The Medical Response To Child Sex Trafficking Jordan Greenbaum, MD Blank Center for Safe and Healthy Children Children’s Healthcare of Atlanta

Medical Response to Child Sex Trafficking Our medical response is coordinated with police and child protective services We provide the forensic interview, medical exam, treatment, rape kit, & referrals in 3 Emergency Depts and 2 clinics in Atlanta We use trained nurse practitioners and forensic interviewers

The Process…. Police pick up victim Police call Children’s Hospital Transfer Center MP contacts social worker (SW) Transfer Center contacts medical provider (MP) on-call MP and SW meet police and child at hospital Child has exam, interview GCCO: this is the Georgia Care Connection, an organization that serves as the ‘gateway’ to services for victims. The GCCO immediately starts a comprehensive assessment of the child and her needs, and obtains services for the child (food, shelter, clothing, behavioral health therapy, skills training, school, legal help, etc) MDT: this is the Multidicisplinary Team consisting of sex trafficking investigators and service providers from ~9 counties in and around Atlanta. We meet monthly to discuss cases and make sure child has received services, monitor her progress and monitor progress of investigation. Child Protective Services are called, GCCO contacted Team agrees on safety plan with GCCO Child followed by MDT Follow up at Center for repeat exam and forensic interview

The Medical Evaluation Detailed medical interview Is NOT a forensic interview Assess chief complaint (current symptoms) Reproductive health history Prior/current injuries/abuse Substance use/misuse Mental Health Screen High-risk behaviors May not have any chief complaint if brought in for runaway status Helps us identify medical needs, high-risk behavior that may need treatment, counseling, mental health needs. Guides referrals Now doing this for adolescents with sexual abuse presentation, to screen for trafficking

Medical Evaluation Document general health, untreated conditions Document nongenital injuries Urine drug testing

Medical Evaluation Sexual assault evidence kit Colposcopic exam with photodocumentation Testing/treatment sexually transmitted infections Pregnancy testing/prophylaxis Referrals for further care

Sex Trafficking Multidisciplinary Team Serves metro Atlanta counties Meets monthly to discuss cases Exchange info on whereabouts of children, stage of investigation, ongoing services Ensure that all relevant authorities are involved Ensure medical exams obtained Share resources Cross-training of professionals I was asked to review medical records of victim being seen by a mental health provider on the team. During month, send out emails about specific kids/investigations, asking for help/info

Education and Training We host a webinar series and computer-based training for medical professionals Topics include: Overview of child sex trafficking The Medical Examination The Medical Interview Special Topics Victim/Survivor-Centered Approach to sex trafficking Free CMEs Also give Grand Rounds, talk at national conferences, regional conferences

Education and Training We give presentations at medical conferences (local, regional and national) We provide introductory training on child sex trafficking for multidisciplinary audiences (police, attorneys, behavioral health professionals, teachers, etc) Free CMEs Also give Grand Rounds, talk at national conferences, regional conferences