Chapter 7: Recommendations for the Health Care Community The recommendations below, which appear in the May 1998 New Directions Report, have been reformatted for replication and distribution. ---------------------------- The health care, social service, criminal and juvenile justice, and other professional communities must integrate their response to violence if crime victims are to be provided a safety net that functions effectively. Health care professionals are beginning to recognize that they must cooperate with and understand justice and other allied professionals' roles when responding to criminal victimization. Many medical associations and professional organizations have taken a strong and visible role in efforts to reduce violence and create a safer, healthier society. To ensure these important efforts continue, the following recommendations for health care professionals are set forth by the field: ---------------------------- 1. All professional schools that educate future health care professionals, including schools of medicine, nursing, social work, rehabilitation, hospital administration, and public health, should incorporate victim issues into their curricula. 2. All patients should be routinely assessed for indications of domestic abuse or other history of violence, and any signs or symptoms of abuse should be documented in their medical records. 3. Hospitals should establish training programs and protocols for all hospital personnel about the rights and needs of victims of crime. 4. Medical facilities including hospitals and rehabilitation and trauma centers should serve as gateways to assist victims of crime. Response staff should be available in these settings to provide onsite crisis counseling, followup with patients, and serve as links to inhouse and community resources. 5. Victims of sexual assault should be given emergency medical care, forensic examinations, and testing for HIV and sexually transmitted diseases at no out-of-pocket cost and in a supportive setting. More hospitals should consider establishing Sexual Assault Nurse Examiner programs to respond sensitively to the needs of sexual assault victims. 6. Cultural competency guidelines should be developed to help health care providers improve screening and intervention services for victims from diverse backgrounds. 7. Medical personnel should be knowledgeable about and have policies in place to ensure that statutory privacy protections are applied to medical records, abuse reporting forms, and medical legal evidence. They should respect the confidentiality and privacy needs of all victims of crime and assist them in dealing with unwanted media attention, especially in cases of sexual assault and assaults on children. 8. Counseling and prevention programs and/or a referral system to such programs should be established in medical facilities that treat violence-related injury, including gunshot victims, to address the broad spectrum of needs of these victims. 9. Protocols for appropriate security and safety procedures should be developed to assist hospital personnel in responding to incidents of gang, family, and other violence that might result in staff victimization. 10. Pediatricians, family practitioners, internists, and other health care professionals treating young children should be educated about the effects on children of witnessing domestic violence and violence in the community. 11. Technology should be utilized to improve medical services for crime victims, especially in underserved and rural areas. 12. Statutes and policies should be adopted to prevent insurance companies from discriminating against victims of crime by denying and/or canceling coverage or by charging higher premiums for such coverage. 13. All health care professionals should be educated about sensitive death notification techniques. 14. Catastrophic physical injury victims, including assault and drunk driving crash survivors with serious injuries, should receive specialized neuropsychological evaluation in health care facilities. ----------------------------