# Presentation: 224889

## 
Look Beneath the Surface:

Role of Health Care Providers in Identifying and Helping 
Victims of Human Trafficking

**Look Beneath the Surface:**
- Role of Health Care Providers in Identifying and Helping
- Victims of Human Trafficking

**Notes:**
I’m going to begin today’s presentation with a story:

A woman kept in domestic servitude in the United States for several years was rescued when a neighbor, noticing that she had a large tumor, offered to take the woman to the emergency room/health clinic [where will depend on who the presentation audience is].  Luckily, the health providers asked the right questions and realized the woman was a victim of human trafficking.  As a result, they helped the woman escape her situation and receive the medical care she desperately needed.  Her employers received 15-20 years in jail.

This is a success story because, first, the neighbor took the important step in bringing the woman to the emergency room/health clinic, and second, because the health providers examining the woman were able to look beneath the surface to probe whether or not she was a possible trafficking victim.  Today, I’m going to discuss the important role health care providers play in identifying, and therefore, helping victims of human trafficking.

## Presentation Overview

- Understanding human trafficking
- Identifying human trafficking victims
- Health problems of trafficking victims
- Special considerations when working with trafficking victims
- Support for victims through Trafficking Victims Protection Act of 2000 (the TVPA)

**Notes:**
The story I just told you should have sounded like a familiar situation, one that you may have experienced first hand as a health provider.  I felt it was important to share this story with you because the next prostitute, migrant worker or illegal immigrant you encounter in your emergency room or health clinic may actually be a victim of human trafficking – not a criminal.

Today, I hope you walk away from this presentation with an understanding of why your role as a health care provider is critical in identifying and assisting victims of human trafficking.  This presentation should provide you with:

An understanding of what human trafficking is and what it is not.  We will discuss the types of human trafficking as well as the myths associated with human trafficking.

We will discuss strategies and clues for identifying trafficking victims as well as health issues seen in trafficking victims.  Victims of trafficking may look like many of the patients coming to health clinics or emergency rooms, but taking another look, beneath the surface, may help you identify potential victims.

We will discuss special considerations when working with trafficking victims, including sample screening questions and the importance of confidentiality.

Finally, we will provide an overview of support services available to trafficking victims through the U.S. Department of Health and Human Services and the Trafficking Victims Protection Act, which was signed into law in October 2000.

## Human Trafficking: What Is It?

- Human trafficking is a form of modern-day slavery
- Victims of trafficking exploited for commercial sex or labor purposes
- Traffickers use force, fraud or coercion to achieve exploitation
***After drug dealing, human trafficking is tied with the illegal arms trade as the second largest criminal industry in the world, and it is the fastest growing.***

**Notes:**
Human trafficking is a devastating human rights violation that takes place not only internationally, but also here in the United States.  It is, indeed, a form of modern-day slavery.

Traffickers use force, fraud or coercion to enslave their victims into situations involving sexual exploitation or forced labor.  

Human trafficking is the fastest growing criminal industry in the world today, often operated by organized crime syndicates. 

## Human Trafficking: What Is It?

**Sex Trafficking: ****Commercial sex** act induced by force, fraud or coercion, or in which person performing the act is under age 18.
*Victims can be found working in massage parlors, brothels, strip clubs, escort services*
**Labor Trafficking: **Using force, fraud or coercion to recruit, harbor, transport, obtain or employ a person for labor or services in **involuntary servitude**, **peonage**, **debt bondage** or **slavery**
*Victims can be found in domestic situations as nannies or maids, sweatshop factories, janitorial jobs, construction sites, farm work, restaurants*
***Crime of trafficking occurs with the exploitation of the victim. ***
***The physical movement of the victim is not a requisite.  ***
***The TVPA protects both U.S. citizens and non-citizens. ***

**Notes:**
As defined by the Trafficking Victims Protection Act of 2000, there are primarily two categories of human trafficking: Sex Trafficking and Labor Trafficking.

