/ en Sun, 27 Apr 2025 03:24:01 -0500 Thu, 14 Jan 21 10:06:28 -0600 /hospitals-against-violence/human-trafficking/kirschner .body p, .body li { font-size: 16px; } h1 { max-width: 900px; margin: 10px 0 30px; } .article { max-width: 900px; margin: 0 auto 40px; } .bio-box { width: 40%; float: right; padding-left: 30px; } .panel { border: 0; } .bio-box h2 { background-color: #9D2235; color: #fff; padding: 10px; width: 100%; margin: 0 auto; text-transform: uppercase; font-size: 1.4em; text-align: center; } .bio-box p { margin: 3px 0; font-size: 1.1em; line-height: 1.2em; border-bottom: 3px solid #9D2235; padding-bottom: 20px; } .bio-box h3 { margin-bottom: 0; line-height: 1.1em; } .bio-box h4 { margin: 3px 0; font-size: 1.2em; } .question { font-weight: bold; } .article span { font-size: .9em; color: #307FE2; text-transform: uppercase; font-weight: bold; } blockquote { padding: 20px; font-weight: 200; font-size: 2em; line-height: 1.4em; color: #307FE2; width: 40%; max-width: 350px; border: none; margin-bottom: 0; } .left { float: left; margin-right: 30px; margin-left: -20px; } .right { float: right; margin-left: 30px; } @media only screen and (max-width: 768px) { .bio-box { width: 30%; } .bio-box h2 { width: 100%; } .blockquote { padding: 20px; } } @media only screen and (max-width: 500px) { .bio-box { width: 100%; } .bio-box h2 { width: 70%; } .left { float: none; margin-right: 0 } .right { float: none; margin-left: 0; } blockquote { width: 100%; text-align: center; max-width: 100%; margin: 0; padding: 20px; margin-left: 0 !important; } } <div class="article"><h2>Jones Day’s Anti-Human Trafficking Task Force and AHA provide tools and training</h2><div class="panel bio-box"><h2>Q&A</h2><img src="/sites/default/files/2021-01/kirschner_curt_500x500.jpg" alt="curt kirschner" width="500" height="500"><h3>Curt Kirschner</h3><p>Partner at Jones Day and a leader of Jones Day’s Anti-Human Trafficking Task Force</p></div><p>Melinda Hatton, AHA general counsel and one of the executive sponsors of the AHA’s Hospitals Against Violence initiative, interviews Curt Kirschner, partner and a leader of Jones Day’s Anti-Human Trafficking Task Force, to discuss the partnership working to expand hospital leadership in the fight against human trafficking.</p><p class="question"><span>Hatton:</span> How is Jones Day involved in the fight against human trafficking and what is your role?</p><p><span>Kirschner:</span> Jones Day is marshaling a coordinated global effort to combat both labor and sex trafficking, while also providing justice for survivors. In 2016, Jones Day launched the Anti-Human Trafficking Task Force to guide the work being done and to focus on developing specific solutions to this global problem.</p><p>Since the launch of the Task Force, an important component of our pro bono trafficking-related work has been in the health care field in partnership with the AHA. As part of the health care-related work of the Task Force, which I lead, we are very proud to have just published, in conjunction with the AHA and HEAL Trafficking, a new tool to help health care providers understand their reporting and education obligations related to anti-human trafficking activities. The new tool — Human Trafficking and Health Care Providers: Legal Requirements for Reporting and Education — covers legal obligations under federal law and the laws of all 50 states and is publicly available free of charge.</p><p>The work of our Task Force extends beyond health care and is truly multi-disciplinary and global. For example, in litigation, Jones Day has represented a significant number of trafficking victims in criminal, restitution, and expungement matters; worked with the National Center for Missing and Exploited Children to produce a resource manual for the representation of victims of online sexual exploitation; conducted trainings for prosecutors and judges in the United States, Thailand, Nepal, and across Africa; produced a manual on the organization and operation of diversionary courts for victims of human trafficking, which formed the blueprint for work by the National Association of Women Judges; and is developing resources for judges and prosecutors to better work with witnesses who have been victims of trauma.</p><blockquote class="left"><p>"“Health care providers have a unique opportunity to identify trafficking victims who may otherwise be hidden from society.”"</p></blockquote><p>In other Jones Day practice areas, regulatory lawyers provide training on avoidance of human trafficking in global supply chains; financial services lawyers provide pro bono services to financial institutions designing systems to identify the red flags of human trafficking within their anti-money laundering and compliance departments; and data privacy lawyers provide pro bono counsel to various organizations handling the personally identifiable information of both victims and perpetrators. In addition, governance, transactional, and real estate lawyers provide counsel to many organizations being established around the world to address both interventions and the provision of legal and social services to victims of trafficking; and lawyers across multiple practices are working with national organizations throughout the United States on public and corporate education materials.