as hard copies using the order form on the organization’s website. See the Resources section for more information. Warm Referral Recommendations Another option for intervention and support when a client has experienced IPV or SA is the “warm referral.” This type of referral extends the process of linking the survivor to resources by making the first contact with those resources during the clinical encounter. Warm referrals require the provider to have some knowledge of resources and possibly identify those most appropriate for the survivor’s situation. When a patient discloses or screens positive for a history of or an acute incident of IPV or SA, the provider may call the resource agency directly and allow the patient to then speak with someone immediately or assist the person in Special Considerations To provide care most effectively for survivors of IPV and/ or, providers must be knowledgeable about reporting and regulatory requirements at the federal, state, and local levels where practicing. Privacy and confidentiality are paramount concerns for the safety of survivors of IPV and SA, and a variety of laws and policies may be in place to prevent discriminatory practices against these vulnerable individuals. Establishing a trusting relationship and providing support and guidance for engaging with the various systems are key roles of the provider when working with survivors and even with perpetrators. Forensic examinations are an important part of the process of evaluating injuries, documenting events, preserving evidence, and providing care even if the patient chooses not to pursue legal action. Forensic
Local IPV and SA centers will also generally have materials that identify resources in specific areas.
accessing the agency’s website while still in the provider’s presence. This eliminates the need for the survivor to take materials them, which can be dangerous for those in abusive living situations. It also provides a safe, private place to connect with or talk to the support agency and removes the potential that the referral to go unused or be lost. Learning about local resources needed to provide warm referrals need not to be time-consuming. Providers can easily obtain local resource contact information by contacting the National Domestic Violence Hotline at 1-800-799-SAFE or at http://www.thehotline.org . nurses and multidisciplinary teams that specialize in the care and processing of IPV and SA cases are often part of a healthcare system or may be accessible through community agencies serving survivors. Providers also need to be aware of the special needs, risks, and sensitivities of various populations who may experience IPV and/or SA including but not limited to, undocumented persons, pregnant persons, and members of the LGBTQIA2S+ community. Nurses are expected to act as advocates for patients, and this role may be especially significant when assisting victims of IPV and/or SA as they obtain care, consider legal action, attempt to improve or leave a violent relationship, and/or move toward recovery and healing.
LEGAL CONCERNS
Providers need to be aware of several legal concerns regarding IPV as related to federal laws, state laws, and mandatory reporting requirements. Federal Laws The Violence Against Women Act (VAWA) was passed in 1994 and reauthorized in 2000, 2005, 2013, and 2022. This federal legislation ensures the rights of victims of IPV and SA to safety, justice, and personal autonomy. One crucial element of the VAWA that providers must understand is the required provision of forensic examinations to victims of IPV and SA regardless of police involvement. In some communities, there is an expectation or even an assumption that law enforcement facilitates the process of obtaining a forensic examination, as evidence may be collected and used to identify an assailant. While it may be necessary to contact local law enforcement in order to locate forensic nursing services, survivors cannot be forced to interact with the police whether or not they choose to have the examination (Biden, 2005) . Care must be taken to provide patients with this information in the event they wish to postpone talking to the police. Laws also exist to protect State Laws Every state has legislation designed to protect victims of IPV. It is a provider’s responsibility to know what the applicable laws are where practicing. The most common civil action in IPV is a protective order, injunction, or restraining order, which is a court order that limits the contact a perpetrator can have with the survivor. Criminal actions against
victims from discrimination within the healthcare system as a result of their experiences of abuse. Section 1101 of the Patient Protection and Affordable Care Act of 2010 prohibits insurance denials based on “pre-existing conditions,” including being a survivor of IPV or sexual violence. Providers must also carefully adhere to the requirements of applicable laws while advocating for privacy for the individual who has experienced IPV and/or SA. Understanding federal requirements and being mindful of regulations or laws related to state mandatory reporting requirements that may differ from federal mandates for IPV and/or SA are critical. All efforts should be made to provide required information to the appropriate authorities while also allowing the survivor their personal choices about how to process and decide about pursuing charges. perpetrators may include prosecution for assault, battery, aggravated assault or battery, harassment, intimidation, attempted murder, or murder. Education or continuing for healthcare providers related to identifying and assessing IPV and/or SA may be required to obtain or maintain licensure in some states. break this confidentiality, particularly in instances where mandatory reporting is legally required. Laws for mandatory reporting of IPV vary by state, with the states generally falling into one of four categories:
Confidentiality and Mandatory Reporting Requirements Confidentiality and mandatory reporting requirements are of particular concern in working with survivors of IPV and/ or SA. Providers are typically obligated to maintain the confidentiality of medical and treatment records. However, IPV is one instance in which providers may be required to
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Book Code: SWFL1825
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