In a recent report, the Atlanta Journal-Constitution looked at nationwide policies for protecting patients from doctors who have been accused or convicted of sexual abuse. The study looked at policies in every state in the country (plus Washington D.C.), assessing how the different states discipline doctors who have had sexual abuse allegations brought against them. The study assigned a letter grade to each state along with a numerical score out of 100.

This state-by-state report card is the latest in an Atlanta Journal-Constitution series started in July. The series has examined sex abuse in the healthcare sector and disciplinary standards for doctors who commit crimes.

The comprehensive report card broke down the grading scale into five different categories,including:Transparency Duty-to-Report Laws Board composition Criminal acts Discipline laws

The Atlanta Journal-Constitution graded each of these categories on a 0 to 100 scale. The newspaper then averaged out those scores into an overall grade. Only one state—Delaware—scored above a 90 in the overall category. Texas landed in second place with an 80, while only three other states (Minnesota, California, and Maryland) scored about 70. Every other state scored 69 or below, with Mississippi ranking at the bottom of the list with a score of 37.Delaware topped the report card thanks largely to its score of 100 in the “duty-to-reportlaws” category. The Journal-Constitution praised Texas for requiring all doctors to “under gorigorous criminal background checks before they’re licensed and while they’re practicing.”However, the report also criticized background check policies across the country, noting that 14 states don’t require licensing-level background checks for physicians. In those states, the responsibility of background checks falls to the individual hospitals. However,once licensed, doctors can prescribe drugs or go into private practice, coverage explained.The Journal-Constitution noted that these doctors aren’t barred in any way from positions in which they can “ask patients to strip down and submit to being touched.”

Per the report, last year, Maryland—a top-five grade recipient on the Journal-Constitution credit card—added background checks at the licensing step for physicians. The state made that overhaul to the process after discovering that it had licensed a doctor who was a convicted rapist.