Essential Health Care Services Addressing Intimate Partner Violence (2024) / Chapter Skim
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8 Recommendations
8 Recommendations
Pages 241-254
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From page 241... ...
Following its thoughtful review and debate of compelling evidence, the committee recommends the following actions. Essential Health Care Services The committee used the Social Ecological Model to guide their understanding of the health care needs of women experiencing IPV and to identify the essential health care services related to IPV.
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From page 242... ...
health care systems classify the following as essential health care services related to intimate partner violence (IPV) : • Universal IPV screening and inquiry • Universal IPV education • Safety planning • Forensic medical examinations • Emergency medical care • Treatment of physical injuries • Gynecologic and reproductive health care, including all forms of Food and Drug Administration-approved contraception and preg nancy termination • Screening and treatment of sexually transmitted infections and HIV • Treatment for substance use disorders and addiction care • Pharmacy and medication management • Obstetric care, including perinatal home visits • Primary and specialty care • Mental health care • Support services, including shelter, nutritional assistance, and child care • Dental care
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From page 243... ...
Women who experience IPV are at high risk for traumatic brain injuries and mental health disorders, which make it difficult for them to navigate the often complex processes of accessing needed health care services. Warm referrals, in which a clinician directly connects an individual to referred services instead of simply providing a phone number or the address of a web site, are critical to facilitating access to essential health care services related to IPV during steady state conditions and PHEs.
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From page 244... ...
Recommendation 4: The Health Resources and Services Administra tion should disseminate best practices for ensuring that multi-sector, confidential services are available for adolescents experiencing intimate partner violence, including prevention services. Essential Health Care Services Related to Intimate Partner Violence in Public Health Emergencies The committee was tasked with identifying the essential health care services related to IPV during PHEs and strategies to ensure access to those health care services during PHEs.
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From page 245... ...
At this point all essential health care services related to IPV are available for all individuals. 2 For the purposes of this report, disaster health responders are the leaders and staff with expertise in public health and health care who are working and providing care in those settings during response to a PHE.
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From page 246... ...
Then, as health care staff and supplies become more available, the full essential health care service can be delivered more broadly. However, the committee emphasizes that all of these services are essential to IPV care regardless of the phase in which they recommend it be restored.
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From page 247... ...
. TABLE 8-1 Essential Health Care Services for IPV During Public Health Emergencies -- A Phased Return to Steady State PHASE WHEN SERVICE SHOULD BE RESTORED Essential Health Care Response Initial Stabilization Service operations Universal IPV screening/ inquiry and education Safety planning Forensic medical exams Emergency medical care Treatment of physical injury Gynecologic and reproductive health care Urgent Non-urgent including pregnancy termination Obstetric care Urgent Non-urgent Perinatal home visits Contraceptives Contraception and not requiring All types of emergency contraception procedures or contraceptives immediate follow-up Screening and treatment Treatment and rapid Treatment and of sexually transmitted testing all screening infections and HIV Substance abuse Withdrawal All treatment treatment mitigation Pharmacy/medication management Primary and specialty care Mental health care Urgent/Crisis Non-urgent Urgent Urgent treatment Dental care treatment for for acute injuries acute injuries Support services including shelter, nutritional assistance, child care Restore services for all patients Selectively restore services for acute needs or restore targeted services Do not restore services during this phase
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From page 248... ...
A discussion of these gaps can be found in Chapter 7. These gaps include: • standard guidance and best practices for the development of IPV care protocols for disaster health responders, • public-facing PHE response plans that specifically address IPV care and formal coordination with community-based IPV care providers, • training specifically focused on IPV for disaster health responders that is easy to find and access, and • protocols to ensure medical supply caches for use in PHE response include all necessary items for delivery of the essential health care services related to IPV.
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From page 249... ...
This can lead planners and disaster health responders to overlook the possibility of IPV in families who do not have children, couples who do not live together, or former intimate partners. As previously noted, disaster health responders may not regularly provide care for women experiencing IPV in their steady state roles.
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From page 250... ...
Recommendation 7: The Health Resources and Services Administration should partner with the Administration for Strategic Preparedness and Response to develop and disseminate standardized guidance for devel oping protocols for intimate partner violence care for disaster health responders as well as the essential supplies required for delivering that care. Protocols for sustaining essential health care services related to IPV need to be incorporated into PHE planning at the federal and SLTT levels.
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From page 251... ...
The committee acknowledges that those located in certain geographic areas in the United States may encounter challenges procuring specific and vital supplies for IPV care, such as emergency contraception or supplies needed for pregnancy termination. However, the committee emphasizes that emergency medical caches should include all of the necessary supplies to support delivery of all essential health care services related to IPV, regardless of geographic location.
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From page 252... ...
These inconsistencies in terminology also limit the ability to compare outcomes across intervention studies. CDC sought to address these inconsistencies when it released its first version of Intimate Partner Violence Surveillance: Uniform Definitions and Recommended Data Elements in 1999 and an updated version in 2015.
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From page 253... ...
While some in the fields of IPV care and advocacy have voiced concern about the potential harms associated with IPV screening, there is limited research available that clarifies the link between IPV screening and these harms or that elucidates the best practices to mitigate them. A more robust body of evidence about the degree to which such harms exist and effective strategies to reduce or prevent those harms can inform IPV screening and education protocols and reduce provider hesitancy around screening.
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From page 254... ...
If adopted, these recommendations will facilitate improvements in the health and well-being of women experiencing IPV, support disaster health responders to care for those women, and contribute to reducing health disparities in the United States.
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