C


Site Visit Methodology and Summaries

SITE VISIT METHODOLOGY

The committee conducted four site visits throughout the country. Sites were chosen to highlight diverse approaches to addressing commercial sexual exploitation and sex trafficking of minors, and potentially to elucidate promising practices and common challenges. The site visits were conducted as roundtable discussions between invited participants and selected committee members. During each site visit, the committee sought to

•    hear community perspectives and experiences with respect to meeting the needs of youth affected by commercial sexual exploitation and sex trafficking;

•    highlight innovative approaches and services in each community (including those tailored to the needs of high-risk populations);

•    discuss barriers or challenges entailed in providing services to victims and survivors of these crimes and how those issues are addressed; and

•    identify the features, relationships, and settings critical to addressing commercial sexual exploitation and sex trafficking of minors.

The site visits were conducted as open-format discussions with organizations and individuals that work to address commercial sexual exploitation and sex trafficking of minors. To maximize time for discussion, each site visit participant was asked to provide as much background information as possible as reading material prior to the visit. Participants also were



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C Site Visit Methodology and Summaries Site visit methodology The committee conducted four site visits throughout the country. Sites were chosen to highlight diverse approaches to addressing commercial sex- ual exploitation and sex trafficking of minors, and potentially to elucidate promising practices and common challenges. The site visits were conducted as roundtable discussions between invited participants and selected commit- tee members. During each site visit, the committee sought to • hear community perspectives and experiences with respect to meet- ing the needs of youth affected by commercial sexual exploitation and sex trafficking; • highlight innovative approaches and services in each community (including those tailored to the needs of high-risk populations); • discuss barriers or challenges entailed in providing services to vic- tims and survivors of these crimes and how those issues are ad- dressed; and • identify the features, relationships, and settings critical to address- ing commercial sexual exploitation and sex trafficking of minors. The site visits were conducted as open-format discussions with organi- zations and individuals that work to address commercial sexual exploita- tion and sex trafficking of minors. To maximize time for discussion, each site visit participant was asked to provide as much background information as possible as reading material prior to the visit. Participants also were 413

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414 Commercial Sexual Exploitation and Sex Trafficking of Minors asked to limit formal presentations to a 10-minute overview of their key messages. Information requested in previsit reading material included the following: • Organization “facts” o Mission/vision o Organization chart (if applicable) o Sources of funding o Organization reports (if available) •  ocal context (During each visit, the committee visitors sought to L see or hear about as many of the following program components as possible.) o evel of awareness regarding commercial sexual exploitation L and sex trafficking of minors o ystems involved in addressing commercial sexual exploitation S and sex trafficking of minors o tate laws addressing commercial sexual exploitation and sex S trafficking of minors o ormal and informal collaboration among systems F o  ther community resources O o  ender, sex, and sexual orientation of youth served by the G program/organization o  ge of youth served by the program/organization A o  ace and ethnicity of youth served by the program/organization R o  outh served by the program/organization court-referred or Y mandated o  itizenship or immigration status of youth served by the program/ C organization o  omeless and runaway youth served by the program/organization H • Settings o  dequacy of spaces/places serving victims and survivors of com- A mercial sexual exploitation and sex trafficking o  cceptability of spaces/places serving victims and survivors of A commercial sexual exploitation and sex trafficking • Evaluation and data collection efforts o  re data collected, analyzed, reported? (If so, how?) A o  ow are programs/services evaluated? H SUMMARIES The committee’s four site visits are summarized below in the order in which they occurred. Appendix C contains agendas for all four visits.