Sex trafficking operations occur in highly visible venues such as street prostitution, as well as more underground locations such as closed-brothel systems that operate out of residential homes.  
Sex trafficking also takes place in a variety of public and private locations such as massage parlors, spas, strip clubs and other fronts for prostitution.  Victims may start off dancing or stripping in clubs and are often coerced into more exploitative situations of prostitution and pornography.
Labor trafficking/exploitation involves domestic servitude; sweatshop factories; construction sites; migrant agricultural work; the fishing industry; janitorial jobs; the food service, hotel and tourist industries; and panhandling. 
It is important to clarify that the crime of trafficking actually occurs when the victim is exploited for sex or forced labor – not when the victim is moved from one location to another.
As health care providers, you may come in contact with victims of sex or labor trafficking, but may mistake them as willing participants.  It’s vital to look beneath the surface when encountering these types of patients and ask yourself if they are potential victims forced into these situations.  As victims, they desperately need your help and compassion.

## Human Trafficking: How Are Victims Trafficked?

- Force, fraud and coercion are methods used by traffickers to press victims into lives of servitude, abuse
**Force:** Rape, beatings, constraint, confinement
**Fraud:** Includes false and deceptive offers of employment, marriage, better life
**Coercion:** Threats of serious harm to, or physical restraint of, any person; any scheme, plan or pattern intended to cause victims to believe that failure to perform an act would result in restraint against them; or the abuse or threatened abuse of the legal process.

**Notes:**

Traffickers use force, fraud and coercion to traffic women, men and children.  

Force involves the use of rape, beatings and confinement to control the victim.  Forceful violence is used especially during the early stages of victimization, known as the ‘seasoning process,’ which is used to break the victims’ resistance to make them easier to control.

Fraud usually involves false offers of employment.  For example, women and children will reply to advertisements promising jobs as waitresses, maids and dancers in other countries and are then forced into prostitution once they arrive at their destinations.  Fraud may also involve promises of marriage or a better life, in general.

Coercion involves threats, debt-bondage and psychological manipulation.  Traffickers often threaten victims with injury or death, or the safety of the victim’s family back home.  Many trafficking victims are also controlled through debt-bondage, usually in the context of paying off transportation fees into the destination countries.  Traffickers commonly take away the victims’ travel documents and socially isolate them to make escape more difficult.  Victims often do not realize that it is illegal for traffickers to dictate how they have to pay off their debt.  In many cases, the victims are trapped into a cycle of debt because they have to pay for all living expenses in addition to the initial transportation expenses.  Fines for not meeting daily quotas of service or “bad” behavior are also used by some trafficking operations to increase debt.  Most trafficked victims rarely see the money they are supposedly earning and may not even know the specific amount of their debt.  Even if the victims sense that debt-bondage is unjust, it is difficult for them to find help because of language, social and physical barriers that keep them from obtaining assistance.

## Human Trafficking: Who Are Victims?

- Approximately 800,000 to 900,000 victims annually trafficked across international borders.
- Between 18,000 and 20,000 victims trafficked into United States annually.
- More than half of victims trafficked into United States are thought to be children; victims are probably about equally women and men.
- Victims can be trafficked into the U.S. from anywhere.  Victims have come from, among other places, Africa, Asia, India, Latin America, Eastern Europe, Russia and Canada.

**Notes:**
Human trafficking is an horrific international problem, with nearly a million victims trafficked across international borders annually

However, this is not just an international problem.  Trafficking also takes place here in the United States.  The U.S. State Department estimates that between 18,000 and 20,000 victims are trafficked into this country each year.  

More than half of those trafficked into the United States are children, although many women and men are victims as well.

The majority of trafficking victims come to the United States from Asia, Central and South America, Russia, Eastern Europe and Canada (but also Africa and India).

## Many victims in the U.S. do not speak English and are unable to communicate with service providers, police, or others who might be able to help them.
Often kept isolated and activities restricted to prevent them from seeking help.
May be watched, escorted or guarded by traffickers Traffickers may “coach” victims to answer questions with cover story about being wife, student or tourist.
Victims comply and don’t seek help because of fear
Within the U.S., both citizens and non-citizens fall prey to traffickers.
Purpose for coming to United States and immigration status no longer issue when determined to be victim of trafficking.

