Form 1 OTIP DCP Survey Questionnaire

Thank you for volunteering to participate in this survey. Your perspective on human trafficking data collection is important to the Department of Health and Human Services (HHS). This survey is supported through funding from the HHS Office on Women’s Health (OWH) and the Administration for Children and Families (ACF), Office on Trafficking in Persons (OTIP) and Children’s Bureau (CB).^³ All respondents for this survey will remain private and this survey is strictly voluntary.

The Human Trafficking Data Collection Project

The Human Trafficking Data Collection Project developed from a national stakeholder meeting in September 2014 and later meetings with anti-trafficking organizations, survivors, researchers, and federal partners. This multi-year effort outlined several current challenges in data collection on human trafficking, including inconsistencies in screening and data collection across a variety of care systems, differences in data standards and formats, and lack of resources to securely collect, analyze, and share data.

Project goals include:

Gain understanding of stakeholder opinions and their level of satisfaction with current human trafficking data collection practices and requirements for improving these practices
Establish universal standards and definitions for data collection on human trafficking
Use data to understand human trafficking victimization and survivor needs
Align federal, state/local, and private sector experts on U.S. human trafficking data collection efforts
Enhance HHS’ and OTIP’s ability to collect and share human trafficking data from partners
Improve the efficiency of reporting legislatively-mandated data
Analyze the need for development of an Interoperable Human Trafficking Data Collection Platform, in which systems will communicate with one another to share relevant information

Survey Background and Purpose

This survey was developed for the Human Trafficking Data Collection Project. It will explore stakeholder opinions and satisfaction on current human trafficking data collection practices and the possibility of creating a system to collect that data. Also, the survey will capture information on models or best practices for collecting data on human trafficking.

Survey Terms and Definitions

The Trafficking Victims Protection Act defines human trafficking (22 USC 7012) as:

Sex trafficking: The recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act which is induced by force, fraud, or coercion. Any child under the age of 18 who has been subjected to a commercial sex act is a victim of trafficking regardless of force, fraud, or coercion.
Labor trafficking: The recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.

For the purposes of this survey, an anti-trafficking service organization is defined as any organization that provides services to victims and survivors of human trafficking and vulnerable populations at high risk of human trafficking.

Pop-up box content:

What is the purpose of the survey?

The purpose of this survey is to understand the way your organization collects, organizes, and processes data about the individuals it serves – including human trafficking victims – and how this data collection could be improved to serve human trafficking victims better.

Why should I participate?

Your participation is voluntary. Your responses will be used to help HHS understand what data is currently collected on human trafficking victim services, your opinions on the current data collection practices, and how HHS could help your organization collect data in a better way. Your responses will also help HHS develop a set of uniform data standards by which service organizations could easily share information while maintaining victim privacy and confidentiality.

How will information from this survey be used?

Survey results will inform how the U.S. Department of Health and Human Services standardizes, collects, and organizes information on vulnerable populations at-risk of human trafficking and on victims and survivors of human trafficking, in order to improve service delivery, resource allocation, and program development.

Why was I selected for the survey?

You have been identified as the person at your organization who is most familiar with the data related to (1) vulnerable and at-risk populations or (2) victims and survivors of human trafficking. If you feel you are not the correct person at your organization to complete this survey, please send an email to Office on Trafficking in Persons (OTIP) at [email protected] with a suggestion for the correct person.

Who wrote the questions?
This survey was based on input provided by federal experts (called the HHS Federal Working Group (FWG)) and anti-trafficking experts (called the Technical Working Group (TWG)), representing 13 programs across HHS and more than 80 NGOs during the Spring of 2016.

What do I have to do?

This survey consists of 55 questions related to the types of information collected on your clients/program participants and your organization’s data collection capabilities. It takes about 30 minutes to complete.

What if I don’t know the answers to some of the questions?

Some of the questions may require you to consult others in your organization. Please do your best to find someone who knows the answers to the questions. Thank you!

Consent

This survey is voluntary. There is no direct benefit to you or your organization. The possible risks of participating in this survey are minimal. We will take steps to protect your privacy.

All survey responses will remain private to the extent permitted by law. This survey does not collect Personally Identifiable Information (PII). You do not have to provide any information that you do not want to. You can choose not to answer any question in the survey. You may stop the survey at any point if you do not wish to continue. If you have any questions about this survey, please email Office on Trafficking in Persons (OTIP) at [email protected].

I consent

I do not consent

Note: If you do not consent to the above statements, you will not be able to participate in this survey.

Survey Questionnaire

Human Trafficking Indicators in the Populations You Serve

Based on the individuals that you serve and risk factors they display, have you ever suspected or thought that one of your clients/program participants has been a victim of human trafficking?

Yes

Do not know

Are you satisfied with your organization’s capacity to distinguish between victims of domestic violence, intimate partner violence, child maltreatment, and human trafficking?

Yes

Do not know

Have the individuals your organization serves shown any of the following indicators^⁴ for trafficking? (Select all that apply.)

Is not free to leave or come and go as he/she wishes

Is in the commercial sex industry and has a pimp/manager

Is unpaid, paid very little, or paid only through tips

Works excessively long and/or unusual hours

Is not allowed breaks or suffers under unusual restrictions at work

Owes a large debt and is unable to pay it off

Was recruited through false promises concerning the nature and conditions of his/her work

High security measures exist in the work and/or living locations (e.g. opaque windows, boarded up
windows, bars on windows, barbed wire, security cameras, etc.)