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Appendix C 415 Site Visit 1: Boston, Massachusetts—March 23, 2012 Invited participants: Beth Bouchard, Support to End Exploitation Now Katie Carlson, Gaining Independence for Tomorrow, Roxbury Youthworks Donna Gavin, Boston Police Department Lisa Goldblatt Grace, My Life, My Choice Susan Goldfarb, Support to End Exploitation Now Tanee Hobson, My Life, My Choice Fran Sherman, Boston College Law School and Juvenile Rights Advocacy Project Committee members and staff in attendance: Meg Barry, Associate Program Officer, Institute of Medicine Abigail English, Director, Center for Adolescent Health & the Law Natalie McClain, William F. Connell School of Nursing, Boston College Patti Simon, Study Director, Institute of Medicine The Massachusetts governor signed antitrafficking legislation into law only 4 months before the committee visited Boston, and passage of the law and its ongoing implementation set the underlying context for the meeting. Many of the individuals and organizations invited to participate in the site visit played a role in developing and advocating for the law, and all will be affected by and engaged in its implementation. While Massachusetts was one of the last states to enact antitrafficking legislation, organizations in Boston have been leaders in addressing commercial sexual exploitation and sex trafficking of minors, particularly among girls. Participants in the site visit recognized that commercial sexual exploitation and sex trafficking of minors also affect boys, but conceded that there are few services within Boston for boys. Many of the participants believe that boys and girls need different, separate intervention models because of their divergent pathways for entry into and experiences within exploitive relationships. The discussion coalesced around six foci that have helped Boston address commercial sexual exploitation and sex trafficking of minors: (1) developing shared understanding and common language among sectors, (2) training, (3) survivor leadership, (4) information sharing, (5) preparing girls to exit exploitive relationships and support for them after they have done so, and (6) laws and policies. Each of these is summarized below. At the conclusion of the meeting, committee members asked participants to identify areas of research that would assist them in providing better ser- vices. They mentioned prevention, points of intervention, intergenerational

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416 Commercial Sexual Exploitation and Sex Trafficking of Minors violence, and underlying contributors to commercial sexual exploitation and sex trafficking of minors. Developing Shared Understanding and Language Among Sectors Participants stated that a coordinated response to commercial sexual exploitation and sex trafficking of minors requires relationships, trust, and open communication among diverse groups of organizations. They noted that a successful response to these crimes involves diverse sectors that do not often work together, and therefore do not have a shared history, under- standing, or language to build upon. Building a shared understanding and language was an important first step in responding to commercial sexual exploitation and sex trafficking of children and adolescents in Boston. Participants said the pivotal understanding for organizations in Boston was that commercial sexual exploitation and sex trafficking of minors are crimes, and that children and adolescents involved in these crimes are vic- tims, not criminals. Training Participants identified training and technical assistance as important to developing a shared understanding and language among sectors, in- creasing awareness of the problems, and identifying victims. Organization representatives present at the site visit noted a correlation between train- ing and additional victim referrals, but lamented a lack of infrastructure and funding to support training. They believe a successful training model would promote a shared language for commercial sexual exploitation and sex trafficking of children and adolescents; teach participants about what other sectors do to address these problems and how they do it; encourage a holistic response; and include discussion of race-, gender-, and class-based violence. Participants identified several groups for which additional training is critical to the success of interventions: child welfare, defense attorneys, judges, school nurses, and emergency room staff. Survivor Leadership Because of the unique trauma involved in surviving commercial sexual exploitation and sex trafficking, participants stated that interventions for victims should be either survivor led or survivor informed. Several partici- pants noted that girls in exploitive relationships often do not think of them- selves as victims, and working directly with survivors who have successfully exited such relationships gives them role models for understanding their trauma, modeling healthy relationships, and promoting a healthy lifestyle.

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Appendix C 417 Information Sharing Participants stressed that coordination and information sharing among professionals who serve individual victims are critical for successfully ad- dressing commercial sexual exploitation and sex trafficking of children and adolescents. The Massachusetts sex trafficking law supports information sharing. In Boston, the Support to End Exploitation Now (SEEN) case coordinator promotes information sharing by identifying all professionals connected to each victim and coordinates information sharing and services among them. Many of the participants believe that information sharing should include mandatory reporting of sexual exploitation and sex traffick- ing. The Massachusetts antitrafficking law adds sexual exploitation and sex trafficking to the list of abuses that trigger mandatory reporting of child abuse. In addition, the law ensures that the Massachusetts child abuse re- porting system does not stop with the child welfare department. Reports of abuse are first sent to child welfare; if the reports do not fit the requirements of a child welfare case, they are sent to law enforcement, which then refers the case to SEEN. Participants acknowledged that mandatory reporting has the potential to damage the relationship between the reporter and the child, but most believe that reporting can occur in conjunction with developing a caring, transparent relationship. Preparing for Exit Site visit participants identified preparing victims to exit exploitive relationships as a necessary component of successful interventions. They mentioned stable housing, addiction treatment, and trusting relationships as three important resources to have in place. Laws and Policies Participants mentioned laws and policies that affect the response to commercial sexual exploitation and sex trafficking of children and adoles- cents. These include some discussed above, such as the new Massachusetts antitrafficking law; mandatory reporting; and Massachusetts’ policy of al- lowing children to stay in the foster care system until age 22. Participants also noted the risks of involving children in formal systems (both juvenile justice and child welfare) when they are at risk of trafficking, and the unique challenges in the juvenile justice system for girls who themselves have children. The group discussed as well decriminalization of prostitution for minors, but there was no agreement on what systems need to be in place before decriminalization is appropriate.