</p><p>We have also prepared other tools beyond our just released guide for health care providers. We published a “Guide to Post-Conviction Relief for Victims of Human Trafficking,” which includes a compendium of post-conviction relief laws and resources at the federal level and in all 50 states. In addition, the Firm is working closely with several of its clients to produce a “Global Compendium,” the first comprehensive legal resource for the field which brings together all the laws of human trafficking around the word in one standardized format.</p><p class="question"><span>Hatton:</span> How did the partnership between Jones Day and ���������� Association begin?</p><p><span>Kirschner:</span> I’ve had the privilege of representing the AHA for over 15 years as the AHA’s designated outside labor counsel. During the course of this work, I’ve seen the AHA’s leadership in many of the most important health issues facing our society. In 2016, when Jones Day launched its Anti-Human Trafficking Task Force and organized its first multi-practice, large scale convening on trafficking in Houston, it seemed natural and important to involve AHA in our efforts. Given that you are the leader of AHA’s Hospitals Against Violence initiative, you were exactly the right person to participate in the convening, and I’m so grateful that you did. During that first meeting, we learned some startling statistics about the prevalence of human trafficking, the common place interactions that occur between trafficking victims and health care providers, and the number of missed opportunities to recognize patients as trafficking victims. It was clear that there was much work that needed to be done to address the scourge of trafficking from a health care provider perspective. You really took up the mantle for the AHA and made trafficking one of the cornerstones of AHA’s Hospitals Against Violence campaign. Since then, AHA and Jones Day, working closely with HEAL Trafficking, have worked together on several trafficking projects related to health care providers, including co-sponsoring a 2018 convening in our Washington, D.C. office focused on the role of health care providers in identifying, referring, and treating trafficking victims.</p><p class="question"><span>Hatton:</span> How do you see health care leaders engaging in the fight against labor and sex trafficking and how can they lead in their organizations and communities? Any key resources?</p><blockquote class="right"><p>"In terms of future goals, we are on a long-term path to convert the steeples of excellence at certain health systems into standard practices among health care organizations."</p></blockquote><p><span>Kirschner:</span> Leaders of health care organizations across the country have a unique and critical role in fighting trafficking. A significant majority of trafficking survivors report being seen by a health care provider while being trafficked, but their situation was not discovered. Health care providers have a unique opportunity to identify trafficking victims who may otherwise be hidden from society. Given that self-reporting by vulnerable victims is rare, front line health care providers need to be educated to recognize patients who are being trafficked. Health care leaders should champion the issue, promote staff initiatives related to trafficking, and prioritize education and training programs among staff. The leaders of health care organizations should also adopt policies and best practices related to the identification, referral, and treatment of trafficking victims.</p><p>Many resources are available to health care leaders on the AHA’s website, and HEAL Trafficking has various model policies and training guides. In addition, Jones Day’s recently published tool to assist health care providers in sorting through the myriad of federal and state obligations related to the reporting and education obligations should be a valuable resource for providers.</p><p class="question"><span>Hatton:</span> What have you been able to accomplish through this partnership and what is the next phase of this work?</p><p><span>Kirschner:</span>The partnership between the AHA, the nation’s preeminent organization representing the interests of our hospitals, and Jones Day, a global law firm, has been extraordinary. Through our jointly sponsored health care trafficking convenings, we’ve been able to amplify the examples of excellence among individual providers and health care systems and publicize the work of some stellar NGO’s, like HEAL Trafficking and the Human Trafficking Legal Center. We’ve created an Advisory Council of the nation’s leading health care experts fighting human trafficking, which has been incredibly valuable in identifying areas of opportunity, especially as health care providers navigate these complex issues during the current COVID-19 pandemic. We have also worked jointly to secure the adoption of the first ICD-10 codes related to trafficking, so that incidence of trafficking within the nation’s health care system can be tracked, measured, and consistently handled.</p><p>In terms of future goals, we are on a long-term path to convert the steeples of excellence at certain health systems into standard practices among health care organizations. To that end, we are looking to achieve more uniformity in state reporting obligations, in order to lessen the compliance burden on health care providers with multi-state practice. In addition, we are jointly sponsoring this year a series of virtual meetings to encourage C-suite leaders to champion these anti-trafficking initiatives within their systems. We are also seeking to spread the word about the best practices adopted by certain state hospital associations to gain more uniformity of commitment on this issue among all of our critically important state associations. Collectively, we’re making progress, but there is still so much important work to do.