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systematically reviewed current U.S. state laws that address human-trafficking education and mandatory reporting by health care providers and other professionals. To date, 17 states in total have enacted laws that establish education initiatives about human trafficking and/or stipulate trafficking per se as a reportable event. Thirteen of the 17 states have educational laws, seven of the 17 have mandatory reporting laws, and three have both education and mandatory reporting laws. Because these laws were enacted only within the past few years, and because data collection and analysis, to the extent undertaken, has not been widely shared, it is difficult to assess the laws’ effectiveness and, hence, to determine best practices. However, several salient issues and questions emerge. Education With the rise in awareness about the scope of human trafficking in the United States, a number of authoritative medical bodies have recently issued calls for education about human trafficking. The Institute of Medicine and National Research Council, in its 2013 report titled Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States, recommends widespread evidence-informed training of numerous professionals, including physicians and other health care providers. Taking it one step further, the report goes on to say, “A legal mandate to ensure that personnel who come into regular contact with minors have been trained in these issues. . .would appear to have potential value” (IOM [Institute of Medicine] and NRC [National Research Council], 2013, p. 187). Within the last three years, at least nine professional medical societies76 have issued new policy statements on human trafficking and made similar recommendations regarding the need for education and training. The American Public Health Association, in its 2015 statement, acknowledges the severe physical and mental health effects of human trafficking and “calls for professional schools, societies, and certifying bodies to improve training of licensed health professionals and to integrate human trafficking into existing curricula on intimate partner violence, domestic violence, and child and elder abuse (American Public Health Association, 2015, p. 1). HEAL Trafficking, a nonprofit organization comprised of health care professionals, has stated that training should be grounded in “a patient-centered, culturally relevant, evidence-based, gender responsive, trauma-informed perspective for identifying and treating victims” and that “trauma informed care should be integrated into health professional training across specialties, clinical practice and professional titles” (HEAL Trafficking, 2015, p. 1, para. 5). Medical organizations are calling for education about human trafficking because, although standard medical training covers issues of child abuse and neglect, intimate partner violence, and elder abuse, it does not yet cover human trafficking (Stoklosa, Grace, & Littenberg, 2015). Physicians and other health care providers report that they are poorly prepared and lack the knowledge and skills to effectively engage with suspected trafficking victims and, furthermore, do not know where to turn for resources (Beck et al., 2015; Titchen et al., 2015). Health care providers need to know about the scope of the problem, the risk factors and “red flags” for victimization, and how to identify victims, as well as to be armed with the clinical skills to diagnose, treat and refer victims of trafficking for various services (IOM and NRC, 2013). While health care providers should keep in mind that this review is limited to state laws and does not consider policies or practice rules enacted by other governing bodies such as medical boards, it is worth noting that several hospitals and other health care facilities across the nation have recently developed protocols for health care providers to follow when presented with a suspected or known case of trafficking. This positive development reflects growing awareness of human trafficking but also the growing need for training on protocol compliance and evaluation of their impact. 128 H. G. ATKINSON ET AL. Furthermore, mandatory reporters need more detailed training on their reporting obligations within the context of trafficking, and on how to ethically
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