Health Care Industry Recommendations

The following is an overview of the recommendations for the health care system discussed briefly in the new report from Polaris, On-Ramps, Intersections, and Exit Routes: A Roadmap for Systems and Industries to Prevent and Disrupt Human Trafficking.

1. Require Completion of Human Trafficking Training for all Staff Health Care Facilities

   • Require staff at all levels, from receptionists and registration staff and security, to physicians and nursing staff, to complete substantive training on human trafficking.

     • SOAR Online is a new, free-of-charge series of self-paced online training modules.

   • Health care facilities should also ensure that health professionals are aware of their local and national resources and mechanisms to access them. Vetted government and non-government resources provide technical assistance for health care professionals, including resources which sets standards for any trafficking training for health professionals, including common pitfalls to avoid.

2. Urge Congress to Pass the SOAR to Health and Wellness Act

   • UPDATE:  As of December 31, 2018, the SOAR to Health and Wellness Act has passed Congress and been signed by the President. In the next year, the Department of Health and Human Services will update Congress on the number of entities that receive grants and the total number and geographic locations/distributions of those trained under the program. They will also collect data on the total number of facilities and service provider organizations that operate under and the number of providers trained through the SOAR program.  

     • The bill would re-authorize and expand funding to ensure that health care and related professionals have access to comprehensive training and technical assistance to help trafficking victims.

     • Additionally, the bill would authorize grants to health care sites and organizations and would centralize data collection on the program’s reach

3. Seek Out Resources to Address Implicit Bias

   • Some health care professionals may unconsciously hold a bias against individuals engaged in the commercial sex industry.

   • Currently, it does not appear that there are any available trainings or resources specifically geared toward implicit bias against individuals in the sex industry.

   • Therefore, it may be important to start with some foundational resources designed to help health professionals understand, address, and overcome implicit bias more generally.

4. Create Human Trafficking Identification & Response Protocols or Adapt Existing Protocol

   • Health care professionals should be equipped with strong protocols, including knowledge of how to approach a potential victim, and connect them to the services they need.

     • Could be adapted from and integrated within existing strong protocols on intimate partner violence, sexual abuse, or child abuse.  

   • An empowerment approach should be taken:

     • Protocols and assessments should not be exclusively focused on prompting a victim’s disclosure or immediately removing the individual from the trafficking situation.

   • Focus on safety planning, assess survivor’s needs and desires, offer resources for support, and working collaboratively with them as partners in determining their best course of action.

5. Post the National Human Trafficking Hotline Numbers for Patients to Access

   • Information about the National Human Trafficking Hotline numbers should be posted in areas where potential victims and at-risk patients could access.

     • Survivors’ ideas include scrolling video clips on waiting room televisions, stickers inside bathroom stalls, and window clings where urine tests are administered.

     • Materials should use language such as experiences or red-flags of unsafe or abusive behavior commonly present in trafficking situations.

     • Address experiences of both sex and labor trafficking victims.

     • Diverse images with all ethnicities, genders, and ages, and not be sensationalized.

   • Crucial to consult with survivor leaders on design

6. Integrate Trauma-Informed Care as a “Universal Precaution”

   • Approach care from a trauma-informed perspective.

   • Survivors were traumatized by their experience with health care and these experiences possibly prevented them from disclosing as well as causing them to avoid future health care.

   • Applying a trauma-informed care approach to all patient interactions allows health professionals to provide an environment that is safer for all survivors of abuse, including trafficking victims.

   • The principles of trauma-informed care, as outlined by SAMHSA include safety; trustworthiness and transparency; peer support and mutual self-help; collaboration and mutuality; empowerment, voice, and choice; and cultural, historical and gender issues.

7. Develop Interdisciplinary Partnerships with Anti-Trafficking Service Provider

   • Essential to establish local partnerships with anti-trafficking programs

     • They can provide or coordinate ongoing case management, housing, independent life skill training, substance use disorder treatment, legal advocacy, and other psychosocial services.

   • A model (already used in domestic violence and sexual assault cases) is a hospital advocacy model where an advocate is sent for every consenting patient that presents to the hospital.

     • These advocates can provide emotional support for potentially trafficked patients, explain the services available to them, and be a liaison between the patient and medical staff. They can also provide training for staff.

8. Develop Interdisciplinary Partnerships within Health Care

   • Many human trafficking survivors have a myriad of physical and mental health conditions that require treatment.

   • It can be confusing, traumatizing, difficult and expensive to access all necessary health practitioners in current U.S. health care system.

   • Several models do exist:

     • Community health centers focus on the integration between primary care and behavioral health, as well as integration of oral health care and primary care.

     • Human trafficking clinics serve to provide holistic health care services to trafficking survivors. The design allows for the patient to see all of their health providers in one physical location.

9. Engage in Prevention with Patients at Risk

   • Prevention is an essential component of the public health response to trafficking.

   • Important for health professionals who work with vulnerable populations to trafficking (homeless youth, immigrants, those within commercial sex industry, those with substance use disorders, or those with disabilities)

     • They could be working with the potential victim prior to or during their recruitment into trafficking.

   • Emergency departments and community health clinics may be ideal locations for innovative pilot programs and funding streams targeted for human trafficking.

10. Advocate for a Comprehensive Labor Trafficking Health Study

    • We need a comprehensive understanding of the unique health concerns of the thousands of individuals trapped in forced labor in the United States. Such a study should:

      • Address a full scope of the physical, psychological, and environmental health concerns and symptoms of labor trafficking victims both during and after their trafficking experience

      • Include labor trafficking survivors representing all types of labor trafficking business models or industries

      • Include diverse genders, ethnicities, ages, sexual orientations, education backgrounds, and not be limited in scope to one state or region of the United States.

      • Collect data on health care access during exploitation such as types of health care facilities used, presenting health issues, health care coverage, workers compensation access, and experiences with health care professionals.

      • Provide survivor-informed recommendations for health care professionals when assessing and treating labor trafficking survivors.