</p></div> Thu, 14 Jan 2021 10:06:28 -0600 Questions and Answers (Q&As) <p>These are meant to help you respond to tough questions about the price transparency rule and the position hospitals and health systems have taken on the requirement to disclose negotiated rates. These can also be tailored as needed.</p> <p><strong>Do you oppose the rule? If so, why?</strong></p> <p>We support making patient cost estimates available to patients. The extensive data disclosure component of the rule revealing privately negotiated rates, however, will not help patients obtain an accurate estimate of their costs. In addition, the data is expensive to compile, display and maintain. And, it could also give large commercial health plans an unfair advantage in negotiations with hospitals.</p> <p><strong>Why would this give health plans an unfair advantage?</strong></p> <p>Commercial health insurance markets are increasingly concentrated; the American Medical Association found that 75% of metropolitan commercial markets studied were highly concentrated. Large commercial health plans have greater leverage at the negotiating table than any individual hospital or health system. Therefore, we can expect payers to demand lower rates from hospitals based on the lowest publicly-released rate even if that rate is inappropriate or unsustainable for that particular provider. And, it is unlikely that health plans would ever pass on the benefits of lower rates to patients instead of pocketing those profits.</p> <p><strong>Have you complied with the Hospital Price Transparency Rule?</strong></p> <ul> <li>(If yes) Our organization has done the best we can to comply with the regulation. However, the government failed to provide sufficient guidance, as some of the data points they are requesting do not exist. Therefore, we do not know if the government will agree that we are in compliance.</li> <li>(If partially) Patients want to know what they will be responsible for paying out-ofpocket for care. For that reason, we have dedicated our efforts during these significantly constrained times to build out our capabilities to provide out-of-pocket cost estimates.</li> <li>(If no) We have limited time and resources, especially during this global pandemic. We have had to focus our immediate efforts on providing the best care possible for our communities and helping patients understand their out-of-pocket costs.</li> </ul> <p><strong>Will you compare your rates with your competitors and/or use the information from peer organizations in negotiations with health plans?</strong></p> <p>The government is requiring that these rates be disclosed, but this is not something we sought or support. It is much more likely that large commercial health plans will use this information to collude on the rates they pay to hospitals. Health plans may also attempt to the match the rates of competitors that receive a better deal from hospitals as part of innovative arrangements to improve patient care.</p> <p><strong>Why is there so much variation in what different payers pay for the same service?</strong></p> <p>A lot of factors go into negotiation of rates between health plans and providers. These could include the scope of the contract (e.g., is it a limited scope contract for a subset of services, like emergency or quaternary care services only); anticipated patient volume associated with the contract; whether or not the rate is adjusted after the fact based on provider performance; and the characteristics of the patients enrolled in a particular health plans. In addition, as is mentioned elsewhere, the rates as reflected in these spreadsheets often do not reflect what is actually paid as they too may be subject to a number of different adjustments as laid out in the contract.</p> <p><strong>Could this lead to government setting fixed prices?</strong></p> <p>Rate-setting is the wrong approach. It is widely acknowledged that Medicare and Medicaid – the two largest public programs – pay below the cost of delivering care. Therefore, we strongly urge against moving in this direction.</p> <p><strong>If not this, what information should hospitals provide?</strong></p> <p>Patients want to know what they will actually pay. We can say this with confidence as this is what patients ask us for when they reach out about their costs. Hospitals and health systems are committed to working with patients to make sure they can easily access outof-pocket cost estimates when those can be reasonably provided, including through online patient cost estimator tools. Commercial health plans are a needed partner in making this information available.</p> <p><strong>Do you expect your revenue to go down as a result of sharing this data?</strong></p> <p>Anyone with any real knowledge of health care financing should not make any kind of decisions based on this data. However, we are concerned that large commercial health plans with market power would attempt to use this information in our negotiations to drive reimbursement to unsustainable levels.</p> <p><strong>What do you expect the incoming administration to do on price transparency?