- Often kept isolated and activities restricted to prevent them from seeking help.
- May be watched, escorted or guarded by traffickers Traffickers may “coach” victims to answer questions with cover story about being wife, student or tourist.
- Victims comply and don’t seek help because of fear
- Within the U.S., both citizens and non-citizens fall prey to traffickers.
- Purpose for coming to United States and immigration status no longer issue when determined to be victim of trafficking.

**Human Trafficking: ****Who Are Victims?**

**Notes:**
Trafficking victims sent to the United States typically do not speak English.  They often are socially isolated and unable to communicate with other victims, clients or service providers.

Victims of trafficking are often kept isolated and their activities restricted in order to prevent them from seeking help.

They are typically watched, escorted or guarded by the traffickers themselves or associates of the traffickers.

Traffickers also may “coach” their victims to answer questions with a cover story about being a wife, student or tourist.

Victims of trafficking often comply with their traffickers and are afraid to seek help because they are in fear for their lives and the lives of their families back in their native countries.

When a victim of trafficking is identified, it no longer matters what their purpose or intent was for coming to the United States.

Under the Trafficking Victims Protection Act of 2000, victims of human trafficking can apply for special visas or receive other forms of immigration relief.

## Trafficking Victims: Understanding Mindset

- Frequently victims:
- Do not speak English and are unfamiliar with the U.S. culture
- Confined to room or small space to work, eat, sleep
- Fear, distrust health providers, government, police
*Fear of being deported*
- Unaware what is being done to them is a crime
- Do not consider themselves victims
- Blame themselves for their situations
- May develop loyalties, positive feelings toward trafficker as coping mechanism
*May try to protect trafficker from authorities*
- Sometimes victims do not know where they are, because traffickers frequently move them to escape detection
- Fear for safety of family in home country

**Notes:**
As a health care provider, it’s important to understand the mindset of trafficking victims.

They don’t speak English or know the U.S. culture.

They often confined to room or small space where they eat, work and sleep.

They fear and don’t trust health providers, the government or the police.  Often traffickers tell their victims that they are in the United States illegally and they will be arrested and deported if they try to get help.  Trafficking victims often fear or distrust the police because they come from countries where law enforcement is corrupt and feared. 

Victims may feel that their current situation is their fault, and they are guilty about it.

Trafficking victims may develop loyalties and positive feelings toward their trafficker as way to cope with their situation – known as the Stockholm or Patty Hearst Syndrome.  In these cases, they may even try to protect the trafficker from authorities.

Traffickers frequently move their victims to escape detection.  As a result, trafficking victims may not even know what city or country they’re in.

Victims of trafficking also fear for the safety of their family members in their native country, who are often threatened by the traffickers.

## Myths Associated with Human Trafficking

- Myth #1:
**All Prostitutes Are Willing Participants**

**Notes:**
Understanding the mindset of human trafficking victims, it’s easy to see why there are several myths or misconceptions associated with human trafficking.  As a health care provider, it’s important for you to be aware of these myths and to look beyond them to see the issue of human trafficking and to help expose the real criminals, the traffickers.

First, there is an overall misconception that all prostitutes are willing participants, or even broader, that all sex trade participants are prostitutes.  That as participants, they are proactively involved in the sex trade on their own free will.  While this may in fact be the case for some, it often times is not the case for victims of human trafficking, who are forced or coerced into the sex trade by traffickers.

Victims of trafficking may be perceived as prostitutes because they often do not initially self-identify as victims.  However, if you look beneath the surface of what you may think is a typical prostitute, you may find an innocent victim in need of help and protection.

## Myths Associated with Human Trafficking

- Myth #2:
**All Immigrants Smuggled into the United States Enter Willingly**

**Notes:**
There are significant differences between victims of human trafficking and migrants who are smuggled into the United States.  Again, you may be in a situation where you arrest someone on illegal immigration charges because someone cannot produce the proper documentation.  Don’t make the assumption that this person was willingly smuggled into the United States illegally and is, therefore, a criminal.  It’s important for you to look beneath the surface of that person because:

Victims of human trafficking are coerced or fraudulently induced into trafficking while smuggling cases include those who freely and knowingly consent.