Is fearful, anxious, depressed, submissive, tense, or nervous/paranoid

Exhibits unusually fearful or anxious behavior after bringing up law enforcement

Avoids eye contact

Lacks medical care and/or is denied medical services by employer

Appears malnourished or shows signs of repeated exposure to harmful chemicals

Shows signs of physical and/or sexual abuse, physical restraint, confinement, or torture

Has few or no personal possessions

Is not in control of his/her own money, has no financial records, or bank account

Is not in control of his/her own identification documents (ID or passport)

Is not allowed or able to speak for themselves (a third party may insist on being present and/or translating)

Claims of just visiting and inability to clarify where he/she is staying/address

Lack of knowledge of whereabouts and/or of what city he/she is in

Loss of sense of time

Has numerous inconsistencies in his/her story

Other (Please specify) [Optional]:_______________

None

Do not know

Does your organization collect or record data on any of these elements? (populate responses from Q16)

Yes

Do not know

Do you ever encounter any of the following risk factors^⁵^,^⁶^,^⁷^,^⁸ among minors (individuals under age 18) you serve? (Select all that apply.)

N/A; My organization does not serve minors

Accompanied by a non-guardian or unrelated adult, or presence of an older boyfriend or girlfriend

Early initiation of sexual activity

Sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases^⁹

History of skipping school or recurrent episodes

Runaway or homeless youth

Unaccompanied minors

Receive threats to be turned over to authorities, or threats to family, if they do not cooperate with
non- guardian or unrelated adult

Experience of abuse, neglect, and maltreatment (emotional, sexual, or physical)

Experience or exposure to violence in the home

Experience or exposure to violence in the community

Refusal or inability to view themselves as victims and/or believe the perpetrator has done anything wrong

Lying about age

Display of shame, guilt, and a lack of self-worth

Withdrawal or lack of interest in previous activities

Drug addiction

Gang involvement

Do not know

Does your organization collect or record data on any of the elements listed below?

N/A; my organization does not serve minors

Accompanied by a non-guardian or unrelated adult, or presence of an older boyfriend or girlfriend

Early initiation of sexual activity

Sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases^¹⁰

History of skipping school or recurrent episodes

Runaway or homeless youth

Unaccompanied minors

Experience of threats to be turned over to authorities, or threats to family, if they do not cooperate with
non- guardian or unrelated adult

Experience of abuse, neglect, and maltreatment (emotional, sexual, or physical)

Experience or exposure to violence in the home

Experience or exposure to violence in the community

Refusal or inability to view themselves as victims and/or believe the perpetrator has done anything wrong

Lying about age

Display of shame, guilt, and a lack of self-worth

Withdrawal or lack of interest in previous activities

Drug addiction

Gang involvement

Do not know

Does your organization use any of the characteristics listed below to recognize indication of human trafficking?

Accompanied by a non-guardian or unrelated adult, or presence of an older boyfriend or girlfriend
Early initiation of sexual activity
Sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases^¹¹
History of skipping school or recurrent episodes
Runaway or homeless youth
Unaccompanied minors
Experience of threats to be turned over to authorities, or threats to family, if they do not cooperate with non- guardian or unrelated adult
Experience of abuse, neglect, and maltreatment (emotional, sexual, or physical)
Experience or exposure to violence in the home
Experience or exposure to violence in the community
Refusal or inability to view themselves as victims and/or believe the perpetrator has done anything wrong
Lying about age
Display of shame, guilt, and a lack of self-worth
Withdrawal or lack of interest in previous activities
Drug addiction
Gang involvement

Yes

Do not know

N/A; My organization does not serve minors

Your Organization’s Data Collection

Are you satisfied with your organization’s current methods of collecting data?

Yes

Does your organization collect any of the following data? If yes, select all that apply.

Demographics

PII (Personally Identifiable Information)

Geographic Information

Human Trafficking Victim Data

Human Trafficking Risk Factors Data

Services Provided

Referrals Provided

Budget and Cost of Services Provided

Other (please specify) [Optional]:_____________

No, we do not collect any of this information

Do not know

Is the data that your organization collects and stores electronic or paper-based? “Electronic” means the data exists on a computer in an electronic format and is stored as files or within a database (i.e., Excel, Word, PDF files). “Paper-based” means the data exists in paper form (either typed or handwritten). (Choose one.)

Electronic

Paper-based
Both electronic and paper-based

Do not know

Which software do you use to collect data? (Select all that apply.)

Microsoft Excel

Microsoft Access

Microsoft Word

Software another organization hosts for you, otherwise known as “cloud” software (e.g., Salesforce,
Efforts to Outcomes, Apricot)

Custom-designed software

Other (please specify) [Optional]:____________

Do not know

Do not use software to collect data

Does your organization have an Information Technology (IT) system (servers, software, and network capabilities) in place to support the collection of the following data from individuals served by your organization? (Select all that apply.)

Demographics

PII (Personally Identifiable Information)

Geographic Information

Human Trafficking Victim Data

Human Trafficking Risk Factors Data

Services Provided

Referrals Provided

Budget and Cost of Services Provided

Other (please specify) [Optional]:_____________

No, we do not collect any of this information

Do not know

Which of the following types of information would you be willing to begin collecting, if your organization does not already collect it? (Choose all that apply.)

Does not apply; we collect all of this information

Demographics

PII (Personally Identifiable Information)

Geographic Information

Human Trafficking Victim Data

Human Trafficking Risk Factors Data

Services Provided

Referrals Provided

Budget and Cost of Services Provided

Other (please specify) [Optional]:_____________

None; we would not be willing to collect any of this information

Do not know

Protecting Client/Program Participant Information

Are you satisfied with your organization’s capacity to protect client or program participant information?

Yes

Do not know

Does your organization ask for informed consent related to sharing client/program participant data for reporting or research?

Yes

Do not know

Does your organization have an individual who keeps track of privacy laws and regulations about information-sharing and exchanging data from your clients/program participants (including human trafficking victims)?

Yes

No, but we need a person like this

Do not know

Do privacy laws and regulations allow your organization to share and exchange the following categories of data with HHS that your organization collects? If yes, select all that apply.

Demographics

PII (Personally Identifiable Information)

Geographic Information

Human Trafficking Victim Data

Human Trafficking Risk Factors Data

Services Provided

Referrals Provided

Budget and Cost of Services Provided

Other (please specify) [Optional]:_____________

No, we do not collect any of this information

Do not know

What policies, procedures, and strategies does your organization use to increase data security and confidentiality? Choose all that apply.