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418 Commercial Sexual Exploitation and Sex Trafficking of Minors Site Visit 2: San Francisco, California—May 11, 2012 Invited participants: Catherine Cousart, Child Protection Center Toby Eastman, Larkin Street Youth Services Mollie Ring, The SAGE Project, Inc. Gena Castro Rodriguez, Youth Justice Institute William P. Siffermann, San Francisco Juvenile Probation Department Carol Taniguchi, Special Programs for Youth (Juvenile Hall San Francisco) Raquel White, Special Programs for Youth (Juvenile Hall San Francisco) Committee members and staff in attendance: Meg Barry, Institute of Medicine Tonya Chaffee, University of California, San Francisco Angela Diaz, Mount Sinai School of Medicine Mark Latonero, University of Southern California Patti Simon, Institute of Medicine Jonathan Todres, Georgia State University College of Law Discussions in San Francisco coalesced around three topics: (1) reliance on the juvenile justice system, (2) laws, and (3) missed opportunities. Reliance on the Juvenile Justice System According to site visit participants, the response to sex trafficking in San Francisco appears to rely heavily on the juvenile justice system. This observation may reflect the participants invited to attend, or may be true of the response in San Francisco more generally. Representatives from the Juvenile Probation Department (JPD) noted that in 2011, prostitution was the fifth most common criminal offense for girls booked into juvenile hall; 12 percent of girls seen in juvenile hall were charged with prostitution. The JPD representatives believe, however, that this figure underestimates the true number of victims of commercial sexual exploitation present in juvenile hall because exploited boys are not represented in this figure and because exploited girls are often held at juvenile hall on charges unrelated to com- mercial sexual exploitation. To respond to the needs of victims, JPD worked with the Youth Justice Institute (YJI) to create an 11-page intake form; JPD and YJI use this form to screen all youth in JPD for a variety of risk factors, including exploitation. If exploitation is detected, JPD refers youth to YJI, the SAGE Project, or other community organizations for treatment. All prostitution arrests trigger an automatic referral to SAGE. Participants

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Appendix C 419 noted that within JPD’s juvenile hall, prostitution-related charges appear to be declining; however, more girls are disclosing involvement in commercial sexual exploitation during their sentence at juvenile hall. Both SAGE and YJI began through partnerships with the juvenile jus- tice system. SAGE has expanded to take referrals from other sources (e.g., shelters and parents), but it continues to provide training and services to youth within JPD and receive a substantial number of referrals. Similarly, YJI began as an organization to address the treatment of girls in the San Francisco juvenile justice system and has since branched out to other services. Laws California does not have a safe harbor law, nor does mandated child abuse reporting apply to commercial sexual exploitation of minors. In con- trast to the enthusiasm for safe harbor legislation expressed during other site visits (i.e., Boston and Chicago), participants in the San Francisco site visit had a more tempered response to the possibility of a safe harbor law in California. They appeared to believe that more work would be needed to prepare for a safe harbor law and mandatory reporting. Missed Opportunities Participants mentioned several sites and sectors that could be more involved in addressing commercial sexual exploitation of minors, such as schools, emergency departments, mental health providers, district attorneys, public defenders, and group homes. Schools in particular were mentioned several times as a potential intervention point. SAGE has done some train- ing in schools; however, school resources for these types of activities are limited. In addition, at least one participant mentioned that youth involved in commercial sexual exploitation may not attend school regularly, so the impact of interventions in schools may be limited. The lack of services for boys was mentioned frequently. SAGE recently expanded its services to boys with funding from the Department of Justice for serving victims of commercial sexual exploitation and sex trafficking, but others mentioned that their ability to identify and serve male victims was limited. Participants also mentioned the Department of Justice–funded task force in San Francisco as a missed opportunity. This task force focuses on international trafficking, and service providers and child welfare are not as involved as in other communities. Participants mentioned the need for more coordination among stakeholders working to address the commercial sexual exploitation and sex trafficking of minors, so a task force focused

