CT HVIP Report, August 2020 Update

albonello

Connecticut Hospital Violence

Intervention Program

HVIP Collaborative

UPDATE

AUGUST 2020


Introduction

Despite the outbreak and disruptions of COVID-19 in recent months, the

CT HVIP Collaborative has continued to press forward with deliberations,

including meetings hosted by Sen. Douglas McCrory, Rep. Matt Ritter and

Rep. Jillian Gilchrest to explore how to build and sustain the hospital-based

violence intervention program (HVIP) model statewide. At the CT Hospital

Association on March 6th, the full CT HVIP Collaborative last gathered in

person – just four days before Gov. Ned Lamont declared a public health

and public safety emergency due to the COVID-19 outbreak. Following this

meeting, the governor further announced a stay-at-home initiative March

20th and extended it on May 20th, necessitating communications this spring

through virtual Zoom meetings and conference calls. This August 14, 2020

Update summarizes significant 2020 Collaborative activities.

Given the medical and frontline service responsibilities of our HVIP practitioners

in Hartford and New Haven, we have quickly pivoted this spring to manage the

emergency duties driven by this historic pandemic, on top of our day-to-day

violence prevention and intervention efforts. Everyone’s home and work lives

have been disrupted at all levels, yet our Work Groups regularly conferred,

to illuminate resource pathways, further explore research and evaluation

techniques, and examine training and technical assistance opportunities, in

the interest of preventing violence through the statewide sustainment and

scaling up of the HVIP model. A meeting of the full committee will take place

virtually on September 17, 2020.

In addition to continuing within our Work Groups to facilitate progress on

the CT HVIP initiative, individual agencies expanded their missions to directly

confront the most pressing issues brought to light by the pandemic – mainly

food insecurity and COVID-19 testing. You can read more about these efforts

in the detailed sections below.

For policy information, the Collaborative continues to examine HVIP

developments in other states, focusing on what can be learned to

enhance effectiveness here. Before and during the pandemic outbreak,

the Collaborative has been sustained with the solid support received from

Congressman John Larson, Sen. Doug McCrory, and Reps. Matt Ritter and

Jillian Gilchrest.

We will continue to hone the best-practice possibilities for structural

legislation followed by funding in 2021 for this state’s HVIPs and their trained,

community-based Violence Prevention Professionals. Those are the originally

agreed-upon stages for future action – and they remain on the table.

2


The Connecticut

HVIP Collaborative 3

Significant Activities

Drawing upon points emphasized in our Policy, Research & Evaluation,

and Training & Technical Assistance Work Group meetings, here is a brief

compilation of the major CT HVIP developments during the COVID-19

adjustment period since March, by Work Group:

Policy Work Group:

The mission of the Policy working group is to partner with legislators

and agency leaders on legislative and/or executive actions for attaining

resources to sustain and expand the CT HVIP, including Medicaid

reimbursement for Violence Prevention Professionals.

• On July 21st, Andrew Woods gave a presentation on the HVIP model

before the Hartford City Council’s Quality of Life and Public Safety

Committee, which offered to support the Collaborative’s statewide and

local efforts.

• On July 23rd, Rep. Jillian Gilchrest facilitated a continuing discussion

with the State Department of Social Services (DSS), which administers

Medicaid, concerning future reimbursements for violence prevention

services. In a Zoom meeting arranged by Rep. Gilchrest, our policy

specialists [Executive Director Fatimah Dreier and Policy Director Kyle

Fischer of the Health Alliance for Violence Intervention (the HAVI) and

Mike McLively, Senior Staff Attorney & Community Violence Initiative

Director at the Giffords Law Center to Prevent Gun Violence, joined our

local partners in a fine-grained dialogue with DSS officials concerning

HVIPs. Points of emphasis: Hartford and Baltimore data concerning

the return on investment/ net public benefit of Violence Prevention

Professionals (VPPs) and their unique frontline role; the acceptance of

VPPs as newly eligible for Medicaid reimbursement under the National

Uniform Claim Committee (NUCC) taxonomic code; the subsequent

reimbursement of Philadelphia VPPs under that new designation; and

data showing VPPs not only decrease victim re-injury and retaliation but

increase preventive health and mental health services that yield overall

cost benefits (as opposed to the typical over-reliance on the Emergency

Room). Follow-up meetings will center on Proof of Concept.

Special Thanks to

Local Funders and

Donors: We would like to

recognize the American Eagle

Financial Credit Union, and

the James and JoAnn Price

Community Safety Fund. The

Connecticut Health

Foundation and the Hartford

Foundation for Public Giving,

as their timely help during

these recent times was and

continues to be critically

important.