Role-based access (Users have specific roles within a system to access certain information)

Sensitivity classification (Data is classified within a system based on the level of sensitivity, and impact if the data were to be made public)

Encryption (Data is not stored in a human readable format)

Data masking (Data is made more generic to protect individual privacy)

Other formal security and confidentiality processes

Security & confidentiality training

Regular security and privacy audits

Other (please specify) [optional]:____________________________

Do not know

What processes, procedures, and strategies do you think your organization should or could use to increase data security and confidentiality? Choose all that apply.

Role-based access

Sensitivity classification

Encryption
Data masking
Formal security and confidentiality processes
Security & confidentiality Training
Regular security and privacy audits
Other (please specify) [optional]:____________________________
Do not know

Does your organization have a process for de-identification of data? De-identification is the process used to prevent a person's identity from being connected with information.

Yes

Do not know

Does your organization have a process or technology for cleaning, editing, and assuring quality of data?

Yes

Do not know

[Optional] If yes, what is that process? ________________

Are you satisfied with the data standards (standard data fields, uniform data definitions, etc.) your organization is able to use for the information it collects from the populations served?

Yes

Do not know

Please choose the data standards your organization uses. (Choose one.)

No standards have been identified or are being used for our organization’s data collection.

Stakeholders are in the process of identifying appropriate standards for our organization’s data collection.

Standards are in place for some, but not all, data collection processes and/or are not fully understood or accepted by all stakeholders.

Information collection standards are in place for all data collection processes and are generally understood and accepted by all stakeholders.

Do not know

Would your organization use a free or low-cost technology platform to help you collect, manage, analyze, visualize, and report your human trafficking victim data?

Yes

Do not know

Demographics on the Populations You Serve

Are you satisfied with your organization’s capacity to collect data on client/program participant demographics^¹² and Personally Identifiable Information (PII)? PII refers to information that can be used on its own or with other information to identify, contact, or locate a single person, or to identify an individual in context. Please check a box next to any data you collect.

Yes

Do not know

Do not collect

Does your organization collect any data on client/program participant demographics^¹³ and Personally Identifiable Information (PII)?

Yes

Do not know

If yes, which of the following demographic data does your organization collect on the individuals it serves? (Select all that apply.)

City and State of Referral

City and State of Service

Dependent Children

Status in the child welfare system (foster care, etc.)

Educational Status

Employment/Vocational Status

Language

Living Situation

Permanent or Transitional Housing

Primary Language

Other (please specify) [Optional]:__________

Do not know

None

Which of the following PII does your organization capture on the individuals it serves? (Select all that apply.)

Address of Residence

Age

Alien Number

Date of Birth

Dental Health Issues

Disability Status

Gender Identity

Name

Nationality

Mental Health Issues

Passport or Visa Number

Physical Health Issues

Race and/or Ethnicity

Sexual Health Needs

Sexual Orientation

Social Security Number

State of Primary Residence

Other (please specify) [Optional]:__________

Do not know

None

Which of the following additional information does your organization capture on the individuals it serves?
(Select all that apply.)

Current Criminal Justice System Involvement

Current Systems Involvement

Public Benefits

Substance/Alcohol Abuse

Do not know

Human Trafficking Data

Are you satisfied with your organization’s capability to collect specific information related to human trafficking from the individuals you serve? Examples of this data is provided below. (Place your cursor over each category for a description of the category.)

Victim Identification Status
Primary type of trafficking (sex or labor or both)
Venue at which victim has been trafficked (currently or in the past)
Exploitation industry in which victim has been trafficked (currently or in the past)
Victim’s relationship to trafficker(s)
Polyvictimization in the last year

Yes

Do not know

Do not collect

Which of the following data does your organization capture on human trafficking victims? (Select all that apply. Place your cursor over the terms for a description.)

Victim Identification Status

Primary type of trafficking (sex or labor or both)

Venue at which victim has been trafficked (currently or in the past)

Exploitation industry in which victim has been trafficked (currently or in the past)

Victim’s relationship to trafficker(s)

Polyvictimization in the last year

Other (please specify) [Optional]:__________

Do not know

Services and Needs

Are you satisfied with your organization’s capability to collect data on clients’/program participants’ services and needs? Examples of services and needs data are provided below.

Direct services provided to individuals (by your organization)
Direct services requested by individuals (indicated by your organization)
Individual’s unmet needs
Reason services were not provided
Services referred out
Reasons that your organization chooses to refer clients/program participants to other organizations
Living situations experienced in the last year
Whether or not the individual has children and other family members who may require services

Yes

Do not know

Do not collect

Which of the following services and needs data does your organization capture on the individuals it serves? (Select all that apply.)

Direct services provided to individual (by your organization)

Direct services requested by individual (indicated by your organization)

Individual’s unmet needs

Reason services were not provided

Services referred out

Reasons for reporting organization to refer out

Living situations experienced in the last year

Whether or not the individual has living children who may require services

Other (please specify) [Optional]:__________

Organization Operating Budget and Costs

Are you satisfied with your organization’s capability to capture budget and costs?

Yes

Do not know

Do not collect

Which of the following data does your organization capture on its budget and costs? (Select all that apply.)

Organization

Total program or service budget

Total program or service costs

Total organization budget

Total organization costs

None

Do not know

Human Trafficking Victim Services

Annual costs related to human trafficking victims (total costs)

Annual costs related to human trafficking victims (total costs per service delivered)

None

Do not know

Data Storage

Are you satisfied with your organization’s capacity to store data?

Yes

Do not know

Do not store data

Does your organization have a database that stores information where it can be queried in a digital, machine-readable format (i.e., Excel, Access, SQL, XML, etc.) to enable analysis and reporting? (Select all that apply.)

