Core Competencies for Human Trafficking Response in Health Care and Behavioral Health Systems


Human Trafficking Response in HealthCare
U.S. Department of Health and Human Services (HHS), Office on Trafficking in Persons (OTIP)

As noted in a few previous posts, the U.S. Department of Health and Human Services (HHS) Office on Trafficking in Persons (OTIP) has released the “Core Competencies for Human Trafficking Response in Health Care and Behavioral Health Systems,” February 2021, 46 pages. These core competencies pinpoint skill sets that health care and behavioral health practitioners (HCPs) should acquire to identify, respond to, and serve individuals who have experienced trafficking and individuals at risk of trafficking.


These core competencies were developed in a partnership by Health, Education, Advocacy, Linkage (HEAL) Trafficking, the International Centre for Missing & Exploited Children (ICMEC), and the National Association of Pediatric Nurse Practitioners (NAPNAP), and the project was funded by the Office of Trafficking In Persons (OTIP). The National Human Trafficking Training and Technical Assistance Center facilitated a 3-year process to develop the competencies.


The purpose of a core competency is to provide guidance in “assessing workforce knowledge and skills, identifying training needs, developing workforce development and training plans, crafting job descriptions, and conducting performance evaluations.” Core competencies comprise skills needed for professionals to most effectively conduct their work. Core competencies help organizations and networks understand baseline skill sets required for HCPs in their field to guide professional development through a standard method of evaluating staff performance. Based on gaps frequently identified by HCPs, core competencies can also help identify training needs for organizations or networks. Additionally, core competencies are dynamic because they are reviewed and revised continually to reflect changes in a discipline or field (e.g., changes due to new research or evidence-based practices).


The Core Competencies for Human Trafficking Response in Health Systems are:


UNIVERSAL COMPETENCY: Use a trauma- and survivor-informed, culturally responsive approach.

  • Trauma-Informed Care

  • Lived Experience Expertise and Leadership

  • Culturally Responsive

COMPETENCY 1: Understand the nature and epidemiology of trafficking.

  • Nature and Scope of Trafficking

  • Trafficking and Social Determinants of Health

COMPETENCY 2: Evaluate and identify the risk of trafficking.

  • Indicators of Trafficking

  • Evidence-Informed Assessment of Risk

COMPETENCY 3: Evaluate the needs of individuals who have experienced trafficking or individuals who are at risk of trafficking.

  • Needs Assessment

  • Plan of Action

  • Practice Within Scope and Community Referrals

COMPETENCY 4: Provide patient-centered care.

  • Patient-Centered Approach

  • Resiliency-Focused Care

  • “No Wrong Door” Access to Diverse Health Services

COMPETENCY 5: Use legal and ethical standards.

  • Mandatory Reporting Responsibilities

  • Legal Rights

  • HIPAA and Patient Consent Compliance

  • Documentation Considerations

COMPETENCY 6: Integrate trafficking prevention strategies into clinical practice and systems of care.

  • Primary Prevention: Preventing Any Trafficking

  • Secondary Prevention: Risk Reduction

  • Tertiary Prevention: Prevention of Re-Trafficking


Successful adoption of these core competencies at the organizational level will most likely require:

  • Leadership buy-in, dissemination, and commitment to funding

  • A diverse and inclusive task force that involves staff and experts with lived experience to develop an implementation plan

  • A systemwide approach and workforce development planning

  • Curricular development and training delivery

  • Integration of the competencies into job descriptions, role responsibilities, policies, and procedures

  • Supervision, assessment, monitoring, and evaluation of implementation

The report provides detailed Sub-Competencies and a Bibliography for the above. At the end of the report, there is a very useful listing of Additional Resources on:

  • Trauma-Informed Care

  • Health and Wellness

  • Culturally and Linguistically Appropriate Services

The OTIP webpage has full and Executive Summary PDF versions of the report and an infographic:

Core Competencies Report (Full)

Core Competencies Executive Summary

Core Competencies Infographic


Hanni Stoklosa et al’s article, “OPINION: Health Workers Can Play Key Role In Helping Trafficking Victims,” March 9, 2021, helps put the OTIP report in perspective. Last year, the U.S. National Human Trafficking Hotline received reports of more than 19,000 potential victims of human trafficking. While individuals experiencing forced labor or sex trafficking may be physically and socially isolated, research suggests that the majority of trafficking survivors have come into contact with a healthcare professional. Healthcare is a point of access for those experiencing trafficking, as indicated by more than 1,600 medical and behavioral health providers who called into the hotline last year. Yet not every healthcare provider may know what to do to spot and respond to human trafficking. Because trafficked persons do not usually identify as such, the onus is on the provider to identify patients who may be at risk for exploitation. If they are unable to do this, a critical opportunity to offer assistance is lost.




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