• On August 11, our CT HVIP stakeholders met with DSS officials

to continue the conversation regarding the acceptance of VPP’s as

eligible for Medicaid reimbursement.

• For November 10, our medical and frontline partners are on the

agenda of the State VOCA Advisory Committee for a discussion of

VOCA funding related to HVIP services.


• Our current Frequently Asked Questions handout references policy

recommendations as of now; these will be reviewed and refined at

the next CT HVIP meeting; they are intended to be useful in future

communications.

Training & Technical Assistance Work Group

The mission of this Work Group is to partner with the Health Alliance for

Violence Intervention (The HAVI) to train and continue to support CT HVIP

staff and stakeholders. This includes training and certifying a cohort of

20-25 front-line, Violence Prevention Professionals (VPPs) in service to HVIP

and Violence Interrupter needs, initially in Hartford and New Haven.

• In a July 29 th discussion, hosted by Leonard Jahad at the Connecticut

Violence Intervention Center (CVIC) in New Haven, frontline workers

from the Hartford Care Response Team joined the CVIC front line

workers to examine their response to the recent upticks in both

cities. A follow-up HVIP Front Line Worker Capacity Building Session

is scheduled for August 19, 2020, from 12-3:00 p.m. at Hartford

Communities That Care for these HVIP staff to review the strengths

and challenges of each program – and what resources may be required

to meet the needs in these cities. The Health Alliance for Violence

Intervention (The HAVI) will provide technical assistance and CT HVIP

Work Group members will provide guidance and/or participate directly

in this exchange as well.

• On August 3, following the initial meeting of frontline professionals

from Hartford and New Haven, several follow-up meetings were

planned in an effort to continue the capacity building effort. A

conference call was held with Cathy Motamed, Training and Technical

Assistance professional at The HAVI, who informed the group of

opportunities The HAVI can provide to the frontline professionals as

well as other stakeholders of the CT HVIP. Cathy was invited to present

additional information at the next capacity building session.

4

• On August 19, continuing this conversation, a capacity building session

will be held virtually with the frontline professionals from Hartford and

New Haven. Both Executive Director Fatimah Muhammad and Cathy

Motamed from The HAVI will attend the session to give a presentation

on how The HAVI can support CT HVIP efforts. This includes highlighting

the 5-day Violence Prevention Professional (VPP) training as well as other

workshops and certifications offered by The HAVI. Cathy also will share

a standardized checklist utilized by other programs nationwide that aids

continuity of services across programs – and would serve as a template

for new community partners. Lastly, Cathy will share an individualized


assessment and evaluation tool, which will provide a macro perspective

of the work that’s been done and provide insight into goal setting for

moving forward.

• Preparations for The HAVI’s Violence Prevention Professional (VPP)

Training in CT continue.

• Additional dollars have been secured from private donors to increase

Hartford’s HVIP response to meet the recent increase in shootings.

Resources are being identified to sustain these temporary frontline

workers and to ensure they receive The HAVI VPP training.

Research & Evaluation Work Group

The mission of this working group is to identify and secure research

and evaluation resources to demonstrate the value and evaluate the

effectiveness of HVIPs.

Drawing from their monthly Research & Evaluation (R&E) Work Group meetings

(via conference call or Web-based conferencing platform), Christa Green of

Hartford Hospital and Dr. Jim Dodington of Yale-New Haven Hospital provided

a three-part summary (and more detailed notes are available):

• VOCA Application Preparation – Planning is under way for a CT HVIP

Collaborative evaluation platform compatible with VOCA Assistance

Grant application in 2021. All four Level-1 Trauma Centers are involved

in discussions within the R&E group for potential shared informatics for

program evaluation specific to HVIP work, including case management

software specifically tailored to HVIPs and VOCA funding and

evaluation (in use now by peer HVIPs nationally). Current collaboration

with the Connecticut Hospital Association relates to VOCA partnership

similar to Virginia and other states that leverage their hospital

associations to support HVIPs at multiple sites. CHA is interested in

serving in a similar role to that served by its counterpart association

in Virginia. Another approach worth noting is the administrative role

played by the New Jersey Attorney General’s Office, which supports

multiple HVIPs in that state.

• Violent Injury Database Concept Development and Presentation to

Funders – One of the primary objectives of the R&E group is to study

the trends and patterns of violent injury and subsequent treatment,

intervention and prevention services provided in CT. Currently, no

statewide database captures all of these variables, so we are proposing

to develop and maintain one that can be utilized by this group and

other CT stakeholders. Such a database will also allow us to study

The Connecticut

HVIP Collaborative 5


the effectiveness of programs and interventions, by strengthening

the evidence base for the HVIP model. This database would ideally

complement our plans to maintain a robust database on participants in

the HVIPs at the four Level-1 trauma centers.