Demographics

PII (Personally Identifiable Information)

Geographic Information

Human Trafficking Victim Data

Human Trafficking Risk Factors Data

Services Provided

Referrals Provided

Budget and Cost of Services Provided

Other (please specify) [Optional]:_____________

No, we do not collect any of this information

Do not know

Does your organization’s data collection system allow information to be exported to one or more of the following formats? (Select all that apply.)

Comma Separated Variables (CSV)
Microsoft Access

Microsoft Excel

Paper

PDF Fillable Forms

XML

System does not allow export

Other (Please specify) [Optional]:_________

Do not know

Data Sharing

Are you satisfied with your organization’s capability to share data with other relevant organizations?

Yes

Do not know

Do not share data

If HHS could provide automated reporting and also protect identity of individuals served, would your organization be willing and able to share information with HHS’ Office on Trafficking in Persons (OTIP) through technology (such as a web-based computer application)?

Yes

Do not know

If your organization is willing and able to share information with OTIP, which of the following categories of data would it share? (Select all that apply.)

	Aggregate Data	Individual Case Data
Demographics
PII (Personally Identifiable Information)
Geographic Information
Human Trafficking Victim Data
Human Trafficking Risk Factors Data
Services Provided
Referrals Provided
Budget and Cost of Services Provided
Other (please specify) [Optional]:
We do not collect any of this information
Do not know

Please indicate your organization’s current capacity to routinely share anonymized client/program participant data to any external organizations (e.g., grantors, state/local governments, other service providers, law enforcement, task forces, hospitals, clinics). (Please choose the option that best describes your organization.)

Some of the information collected is easily shareable with external stakeholders.

Most of the information collected is easily shareable with external stakeholders.

We are in the process of identifying shareable information.

No shareable information has been identified, OR we are not willing to share any information.

Do not know

Please indicate your organization’s current capacity and willingness to routinely share anonymized client/program participant data with OTIP (choose one):

Some of the information collected is easily shared with OTIP.

Most of the information collected is easily shared with OTIP.

We are in the process of identifying information that we could share with OTIP.

No shareable information has been identified, OR we are not willing to share any information.

Do not know

What do you use to facilitate data sharing among State and Local Public Health Departments, State Child Welfare Agencies, Federally Qualified Health Centers, Federally-Funded NGOs, Other NGOs, and State Attorneys General?

Referral protocols

MOUs (Memorandum of Understanding)

Jointly-funded initiatives

Other (please specify) [Optional]: _______

Are you aware of, or use, the following data collection/exchange frameworks? (Check all that apply.)

	Aware	Use
The National Information Exchange Model (NIEM)
The National Human Services Interoperability Architecture (NHSIA)
Health Level Seven (HL7) Standards
Other (Please Specify) [Optional]

Not aware of and do not use these

Are you aware of, or use, the following data collection/exchange systems? (Check all that apply.)

	Aware	Use
The National Child Abuse and Neglect Data System (NCANDS)
The Adoption and Foster Care Analysis and Reporting System (AFCARS)
Statewide Automated Child Welfare Information System (SACWIS
National Electronic Interstate Compact Enterprise (NEICE)
Runaway and Homeless Youth Management Information System/Homeless Management Information System (RHYMIS-HMIS)
National Youth in Transition Database (NYTD)
Trafficking Information Management System (TIMS)
Other (Please Specify) [Optional]

Not aware of and do not use these

Data Reporting and Analysis

Are you satisfied with your organization’s capability to report data to other relevant organizations?

Yes

Do not know

Do not share data

If you report data, is the data reported to any state, federal, or local agency, or non-governmental organization? How often? (Select all that apply.)

	Weekly	Monthly	Quarterly	Semi-Annually	Annually	As Requested
State Agency
Federal Agency
City Agency
County Agency
Nonprofit organization
Philanthropic organization
Other (Please specify) [Optional]:
Other (Please specify) [Optional]:

Please evaluate your organization’s available resources to continue its current data and reporting capabilities. Resources may include, but are not limited to, budget for staff (e.g., chief information officer, data manager, information technology), technical assistance and training needed to support data collection, and reporting within your organization. (Choose one.)

My organization does not have the resources (human or financial) to maintain its current data and reporting capabilities.

My organization has some resources available to maintain current data and reporting capabilities, but they are not dedicated solely for this task.

My organization has adequate resources available to maintain current data and reporting capabilities, but does not have the resources to improve the current system.

My organization has more than enough resources to maintain current data and reporting capabilities, and has the resources to implement a new system if it wished to.

Do not know

Please indicate your organization’s current capabilities to perform analysis related to data collected from individuals served. (Choose one.)

My organization does not perform any data analysis.

My organization performs basic analysis (e.g., frequencies, simple charts, etc.) on the data it collects.

My organization performs intermediate analysis (e.g., results by demographics, comparisons, etc.) on the data it collects.

My organization performs advanced analysis on the data it collects.

Do not know

What are future or existing plans for analysis and dissemination of organization-wide or statewide data? Please elaborate:_______________

Do not know

None

Organization Characteristics

What is your title/role within your organization?
Please specify: __________

How many paid employees are in your organization?
0-10

11-25

26-50

51-100

Over 100

I do not know

How many volunteers are in your organization?
0-10

11-25

26-50

51-100

Over 100

I do not know

How many service locations does your organization operate or manage, such as a clinic or intake center?

Please specify: __________
I do not know

How would you describe the geographic area that your organization serves? (Please choose all that apply.)

Urban

Suburban

Rural

Do not know

Please identify the types of services your organization directly provides in-house to the individuals it serves. (Select all that apply.)

