HUMAN TRAFFICKING IDENTIFICATION & RESPONSIBLE RESPONSE TO SURVIVORS. A training for healthcare providers

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HUMAN TRAFFICKING IDENTIFICATION & RESPONSIBLE RESPONSE TO SURVIVORS A training for healthcare providers

Introduction Name Agency How long you ve been there

We believe that housing, healthcare, jobs and justice are the way out of poverty.

What is the first word that comes to your mind when you think of the human trafficking

What is human trafficking? Modern Day Slavery Anyone who is compelled by force, fraud or coercion for the purposes of commercial sex or forced labor.

Why healthcare providers should know about human trafficking Treatment Source Any contact with healthcare 87.8% Any type of clinic 57.1% Hospital/ER 63.3% Planned Parenthood 29.6% Regular Doctor 22.5% Urgent Care clinic 21.4% Women s Health Clinic 19.4% Neighborhood clinic 19.4% Onsite Doctor 5.1% Other 13.3% % Reporting Based on a study in the US of adult and minor female survivors of domestic sex trafficking (Lederer & Wetzel, 2014)

Why healthcare providers should know about human trafficking This case actually involves a foreign national, a Mexican foreign national. She was living with....this is an outcry. She was working for, we ll just say, the four traffickers and she was just doing a domestic servitude kind of situation. They had their... she had a cleaning business. One of the traffickers did. So she was forced to clean office buildings at night. And then one of the traffickers had his own construction business, and she was forced to also to work construction as well as cleaning the house and making food. She was mowing the backyard and she got poison ivy and they wouldn t take her to the doctor. So finally after like two weeks, she was in so much pain that she ran out of the house and got someone to take her to the hospital. And that s when she made her outcry and we got her information Ice Agent, Hidden in Plain Sight, Urban Institute

True or False Human trafficking requires a person to cross an international border.

Human Trafficking is Different from Smuggling Smuggling: transportation - Involves an agreement to transport or harbor someone in violation of US immigration law - Can evolve into trafficking Trafficking: exploitation - As defined under federal and Illinois laws - An initial agreement of smuggling that evolves into trafficking, does not negate one s status as a trafficking victim and ability to seek remedies

True or False Foreign national victims in the United States are always undocumented or come in using false documents.

Foreign National Victims in the US: - Are NOT always undocumented or DO NOT always come in using false documents. - Many arrive with - Fiancé visa - Temporary worker visa - Student/exchange programs - Others(R-1/NATO/etc.)

Elements of Human Trafficking Force Fraud Coercion Physical assault Sexual Assault Isolation Confinement False/deceptive offers of employment Sham marriages Lying about conditions of work and living situations Withholding wages Taking documentation Threat s of violence against victim and/or his/her family Threats of arrest and/or deportation Debt bondage Withholding legal documentation and identification

IL Safe Children s Act (2010) Under 18 : immune from prosecution for prostitution under any circumstances. Amends the IL Abuse and Neglected Child Reporting Act to: include cases of sex/labor trafficking or involuntary servitude, and mandates DCFS as the agency-responder to such reports.

Location of potential human trafficking cases reported to NHTRC hotline in 2015 Consistently, the number one source of calls were community members, with the second source being victims of trafficking. Other sources: NGOs, victims of other crime, etc.

In Illinois 609 calls with 198 cases reported 10 9 23 156 Labor Sex Both Unknown 140 120 100 80 60 40 85% - Female; 12% male; 3% gender minority 20 0 Adult Minor US Citizen Foreign National

Human trafficking happens everywhere Prostitution Brothels Massage parlors Meat packing industry Child sexual exploitation Domestic Servitude Construction Restaurant industry Hotel industry Elderly Care Hair braiding Escort services Internet Nail/hair salons Strip clubs Factory work Agriculture Pornography