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420 Commercial Sexual Exploitation and Sex Trafficking of Minors on the commercial sexual exploitation of minors could be useful in San Francisco. Site Visit 3: Chicago, Illinois—July 11, 2012 Invited participants: Sehla Ashai, The International Organization for Adolescents Lisa Gilmore, Center on Halsted Jennifer Greene, Cook County State’s Attorney’s Office Lynne Johnson, Chicago Alliance Against Sexual Exploitation Erin Knowles-Wirsing, Salvation Army STOP-IT Michelle Nasser, U.S. Attorney’s Office, Northern District of Illinois Traci Walker, Chicago Police Department Committee members and staff in attendance: Meg Barry, Institute of Medicine Tonya Chaffee, University of California, San Francisco Ellen Wright Clayton, Vanderbilt University Angela Diaz, Mount Sinai School of Medicine Abigail English, Center for Adolescent Health & the Law Catherine Gallagher, George Mason University Barbara Guthrie, Yale University School of Nursing Richard D. Krugman, University of Colorado School of Medicine Sharon Lambert, George Washington University Mark Latonero, University of Southern California Alejandra Martín, Institute of Medicine Natalie McClain, Boston College William F. Connell School of Nursing Callie Marie Rennison, University of Colorado Denver John A. Rich, Drexel University School of Public Health Patti Simon, Institute of Medicine Patti Toth, Washington State Criminal Justice Training Commission In the past few years, Illinois has enacted several laws to aid in identi- fying and assisting minors that are victims/survivors of commercial sexual exploitation or sex trafficking, and it is also concentrating efforts on the de- mand side of these crimes. Like Boston, Illinois has a multisector approach to commercial sexual exploitation and sex trafficking of minors, working across levels of government (i.e., state and federal attorney’s offices), law enforcement, and nonprofit organizations. Discussions in Chicago coalesced around six topics: (1) building part- nerships and trust, (2) legislation, (3) partnering with child welfare and

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Appendix C 421 child abuse systems, (4) victim-centered approaches, (5) reducing demand, and (6) gaps in services. Building Partnerships and Trust Formal collaboration among site visit participants occurs through the federally funded Cook County Human Trafficking Task Force, which is co- led by the Cook County State’s Attorney’s Office; the U.S. Attorney’s Office, Northern District of Illinois; the Salvation Army STOP-IT Program; and the International Organization for Adolescents. Much of the work of the task force occurs through committees, including a steering committee made up of 23 organizations and a law enforcement working group. The relationships and partnerships that contribute to the success of the task force began even before it received federal funding. Participants began working together more than 10 years ago through the Prostitution Alterna- tives Roundtable, established by the Chicago Coalition for the Homeless. Subsequently, the Cook County state’s attorney recognized commercial sexual exploitation and sex trafficking of minors as problems she wanted to pursue more aggressively, so the office assigned several staff members to work full time learning about existing efforts to address these problems in the county, building partnerships, and prosecuting. The long-standing relationships developed through these efforts have fostered trust, even among sectors that do not traditionally work well together. Service providers mentioned that police have involved them in long-term investigations and street outreach, and STOP-IT has an office embedded at the State’s Attorney’s Office. Law enforcement representa- tives stated that they trust that service providers understand their role in addressing commercial sexual exploitation and sex trafficking of minors and will not interfere unnecessarily with investigations. Different levels of law enforcement also have unique levels of trust. Each month, the U.S. Attorney’s Office hosts a meeting of the Law Enforcement Working Group (a subgroup of the task force), where representatives of federal and local prosecutors, the Federal Bureau of Investigation, the county sheriff, local police, and the Internal Revenue Service, among others, gather to openly discuss evidence for every case of commercial sexual exploitation and sex trafficking of minors that is under investigation or assigned to a prosecutor. Participants acknowledged that several unique factors contribute to their collaboration. First is low turnover at nearly all of the service and law enforcement organizations—many of the participants have been working together since the Prostitution Alternatives Roundtable began. In addition, participants repeatedly mentioned that building relationships outside of crisis has been critical to their success.