Victims of human trafficking are continuously exploited for labor or commercial sex, while the act of smuggling ends when the migrants arrive at the intended destination.

Movement from place to place is not a requisite to the crime of trafficking.  For example, victims can be trafficked even if they are not transported from country to country.  In contrast, human smuggling involves the illegal transport of persons across international borders.  

Some victims of human trafficking travel willingly and legally to the United States with the proper documentation.  However, once they come into contact with their trafficker or “employer,” their legal documents are usually taken from them, never to be seen again.

## Myths Associated with Human Trafficking

- Myth #3:
**All Participants Involved in Human Trafficking Are Criminals**

**Notes:**

Often times, persons identified as trafficked individuals are viewed by health care providers and/or police as criminals (willing participants of the crime), not victims.

Victims are often arrested under the assumption they are criminals or illegal immigrants willingly smuggled into the United States.

When examining a potential trafficking victim, the most important thing to remember is that trafficked individuals are not criminals.  They are victims of crimes – who need protection, medical care and shelter.

## Identifying Victims of Human Trafficking

- Frontline health providers play important role identifying and helping trafficking victims
- While trafficking is largely hidden social problem, many victims are in plain sight if you know what to look for
- Very few places where someone from outside has opportunity to interact with victim

**Notes:**
As a frontline health provider, you play an important role in identifying and helping trafficking victims. 

While trafficking is largely a hidden social problem, many trafficking victims are in plain sight if you know what to look for.  You have likely come in contact with a trafficking victim without realizing it and, therefore, missed an opportunity to help this individual escape bondage.

There are very few places where someone from outside has the opportunity to interact with a trafficking victim.  Occasionally, a health problem will necessitate a trafficker to bring a trafficking victim to a health clinic or emergency room.  In these cases, however, the trafficker will likely insist on accompanying the “patient” at all times, making confidential interaction with the patient extremely difficult.

## Identifying Victims of Human Trafficking

- Is potential victim accompanied by another person who seems controlling?
- Does person accompanying potential victim insist on giving information to health providers?
- Can you see or detect any physical abuse?
- Does potential victim seem submissive or fearful?
- Does potential victim have difficulty communicating because of language or cultural barriers?
- Does potential victim have any identification?
- Is potential victim suffering from common health problems experienced by trafficking victims?

**Notes:**
A person who is trafficked may look like many of the patients you see daily, but sensitively asking the right questions and looking beneath the surface will help you identify those people who have been forced or coerced into a life of sexual exploitation or forced labor.  While the patient may appear to you as a prostitute or a willing participant, look beneath the surface for the following clues:

Is the patient accompanied by another person who seems controlling?  This may be the trafficker or someone working for the trafficker.
Does the person accompanying the patient insist on giving information to health providers?
Can you see or detect any physical abuse?  Does the patient have bruises or other signs of battering?
Does the patient seem overly submissive or exhibit fearful behavior in the presence of others?
Does the patient have difficulty communicating with you because of language or cultural barriers?
Does the patient have any sort of identification?
Is the patient suffering from health issues experienced by trafficking victims?  

During the next few minutes, I will outline these health issues so you know what to look for. 

## Health Issues Associated with Victims of Human Trafficking

- Victims suffer from host of physical and psychological problems stemming from:
*Inhumane living conditions*
*Poor sanitation*
*Inadequate nutrition*
*Poor personal hygiene*
*Brutal physical and emotional abuse*
*Dangerous workplace conditions*
*General lack of quality medical care*

**Notes:**
Trafficking victims suffer from a host of physical and psychological problems because they are often forced to live in inhuman conditions, work in dangerous conditions, and subjected to brutal physical and emotional attacks.  Often they lack access to quality medical care.