• Collaboration with CT DPH on CDC FASTER Project – The CDC

issued an RFA for cooperative agreements with seven states, to develop,

study and disseminate findings from statewide syndromic surveillance

of nonfatal firearm injuries in emergency departments. We reached

out to DPH to offer our expertise and connections to firearm violence

prevention stakeholders throughout the state. We submitted our first

letter of support as a Collaborative to be included in DPH’s application.

If awarded, the project period would begin September.

2020 HAVI Conference Presentations

Look for a strong CT HVIP Collaborative representation at the 2020 annual

HAVI conference to take place September 29 through October 1. Our CT

HVIP members submitted four abstracts – and all were accepted for national

conference workshop presentations:

• “A Tale of Two Coalitions: Movement Building in the Modern Age,”

presented by Kyle Fischer, Andrew Woods and others);

• “Linking Front Line Workers with Home-Based Medical Providers

to Optimize Recovery,” presented by Andrew Woods, Shenell

Benjamin, and Larry Johnson;

• “The Future of HVIP Research and Evaluation: A Statewide Collaborative

Approach,” presented by Christa Green, Dr. James Dodington, Dr. Kevin

Borrup, and Dr. Mary Bernstein; and

• “Benefits and Challenges of Integrating Research and Service:

Lessons from an HVIP,” (Paper by O’Neill, Vega, Nedd and

Dodington).

For additional information about the conference or to register, please visit

this link: https://www.thehavi.org/2020-conference.

Earned Media

1. An op-Ed June 24th by partner Jeremy Stein of CT Against Gun

Violence, maintained that the “Solution to racial injustice must include

gun violence prevention,” and cited numerous partners’ key roles in

providing positive street presence.

6


2. In an op-Ed in the CT Mirror July 2nd, our hospital and frontline leaders

made the case, “In an emergency, get the playbook off the shelf … and

use it,” putting in perspective the importance of proactive, evidencebased

crisis response. For this viewpoint, the CT Mirror editor provided

a link to the January testimony on HVIPs, given before the Medical

Assistance Program Oversight Council (MAPOC), Women and Children’s

Health Subcommittee, chaired by Rep. Gilchrest.

The op-Ed noted that, from July 1, 2019 to May 28, 2020, for example,

“the Hartford Care Response Team of Trinity-Saint Francis and HCTC

served 72 clients – including 28 survivors of homicides and 40 assault

victims – offering a total of 286 services to clients and connecting 62

families to services. Similarly, the record of HVIP service from the Yale-

New Haven Hospital-CT Violence Intervention Program partnership in

New Haven shows approximately 250 cases of victims of violence from

January through May of 2020 alone, of which more than 40 have been

engaged by the Connecticut Violence Intervention Program and the

YNH HVIP. Almost all had been shot.”

3. An article in the Hartford Courant on May 4, 2020 headlined, “As

coronavirus testing expands to Hartford’s vulnerable communities,

advocates see chance to mend decades of mistrust,” highlights the

mistrust the institutionalized medical system faces with vulnerable

populations and the impact that is having on addressing the coronavirus

pandemic in hardest hit areas of Hartford. Recognizing the need to

address the rising cases of COVID-19 in these neighborhoods, Hartford

HealthCare, Saint Francis Hospital and other medical providers began

to hold walk-up testing clinics in the neighborhoods. The article points

out that mobile testing can go a long way toward mending the strained

relationship between people of color and the healthcare system.

Andrew Woods and the team at Hartford Communities that Care (HCTC)

staffed five of these mobile testing sites, along with partners Harriott

Home Health Services and Hartford HealthCare. These included two

events hosted at HCTC headquarters at 2550 Main Street in the North

End of Hartford. Executive Director Woods stated that these events serve

as a “trusted conduit, not only to get tested, but to receive accurate

information about COVID-19” and highlighted the work of HCTC and

other members of the Hartford Community Safety Coalition to address

resident needs. Food and other supplies were distributed to more than

200 families in processes that offered timely opportunities to check in on

homebound neighbors as well as to share useful information on COVID-19

precautions and testing.

The Connecticut

HVIP Collaborative 7


In an op-Ed from The Trace on May 7, 2020: The Pandemic’s Impact on

Racial Inequity and Violence Can’t Be Ignored, Violence Prevention Professionals

and Hospital Violence Intervention Programs are cited as key players

in stemming the spread of COVID-19 and quelling the associated rise in

violent crime. This article cites the growing economic and social instability

caused by the pandemic and how these can be root factors in rising incidents

of violence. The article states that the work of VPP and HVIP professionals,

taking into account the root causes of systemic community violence,

helps calm potentially violent situations. Among other national HVIPs,

HCTC is highlighted as an organization able to pivot and meet urgent community

needs by starting a food distribution initiative. The article calls for

making HVIPs a legislative priority with funding to continue violence reduction

work as well as to supply personal protective equipment for frontline

staff in the field.

