Without adequate reimbursement for screening and services provided to victims of family violence, little incentive would seem to exist to train health professionals to provide these services. The literature, however, does not appear to address the implications of reimbursement for training. Acknowledging the importance of this topic, the Agency for Healthcare Research and Quality and the Family Violence Prevention Fund sponsored a meeting in September 2001 of experts on various aspects of either intimate partner violence or coding and reimbursement issues to discuss existing systems, practices, and research. The group specifically addressed variation in reimbursement levels from system to system (e.g., Medicare, Medicaid, and private sector), financial incentives or disincentives associated with the current coding systems, and the implications of coding practices for patients and health care service delivery.6 Further examination of the role third-party reimbursement plays in health professional training about family violence is needed and may result from this meeting.

LAWS MANDATING REPORTING AND EDUCATION

Mandatory reporting and mandated education laws have been conceived as possible means for ensuring that health professionals receive training in family violence. Legislatures may enact such laws, usually with the intention of improving the service system. The committee struggled with the relationship of these laws to the training of health professionals. Little evidence indicates the effect these laws have on health professional education, and the legislation has created much controversy among those who work in family violence. Numerous interpretations of what the laws actually require and how they differ around the country exist, but few comprehensive resources on these laws are available. In the committee’s judgment, mandated reporting laws appear to drive the fields of child protection and elder protection and serve as a backdrop. And, in some states, they serve as a driver in intimate partner protection. Because they do appear to influence (and possibly distort) the content of education and ultimately of practice, the committee considered it important to examine these laws in detail to determine what is known about their actual impact. We sought to understand where such provisions are present, what they contain, and whether they achieve the intended effects. Having done the difficult work of collecting and examining all of the existing laws, the committee offers the details it has complied in the report appendixes and provides here the following descriptive analysis to assist others addressing the issue. The tables in Appendixes C and D describe state laws mandating reporting of and training about child abuse and

6  

The findings from this meeting were not available when this report went to press.



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