Basic Necessities

Case Management Services

Child Care

Crisis Intervention

Educational Services

Emotional Support

Employment Services

Family Reunification Services

Financial Assistance

Housing Services

Language Services

Legal Services/Advocacy

Life Skills Support

Medical and/or Dental Services

Mental or Behavioral Health Services

Reproductive/Sexual Health Services

Safety Planning

Substance Abuse Services

Transportation

Other (please specify) [Optional]:__________

I do not know

Please select the following high-risk population(s) that your organization currently serves or has served in the past. Please note that these populations may not explicitly include human trafficking victims/survivors. (Select all that apply. Place your cursor over each category for a description of the category.)^¹⁴

	Adults	Minors (Under 18)
Disconnected, Isolated, or Displaced Populations
Runaway and Homeless Youth
Unaccompanied Children
Refugees
Migrant Workers
Other (Please specify) [Optional]
Underserved Populations
Racial/Ethnic Minorities
Native Americans
LGBTQ Individuals
Individuals with Disabilities
Other (Please specify) [Optional]
Experience of Abuse, Exploitation, and Neglect
Victims of Labor Trafficking
Victims of Sex Trafficking
Victims of Intimate Partner Violence and/or Sexual Assault
Victims of Child Abuse and Maltreatment
Currently Engaged in Child Welfare System
Formerly Engaged in Child Welfare System
Other (Please specify) [Optional]

I do not know

Please estimate your organization’s total yearly budget for programs providing direct services to all of its clients/program participants in the United States (do not include fundraising or overhead, etc.). (Please choose one.)
$100,000 or less

$100,001 - $250,000

$250,001-$500,000

$500,001 - $1,000,000

$1,000,001 - $2,500,000

$2,500,001 - $5,000,000

More than $5,000,000

Do not know

Please estimate your organization’s total yearly budget for programs providing direct services specifically to human trafficking victims (do not include fundraising or overhead, etc.).
None

$100,000 or less

$100,001 - $250,000

$250,001-$500,000

$500,001 - $1,000,000

$1,000,001 - $2,500,000

$2,500,001 - $5,000,000

More than $5,000,000

Do not know

Does your organization use and make referrals to a network of services for (1) at-risk populations and (2) victims and survivors of human trafficking?
Yes

Do not know

If yes, which referral sources does your organization use? (Check all that apply.)

Service Delivery System:

National hotline

State/local hotline

Hospital/ER/medical

Federally-qualified health centers

Law enforcement

Court

Legal services providers

District attorney/state’s attorney/victim assistance

Defense attorney/public defender/legal aid organizations

State attorneys general

State and local public health departments

State child welfare agencies

Child protective services

Homeless agency/shelter

Domestic violence agency/shelter

Other agency (specify type) [Optional]: ____________________

Does your organization receive referrals from a network of services for (1) at-risk populations and (2) victims and survivors of human trafficking?
Yes

Do not know

If yes, which referral sources send clients/program participants to you? (Check all that apply.)

Service Delivery System:

National hotline

State/local hotline

Hospital/ER/medical

Federally-qualified health centers

Law enforcement

Court

Legal services providers

District attorney/state’s attorney/victim assistance

Defense attorney/public defender/legal aid organizations

State attorneys general

State and local public health departments

State child welfare agencies

Child protective services

Homeless agency/shelter

Domestic violence agency/shelter

Other agency (specify type) [Optional]: ____________________

Informal Referral Sources:

Family member/guardian

Friend/peer/acquaintance

Self (following outreach)

Self (word of mouth/internet)

Other (specify type/relationship) [Optional]:______________________

Please select the statement below that best describes your organization’s level of collaboration with other organizations in your jurisdiction (city, county, state, etc.) to achieve common goals (choose one):
My organization does not work with other organizations in our service area.

My organization seldom works with other organizations in our service area.

My organization often works with other organizations in our service area but does not seek out new partnerships.

My organization frequently works with other organizations in our service area and seeks to create new partnerships.

Do not know

Do you currently have a process for sharing client/program participant information with other service organizations?

Yes

Do not know

If yes, which processes do you use?

Email (either through the body of the email or attaching documents)

Postal mail

Phone

Fax

Online database (please specify) [Optional]:______

Other (please specify) [Optional]:_________

Is your organization involved in an anti-trafficking task force, coalition, working group, etc., at the local, state, or regional level (i.e, organizations that work together to combat human trafficking)?
Yes

Do not know

Final Thoughts

Would a national human trafficking data collection system help your organization achieve its mission?

Yes

Do not know

If yes, how might you use it? Please check all that apply.

To connect to other organizations/resources

To adjust service delivery

To make recommendations for policymakers

To measure and report progress

To request increased funding

To encourage data sharing

Other (please specify) [Optional]:______________

What are the greatest challenges your organization would face in collecting and providing information to HHS? Please rank all challenges, with the greatest challenge as “1”. (Place your cursor over each category for a description of the category.)

Funding/Budget

Staffing

Data Sharing Restrictions

Reporting Processes

Data Accessibility

Data Privacy and Security

Other (please specify) [Optional]__________

Do not know

What information would you like to see included in the database? (Please specify.)

Human trafficking prevalence in certain areas

Services provided/available to human trafficking victims in certain areas

Organization list by service delivery type

Other (please specify) [Optional]:____________________

Please provide up to three recommendations for HHS to better coordinate with stakeholders to successfully create a national human trafficking information data collection system.

_________
_________
_________

Do not know

Would you be willing to have a follow-up discussion on your organization?

Yes

Would you be interested in participating in a workgroup to create a national human trafficking data collection and sharing system?

Yes

If so, please provide us with your name and email address:____________

Do you have any final thoughts to share? Is there anything this survey did not address?

Please elaborate:______________

Thank you. Your information will automatically be delivered to HHS Office on Trafficking in Persons. Please email [email protected] with any comments or questions.

APPENDIX: Human Trafficking Data Collection Terms

Term

Definition

Source

Adoption and Foster Care Analysis and Reporting System (AFCARS)

The Adoption and Foster Care Analysis and Reporting System (AFCARS) collects case-level information from state and tribal title IV-E agencies on all children in foster care and those who have been adopted with title IV-E agency involvement.