Final Note

Communications for the CT HVIP are managed by HCTC Executive Director

Andrew Woods, whose 30 years’ experience in the field lend institutional

knowledge. The writing and editing of information materials is handled by

HCTC’s experienced MSW and community organizer, Johanna Schubert,

and volunteer research assistant, Kent Ashworth. It is important to note,

however, that in addition to the time spent by these three contributors,

all Work Group leaders produce meeting notes, reviews and suggestions

– and their time has a real cost. Sustaining these internal and external

communications activities will be an important topic for our ongoing

deliberations about the future structure of the CT HVIP Collaborative.

Rapid Response to COVID-19

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Hit with the Emergency of Home Isolation: The HCRT with its

Community Safety Coalition partners in April 2020 began a newly

conceived COVID-19 Initiative of outreach, beginning at the Phillips

Health Center’s 2550 Main Street site. The purpose of the COVID-19

Initiative was to engage and support hundreds of Greater Hartford residents

impacted by the disease, by providing relief, through the distribution of

food, household and personal items, face masks, and information on how to

stay safe and physically take care of themselves and their households. Along

with the deliveries on April 27, May 11, May 18, June 1, and June 15, 2020,

referrals and information covered a range of basic needs, including what to

do when a family member has contracted COVID-19, access to COVID-19

testing and Contact Tracing, food pantry availability, housing or eviction

prevention assistance, connection to Tele-Health and Tele-Therapy, Victims

of Crime Act (VOCA) information and other specific resources for families


experiencing violence – especially school-age children, seniors, and other

individuals with special needs.

Real-time Response: Implementing Neighborhood COVID-19 Testing.

As the need for – and local inaccessibility to – COVID-19 testing emerged

this spring, Senator Douglas McCrory led efforts to bring together CT HVIP

coalition partners Harriott Home Health Services, Hartford HealthCare,

Hartford Communities that Care and Phillips Health Center to support and

coordinate five (5) neighborhood COVID-19 testing events. These were free

and open to the community, allowing participants to safely and quickly be

tested. With guidance from the Connecticut Department of Public Health

and Hartford HealthCare, more than 1,100 area residents were tested for

COVID-19, supervised by HCTC/ HCRT staff:

• 1,148 people tested at five COVID-19 testing events

• 11 Front Line Staff/ Volunteers trained and certified by Johns Hopkins

University as COVID-19 Contact Tracers

• Personal Protective Equipment (PPEs) valued at $25,000, from private

and public donors: Carter Health Disposables, Connecticut Department

of Emergency Services and Public Protection, Harriott Home Health

Services, Fairview Capital and the James and JoAnn Price Community

Safety Fund

Since then, our CT HVIP partner hospitals have tested and treated tens of

thousands of residents for COVID-19.

The Connecticut

HVIP Collaborative 9


Connecticut Hospital Violence

Intervention Program

HVIP Collaborative

Partners

10


Congressman John Larson

Senator Douglas McCrory

State Representative Matt Ritter

State Representative Jillian Gilchrest

Capital Workforce Partners

Connecticut Against Gun Violence

Connecticut Children’s Medical Center

Connecticut Department of Public Health

Connecticut Health Foundation

Connecticut Hospital Association

Connecticut Violence Intervention Program 1

Everytown Against Gun Violence

Giffords Law Center

Harriott Home Health Services 2

Hartford Communities That Care 2

Hartford Community Safety Coalition

Blue Hills Civic Association

COMPASS Peacebuilders

Hartford Communities That Care 2

Mothers United Against Violence

YMCA of Greater Hartford (Wilson-Gray)

Hartford Foundation for Public Giving

Hartford Hospital

Mothers United Against Violence 2

Phillips Health Center

The Health Alliance for Violence Intervention

(The HAVI)

Trinity Health of New England

(Saint Francis Hospital and Medical Center) 2

Trinity College

UCONN Health

Yale New Haven Hospital 1

YMCA of Greater Hartford (Wilson-Gray)

YWCA Hartford Region 2

1

Hospital-based Violence Intervention Program (HVIP)

partners serving New Haven.

2

Hospital-based Violence Intervention Program (HVIP) partners

serving Hartford (The Hartford Care Response Team).

The Connecticut

HVIP Collaborative 11


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