</strong></p> <p>We look forward to working with the new administration to achieve a shared goal of increasing price transparency by making patient out-of-pocket cost estimates easier for patients to access and understand. We hope they will agree that our efforts are best focused on providing patients with the information they actually need to make informed decisions about their health care.</p> Fri, 18 Dec 2020 11:51:30 -0600 Questions and Answers (Q&As) /education-events/project-firstline-q-providing-safe-care-covid-19-patients <p>Please join AHA and the Centers for Disease Control and Prevention (CDC) for a conversation on providing safe care to COVID-19 positive patients in various settings on Friday, November 20, 2020 at 2 p.m. ET. Dr. Michael Bell, deputy director of the division of health care quality promotion at the CDC, will share the latest information on the COVID-19 therapeutics now available through outpatient centers and answer your questions on infection control measures. This event is part of CDC’s <a href="/center/project-firstline">Project Firstline</a>, a national collaborative to provide infection control training and education to front-line health care workers and public health personnel.</p> Wed, 18 Nov 2020 09:30:19 -0600 Questions and Answers (Q&As) /questions-and-answers-qas/2020-07-20-combating-human-trafficking-qa .body p, .body li { font-size: 16px; } h1 { max-width: 900px; margin: 10px 0 30px; } .article { max-width: 900px; margin: 0 auto 40px; } .bio-box { width: 40%; float: right; margin-left: 30px; } .panel { border: 0; border-bottom: 3px solid #9D2235; padding-bottom: 20px; } .bio-box h2 { background-color: #9D2235; color: #fff; padding: 10px; width: 100%; margin: 0 auto; text-transform: uppercase; font-size: 1.4em; text-align: center; } .bio-box p { margin: 3px 0; font-size: 1.1em; line-height: 1.2em; } .bio-box h3 { margin-bottom: 0; line-height: 1.1em; } .bio-box h4 { margin: 3px 0; font-size: 1.2em } .question { font-weight: bold; } .article span { font-size: .9em; color: #307FE2; text-transform: uppercase; font-weight: bold; } blockquote { padding: 20px; font-weight: 200; font-size: 2em; line-height: 1.4em; color: #307FE2; width: 40%; max-width: 350px; border: none; margin-bottom: 0; } .left { float: left; margin-right: 30px; margin-left: -20px; } .right { float: right; margin-left: 30px; } @media only screen and (max-width: 768px) { .bio-box { width: 30%; } .bio-box h2 { width: 100%; } .blockquote { padding: 20px; } } @media only screen and (max-width: 500px) { .bio-box { width: 100%; } .bio-box h2 { width: 70%; } .left { float: none; margin-right: 0 } .right { float: none; margin-left: 0; } blockquote { width: 100%; text-align: center; max-width: 100%; margin: 0; padding: 20px; margin-left: 0 !important; } } <div class="article"><h2>Health care systems working together in the fight against human trafficking</h2><div class="panel bio-box"><h2>Q&A</h2><img src="/sites/default/files/2020-07/Stoklosa%2C_Hanni_500x500%5D.jpg" alt="hanni stoklosa" width="500" height="500"><h3>Hanni Stoklosa, MD, MPH</h3><p>Emergency medicine physician, Brigham and Women’s Hospital, Boston, and<br>Co-founder and Executive Director of HEAL Trafficking</p></div><p>The AHA’s Hospitals Against Violence (HAV) initiative has a partnership with HEAL Trafficking (Health, Education, Advocacy and Linkage), which is a multidisciplinary group of more than 3,100 survivors and professionals in 35 countries dedicated to ending human trafficking and supporting its survivors. From a public health perspective, HEAL Trafficking equips providers and health systems with toolkits and other resources to aid in creating policies and procedures to implement response programs. <strong>Melinda Hatton,</strong> AHA general counsel and executive sponsor for HAV, interviewed <strong>Hanni Stoklosa, MD, MPH, </strong>emergency medicine physician at Brigham and Women’s Hospital and co-founder, Executive Director of HEAL Trafficking, to discuss the state of anti-trafficking efforts and how health systems play a role in reducing health disparities among victims of sex and labor trafficking.</p><p class="question"><span>Hatton:</span> Tell us more about HEAL Trafficking and how your work supports hospitals and health systems.</p><p><span>Stoklosa:</span> Research shows that the majority of people who have experienced human trafficking access health care at some point while they are being trafficked. Every day, trafficked persons come through the doors of emergency departments, orthopedic clinics, community health centers and inpatient psychiatric units. When I first learned of the intersection between health care and trafficking, I was reminded of two quotes by abolitionist William Wilberforce, “You may choose to look the other way but you can never say again that you did not know” and “Great indeed are our opportunities; great also is our responsibility.” It was this drive that compelled me to co-found HEAL (health, education, advocacy, linkage) Trafficking in the fall of 2013. I believe that there should be no “wrong door” for a trafficked person to enter the health care system.</p><blockquote class="left"><p>"Every day, trafficked persons come through the doors of emergency departments, orthopedic clinics, community health centers, and inpatient psychiatric units."