Examples of data reported in AFCARS include demographic information on the foster child as well as the foster and adoptive parents, the number of removal episodes a child has experienced, the number of placements in the current removal episode, and the current placement setting. Title IV-E agencies are required to submit the AFCARS data twice a year based on two 6-month reporting periods.

Children’s Bureau, Administration on Children and Families (ACF). AFCARS. Retrieved from https://www.acf.hhs.gov/cb/research-data-technology/reporting-systems/afcars

Alien Number

Also known as “alien registration number” or “’A’ number.” A unique seven-, eight- or nine-digit number assigned to a noncitizen at the time his or her A-file is created. The 9-digit U.S. Citizenship and Immigration Services number listed on the front of Permanent Resident Cards (Form I-551) issued after May 10, 2010, is the same as the Alien Registration Number. The A-number can also be found on the back of these Permanent Resident Cards.

U.S. Citizenship and Immigration Services. “Glossary.” Retrieved from https://www.uscis.gov/e-verify/customer-support/glossary

Annual Direct Costs

Staff/non-staff costs for:

Basic Necessities
Case Management Services
Educational Services
Housing Services
Language Services
Legal Services
Mental Health Services
Medical and/or Dental Services
Employment Services
Safety Planning Services

Bureau of Primary Care. Health Resources and Service Administration (HRSA) Bureau of Primary Health Uniform Data System Manual. Retrieved from http://bphc.hrsa.gov/datareporting/reporting/2015udsmanual.pdf

Annual Direct Costs Related to Human Trafficking Victims

Staff/non-staff costs for:

Basic Necessities
Case Management Services
Educational Services
Housing Services
Language Services
Legal Services
Mental Health Services
Medical and/or Dental Services
Employment Services
Safety Planning Services

At-risk

Includes those exposed or participating in activities that increase the risk of human trafficking. Such activities include prostitution, illegal immigration, organized crime, and domestic servitude.

Office on Trafficking in Persons (OTIP) in Partnership with Office on Women’s Health (OWH). “Human Trafficking Data Element Worksheet.”

Adapted from:

Alliance of Nurses for Healthy Environments. “Risk and Vulnerability.” Retrieved from http://envirn.org/pg/pages/view/1345/risk-and-vulnerability

Basic Necessities

Family Reunification
Personal Items (Includes material goods or support to obtain goods including food, clothing, toiletries, housing supplies)
Safety Planning
Transportation (Services provided to a client related to transportation to ensure clients have access to services and other activities. Includes but not limited to metro/subway passes, bus tickets, etc.)
Emergency Placement/Housing
Child Welfare Referral

HHS Administration for Children and Families (ACF). Services Available To Victims of Human Trafficking. Retrieved from http://www.acf.hhs.gov/sites/default/files/o

Office of Refugee Resettlement (OCR) and Administration for Children and Families (ACF). FACT SHEET: VICTIM ASSISTANCE (English). Retrieved from http://www.acf.hhs.gov/programs/orr/resource/fact-sheet-victim-assistance-english

Case Management Services

An encounter between a case management provider and a patient during which services are provided that assist victims in the management of their health and social needs, including patient needs assessments, advocacy, emotional support, the establishment of service plans, and the maintenance of referral, tracking, and follow-up systems. Interactions on behalf of a victim with third parties are not counted as case management encounters. Examples include, but are not limited to:

Explanation of Benefit Entitlements/Availability
Moving/Re-Location Assistance
Intensive Case Management
Child Welfare Case Management (Adoption, Pre-Adoption, Foster Care, Guardianship)
Juvenile Detention Re-Integration

Bureau of Primary Care. Health Resources and Service Administration (HRSA) Bureau of Primary Health Uniform Data System Manual. Retrieved from http://bphc.hrsa.gov/datareporting/reporting/2015udsmanual.pdf

Child Abuse

Physical or sexual abuse or neglect of a child, including human trafficking and the production of child pornography

42 U.S. Code § 13001a(5)

Child Care

Supervision of a client’s child by your organization or another organization or individual

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

City and State of Referral

City and state in which referring organization provided services

Census Bureau. Census Bureau Region and Division Codes, State, County, Minor Civil Division (MCD), and Incorporated Place Federal Information Processing System (FIPS) Codes. Retrieved from http://www.census.gov/popest/about/geo/codes.html

City and State of Service

City and state in which services were provided

Coercion

Threats of serious harm to or physical restraint against any person; any scheme, plan, or pattern intended to cause a person to believe that failure to perform an act would result in serious harm to or physical restraint against any person; OR the abuse or threatened abuse of law or the legal process.

The use of coercion may be used to determine T Visa eligibility and is included as part of the definition of a severe form of trafficking in persons in the TVPA.

22 USC 7102(3), 22 USC 7101:

“Chapter 78-Trafficking Victims Protection, Title 22-Foreign Relations and Intercourse.” Retrieved from http://uscode.house.gov/view.xhtml?req=22+USC+7102&f=treesort&fq=true&num=27&hl=true&edition=prelim&granuleId=USC-prelim-title22-section7102

Commercial Sex Act

Any sex act, on account of which anything of value is given to or received by any person.

22 USC 7102(4),

Chapter 78-Trafficking Victims Protection, Title 22-Foreign Relations and Intercourse. Retrieved from http://uscode.house.gov/view.xhtml?req=22+USC+7102&f=treesort&fq=true&num=27&hl=true&edition=prelim&granuleId=USC-prelim-title22-section7102

Crisis Intervention

Interventions and services provided to a client currently in crisis

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Current Criminal Justice System Involvement

Victim or witness in open case or pending juvenile or criminal charges. May include, but is not limited to, any of the following:

Crime victim in open case
Crime witness in open case
Pending juvenile justice charges
Pending criminal charges

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Administration on Children and Families. “Client Status at Intake.”