## Health Issues Associated with Victims of Human Trafficking

- Preventive health care virtually non-existent
- Health problems typically not treated in early stages
*Tend to fester until they become critical, *
*	**life-endangering situations*
***Health care frequently administered***
***at least initially by unqualified “doctor”***
***hired by trafficker with little regard for ***
***well-being of “patients” – even less regard for disease, infection or contamination control***

**Notes:**
Preventive health care for trafficking victims is virtually non-existent and health problems are typically not treated in their early stages.  These problems tend to fester until they become critical, life-threatening situations.  That’s when you, as a frontline health care provider, are likely to encounter a trafficking victim.

What’s especially frightening is that trafficking victims’ health care is frequently administered at least initially by an unqualified “doctor,” hired by the trafficker with little regard for the well-being of their “patients” – and even less regard for disease, infection or contamination control.

## Health Issues Associated with Victims of Human Trafficking

- Sexually transmitted diseases, HIV/AIDS, pelvic pain, rectal trauma and urinary difficulties
- Unwanted pregnancy, resulting from rape or prostitution
- Infertility from chronic untreated sexually transmitted infections or botched or unsafe abortions
- Infections or mutilations caused by unsanitary and dangerous medical procedures performed by unqualified individuals
- Chronic back, hearing, cardiovascular or respiratory problems from endless days toiling in dangerous agriculture, sweatshop or construction conditions
- Weak eyes and other eye problems from working in dimly lit sweatshops

**Notes:**
The following three slides list some of the most common health issues experienced by trafficking victims [review health issues listed in each of these slides].

## Health Issues Associated with Victims of Human Trafficking

- Malnourishment and serious dental problems
*These are especially acute with child trafficking victims who often suffer from retarded growth and poorly formed or rotted teeth*
- Infectious diseases like tuberculosis
- Undetected or untreated diseases, such as diabetes or cancer
- Bruises, scars and other signs of physical abuse and torture
*Sex-industry victims often beaten in areas that will not damage their outward appearance, like lower back*

## Health Issues Associated with Victims of Human Trafficking

- Substance abuse problems or addictions
- Psychological trauma from daily mental abuse and torture, including depression, stress-related disorders, disorientation, confusion, phobias and panic attacks
- Feelings of helplessness, shame, humiliation, shock, denial or disbelief
- Cultural shock from finding themselves in strange country

**Notes:**
Trafficking victims often have substance abuse problems either from being coerced into drug use by their traffickers or as a way to cope with their desperate situation.  

They suffer psychological trauma from daily mental abuse and torture.  As a result, they can suffer from depression, stress-related disorders, disorientation, confusion, phobias and panic attacks.

They feel helpless and ashamed.  They may be in shock, denial or disbelief about their current situation.

And because they’re in a strange country with strange customs, they can suffer from cultural shock.

## Communicating with Victims of Human Trafficking

- Before questioning potential trafficking victim, isolate individual from person accompanying her/him without raising suspicions
*Individual accompanying patient may be trafficker posing as spouse, other family member or employer*
*Say that ER/health clinic policy is to examine patient alone*
- Enlist trusted translator/interpreter who also understands victim’s cultural needs
*If patient is child, important to enlist help of social services specialist skilled in interviewing child trafficking or abuse victims*

**Notes:**
There are a number of special considerations you should keep in mind when working with a potential or known trafficking victim:

Before questioning a potential trafficking victim, it’s vital to isolate the patient from the person accompanying him or her to the emergency room or health clinic.  However, try to do this without raising suspicions of the individual accompanying the patient, who may say they are a spouse, other family member or employer.  That’s because this individual may actually be the trafficker.  You may want to say that your ER/health clinic policy is to examine the patient alone.  

It’s also important to enlist a trusted translator/interpreter who also understands the patient’s cultural needs.  Don’t rely on the individual accompanying the patient to translate, since this individual could be the trafficker and will likely sanitize the patient’s responses. 

If the patient is a child, it is important to call in a social services specialist skilled in interviewing children who are trafficking or abuse victims.

