by Beth Maples-Bays
Equality Herald - Editor and Publisher

Despite the best efforts of local officials to insure that services are made available to victims of domestic violence, local agencies continue to fail to make the crucial connections that enable effective service delivery.

Gail (not her real name) recently required emergency services after her boyfriend of seven years beat her, stomping her head and repeatedly kicking her, causing painful contusions all over her body, including her neck, ribs, arms, and back. An observant Knoxville Police Department (KPD) officer questioned Gail when he suspected domestic violence after seeing her at a local convenience store. Because of the officer’s intervention, Gail was taken by ambulance to the University of Tennessee Medical Center’s emergency department where she was treated for her injuries. Miraculously she escaped permanent neurological impairment due to repeated trauma to her neck.

The perpetrator was taken to jail due to several outstanding warrants including another assault, probation violation, and failure to appear for scheduled court hearings. The victim, fearful of reprisal, declined to file a complaint regarding the assault. While that is seen as a “failure” on the part of the victim to seek redress under the law, victim complaint is not needed to make an arrest in the state of Tennessee.

Pro-arrest Policy

If a member has probable cause to believe that a person has committed a crime involving domestic abuse, whether the crime is a misdemeanor or felony or was committed with or without the presence of the member, the preferred response of the member is arrest A law enforcement officer shall not threaten, suggest, or otherwise indicate the possible arrest of all parties to discourage future requests for intervention by law enforcement personnel; or base the decision of whether to arrest on the consent or request of the victim; or the officer's perception of the willingness of the victim or of a witness to the domestic abuse to testify or participate in a judicial proceeding. (TCA 36-3-619).

Nationwide more than 200,000 emergency room visits each year are directly related to domestic violence. Coordination between emergency room (ER) and area agencies serving domestic violence victims is critical to delivery of appropriate assistance, however at this time the University of Tennessee Medical Center appears to offer no information to discharged ER patients with regard to follow up services to assist them.

Gail’s toxicology report proved to be positive for cocaine. This information was shared without her consent with a friend who had come to the ER to help, in flagrant violation of current Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations. Patient privacy and confidentiality are even more critical in cases of domestic violence as information given to the perpetrator and/or his friends and family members may be seen as justification for further abuse. In this case, the patient/victim’s medical information was shared without her consent, laying the groundwork for a bumpy road ahead.

In addition, no referrals to area agencies designed to assist the victim were given. She was discharged in the care of the perpetrator’s sister with no written material regarding how to access local services.

“We provide referral services if there is suspected or apparent abuse,” explains UT Emergency Department Director Sheila Duncan, R.N.-B.S.N.

Gail received no referrals after her twelve-hour stay in UT’s ER. She had no case manager to assist her with navigating the overwhelmingly complicated system of services that could have helped her to get back on her feet.

She should have been referred to the Family Justice Center (FJC) The FJC offers a litany of services provided by nine on-site agencies as well as referrals to 54 other service providers. Their list includes counseling, long and short-term housing, child and pet care, prosecution and other advocacy services as well as specialized services for the disabled and elderly. The interface between area ER’s and the FJC is codified in a memorandum of understanding held on file at the FJC. The FJC celebrated their first anniversary in April 2007.

All area hospitals have signed on except UT Medical Center. As the area’s only Level I trauma center, UT undoubtedly provides medical services to more domestic violence victims than other hospitals in the area.

“We welcome the opportunity to cooperate with all area hospitals,” offers Amy Dilworth, executive director of the Family Justice Center.

The center is a one-stop resource center, the result of collaboration among 63 agencies in Knoxville, including those focused on social services, law enforcement, and the criminal justice system. The center has nine agencies on-site including Child and Family Tennessee, the Community Coalition on Family Violence, Legal Aid of East Tennessee, the Salvation Army, YWCA, the Knoxville Police Department and Knox County District Attorney, Probation, and Sheriff's Offices.

From the Family Justice Center’s Web site:

Domestic Violence Facts

Domestic Violence occurs in families of all races, cultures, religions and income levels. It can happen to people of any age or sexual orientation.

· On average, more than three women are murdered by their husbands or boyfriends in this country every day.

· One in four women will be physically abused or sexually assaulted by an intimate partner during her lifetime.

· The health-related costs of rape, physical assault, stalking, and homicide by intimate partners exceed $5.8 billion each year.

· Approximately 40-50% of female victims are physically injured when assaulted by their intimate partner. This accounts for over 200,000 visits to hospital emergency rooms each year.

The Effects of Domestic Violence on children include:

· Being 1000 times more likely to be abused as adults.

· Having a rate of suicide is 6 times the national average.

· Suffering a variety of physical and emotional symptoms, as well as having problems in school.

"Those who need help will find it easier to get at the Knoxville Family Justice Center, which provides one telephone number and one place for service to make it easier for those who need help to get it," said Randy Nichols, Knox County district attorney general and member of the center's executive board. "In addition, the center makes it easier for agencies to provide help in efficient and effective ways through continued cooperation and collaboration." (Ed. – Nichol’s remarks from the ribbon cutting ceremony launching the FJC on May 16, 2006.)

Indeed the FJC has proved to be an invaluable community resource, assessing and counseling families in crisis.

Executive Director Jo Terry of the Community Coalition on Family Violence (CCFV) weighs in.
”We’re actively working to make the court system process smoother. The problems [facing women and their families] are so large and so complex that we need broader support.”

The mission of the Community Coalition on Family Violence:

Our mission is to provide a community-wide approach to the prevention of family violence through a coordinated effort among all agencies, local governments, departments, groups and courts. The Coalition shall promote education, prevention and intervention to improve the community response to family violence.

“CCFV, in partnership with the Knoxville Academy of Medicine has developed and implemented an educational program for children in grades K-4. This is just one of our attempts at preventive education. When it comes to family violence, prevention is where this needs to go,” adds Terry.

Kelly Vogel, Knox County Health Department public health educator, confirms that her agency has a memorandum of understanding with the FJC.

“We need more training for area service providers,” says Vogel regarding the FJC. “Our main emphasis at this time is primary prevention, working with children in the schools.”

Sexual-assault nurse examiners who also serve as counselors for victims of domestic abuse are available at FJC. University of Tennessee College of Nursing professors Sally Helton and Ginger Evans, along with other certified forensic nurses, provide services to the FJC through Forensic Consulting of East Tennessee (FCET). “We have provided week-long training modules as far away as Rutgers in New York as well as locally.” The firm has also worked with the Anderson County Coroner’s Office. They have an official memorandum of understanding with the FJC as well.

If you or someone you know is a victim of domestic violence, help is available. In case of emergency, call 911. For services or help, call The Family Violence Helpline:
(865) 521-6336

If you have been the victim of domestic violence and have not received satisfactory services from local hospitals and/or agencies, contact us at publisher (at) equalityherald.com. We want to hear your story.