Current Systems Involvement

Involvement in any of the following systems:

All Clients:

Mental health
Domestic violence
Homeless program/shelter (adult)
Substance abuse treatment
Probation

Youth/Young Adult Clients Only:

Child welfare
Child welfare dependency
Is client a legal ward of court or child welfare agency?
Youth homeless program/shelter

Administration on Children and Families. “Client Status at Intake.”

De-Identification

The process of de-identification, by which identifiers are removed from the health information, mitigates privacy risks to individuals and thereby supports the secondary use of data for comparative effectiveness studies, policy assessment, life sciences research, and other endeavors.

Health and Human Services (HHS). Guidance Regarding Methods for De-identification of Protected Health Information in Accordance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. Retrieved from https://www.hhs.gov/hipaa/for-professionals/privacy/special-topics/de-identification/#rationale

Demographics

May include, but are not limited to:

Date of Birth
Age
Gender Identity
Sexual Orientation
Race and/or Ethnicity
Primary Language
Nationality
Disability Status
Highest Level of Completed Education
Permanent or Transitional Housing

U.S. Government Printing Office (GPO). AFCARS Proposed Definitions. Retrieved from https://www.gpo.gov/fdsys/pkg/FR-2015-02-09/pdf/2015-02354.pdf

Dental Health Issues

Urgent and non-urgent dental issues

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Dental Services

Dental Services: An encounter between a dentist or dental hygienist and a patient for the purpose of prevention, assessment, or treatment of a dental problem, including restoration.

Code on Dental Procedures (CDT) and Nomenclature. Retrieved from http://www.ada.org/en/publications/cdt/

Dependent Children

Number of children, ages, custody/living arrangement

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Direct Costs

"Direct" program costs can be specifically identified with delivery of a particular project, service, or activity undertaken by an organization to achieve an outcome. Direct program costs are incurred for the service delivery and management components within a particular program or project. Therefore, direct program costs include expenditures on some activities with administrative qualities, including salaries and benefits of program staff and managers, equipment, training, conferences, travel, and contracts that expressly relate to the delivery of an individual program or service funded by a specific grant source.

Office of Community Services (ACF HHS). “CSBG IM No. 37 Definition and Allowability of Direct and Administrative Cost Block Appropriation and Allocations.” Retrieved from https://www.acf.hhs.gov/ocs/resource/im-no-37-definition-and-allowability-of-direct-and-administrative-cost

Educational Services

Provision of services related to client education, including (but not limited to):

GED Preparation
Preventive Education
Life Skills Training (includes managing personal finances, self-care, mentorship, and programs that help clients achieve self-sufficiency)
School Enrollment
Financial Literacy
Health Education

Adapted from:

HHS OTIP Rescue and Restore Services Available to Victims of Human Trafficking: A Resource Guide for Social Service Providers. Retrieved from http://www.acf.hhs.gov/sites/default/files/orr/traffickingservices_0.pdf

NAS, Ellen Wright Clayton, Richard D. Krugman, and Patti Simon, Editors. “Committee on the Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States.” Retrieved from http://www.ojjdp.gov/pubs/243838.pdf

OVC TIMs Form and HHS Office of the Assistant Secretary for Planning and Evaluation. Study on HHS Programs Serving Victims of Human Trafficking.

Department of Justice (DOJ) (Caliber) Study, 2007, Evaluation of Comprehensive Services for Victims of Human Trafficking: Key Findings and Lessons Learned.

Educational Status

Includes: Current school enrollment (High school, GED program, postsecondary non-degree award program [e.g., vocational school], community college, college, graduate school), Special education needs, Highest education completed (less than high school, high school diploma or equivalent [e.g., GED], some college [no degree], postsecondary non-degree award [i.e., trade or vocational certification], associate's degree, bachelor's degree, master’s degree, doctoral or professional degree)

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Administration on Children and Families. “Client Status at Intake.”

Emotional Support

Emotional support and informal counseling provided to a client by organization staff or volunteers who are not mental health providers; Includes informal counseling and peer support

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Employment Services

Activities and services in regard to providing the client with assistance in finding employment.

Includes, but is not limited to: Employment assistance, vocational training, job placement, job skills training

Adapted from:

OVC TIMs Form and HHS Office of the Assistant Secretary for Planning and Evaluation. Study on HHS Programs Serving Victims of Human Trafficking.

Department of Justice (DOJ) (Caliber) Study, 2007, Evaluation of Comprehensive Services for Victims of Human Trafficking: Key Findings and Lessons Learned.

Employment Status

Current employment, type of work, usual hours per week; Job training/vocational program enrollment

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Exploitation Industry Victim Has Been Trafficked In

Agriculture / Field Labor
Assisted Living/Elder Care
Begging/panhandling/selling goods
Carnival
Child care
Commercial Cleaning
Commercial Food Production
Construction
Cosmetology / Beauty (e.g., massage parlors / nail salon, spa)
Domestic Servant
Drugs
Escort Service
Factory/Manufacturing
Forced Criminal Activity
Forestry / Fishing
Healthcare
Herding / Livestock
Hospitality (i.e. restaurants, hotels)
Landscaping
Manufacturing
Mining/Quarrying
Online Ad / Webchat
Petty Theft
Pornography
Religious Institution
Retail Sales
Sexualized Labor (i.e., Prostitution)
Sports
Stripping/Exotic Dancing
Transportation
Traveling Sales Crew

Adapted from:

Office for Victims of Crime (OVC) Trafficking Management Information System (TIMs) form and National Human Trafficking Resource Center. 2015 Human Trafficking Hotlines Data Released. Retrieved from https://polarisproject.org/news/press-releases/2015-human-trafficking-hotlines-data-released.

Department of Labor (DOL). “Lists of Goods Produced by Child Labor or Forced Labor. Retrieved from http://www.dol.gov/ilab/reports/pdf/TVPRA_Report2014.pdf

Family Reunification Services

Activities and services to support a client to reunify with his or her family members

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Financial Assistance

All types of money given to the client including phone and gift cards (excludes housing expenses covered in Housing Financial Assistance)

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Foreign National

A foreign national is anyone who is not a U.S. citizen; Lawful permanent resident (green card holder); or “Protected Person” (i.e., political asylum holder).