## Communicating with Victims of Human Trafficking

- For victim’s safety, strict confidentiality is paramount
*Ask questions in safe, confidential and trusting environment*
*Limit number of staff members coming in contact with suspected trafficking victim*
- Importance of indirectly and sensitively probing to determine if person is trafficking victim
*May deny being trafficking victim, so best not to ask direct questions*
*Phrase “trafficking victim” will have no meaning*

**Notes:**
Trafficking victims are often in intense danger (or their families could be in danger) if they try to leave their situations.  As a result, strict confidentiality is paramount.  Therefore, ask the patient questions in a safe, confidential and trusting environment and limit the number of staff members who come in contact with the trafficking victim.

And because the patient may initially deny being a trafficking victim out of fear, it is best not to ask direct questions.  Instead, indirectly and sensitively probe the patient with sample questions on the next slide.

## Communicating with Victims of Human Trafficking: Questions

- Can you leave your work or job situation if you want?
- When you are not working, can you come and go as you please?
- Have you been threatened with harm if you try to quit?
- Has anyone threatened your family?
- What are your working or living conditions like?
- Where do you sleep and eat?
- Do you have to ask permission to eat, sleep or go to the bathroom?
- Is there a lock on your door or windows so you cannot get out?

**Notes:**
This slide lists sample indirect questions you may want to ask your patient to determine if she/he may, indeed, be a trafficking victim.  

## Communicating with Victims of Human Trafficking: Messages

- Gaining victim’s trust important first step in providing assistance
- Sample messages to convey:
*We are here to help you.*
*Our first priority is your safety.*
* **If you are a victim of trafficking and you cooperate, you will not be deported.*
*We will **give you the medical care that you need.*
*We can find you a safe place to stay.** *
*We can help get you what you need. *
*We want to make sure what happened to you doesn’t happen to anyone else. *
*You are entitled to assistance.  We can help you get assistance.*
*If you are a victim of trafficking, you can receive help to rebuild your life safely in this country.*

**Notes:**
Gaining trust with the trafficking victim will be an important first step in providing much-needed assistance to this individual.  This slide gives sample messages you may want to convey to trafficking victims to help gain this trust and demonstrate that you care for their well-being and safety.

## Victims of Trafficking and Their Needs

- There are four general areas of victim needs:
**Immediate assistance **
*Housing, food, medical, safety and security, language interpretation and legal services*
**Mental health assistance**
*Counseling*
**Income assistance**
*Cash, living assistance*
**Legal status**
*T visa, immigration, certification*

**Notes:**
Victims of human trafficking are vulnerable human beings who have been subjected to severe physical and emotional coercion.  These trafficking victims are usually in desperate need of assistance.  Victims of human trafficking need to know that once they come in contact with health care/social service providers, they should feel protected and safe. 

There are benefits and services available to trafficking victims.  These benefits and services include legal, healthcare, counseling, housing, food, medical, cash and employment assistance.

HHS has also created a toll-free number for you to call if they have identified a victim of trafficking.  By calling the Trafficking Information and Referral Hotline,1.888.3737.888, you can help identified victims of trafficking get this assistance.  For more information human trafficking visit www.acf.hhs.gov/trafficking.

## Getting Victims of Human Trafficking the Help They Need

- If you think you have come in contact with victim of human trafficking, call **National Human Trafficking Resource Center****, 1.888.3737.888**.
- This hotline will help you:
- Determine if you have encountered victims of human trafficking
- Identify local community resources to help victims
- Coordinate with local social service organizations to help protect and serve victims so they begin process of restoring their lives
- For more information on human trafficking visit **www.acf.hhs.gov/trafficking**.
***Call local police if victim at risk of imminent harm***
**1.888.3737.888**
**www.acf.hhs.gov/trafficking**

**Notes:**
The first step in providing assistance to trafficking victims is to call the Trafficking Information and Referral Hotline.  However, if the victim is at risk for imminent harm, first call the local police.

This hotline will help you determine if you have encountered victims of human trafficking, will identify local resources available in your community to help victims, and will help you coordinate with local social service organizations to help protect and serve victims so they can begin the process of restoring their lives.