</p></blockquote><p>I believe that every hospital and health system must be ready and prepared to care for the trafficked persons who come through our doors. HEAL Trafficking provides training and capacity building for health systems to respond to trafficking, from a public health and racial justice lens. Our website hosts compendia of the latest in evidenced-based, open-access resources. We have helped to create regional health care response frameworks for trafficking in states such as Maine, Minnesota, Alaska, Delaware, California, Tennessee, Ohio, and Massachusetts. Our HEAL Protocol Toolkit is being used by health systems in 35 countries to create their policies and procedures. Our standard-setting educational assessment tool was recently featured in the <a href="https://www.state.gov/trafficking-in-persons-report-2020/" target="_blank">U.S. State Department’s 20th Anniversary Global Trafficking in Person’s Report</a>, and has been used by the state of Texas in implementing their recent trafficking education law for health professionals. Where we see gaps in health care’s response to trafficking, we step in with advocacy, tools and education.</p><p class="question"><span>Hatton:</span> What are some of the trends you’ve identified on how hospitals and health systems are combating human trafficking?</p><p><span>Stoklosa:</span> Over the last 10 years, it has been amazing to see the awareness of and response to trafficking among health organizations grow. Some community health centers have dedicated resources to create medical homes for trafficked persons. Some health systems have trained their entire staff on trafficking, including reception staff and security personnel. Rural hospitals have focused on trafficking prevention work, addressing the social determinants of health that make their patients more vulnerable to trafficking. It is becoming a norm to have anti-trafficking response protocols as part of hospital anti-violence initiatives.</p><p>COVID-19 has brought its own challenges and highlighted existing inequities in our systems, particularly for people of color. Through a series of recent HEAL COVID listening sessions, we have heard from health systems in our community about how COVID-19 also opened doors to new opportunities, as we reimagine what health care looks like. For example, telemedicine has broken down access barriers previously thought to be insurmountable, which is vital for hard to reach populations most vulnerable to trafficking.</p><p class="question"><span>Hatton:</span> 3. Racial inequities play a significant role in the experience of a trafficked individual, can you please share some considerations to ensure trauma-informed and survivor-centered care?</p><blockquote class="right"><p>"Health systems should see racial justice work as integral to their anti-trafficking efforts"</p></blockquote><p><span>Stoklosa:</span> I am so glad you asked this question. Despite portrayals in media, people of color are more likely to be trafficked, and less likely to be able to access resources to help prevent them from being re-trafficked even after their exploitation is identified. Also, people of color are often criminalized rather than seen as victims for their trafficking experience. Furthermore, we know that they face baseline existing inequities in our health system. What this means is that health systems should see racial justice work as integral to their anti-trafficking efforts.</p><p class="question"><span>Hatton:</span> Can you share some key resources to help health care leaders get started?</p><p><span>Stoklosa:</span>The ���������� Association has compiled a great <a href="/system/files/2019-01/human-trafficking-response-resources-january-2019.pdf" target="_blank">list of resources</a> for health professionals to get started, including a podcast on which I provide updates on national efforts and resources in the fight against human trafficking. For hospital administrators, I recommend the <a href="https://healtrafficking.org/2017/06/new-heal-trafficking-and-hope-for-justices-protocol-toolkit-for-developing-a-response-to-victims-of-human-trafficking-in-health-care-settings/" target="_blank">HEAL Protocol Toolkit</a> which is an A-Z roadmap for creation of anti-trafficking policies and procedures. We have also developed a <a href="https://healtrafficking.org/wp-content/uploads/2020/06/Human-TraffickingCOVID19HEAL_05292020.pdf" target="_blank">COVID resource guide</a> for health professionals.</p><p class="question"><span>Hatton:</span> What is the next phase of this work?</p><p><span>Stoklosa:</span>As I mentioned earlier, where HEAL sees gaps in health care’s response to trafficking, we step in with advocacy, tools and education. We are excited to be collaborating with the U.S. Department of Health and Human Services and National Association of Pediatric Nurse Practitioners (NAPNAP) on developing core competencies for human trafficking for health professionals. Also, we take a racial equity lens to our work, it is important to highlight and mitigate a disparity we have seen in health system responses to trafficking. A lion share of those efforts focus exclusively on sex trafficking. Yet globally we know labor trafficking is more common. As health system administrators increasingly take up the banner of anti-trafficking efforts as part of their anti-violence initiatives, labor trafficking education and victim care must be as resourced as sex trafficking efforts.</p></div> Mon, 20 Jul 2020 10:25:20 -0500 Questions and Answers (Q&As)