New York State Laws
In 1990, New York became the first state to require all hospitals to establish protocols for identifying and treating victims of DV. Health care providers need to know the laws and regulations that apply to their work with victims so that they allocate enough time to meet those responsibilities, understand how their work intersects with that of other professionals, and intervene ways that do not compromise the safety of victims.
Family Protection and Domestic Violence Intervention Act
(Chapter 222 of the Laws of 1994) Hospitals and Diagnostic and Treatment Centers are required to provide copies of the Victim's Rights Notice to all suspected or confirmed adult DV patients, in a private and confidential manner. View this Memorandum from the NYS DOH Web site, about the responsibilities of hospitals in complying with these requirements.
The Victim's Rights Notice, also available in Spanish, tells patients what their legal rights are, what kind of help is available from the police and the courts, and where to call for emergency assistance. Hospital administrators are reponsible for making it available in other languages commonly spoken in their catchment area.
Chapter 271 of the Laws of 1997
Facilities that serve maternity and pre-natal patients, on either an inpatient or outpatient basis, are required to distribute copies of Are You and Your Baby Safe, which is available from the Department of Health, in English and Spanish.
Injury Reporting Laws
New York State's Penal Law requires that:
- All injuries resulting from discharge of a firearm, and all potentially
life-threatening injuries inflicted by a knife or other sharp object,
must be reported to the local police. (§265.25)
- All 2nd or 3rd degree burns to 5% or more of the body, all respiratory tract burns, and all burns which might result in death, must be reported in writing within 72 hours to the Office of Fire Prevention and Control. (§265.26)
- These reports must be made by the physician or manager in charge of the case, and intentional failure to report is a class A misdemeanor.
Department of Health Regulations
Department of Health Domestic Violence Protocol
The Department of Health protocol, Identifying and Treating Adult Victims of Domestic Violence, outlines the responsibilities of health care providers and members of their staff toward victims of DV, and focuses particularly on the responsibilities of Emergency Department staff. It requires medical facilities to develop and implement policies and procedures that provide for the identification, assessment, treatment and referral of confirmed or suspected victims of DV, and identification of "medically-related, personal and social problems which may interfere with the patient's treatment." These policies must include:
- A plan for making social work and psychological services available as needed to meet patients' treatment goals;
- Relevant on-the-job training on the identification and treatment of victims of DV for every employee;
- Policies and procedures for managing suspected or confirmed cases of DV in emergency services.
DV Screening for HIV Partner Notification(Regulation: 10NYCRR Part 63)
Department of Health regulations require notification of past and present partner of their possible exposure to HIV. Such notification has the potential to lead to or increase the risk of physical violence against the infected individual, their children, or others. Therefore, screening for risk of DV is a standard component of post-test counseling for HIV infected individuals, and partner notification will be deferred if it is determined that there is a risk of violence.
HIV counselors are required to:
- Screen for DV by each contact named by the infected individual, regardless of the current status of the relationship;
- Keep information about DV confidential, except in clearly defined circumstances;
- Defer partner notification if screening reveals a likelihood of physical harm to the infected individual or others close to them;
- Follow up with the infected individual in 30 days to determine whether it is safe to proceed with partner notification, and continue to assess thereafter;
- Document deferrals carefully in order to avoid putting victims at further risk;
- Refer for services if DV is disclosed.
Key components of the American Medical Association's Diagnostic and Treatment Guidelines on Domestic Violence include the following:
- Providers should routinely screen all women patients in emergency, surgical, primary care, pediatric, prenatal, and mental health settings.
- Providers should be aware that asking about DV in the presence of the woman's partner is not safe, and may interfere with making an accurate assessment.
- Providers' first concern must be the safety of the victim and her children.
- Optimal care for the woman depends on the provider's working knowledge of community resources that can provide safety, advocacy, and support.
- Providers need to be aware of state laws, and of local services for victims.
- Providers must be aware that orders of protection do not guarantee a victim's safety, and should continue to reassess it.
- Providers should disclose abuse to any third party, including authorities, only with the victim's knowledge and consent.
The Joint Commission on Accreditation of Health Care Organizations' Accreditation Manual for Hospitals (1999) includes several standards relevant to work with patients who may be victims of DV:
- Each patient's physical, psychological, and social status are assessed. (PE.1.)
- The need for a discharge planning assessment is determined. (PE.1.5)
- Possible victims of abuse are identified using criteria developed by the hospital. (PE.1.8)
- Reassessment occurs at regular intervals in the course of care. (PE.2.1)
- Patients who are possible victims of alleged or suspected abuse or neglect have special needs relevant to the assessment process. (PE.8)
- The leaders ensure that the competence of all staff members is assessed, maintained, demonstrated, and improved continually. (HR.3)
This regulation makes it clear that every limited-English-proficient patient has a right to meaningful access to a hospital’s services; requires every hospital to develop a language assistance program and designate a language assistance coordinator; requires hospitals to identify and document each patient’s language of preference and the acceptance or refusal of language assistance services; sets clear limits on the use of friends, strangers, and family members as interpreters, including age restrictions; and so forth.