Victims of human trafficking who are non-U.S. citizens are eligible to receive a special visa and benefits and services through the Trafficking Victims Protection Act to the same extent as refugees.  Victims who are U.S. citizens are already eligible to receive many of these benefits. 

## Trafficking Victims Protection Act of 2000 (TVPA)

**Areas of Focus:**
- Prevention
*Public awareness and education*
- Protection
*T visa, certification, benefits and services*
- Prosecution
*Created Federal crime of trafficking, new law enforcement tools and efforts*

**Notes:**
The law is comprehensive in addressing the various ways of combating trafficking, including prevention, protection and prosecution: 

The law authorizes prevention efforts that include public awareness and education programs. 
Protection and assistance for victims of trafficking under the law includes legal assistance and interpretation, job training and counseling programs. 
The TVPA establishes a new visa status, the T visa, which allows victims of severe forms of trafficking to become temporary residents of the United States.  The T visa signifies a shift in the immigration law policy, which previously treated victims of trafficking as illegal aliens subject to deportation.  The T visa is a critical tool as it will help keep victims in the United States legally so they can cooperate with you and serve as witnesses for the prosecution.
The law makes victims of severe forms of trafficking eligible for benefits and services under Federal or state programs once they become certified by the U.S. Department of Health and Human Services.  Once certified, trafficking victims will be eligible to apply for benefits and services under any Federal or state funded programs, to the same extent as refugees.  Certified victims are also eligible for refugee cash, medical assistance and social services. 
Victims under 18 years of age do not need to be certified in order to be eligible for benefits and services.  For these victims, the Department of Health and Human Services issues a “Letter of Eligibility” so that they have proof of eligibility for federally funded and administered benefits and services.
New law enforcement efforts are now available through the law, making it easier to prosecute traffickers who are identified and convicted of trafficking offenses.  

## TVPA: How Law Protects Victims

- Enables trafficking victims to obtain medical care, witness protection, other types of social service assistance
- Enables victims to obtain legal immigration status
- Criminalizes trafficking
- Permits prosecution where victim's service compelled by confiscation of documents
- Increases prison terms for all slavery violations from 10 years to 20 years; adds life imprisonment for death, kidnapping or sexual abuse of victim

**Notes:**
In summary, this Federal law protects trafficking victims by:

Enabling them to obtain medical care, witness protection, other types of social service assistance.

Enabling victims to obtain legal immigration status.

Criminalizing trafficking, including prosecution where non-violent coercion is used to force victims to work in belief they would be subject to serious harm.

Permitting prosecution where a victim's service is compelled by confiscation of documents such as passports or birth certificates.

Increasing prison terms for all slavery violations from 10 years to 20 years.  It also adds life imprisonment for death, kidnapping or sexual abuse of victim.  

## TVPA Reauthorized in 2003

- Federal government authorized more than $20 million to continue domestic fight against human trafficking
- New law strengthens legal elements of TVPA
*Sex and labor trafficking now considered offenses under RICO statute*
*Encourages nation’s 21,000 law enforcement agencies to investigate cases of trafficking*

**Notes:**
In December, the President signed the Trafficking Victims Reauthorization Act, which authorized more than $200 million to combat the issue of human trafficking, particularly of women and children forced into prostitution.

TVPRA provides fresh resources to assist victims of trafficking and even further strengthens the law enforcement tools designed in the original law:

TVPRA adds human trafficking to the list of racketeering offenses covered under the Federal Racketeer Influenced and Corrupt Organizations Act (RICO Statute) and allows trafficking victims to sue their captors in Federal courts.

## Questions and Answers

**Notes:**
Thank you for your taking the time to learn about this important issue and how you can help.  I would be happy to answer any questions you may have.

## 
Looking Beneath the Surface:

Role of Health Care Providers in Identifying and Helping 
Victims of Human Trafficking

**Looking Beneath the Surface:**
- Role of Health Care Providers in Identifying and Helping
- Victims of Human Trafficking