Traveling Sales Crews 419 cases of labor trafficking on sales crews. * 42 states where labor trafficking on sales crews have been reported. * 25% of cases referenced abandoned workers with no means to return home. * * Cases reported to the National Hotline and Polaris s BeFree Textline (Jan. 2008 - Feb. 2015)

ASSESSING FOR TRAFFICKING

Faces of Human Trafficking - Youth https://ovc.ncjrs.gov/humantrafficking/publicawareness.html

Must Dos 1. Build rapport 1. What is their experience from the moment they walk in? 2. Choices (where to meet, what to drink) 3. Small talk 2. Client-Centered (go at their pace) 3. Assess NEEDS only 1. What can I do to help you today? 2. What do you need to feel safe? What makes you feel unsafe? 3. I can help you with a variety of things. Is it okay if I go over a list with you and you tell me if you need help in that area?

Indicators in healthcare setting Untreated injuries/illnesses Malnourishment Exhaustion Signs of physical abuse Chronic STIs Teenage pregnancy Depression Anxiety

How to increase possibility of identification Nonjudgmental Listen Believe Save face Validate. Educate. Support. Create a safe environment Have a plan Know your partners

Needs to Assess For Housing Medical care Culturally appropriate food Mental health services Transportation Communication (cell phone) Identification documents Legal services Education Employment Childcare Budgeting

What to listen for Confiscated identification documents Long hours at work with low/no pay Violence in the workplace Why they came to the US (if foreign-born) Limited support of family/friends Lack of familiarity with community/area Debt owed to an individual or employer Untreated Illness/injury

Barriers to identification Barriers to Identifying Victims Barriers to Identifying Immigrant Victims Hidden crime Coached by trafficker Charged as perpetrator Don t always identify as victim Fear of deportation Language & economic barriers Lack of protection in home country Misinformation from perpetrator about rights & available services

How to increase possibility of identification Don t ask what is wrong with the person, ask what happened to them. We need to ask the questions otherwise we are missing an opportunity to help someone who is being exploited or at risk of further exploitation.

Missed Opportunity I showed up to her house and half of my hair was gone, basically was pulled out from the roots [from abuse by trafficker], and she said she recalled her mom, her mom was a nurse and now I remember it, her mom was a nurse and her dad was a minister, and I showed up at that door and it was raining and I was crying because you know they had just beat me and her mother s response, who was a nurse was, you know, We just don t want to get involved in this. I think my only attempt was that time when I went to [friend s] house when I was in [state] when I ran to her house, but of course if a pastor and a nurse can t help me, then I felt like nobody could. (site 2, survivor 7, female, domestic servitude) Hidden in Plain Sight, Urban Institute

TRAUMA INFORMED & VICTIM CENTERED RESPONSE Best Practices when working with clients who have experienced trauma

The world is generally a safe place People are generally good. I am generally in control of my life. Trauma can occur when our basic life assumptions are challenged or shattered.

Individualize the response According to: Age Physical condition Emotional condition Ability to protect the minor What is known about the trafficker Ability to provide services to minor within protective custody Ability to follow up a later date

Mandated reporting Healthcare workers are mandated reporters, not mandated interveners! Immediate removal of a minor from the situation is not always safe. https://healtrafficking.org

When to leave Where to live Report to police Engage in services Receive mental health counseling specialized, trauma informed case management Current resources Public benefits Immigration relief Criminal justice advocacy Education & job training/readiness Reduced risk of re-exploitation Increased participation in the community and work force Decrease traumatization Better quality of life

No documents Facilitated drug addictions Debt Inability to get help isolation, confinement, and guarded Distrust of law enforcement agencies and service providers Unaware of their rights or resources available to them Empathy/emotional ties to traffickers i.e. Stockholm syndrome Fear of not being believed Fear of retaliation (for them self and others) Shame Overwhelming sense of hopelessness, no one cares or a normalization of the exploitation

