Introducing a New Model Protocol for Health Centers to Address Intimate Partner Violence and Exploitation

October 6, 2021

By: Anna Marjavi, Health Partners on IPV + Exploitation, and Kimberly S.G. Chang, MD, MPH, Asian Health Services


This is the 2020 UDS number of patients served at health centers reported to receive services for intimate partner violence (IPV).

This is a miniscule fraction (.05%) out of a total of 28,590,897 patients served at health centers.

It is also a huge undercount. It misses thousands of patients currently experiencing violence, abuse, and trauma in their relationships. That translates to thousands of patients with untreated and unrecognized health impacts stemming from violence and abuse – from invisible head injuries and strangulation, to depression/anxiety/PTSD, to reproductive coercion and sexually transmitted infections. It also reflects a missed opportunity to offer patients referrals to community based programs for safety and relationship support.

We know that IPV is widespread. Nationwide, 1 in 4 women; 1 in 9 men; and 1 in 3 transgender individuals has experienced IPV within their life.  We know that the incidence increased during the pandemic, with the National Domestic Violence Hotline receiving 9% more calls during three months from March to May, 2020. One caller noted that the abuser “was using the virus as a scare tactic to keep me away from our kids”, and another noted “there were red flags in the relationship, but things are escalating with the pandemic, and I can’t even go to therapy.”

What does this mean for health centers? How can we help our patients experiencing abuse? Every single health center has at least one patient who has experienced IPV—we must be able to reach them.

During October’s Domestic Violence Awareness Month, and as the newest NTTAP, Health Partners on IPV + Exploitation, a project of Futures Without Violence, is pleased to announce and share a new Protocol for HRSA-supported Community Health Centers to Engage Patients through Universal Education Approaches on Exploitation (E), Human Trafficking (HT), Domestic Violence (DV) and Intimate Partner Violence (IPV). The protocol is a guide for health centers to operationalize and implement care, services, and community partnerships for patients at risk of or experiencing IPV, exploitation, and/or human trafficking. The protocol is a model template that provides useful clinic wide policies that help to facilitate conversations with patients, scripts that providers can use to initiate discussions, a universal education approach to ensure resources are available to all patients regardless of them disclosing abuse, and tips and tools to enable health centers to develop partnerships with local domestic violence programs, such as an organizational Memorandum of Understanding. If your health center already has policies and procedures in place, you can use this protocol as a reference to update and refresh your operations, and adapt to best meet your needs.

At Health Partners on IPV + Exploitation, we are committed to providing you with tools and education to ensure that your health center can continue to provide the best care for your patients and communities in these areas. We are also proud to announce our new website, where you can find our schedule for webinars and learning collaboratives, and download resources and recordings.

And finally, there are many opportunities for you to share your health center’s models of care, successes and conundrums as it relates to IPV and exploitation/human trafficking. This year is our second year as an NTTAP and we’re collaborating with several other NTTAPs on upcoming learning collaboratives and webinars. Join us as we continue building a health center movement to address IPV and exploitation!  Each of these collaborations below explores the intersection of health and IPV/exploitation/trafficking. Activities are free and open to all staff members working at community health centers:

  • With the National Network for Oral Health Alliance on an October 27th Domestic Violence Awareness Month webinar

  • With The School-Based Health Alliance: Healing-Centered Approaches to Relationship Abuse and Trafficking Prevention on a learning collaborative (LC)

  • Addressing Intimate Partner Violence in HIV Programs, for Ryan White funded health centers and others caring for patients with HIV (LC)

  • With the Migrant Clinicians Network and Farmworker Justice (LC)

  • With the National Center for Medical-Legal Partnerships (LC + webinar)

  • With National Health Care for the Homeless Council (LC + webinar)

These are just a few upcoming programs.  Sign up to our listserv for information on how to participate and for timely notices (not too many emails, we promise!) on new resources and educational opportunities.

Thank you for all that you do to care for your patients and communities! Let’s make sure we are reaching the patients affected by IPV and exploitation, and that UDS numbers more closely reflect the realities of patients!

Anna Marjavi is the Director of Health Partners on IPV + Exploitation, a new NTTAP administered by Futures Without Violence

Kimberly S.G. Chang, MD, MPH is a Family Physician, and Director of Healthcare and Human Trafficking Policy at Asian Health Services in Oakland, California. She is Faculty with Health Partners on IPV + Exploitation, and serves as Vice Speaker of the House for NACHC

This post was originally shared on the National Association of Community Health Centers blog

This blog post is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $650,000 with 0% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government.