National and State Responses to Domestic Violence Challenge

By Arline Kaplan © 2001 (All Rights Reserved)

After a significant delay, Congress passed the Victims of Trafficking and Violence Prevention Act of 2000 (H.R. 3244) to provide needed support and services to domestic violence victims. However, most states have yet to adopt laws that would improve the health care response to domestic violence, according to a study by the Family Violence Prevention Fund (FVPF).

H.R. 3244 signed into law (October, 2000), both reauthorized and built on the Violence Against Women Act of 1994 (VAWA). In addition to funding shelter services and the National Domestic Violence Hotline, the law helps courts improve interstate enforcement of protection orders and train judges on violence against women. The law also authorizes a civil legal assistance program for victims of domestic violence, sexual assault and stalking, and it directs some financial resources toward underserved populations, such as older women and women with disabilities.

With regard to health care professionals, the law requires the U.S. attorney general to develop a recommended national standard for training licensed health care professionals performing sexual assault forensic examinations. Additionally, it asks the attorney general to recommend sexual assault forensic examination training for all health care students to improve the recognition of injuries suggestive of rape and sexual assault and to improve baseline knowledge of appropriate referrals in victim treatment and evidence collection.

Meanwhile, legislation at the state level has proved disappointing. The Family Violence Prevention Fund assessed each state’s progress in passing laws that help physicians and nurses aid victims of domestic violence and in preventing insurance discrimination against women facing abuse. The State-by-State Report Card on Health Care Laws and Domestic Violence (available online at www.fvpf.org evaluated state laws in five categories:

Training on domestic violence: helps health care professionals treat domestic violence victims effectively and get them the help they need. Eleven states had enacted laws addressing domestic violence training—Alaska, California, Florida, Kentucky, Maryland, New Hampshire, New York, Ohio, Oklahoma, Pennsylvania and Washington.

Screening: requires health care facilities to establish and adopt written policies to screen patients for the purpose of detecting spousal or partner abuse. Four states had such laws—California, Maryland, New York and Pennsylvania.

Protocols: requires health care systems to develop written policies on screening for family violence, recording patient injuries, making referrals to community agencies and related issues. Nine states had such laws—Alaska, California, Iowa, Maryland, New Hampshire, New York, Ohio, Pennsylvania and Texas.

Reporting: requires health care professionals to report an incident of domestic violence to law enforcement only where there is life threatening injury and/or gunshot wounds. Thirteen states have such laws—California, Colorado, Florida, Kansas, Kentucky, Maine, Minnesota, Missouri, New Hampshire, Rhode Island, Texas, Vermont and Washington.

Insurance: forbids insurers from discriminating because someone is a victim of domestic violence. Nineteen states have enacted discrimination protections—Alabama, Arizona, California, Georgia, Hawaii, Illinois, Indiana, Kansas, Kentucky, Massachusetts, Montana, Nebraska, New Mexico, Oregon, Pennsylvania, Utah, Washington, West Virginia and Wisconsin.

Health care and domestic violence experts used the existence or absence of such laws as a basis for giving states zero to two points for each of the five categories. The number of cumulative points determined the grade the state received. Most of the states received grades of C or D.
Most states received grades of "C" or "D." Pennsylvania was the only state to received an "A"; California, Maryland, New Hampshire, New York and Washing received "Bs"; and Colorado failed.

"Every day that a doctor fails to screen a battered patient for domestic violence or a nurse fails to record information that can help a victim win a restraining order is another potentially life-saving opportunity lost," said FVPF executive director Esta Solar is a news release. "Every state lawmaker should make it a priority to pass laws that will help battered women and their children."


Dear Friends,

Hi. I am a freelance medical journalist. Most of the articles posted on this website were originally written for healthcare professionals, but I believe patients/consumers may find value in the articles as well. Many of us who have long-lasting or life-threatening health problems become experts on them. For that reason I have kept the rights to electronically post these articles. I hope to continue to post even more articles and develop new ones specifically for this site. It is my intention to keep this site free from the influence of advertisers and just offer you high quality, well-researched information. Your financial support is needed to continue this user-sponsored service.

I welcome your comments, suggestions and financial support. You can send voluntary contributions to, or contact me at:

HealthRising
Arline Kaplan
P.O. Box 3644
Costa Mesa, CA 92628