Essential Health Care Services Addressing Intimate Partner Violence (2024) / Chapter Skim
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3 Intimate Partner Violence and Public Health Emergencies
3 Intimate Partner Violence and Public Health Emergencies
Pages 63-98
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Terms and Approaches Five Phases The five phases or steps of emergency management are prevention, mitigation, preparedness, response, and recovery (DHS, 2015)
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All-Hazards Approach An all-hazards approach, as defined by the Centers for Medicare and Medicaid, "is an integrated approach to emergency preparedness planning that focuses on capacities and capabilities that are critical" in order to prepare for, respond to, and recover from the full spectrum of emergencies or disasters, whether human-made or natural (CMS, 2017)
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, as well as the plethora of sub-entities formed within each department. For exam ple, under DHS, the Federal Emergency Management Agency (FEMA)
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The most relevant federal declarations to ensure access to essential health care services related to IPV during a PHE are made under Section 319 of the PHSA and the various declarations available under the Stafford Act. A Section 3197 PHE declaration allows HHS and its multiple sub agencies, including the CMS, to suspend or waive specific federal requirements, including requirements rising out of the Health Insurance Portability and Accountability Act (HIPAA)
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CMS Emergency Preparedness Rule The CMS Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule (EP rule) has particular relevance to PHE planning relevant to ensuring access to essential IPV health care services.
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. The rule mandated the documentation of annual disaster response training; drill exercises; and plans for communicating how to contact local, state, and federal emergency preparedness officials (CMS, 2016)
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. These unique relationships are recognized within the American emergency preparedness and response structure at the federal level through amend ments to the Stafford Act,15 which allow tribal governments to declare emergencies and request presidential disaster declarations independent of the states, and the FEMA policy16 which both recognizes the unique relationship between the tribal governments and the federal government and emphasizes specific consultations with tribal nations on issues that impact them (FEMA, 2020)
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. In a PHE, these entities are the essential health care organizations providing a comprehensive range of health and supportive services, including support and care to individuals experiencing IPV.
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Disaster Response Resources Much of the human resources operational capacity for larger-scale PHE response is focused at the federal level. Volunteer organizations such as the American Red Cross and faith-based organizations also play an important role.
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. Additional protections are required for essential health care workers to continue providing care for people experiencing IPV during a PHE.
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. Public Health Emergency Response Strike Teams Public Health Emergency Response Strike Teams are active duty officers with the U.S.
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Widen 18 Emergency Management Assistance Compact, Public Law 104-321, 104th Congress, (October 19, 1996)
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The acute disruption of a disaster can exacerbate these potential vulnerabilities for older adults. Almost 50 percent of deaths attributed to Hurricane Katrina were among adults aged 75 and older (Brunkard et al., 2008)
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In other words, historically and structurally marginalized populations face more harm from natural disasters, but they are also more likely to face them. Calgary ¯ Vancouver Seattle Montreal Toronto Detroit Boston Chicago UNITED New York Denver Philadelphia STATES St Louis Washington San Francisco Los Angeles Atlanta Dallas Houston San Juan Natural Hazards Monterrey Miami Puerto Rico Index Sum MÉXICO Havana 37 Alaska CUBA Hawaii Guadalajara 5 Mexico City Imagery: Esri, FAO, NOAA, USGS, Esri, Garmin, FAO, NOAA, USGS, EPA, Esri, HERE, Garmin, FAO, NOAA, USGS Port-au-Prince FIGURE 3-2 Natural Hazards Index (NHI)
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Those experiencing IPV may be further isolated by abusive partners and structural barriers emerging during the PHE, such as a lack of support services, making it more challenging to connect with care. IPV During the COVID-19 Pandemic The most recent surveillance data and research related to IPV during PHEs comes from the COVID-19 pandemic.
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. Researchers have examined data from IPV hotlines, hospitals and other health care settings, IPV support service providers, and surveys to gain insight into IPV during the COVID-19 pandemic.
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. Similarly, in a cross-sectional online survey in the spring of 2020, 18 percent of respondents reported IPV, with increased odds of experiencing IPV among those with employment or income change due to the pandemic than those without change (Jetelina et al., 2021)
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reported increases in the lifetime prevalence of gender-based violence and IPV in the 2 years after Hurricane Katrina, with associated increases in depressive symptoms and suicidal ideation. IPV During Technological Disasters Technological disasters are caused by the breakdown or malfunction of a technological system (Lindsey et al., 2021)
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. Double Survivorship Women experiencing IPV during PHE experience double survivorship, in the form of enduring IPV (one survivorship experience)
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. Services for women experiencing IPV during PHEs should apply these principles of traumainformed care and empower those individuals to define their own needs and preferences, set their own goals, and make their own choices about the services they receive, with a focus of promoting physical, psychological, and emotional safety (CDC, 2020)
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Presented at Sustaining Essential Health Care Services Related to Intimate Partner Violence During Public Health Emergencies Meeting #3B, Washington, D.C. PREPUBLICATION COPY -- Uncorrected Proofs
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Presented at Sustaining Essential Health Care Ser vices Related to Intimate Partner Violence During Public Health Emer gencies Meeting #2, Irvine, CA. PREPUBLICATION COPY -- Uncorrected Proofs
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. Accessing IPV-related health care services during PHEs requires a workforce to deliver that care.
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. Among people experiencing IPV, access to safer housing (e.g., domestic violence shelters)
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IPV AND PUBLIC HEALTH EMERGENCIES 87 BOX 3-3 IPV Service Providers' Adaptations During the COVID-19 Pandemic "…in 2020 a lot really had changed. In our county, we all had to shelter in place beginning, I think it was March 16th, 2020, when all of our school districts were ordered to go to work remotely from home.
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Some state emergency operations plans echoed a common theme from various federal guidance items that encouraged emergency responders to have phone numbers for domestic violence hotlines and shelters available.21 Notably, most guidance referred to domestic violence instead of explicitly addressing IPV. In instances when IPV and domestic 21 For example, see the emergency operations plans found on the emergency management department websites for Kentucky (https://kyem.ky.gov/programs/Pages/State-ESP-and-EOP.
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. CDC's most recent Public Health Emergency Preparedness and Response C apabilities: National Standards for State, Local, Tribal, and Territorial Public Health, last updated in 2019, mentions the need to include community-based organizations in planning and the need to prioritize the development of behavioral health services for families (CDC, 2019)
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. The National Resource Center on Domestic Violence's online information center, VAWnet, includes a Disaster and Emergency Preparedness and Response collection.22 The majority of resources and information in the collection are targeted at informing and preparing domestic violence and sexual violence organizations for disasters.
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2023. Association of the COVID-19 pandemic with unstable and/or unsafe living situations and intimate partner violence among pregnant individuals.
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2023. Acculturation, acculturative stress, adverse child hood e xperiences, and intimate partner violence among Latinx immigrants in the US.
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2018. The deepwater horizon oil spill: Resilience and growth in the aftermath of postdisaster intimate partner violence.
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2011. Experience of Hurricane Katrina and reported intimate partner violence.
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2019. Social isolation, acculturative stress and intimate partner violence (IPV)
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2016. Health at the intersections of precarious documentation status and gender-based partner violence.
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2022. Sociodemographic character istics, depressive symptoms, and increased frequency of intimate partner violence among LGBTQ people in the United States during the COVID-19 pandemic: A brief report.
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PREPUBLICATION COPY -- Uncorrected Proofs
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