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conducts investigations of reported cases, and the outcomes of such investigations (Flaherty, Jones, & Sege, 2004; Flaherty, Sege, & Hurley, 2008). Such “procedural” training has been shown to enhance the willingness of physicians to report cases of child abuse and neglect (Alvarez et al., 2010). These new state laws aimed at promoting trafficking awareness and education among health care providers and other professionals, if implemented in an effective manner, have the potential to significantly improve outcomes. But best practices are as yet difficult to discern, without data to draw from this early in the implementation. Lessons can be drawn, however, from the field of domestic violence (DV). While human trafficking differs in important ways from DV, there are many similarities, including the tactics that perpetrators use to establish power and control over their victims, the trauma bond that often develops between victim and abuser, the physical and psychological consequences that result, and the barriers to physicians identifying and intervening on behalf of victims (Williamson, Dutch, & Clawson, 2010). Furthermore, there is, at times, considerable overlap between DV and trafficking victims, in that many adolescents and women are often trafficked by people who are family members and/or intimate partners. Although current practices and procedures for intervening on behalf of domestic violence are not perfect, three decades of work in this arena have provided a solid foundation of knowledge about training health care providers to identify and offer services to victims of interpersonal violence (Williamson et al., 2010). Research on the effectiveness of domestic violence education in postgraduate and continuing medical education activities suggest that multifaceted educational interventions for health care providers (e.g., interactive workshops, Web-based learning, patient simulations, and experiential training) combined with system support interventions (e.g., general awareness initiatives, workplace reminders about victim identification, improved systemic access to support services) increase health care providers’ knowledge and skills, referrals to resources, and, ultimately, positive outcomes for victims (Bair-Merritt et al., 2014; Harris, Kutob, Surprenant, Maiuro, & Delate, 2002; MacGregor, Wathen, Kothari, Hundal, & Naimi, 2014; Shefet et al., 2007; Zaher, Keogh, & Ratnapalan, 2014). Given that quality education and training underpin health care providers’ competencies in identifying, treating, and appropriately referring and reporting trafficking victims, it is critical that we determine best practices specifically for human trafficking. A new federal law passed in 2015, which seeks to identify and disseminate best practices for training on human trafficking, is expected to help in this regard. More evidence-based research is needed, but some best practices are already starting to emerge, thanks to many innovative local initiatives that have spread. These include, among others, developing screening tools to help identify trafficking victims, training new clinical employees and urging all clinicians to attend, creating a multipart Webinar, producing online training videos, and forging relationships with law enforcement and social services before the need to refer or report arises (McKinney, 2015). A U.S. Department of Health and Human Services pilot project called Stop Observe Ask Respond (SOAR) has provided training to health care providers in at least six cities, using both a pretraining survey to better gauge participants’ baseline knowledge and a posttraining survey to check their retention of new material (McKinney, 2015). Finally, funding sources must be identified to support these educational and research endeavors; a lack of funding will hamper full implementation and sabotage the best of intentions. Mandatory reporting New laws extend reportable offenses to include trafficking situations To date, seven states have specifically made trafficking of a minor a reportable offense. It is important to note that some trafficking situations are already covered under current state laws: Mandatory reporters are obliged to treat many sex-trafficking situations involving minors as JOURNAL OF HUMAN TRAFFICKING 129 reportable offenses because they constitute “sexual abuse” or “sexual exploitation” (e.g., DE, GA, MI, NM, OR).77 For example, a situation that entails a stepfather prostituting his minor stepdaughter would be reportable under established CAN laws. Most child abuse laws define “sexual exploitation” as primarily covering the following: acts of prostitution; enticing, preparing, publishing, and distributing sexually exploitative material; or sexual performances by children. But while all CAN laws include variations of “sexual abuse” and some separately define “sexual exploitation” as reportable offenses, the specific forms of abuse, as defined in these older statutes, may not be broad enough to cover all trafficking situations. If a state only has the language of “sexual exploitation” or a vague definition of “sexual abuse” and does not specifically designate “trafficking,” then many incidents of trafficking, including labor trafficking, may not be covered as reportable offenses. Furthermore, in about one third of states, acts are reportable under the CAN reporting laws only if a parent, guardian, custodian, or other person responsible for the child commits them (Glosser, Gardiner, & Fishman, 2004). Thus, while a sexual act with a minor may violate the state’s criminal code, it may not be reportable as child abuse if committed by someone other than a parent or guardian. For example, in a state that limits reporting to abuses committed by a parent or responsible caretaker, a 16-year-old girl being trafficked by her older “boyfriend” may violate the state’s criminal laws but not be reportable as child abuse by mandatory reporters. Hence, states are taking steps to extend the scope of reportable offenses to include a range of trafficking situations. The intent of these mandatory-reporting laws is to interrupt the violence and ultimately to make a positive impact on the lives of trafficked victims. However, in order to achieve these desired outcomes, victim-centered procedures and services must be in place to adequately support and to assist survivors of trafficking. Otherwise, reporting may do more harm than good. This is not an unreasonable concern. Too many states are unprepared to deal with the distinct needs of trafficked victims. State child-welfare systems are already overburdened and need to increase their capacities to respond. Many current protocols, procedures, and services for victims of abuse and exploitation were not developed with trafficking victims in mind (IOM [Institute of Medicine] and NRC [National Research Council], 2013). Reports from the field cite instances where mandatory reporting of trafficked minors has resulted in serious and harmful, even if unintended, consequences (IOM [Institute of Medicine] and NRC [National Research Council], 2013). According to the IOM/NRC Report, “In many states, a report of commercial sexual exploitation or sex trafficking of a minor to child protective services would be considered outside the purview of child protective services if the abuse were extra familial in nature. A report to law enforcement, on the other hand might lead to a victim’s arrest or some form of detention” (2013, p. 26). In some states, minors can still be arrested and charged with a crime—prostitution, for example—and prosecuted and incarcerated by law enforcement. To date, only 34 states have passed various forms of “safe harbor” laws, which shield young trafficking victims from criminal charges and require they be treated as victims and referred for services (Polaris, 2015). Most states with safe harbor laws have limited the protection to minors who have been commercially sexually exploited (CSEC), for example, prostitution and prostitution related-crimes. Importantly, the most recently reauthorized TVPA sets forth the U.S. attorney’s model78 for state criminal law for protection of child-trafficking victims and survivors and directs that the model law contain a safe harbor provision.79 If, after separating victims from traffickers, the goal of every state is to assist victims in their recovery process, then provision of services is key to assessing these statutes’ ultimate effectiveness. But none of the mandatory reporting statutes discussed herein is funded. Furthermore, trafficking victims often do not gain access to or benefit from services that are available (IOM and NRC, 2013). Services may be offered to victims who may then decline assistance for various reasons and then, all too often, end up back in abusive situations. Many trafficking victims have a long history of abuse and