Measures Establish Hospital-Based Violence Intervention Program Initiative in State’s Trauma Centers and funds Violence Intervention Program in local communities
Advancing actions toward preventing gun violence in the state, six legislative measures spearheaded by Assemblyman Lou Greenwald that will work to stem gun violence by engaging patients in the hospital, during their recovery and in the community following a firearm incident, putting much needed attention on mental health and counseling needs of gun violence victims, cleared the Assembly Health and Senior Services Committee Thursday.
In a recently published op-ed, Dr. Stephanie Bonne of University Hospital in Newark – the only hospital in the state with a fully operating community-based intervention program – spoke of gun violence as a public health crisis and described a particular approach to addressing it.
“Dr. Bonne made a poignant statement in her op-ed, ‘Physicians, in general, are not anti-gun, we are anti-bullet hole.’ We should all be too as legislators and policymakers,” said Greenwald (D-Camden, Burlington). “A coordinated approach is the best way to tackle public health problems of mental health and violence. Community- and hospital-based prevention services are the key to improving safety in our communities.”
Nationally, homicide remains one of the leading causes of death among youth and young adults ages 15 to 34. Recurrent violence-related trauma accounts for up to 45 percent of all hospital trauma admissions. In some urban hospitals, up to 45 percent of patients treated for violent injuries like gunshot wounds are re-injured within a five year period following discharge.
“Each day, too many families in New Jersey wake up expecting to hear the sound of gunfire – and live with the constant fear of losing a loved one,” said Mike McLively, director of the Urban Gun Violence Initiative at Giffords Law Center to Prevent Gun Violence. “Underserved areas are reeling from gun violence that is overwhelmingly concentrated in communities of color. In fact, just 5 cities in New Jersey account for more than half of total homicides. The good news is that we know by working with local leaders and community organizations in neighborhoods that are hurting, we can dramatically reduce gun violence and save lives in the process.”
“Many hospitals see a “revolving door” of gunshot injuries, as patients who have been shot are at a very high risk of being violently reinjured and committing violent acts themselves,” said Greenwald. “Making counseling a critical part of the services a patient receives may be just the prescription needed to save lives and discourage recidivism and the use of retaliatory violence.”
Acknowledging the immense role access to mental health care plays in prevention, the bill package would align New Jersey with a national trend of developing hospital based violence intervention programs in the hospitals who handle trauma incidents related to gun violence.
Hospital Violence Intervention Programs (HVIP) would provide intensive counseling, case management, and social services to patients who are recovering from gunshot wounds or other violent injuries.
New Jersey anti-gun violence and health advocates are also speaking out in support of Greenwald’s hospital intervention bills and their importance to the work of physicians and hospital staff on the frontlines dealing with gunshot victims.
“As a mental health professional and gun violence prevention advocate, I know how important it is that gun violence survivors receive immediate support through counseling and community resources. Hospital-based violence intervention programs have been proven to reduce the likelihood that a survivor is involved in a retaliatory shooting or re-victimized and can increase their educational and employment outcomes. These bills will ensure that all those who have been impacted by gun violence are provided with the essential support required to process and work through their traumatic experience and will provide disproportionately impacted communities with much-needed resources to advance proven and community-led gun violence prevention strategies,” said Diana Trasatti, volunteer with the New Jersey chapter of Moms Demand Action for Gun Sense in America.
“Since the inception of our specialty, emergency physicians have been on the front lines inside emergency departments, responding to acts of violence. Efforts to provide access to effective, affordable, and sustainable counseling services to victims of violent injury at point of care may help our patients stay safe in high risk situations. As a specialty, we will continue to lead and to collaborate with partners across the emergency response continuum, in efforts aimed at reducing potentially preventable deaths and disability,” said Marjory Langer, MD, FACEP, who is President, NJ American College of Emergency Physicians.
Specifically, the bills in the package would establish the “Hospital-Based Violence Intervention Program Initiative’ in the Department of Human Services (A-4806); require the Victim of Crime Compensation Office (VCCO) to partner with trauma centers to provide referrals for trauma victims (A-4805); require Medicaid to cover professional violence prevention counseling services (A-4804); authorize certain entities providing counseling services to firearm and stabbing injury crime victims to directly bill the Victims of Crime Compensation Agency for counseling services (A-4803); and mandate Level One or Level Tow trauma centers provide hospital-based or hospital-linked violence intervention programs for firearm or stabbing related injuries (A-4802).
Multiple case studies and controlled trials have shown that HVIPs are highly effective at reducing patient’s rates of violence and re-injury. Reducing the likelihood that patients will be re-hospitalized or will perpetrate violence in the future has also contributed to a substantial cost savings in health care in the long run.
“Coordinated hospital intervention and counseling services can help to break the cycles of violence and retaliation through intervention when it is most important, at the time it happens,” continued Greenwald.
The final bill in the package focuses on funding community based violence intervention programs through a grant award program. The bill (A-4801) establishes the New Jersey Violence Intervention program for the purpose of saving lives by investing in effective, evidence-based violence initiative focused on the highest-risk individuals in communities disproportionately impacted by community violence, particularly firearm violence.
The measure creates a grant program, utilizing federal funding for the purpose of administering and funding the NJVIP.
“The handful of states already making this investment, including New York, Massachusetts, and Connecticut, are seeing impressive results–bringing relief and progress not through a heavy-handed approach but working directly with individuals that need resources,” added McLively of Giffords Law Center. “We applaud Assembly Majority Leader Greenwald and Governor Murphy for strategically directing critical resources to the state’s most impacted communities.”
Greenwald recently attended two roundtables, the first with Gov. Phil Murphy on gun violence in Trenton and the other at University Hospital in Newark to discuss their Hospital Based Violence Intervention program.
“We know that the path to silencing gun violence requires a multi-pronged approach involving steps that improve gun safety, anti-gun trafficking laws and, equally as important, the improvement of mental health services for victims of violence,” Greenwald said. “Ending gun violence will be an ongoing conversation for as long as it takes to rid it from our communities, our state and our country.”