Word choice & conveying appropriate information to victims of trafficking DON TS You are safe now. DOS We will do everything we can to keep you safe. DON TS You are a victim, not a criminal. DOS The people who did this to you are the criminals. You were mistreated and your rights were violated. No one here will hurt you. Coming to us and working with us will help you. We are not working with the individuals who hurt you and took advantage of you. We are here to help you. We are here because we want to do our best to help you and protect you as well as your family. You can trust me We want to make sure what happened to you doesn t happen to any one else. [Do not say this. Show them this. It is much more impactful.] [Inflicts guilt; victim blaming; onus is never on the victim for prevention]

Friends Attorney What does being client-centered mean to you? Guardian SURVIVOR LEA Case Manager Therapist

Guiding principles of trauma informed care 1. Safety: Ensuring physical & emotional safety 2. Trustworthiness: Maximizing trustworthiness through task clarity and maintaining appropriate boundaries 3. Choice: Prioritizing survivor choice and control 4. Collaboration: Maximizing collaboration and sharing power with survivors 5. Empowerment: Prioritizing survivor empowerment and skill building 6. Language Access & Cultural Competency: Eliminating service disparities based on language or culture

TAKING ACTION What to do when a client is identified as a potential survivor of human trafficking

Specific Strategies For Your Office Have resource brochures and one pagers on hand Hang the NHTRC flyer in your organization Add questions to typical intake at initial meeting with client Coordinated Assessment Require all staff to be trained on how to identify human trafficking

Next Steps: Safety & Referral 1. Ensure any potential perpetrators or threats to the victim are removed. 2. Understand immediate safety concerns. 3. What do you need to feel safe? What would you like to do next? *FOLLOW THIS LEAD

Available Resources for Survivors Specialized anti trafficking services Comprehensive case management Trauma informed & victim centered Specialized anti trafficking legal services comprehensive, holistic legal services Trauma informed & victim centered Explain and protect rights

Role of Law Enforcement Victims have a right to an attorney and should have one present when speaking with law enforcement Offering to call law enforcement could cause the survivor to become extremely fearful and he/she may leave your care without further help/referrals and not return

Specialized Services = Best Practice Housing Healthcare Housing Criminal Justice Advocacy Public benefits Antitrafficking case manager Job training Mental health Criminal Justice Advocacy??? Mental Health?? Job training Legal services Healthcare? Public benefits Legal services

45 Services Available in Chicagoland (*statewide) Free Legal Services National Immigrant Justice Center* (312) 660-1370 LAF* (312)341-1070 Metropolitan Family Services Human Trafficking Initiative/VLAN (312)986-4200 Comprehensive Social Services Salvation Army STOP IT Program 1-877-606-3158 Heartland Human Care Services* 312-662-6185 Metropolitan Family Services Victim Assistance Legal Network (VLAN) (312) 986-4200 If the potential victim is outside of Illinois, please contact the National Human Trafficking Resource Center at 1 888 373 7888.

Immigration Relief Process for Foreign Born Survivors Meet with attorney Report to law enforcement File Visa Visa Decision 6 to 8 months 12 to 16 months 18 24 months

Immigration Relief Available to Survivors Continued Presence T Nonimmigrant Visa U Nonimmigrant Visa Issued by law enforcement Temporary relief 1 year increments Can be renewed or revoked Obtain work authorization Access to public benefits Completed with an immigration attorney Must be in the US on the account of trafficking Law enforcement certification is optional Valid for four years Obtain work authorization Access to public benefits After 3 years, can begin adjustment to LPR Completed with an immigration attorney 26 different crimes Law enforcement certification is required Obtain work authorization Not eligible for public benefits Valid for 4 years, can adjust to LPR status after U visa

Access to Public Benefits Food stamps Cash Assistance Health Insurance Child Care Receiving temporary benefits allows the survivor to engage and prepare him/herself for the workforce: Work with immigration attorney to obtain legal status to work Participate in ESL Enroll in job training programs Complete education

QUESTIONS? Darci Flynn dflynn@heartlandalliance.org 312 662 6185