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422 Commercial Sexual Exploitation and Sex Trafficking of Minors Legislation Participants praised Illinois’ collection of laws addressing commercial sexual exploitation and sex trafficking of minors. In 2005, Illinois enacted its original human trafficking law,1 which defines and lays out the penalties for trafficking and related crimes. Shortly following the site visit, the legisla- ture passed an update to that law to improve its usefulness to law enforce- ment.2 In 2010, the Illinois legislature passed the Safe Children Act,3 which includes a safe harbor (prohibits prosecution of children under age 18 for prostitution), transfers jurisdiction for all children arrested for prostitution from criminal justice to child welfare, allows wiretapping during investiga- tions of child sex trafficking, and increases penalties against purchasers of sex with children. In addition, the Justice for Victims of Sex Trafficking Crimes Act4 allows victims of sex trafficking to clear their criminal record of prostitution charges that occurred while they were being trafficked. Several civil laws allow victims to recover monetary damages from traffickers and purchasers of sex. The Predator Accountability Act5 allows juvenile victims of trafficking to pursue civil remedies against traffickers, purchasers, and others who knowingly benefit from commercial sexual ex- ploitation and sex trafficking of minors. According to participants, the Gen- der Violence Act,6 which allows civil remedies for victims of gender-related violence, has also been used to help victims of commercial sexual exploita- tion and sex trafficking of minors recover civil penalties from exploiters. Partnering with Child Welfare and Child Abuse Systems Participants called Illinois’ child welfare agency, the Department of Children and Family Services (DCFS), a critical partner in addressing com- mercial sexual exploitation and sex trafficking of minors, particularly since the Safe Children Act gave DCFS jurisdiction over all children arrested for prostitution. Members of the Cook County Human Trafficking Task Force began working with DCFS several years before that legislation was passed and have continued to do so to build systems that can accept and process reports of commercial sexual exploitation and sex trafficking of minors and deliver appropriate services to victims. This work has involved convening groups of key leaders within DCFS to engage in dialogue and craft a com- prehensive blueprint for how DCFS should manage cases of commercial 1  005 2 Ill. Pub. Act 94-0009. 2  012 2 Ill. Pub. Act 97-0897. 3  010 Ill. Pub. Act 96-1464. 2 4 725 Ill. Comp. Stat. 5/116-2.1. 5 740 Ill. Comp. Stat. 128. 6 740 Ill. Comp. Stat. 82/1.

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Appendix C 423 sexual exploitation and sex trafficking of children and adolescents, training DCFS staff to identify such cases, providing technical assistance, and con- necting DCFS with service providers in the community. Participants also mentioned child advocacy centers (CACs) as potential partners in address- ing commercial sexual exploitation and sex trafficking of minors because they have locations outside of major urban areas where few services for victims of these crimes currently exist, and they have extensive experience with forensic interviewing of children and victims of abuse. Participants identified several challenges to implementing a child wel- fare response to commercial sexual exploitation and sex trafficking of minors: the need to ensure that the harms caused by the juvenile justice system are not recreated in the child welfare system; the size of the agency and the resulting numerous points of entry for victims; lack of funding to implement a response; challenges in creating specialized, voluntary, non- judgmental services; and the need to build capacity for data collection and evaluation. Participants emphasized that while DCFS is a necessary part- ner, states should not view the child welfare system as sufficient to address commercial sexual exploitation and sex trafficking of minors. A network of community-based, specialized services for victims of these crimes is a criti- cal complement to child welfare, both to give DCFS the flexibility to refer victims into the community and to give victims the option of not engaging in a potentially abusive system. Victim-Centered Approaches Both law enforcement representatives and service providers stated that they take victim-centered approaches to their work. The State and U.S. At- torney’s Offices apply the philosophy that investigations should be victim centered, but not victim built. This means they help victims obtain services and do not rely on a victim’s testimony alone to build a case. Examples of corroborative evidence they have used include wiretaps, victims’ journals, victims’ tattoos, evidence of traffic stops where a trafficker was stopped with victims, hotel records, and medical records. The STOP-IT program tailors services to each victim depending on his or her preferences. A full range of services (including medical, mental health, and sexual health) is made available to each victim, but the victim chooses which services to accept. Service providers meet victims wherever they feel comfortable and safe, which requires case managers to travel around a large service area. Participants also discussed the value of services tailored specifically to victims of commercial sexual exploitation and sex trafficking of minors, particularly survivor-led, trauma-informed services based on an empowerment model.

