Guideline 10

1. Share information about relationships and how they affect health. Make sure clients know that you're a safe person for them to talk to.  
2. Provide client with community resources for IPV advocacy support and services; remember to evaluate safety risks for client before leaving print IPV materials in the home. A safer strategy is to include IPV resources in a full list of general resources, or to focus on information about healthy relationships. 

1. Screen clients for IPV alone, never with partner, friends or family. 
2. Use a professional interpreter if needed, never a family member. 
3. Consider factors, including participants' comfort levels and preferences, before screening on a virtual visit. See additional guidance on addressing IPV on virtual home visits here: https://nhvrc.org/wp-content/uploads/NHVRC-Brief-040121-FINAL.pdf 
4. If it is not possible to screen for IPV safely, do not screen client. Defer screening until a follow up visit. 
5. Normalize the screening process to promote comfort with the discussion and encourage candid responses: use a framing statement such as, “We've talk to all of our clients about safe and healthy relationships, because these have such a large impact on your health." 
6. Note that non-structured discussions that focus on parenting, safety or healthy relationships are more likely to illicit disclosure of violence, so it is most helpful to establish a therapeutic relationship before using the IPV screening tool.  
7. After establishing rapport and creating a safe environment, use a validated tool to screen for IPV. Examples of validated tools include:
• Futures Without Violence Relationship Assessment Tool  
  https://www.wvdhhr.org/wvhomevisitation/forms/relationship_assessment_tool.pdf  
• Hurt, Insulted, Threaten, Scream (HITS) 
  https://portal.ct.gov/-/media/dph/maternal-mortality/e-hits-screening.pdf  
• For NFP program, use the Clinical IPV Assessment form 
8. Ensure clients also know that what they say is confidential unless what they tell you falls within the mandatory reporting guidelines. Among others, this includes child abuse or neglect: if you suspect a child with whom you have had contact is being abused or neglected, or that a person has abused a child, you must report it. For full mandatory reporting information, go to: http:/www.oregon.gov/DHS/ABUSE/Pages/mandatory_report.aspx 

Safety Planning 
When IPV is identified, speak with the client about their immediate and future safety. Support the client in making a safety plan. See more information on safety plans here: https://www.thehotline.org/what-is-a safety-plan/  
The plan should cover:  

• Safety during a violent incident 
• Safety when preparing to leave 
• Safety in client's own home 
• Safety with a protection order, including Extreme Risk Protection Orders and firearms (https://erpo.org/state/oregon/#:~:text=In%20Oregon%2C%20an%20Extreme%20Risk,deadly%20weapons%20(including%20firearms).)

1. How to Screen for Intimate Partner Violence: Tools from ACOG. 
   https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2012/02/intimate-partner-violence#:~:text=Screen%20for%20IPV%20in%20a,one%20associated%20with%20the%20patient. 
2. Addressing Intimate Partner Violence in Virtual Home Visits 
   https://nhvrc.org/wp-content/uploads/NHVRC-Brief-040121-FINAL.pdf 
3. IPV and Home Visiting 
   https://homvee.acf.hhs.gov/sites/default/files/2020-08/Home_Visiting_IPV_Research_Brief_1.pdf 

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