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Domestic Violence Program a SuccessOn April 15, 2009 representatives of the judicial, legal and medical community attended the “The Professional Face of Domestic Violence”, the jointly sponsored CME/CLE program at the Millennium Hotel. Keynote Speaker and AMA President Nancy Nielsen, MD opened the program and cited that when discussing intimate partner violence 4.8 million women are physically assaulted or raped and 2.9 million men are physically assaulted. Fourteen percent of children experience some maltreatment, of those 75% are emotionally abused, 48% are physically abused, 8% sexually abused and 22% are neglected. In terms of elder abuse 1 in 25 are abused, either physically, sexually, emotionally or financially. An excellent resource for physicians can be found in the AMA’s video, “Preparing Your Practice to Address Family Violence”, which can be viewed by clicking the following link: Preparing Your Practice to Address Family Violence
Among the panelists, attorney Patricia Walker spoke to the audience of her own experience as a domestic violence survivor. Detective Cindy Herberger reviewed the “Power & Control Wheel” which is helpful to understand the pattern of abusive and violent behaviors that a perpetrator will use to establish and maintain control over the victim, as well as outlined some of the problems that law enforcement agencies face when attempting to gather necessary information from the medical community. Screening tools such as WAST (Women Abuse Screening Tool), ISA-P (Index of Spouse Abuse, Partner Abuse Scale: Physical), WEB (Women’s Experience with Battering) and PVS (Partner Violence Screen) were reviewed by Nicole Trabold, PhD, LMSW as possible tools that could be used in any patient care setting. Doctor Trabold also provided an excellent “personalized safety plan” document that victims should be using realization that they need to move away from their home. Attendees learned from Attorneys Kristin Arcuri and Melissa Zittel the standards of practice for both the medical and legal professions. Both stressed the need for effective communication while stressing the need to provide security and confidentiality. Erie County Family Court Judge, Lisa Bloch Rodwin provided insight into understanding victim/perpetrator behavior including the offender’s intent when using violence and the meaning of that violence on the victim as well as other family members (children). She explored the needs of both the victim and children, stating that above all else there was need for the physiological (food, shelter, sleep etc.) as well as safety, social (friendship), self esteem, hope and self actualization. Participants then learned about resources which are available through the Family Justice Center, www.fjcsafe.org, (located at 237 Main Street in downtown Buffalo) to which abused patients and clients can be referred. At this site, without any cost, victims can meet with a prosecutor, speak to trained counselors, have their injuries documented in a forensic medical unit, and arrange for placement in a safe and secure shelter – all in their native language while their children play safely in a supervised waiting room down the hall. No longer are victims required to visit multiple agencies, all in different locations. Because we received a number of calls about the prevalence of domestic violence, and the concern of some who were being victimized and fearful for being identified we are in the process of completing an application for CME credit as an “Enduring Document”. This means it that if you were not able to attend, the program tape and all seminar documents will be made available for purchase and submission for CME credit. As soon as we are approved you will be notified of how to purchase the product and apply for credit. If you have any questions about the program, or have suggestions for future programming, please give me a call (716-852-1811) or via email, chris@eriemds.org.
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ASSEMBLY PASSES LEGISLATION TO PERMIT NO-FAULT PAYMENT FOR EMERGENCY CARE TO INTOXICATED DRIVERS
Legislation (A.6843, Dinowitz) passed the Assembly this week that would assure that physicians are appropriately reimbursed for providing necessary emergency care to an intoxicated person in a general hospital.
Identical legislation (S.3554, Breslin) has been referred to the Senate Insurance Committee. MSSNY supports this legislation, and urges physicians to contact their legislators to convey their support. The legislation would address an anomaly in the law well-known to physicians who provide emergency care. Under current “no-fault” insurance law, injuries to intoxicated motorists are not covered by their motor vehicle insurance. Yet, at the same time, the federal Emergency Medical Treatment and Active Labor Act (EMTALA) requires health care providers to provide emergency medical services to persons in need of such care.
As a result, physicians often do not receive payment for providing this necessary, often life-saving, care. This bill, put forward by the New York State Insurance Department and the Office of Alcoholism and Substance Abuse Service, seeks to address concerns articulated by Governor Paterson when he vetoed similar, but broader, legislation passed by the State Legislature in 2008. In his veto message on that bill Governor Paterson noted that, while the goals of the bill were sound, it was drafted so expansively that it would have required coverage far in excess of emergency care. The Governor's veto message instructed his staff and interested parties to “help enact a new bill that accomplishes the intended purpose... in a manner that will protect the interests of the health service providers, injured patients and the public.” The bill narrows the scope of the bill to necessary emergency care provided to an intoxicated driver in a general hospital. Please call your senator (518-455-2800) to urge their support for this measure, and a send a letter to your legislators from the MSSNY website by clicking here.