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424 Commercial Sexual Exploitation and Sex Trafficking of Minors Reducing Demand Participants identified reducing demand for commercial sex as a prior- ity in Chicago. The Chicago Alliance Against Sexual Exploitation (CAASE) runs a campaign called End Demand Illinois that focuses on encouraging law enforcement to hold exploiters and purchasers of sex accountable for crimes related to commercial sexual exploitation and sex trafficking of minors. The campaign has sponsored research examining demand for com- mercial sex and has sponsored several related bills that have been enacted by the Illinois legislature. Gaps in Services Participants mentioned the following gaps in services: housing; mental health services; nonjudgmental providers of all services; and services for male and lesbian, gay, bisexual, and transgender (LGBT) victims. Par- ticipants repeatedly mentioned the need for additional housing and mental health services for all victims of commercial sexual exploitation and sex trafficking of minors. While Chicago has a sizable number of shelter beds designated for the homeless, service providers are rarely able to find beds for victims of commercial sexual exploitation and sex trafficking. Partici- pants mentioned that LBGT youth, particularly those of color, have a high rate of homelessness in Chicago. Participants emphasized the importance of having service providers (e.g., health care providers) approach potential victims of commercial sex- ual exploitation and sex trafficking in a nonjudgmental way. They reported that many victims feel uncomfortable interacting with service providers, and therefore are unlikely to disclose abuse or exploitation. Victims may be more willing to participate in services and disclose exploitation if pro- viders approach all potential victims with a completely nonjudgmental perspective and an interest in the victim’s welfare. They suggested that CAC forensic interviews could be evaluated as a model for interviewing victims of commercial sexual exploitation and sex trafficking. Finally, participants mentioned the need for additional services in all areas related to commercial sexual exploitation and sex trafficking for LGBT and male adolescents. Site Visit 4: New York, New York—September 12, 2012 Invited participants danah boyd, Microsoft Research Courtney Bryan, Center for Court Innovation Janice Holzman, Girls Educational and Mentoring Services (GEMS)

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Appendix C 425 Daniella Latimer, Mount Sinai Sexual Assault and Violence Intervention (SAVI) Program Michael Polenberg, Safe Horizon John Steever, Mount Sinai Adolescent Health Center Johannah Westmacott, Safe Horizon Committee members and staff in attendance: Meg Barry, Institute of Medicine Angela Diaz, Mount Sinai School of Medicine Barbara Guthrie, Yale University School of Nursing Sharon Lambert, George Washington University Alejandra Martín, Institute of Medicine John A. Rich, Drexel University School of Public Health Patti Simon, Institute of Medicine In 2008, New York State enacted the nation’s first safe harbor law for victims and survivors of commercial sexual exploitation and sex trafficking. Since then, New York City’s criminal and juvenile justice systems have be- gun to recognize minors arrested for prostitution as victims and survivors in need of services and assistance. Members of the committee met with invited participants from local organizations to discuss their roles in preventing, identifying, and responding to commercial sexual exploitation and sex trafficking of minors and the challenges they face in conducting this work. Discussions coalesced around six topics: (1) assessing risk, abuse, home- lessness, and/or exposure to violence; (2) providing case management; (3) conducting training for and outreach to professionals and members of the community; (4) lack of housing for victims and survivors; (5) challenges in working with child protective services; and (6) using technology in prevent- ing, identifying, and responding to commercial sexual exploitation and sex trafficking of minors. Assessing Risk, Abuse, Homelessness, and/or Exposure to Violence Participants stressed the importance of assessing (often referred to as “screening”) children and adolescents for risk of or current involvement in commercial sexual exploitation and/or sex trafficking. For example, service providers from the participating organizations conduct assessments to iden- tify risk through questions about experience with or exposure to violence or child abuse, living situations and conditions, and sexual behavior and history, among others. Assessments are conducted by a range of service providers based on the point of contact with children and adolescents. For example, minors arrested for prostitution may be screened through a

