All such persons employed by a health care facility were required to participate in a one-time training course within one year of the law’s enactment (May 6, 2013). The training must cover “the handling and response procedures of suspected human trafficking activities.” The Department of Health is responsible for ensuring that all required employees of licensed health care facilities attend the training course; new employees must take the course within six months of employment. Florida is utilizing a continuing medical education (CME)-based approach. Currently, physicians can, but do not have to, satisfy their two-hour domestic violence (DV) CME requirement by taking a 118 H. G. ATKINSON ET AL. course “Domestic Violence with a Special Focus on Human Trafficking.” 34 Looking ahead, two new bills would move Florida to a mandatory education model.35 At their broadest, the bills would apply to physicians, midwives, nurses, dentists, and psychologists, among others. The content of the training, on both sex and labor trafficking, would include information on the types and extent of trafficking, risk factors and patient identification, patient safety and security, management of patient records, and resources and referral procedures for legal and social services. A federal bill, the Trafficking Awareness Training for Health Care Act of 2015, which became an official session law on May 29, 2015, requires the Administrator of the Agency for Healthcare Research and Quality to award one grant to “an accredited school of medicine or nursing with experience in the study or treatment of victims of a severe form of trafficking” 36 to determine best practices for health care professionals to recognize and respond appropriately to victims of severe forms of human trafficking. The bill seeks to have the grantee then make subgrants to one entity located near an established anti-human-trafficking task-force initiative in each of the 10 administrative regions of the Department of Health and Human Services to develop pilot programs to test best practices for trainings and to collect and analyze data. Health and Human Services will disseminate the evidence-based best practices on its Web site and to health care professional schools. State reporting laws Seven states (CA, CO, FL, IL, MD, MA, NC) now have specific mandatory reporting laws regarding human trafficking37 (see Table 3). Four of these states (FL, IL, MA, NC) address both sex and labor trafficking, whereas California, Colorado, and Maryland require reporting of sex trafficking only. All seven states with reporting laws limit their mandate to minors only. Illinois, however, extends the requirement to residents of state facilities aged 18–22.38 Of course, every state in the United States already has child abuse and neglect (CAN) laws (Mandatory Reporters of Child Abuse and Neglect, 2013); however, these older laws as written do not always cover all trafficking situations. The new human trafficking reporting laws discussed herein establish that trafficking, in its various manifestations, is a distinct reportable offense. Just as states diverge in the particulars of their education requirements, so too have they adopted different definitions of what constitutes the crime of human trafficking (see Table 3). As a legislative matter, these laws effectively add trafficking specifically to the types of abuse covered under the child abuse and neglect reporting laws, which were drafted long before legislators became aware of human trafficking. Who reports, when, and under what circumstances Five states (CA, CO, IL, MD, MA) define “reporter” broadly, including not only a range of health care providers but also law-enforcement and court personnel, social service workers, school personnel, and clergy.39 Florida and North Carolina go further: All residents are mandatory reporters40 (see Table 4). In all seven states, the failure to report is subject to escalating penalties, starting with fines, proceeding to a criminal misdemeanor, and, for repeat offenders, a felony. In Massachusetts, the maximum fine is $1,000, but a reporter who knows of abuse or neglect of a child that results in serious bodily injury or death and who willfully fails to report is subject to a $5,000 fine and up to 2½ years imprisonment.41 California similarly punishes a mandated reporter who fails to report known or reasonably suspected child abuse or neglect with a $1,000 fine, up to 6 months imprisonment, or both.42 Five states (CA, CO, IL, FL, MD) require reporting to take place “immediately or as soon as possible,” 43 while Massachusetts extends to 48 hours.44 Only Massachusetts mandates a written report only,45 while the rest mandate oral reporting with a written report to follow.46 JOURNAL OF HUMAN TRAFFICKING 119 Table 3. State Human Trafficking Reporting Laws. State Statutes Trafficking Type What to Report To Whom and How to Report California CAL. PENAL CODE § 11165.9 (West 2007), § 11165.6 (West 2008), § 11167 (West 2011), §§§ 11165.1, 11165.7, 11166 (West 2016) Sex Definition: Reporters must report suspected child abuse or neglect that includes “sexual abuse” that is defined to include “commercial sexual exploitation” that refers to, among other things, sexual trafficking of a child. Sexual trafficking of a child is committed by “any person who causes, induces, or persuades, or attempts to cause, induce or persuade, a person who is a minor at the time of commission of the offense to engage in a commercial sex act” with the necessary criminal intent. CAL. PENAL CODE § 236.1(c) (West 2012) Name, business address, and telephone number of the mandated reporter; The capacity that makes the person a mandated reporter; The information that gave rise to the reasonable suspicion of child abuse or neglect and the source or sources of that information; Child’s name, the child’s address, present location, and, if applicable, school, grade, and class; The names, addresses, and telephone numbers of the child’s parents or guardians; The name, address, telephone number, and other relevant personal information about the person or persons who might have abused or neglected the child. Reporter must, within his or her professional capacity or within the scope of his or her employment, have knowledge of or observe a child whom the reporter knows or reasonably suspects has been the victim of child abuse or neglect. Reporter must report to any police or sheriff’s department or county welfare department immediately or as soon as practicably possible, with a written report to follow within 36 hours of receiving the information of the abuse or neglect. Reports must be made even if the child has died, regardless of whether the abuse or neglect was a contributing factor to the death, and even if the suspected abuse was discovered during an autopsy. If a reporter is unable to submit an initial report by telephone, they shall make a one-time automated written report on the Department of Justice’s form. Such automated form reports shall be submitted to the counties and the Legislature by the State Department for data collection. Colorado COLO. REV. STAT. §§§ 16–22-102 (2002), 19–3-304 (1993), 19–3-307 Sex Definition: Reporters must report “unlawful sexual behavior,” which includes “Human trafficking of a minor for sexual servitude,” defined as a person who knowingly sells, recruits, harbors, transports, transfers, isolates, entices, provides, receives, obtains by any means, maintains or makes available a minor for the purpose of commercial sexual activity. COLO. REV. STAT. § 18–3-504(2)(a) Name, address, age, sex, and race of child; The name and address of the person responsible for the abuse; The nature and extent of the child’s injuries, including any evidence of previous cases of