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426 Commercial Sexual Exploitation and Sex Trafficking of Minors court-based program, such as the Midtown Community Court, a project of the Center for Court Innovation. Participants agreed that broad use of assessments can help with early identification and the rapid provision of services and assistance to individuals at risk for and victims and survivors of commercial sexual exploitation and sex trafficking. Providing Case Management To address the complex needs of victims and survivors of commercial sexual exploitation and sex trafficking, site visit participants support the use of case management. With the assistance of a case manager, services and assistance can be designed and coordinated to meet each individual victim’s/ survivor’s needs. Case managers can assist victims/survivors with setting personal goals and can facilitate access to a range of victim and support services—including health care, legal services, mental health services, and housing. In addition to case management, a number of the site visit par- ticipants, such as representatives of Girls Educational and Mentoring Ser- vices (GEMS) and Safe Horizons, use survivor-led and/or trauma-informed service models. Their goals include helping to create a safe environment in which victims/survivors can talk about their experiences, and their specific needs can be determined and addressed. Conducting Training for and Outreach to Professionals and the Community Participants discussed the training and outreach programs they conduct to increase awareness of the issues and risk factors related to commer- cial sexual exploitation and sex trafficking of minors. Participants argued that increased awareness and understanding may result in destigmatizing victims/survivors and may assist community members and professionals in identifying victims and survivors among the populations they serve or encounter. Specifically, participants conduct training for community court judges, attorneys, teachers, law enforcement personnel, health care pro- viders, and social workers, among others. Other participants described outreach efforts among homeless children and adolescents who may be at risk of being or have been exploited or trafficked for sexual purposes. For example, Safe Horizons’ Street Work Project provides outreach services to homeless children and adolescents in New York City, with a focus on reduc- ing harm. This program is one of the ways in which Safe Horizons identifies and works with victims and survivors of commercial sexual exploitation and sex trafficking.

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Appendix C 427 Lack of Housing for Victims/Survivors Victims and survivors of commercial sexual exploitation and sex traf- ficking may lack stable, safe housing. Site visit participants noted that housing/shelter, including emergency, transitional, and long-term housing, are among the most difficult resources to find and provide in New York City, particularly for minors. Participants stated that special consideration and accommodation may be needed for specific groups, such as LGBT youth, who may face additional discrimination. For example, participants explained that transgender youth often are not given the opportunity to designate the sex-specific housing with which they identify, potentially ex- posing them to violence and discrimination. In response, New York City’s Department of Homeless Services implemented a policy that allows home- less transgender individuals to self-select gender housing/shelter; however, it is unknown how fully and how often this policy is implemented. Challenges in Working with Child Protective Services Many victims and survivors of commercial sexual exploitation and sex trafficking of minors have come in contact with child protective services and/or the juvenile and criminal justice systems. For this reason, site visit participants explained that child protective services should function as a partner in identifying and providing services to victims and survivors of these crimes. In the opinion of the site visit participants, however, child protective services currently lacks the necessary resources to identify and assist these children and adolescents within the populations they serve. Site visit participants suggested that child protective services could benefit from additional training related to commercial sexual exploitation and sex traf- ficking of minors. Using Technology Finally, the site visit included a discussion of the role of technology in the commercial sexual exploitation and sex trafficking of minors in the United States. Participants learned about research focused on technological interventions for social problems, such as using PhotoDNA, a program for identifying and removing pornographic images of sexually exploited minors from the Internet. Participants discussed the complex and emerging role of technology as part of the problem of commercial sexual exploitation and sex trafficking of minors, as well as a potential solution. For example, the potential exists to increase the identification of victims and exploiters by investigating how social networks are used to recruit victims. As technology

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428 Commercial Sexual Exploitation and Sex Trafficking of Minors continues to play an increasing role in the response to commercial sexual exploitation and sex trafficking of minors, special consideration will need to be given to emerging legal and law enforcement issues (e.g., determining jurisdiction for crimes committed online).