“Title 8 – Aliens and Nationality.” 8 U.S.C. 1324b(a)(3). Retrieved from https://www.gpo.gov/fdsys/pkg/USCODE-2010-title8/pdf/USCODE-2010-title8-chap12-subchapII-partVIII-sec1324b.pdf

Foreign Victims of Human Trafficking

Victims of human trafficking who are not U.S. citizens or lawful permanent residents (green card holders)

Office on Trafficking in Persons (OTIP) in Partnership with Office on Women’s Health (OWH). “Human Trafficking Data Element Worksheet.”

Gender Identity

Male
Female
Transgender Female to Male (FTM)
Transgender Male to Female (MTF)
Transgender General (Includes two-spirit, Transsexual, Cross-dresser)
Genderqueer/ Gender Non-conforming (Includes gender-variant children)
Intersex/Non-binary gender

National Institutes of Health. “Developing and Implementing Questions for Collecting Data on Sexual Orientation and Gender Identity.” Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25162618

Geographic Information

City and State of Service
City and State of Referral
State of Primary Residence
Home Address

Office on Trafficking in Persons (OTIP) in Partnership with Office on Women’s Health (OWH). “Human Trafficking Data Element Worksheet.”

Housing Services

Housing Financial Assistance (includes expenditures for client’s rent, shelter stay, hotel/motel stay, or other housing expenses)
Housing Advocacy (Includes assistance to locate and place client in housing)
Short-term, Medium Term or Long-Term Housing
Emergency and Transitional Housing
Assisted Living

Adapted from:

OVC TIMs Form and HHS Office of the Assistant Secretary for Planning and Evaluation. Study on HHS Programs Serving Victims of Human Trafficking.

Department of Justice (DOJ) (Caliber) Study, 2007, Evaluation of Comprehensive Services for Victims of Human Trafficking: Key Findings and Lessons Learned.

Human Trafficking

The Trafficking Victims Protection Act defines human trafficking (22 USC 7012) as:

Sex trafficking: The recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act which is induced by force, fraud, or coercion. Any child under the age of 18 who has been subjected to a commercial sex act is a victim of trafficking regardless of force, fraud, or coercion.
Labor trafficking: The recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.

In simple terms: Human trafficking is modern-day slavery and involves the use of force, fraud, or coercion to obtain some type of labor or commercial sex act.

Trafficking Victims Protection Act (22 USC 7102)

Indirect Costs

Also known as “administrative costs.” As distinguished from program administration or management expenditures that qualify as direct program costs, administrative costs refer to central executive functions that do not directly support a specific project or service. Rather, these costs are incurred for common objectives that benefit multiple programs administered by the organization and are not readily assignable to a particular program funding stream. Indirect or administrative costs relate to the general management of the organization, such as strategic direction, Board development, Executive Director functions, accounting, budgeting, personnel, procurement, and legal services.

Individuals with Disabilities

Unable to engage in any substantial gainful activity (SGA) because of a medically-determinable physical or mental impairment(s): that is expected to result in death, or that has lasted or is expected to last for a continuous period of at least 12 months.

U.S. Census Bureau. “Disability - American Community Survey (l) - People and Households.” Retrieved from http://www.census.gov/people/disability/methodology/acs.html

Informed Consent

The informed consent process involves three key features: (1) disclosing to potential research subjects information needed to make an informed decision; (2) facilitating the understanding of what has been disclosed; and (3) promoting the voluntariness of the decision about whether or not to participate in the research.

Health and Human Services (HHS). Informed Consent FAQs. Retrieved from https://www.hhs.gov/ohrp/regulations-and-policy/guidance/faq/informed-consent/

Interoperable

Interoperability describes the extent to which systems and devices can exchange data, and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user.

Healthcare Information and Management Systems Society. “What is Interoperability?” Retrieved from http://www.himss.org/library/interoperability-standards/what-is-interoperability

Intimate Partner Violence

Intimate Partner Violence—Overall Definition

Intimate partner violence includes physical violence, sexual violence, stalking and psychological aggression

(including coercive tactics) by a current or former intimate partner (i.e., spouse, boyfriend/girlfriend, dating partner, or ongoing sexual partner).

Intimate Partner: An intimate partner is a person with whom one has a close personal relationship that may be characterized by the partners’ emotional connectedness, regular contact, ongoing physical contact and sexual behavior, identity as a couple, and familiarity and knowledge about each other’s lives. The relationship need not involve all of these dimensions.

Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control, Division of Violence Prevention. Intimate Partner Violence Surveillance Uniform Definitions and Recommended Data Elements. Retrieved from https://www.cdc.gov/violenceprevention/pdf/intimatepartnerviolence.pdf

Involuntary Servitude

A condition of servitude induced by means of—

Any scheme, plan, or pattern intended to cause a person to believe that, if the person did not enter into or continue in such condition, that person or another person would suffer serious harm or physical restraint; or
The abuse or threatened abuse of the legal process.

Trafficking Victims Protection Act (22 USC 7102).

Labor Trafficking

The recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.

Trafficking Victims Protection Act (22 USC 7102).

Language

Primary language; Assistance needed with English

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Status Items on Client Status at Intake Form.”

Language Services

Interpretation and/or Translation Services for the following, to assess service needs and/or provide services to a client:

Limited English Proficiency (LEP) Clients
Monolingual (Non-English) Speakers
Blind, Deaf, Hard-of Hearing

Classes for English Language Learner (ELL)

Adapted from:

OVC TIMs Form and HHS Office of the Assistant Secretary for Planning and Evaluation. Study on HHS Programs Serving Victims of Human Trafficking.

Department of Justice (DOJ) (Caliber) Study, 2007, Evaluation of Comprehensive Services for Victims of Human Trafficking: Key Findings and Lessons Learned.

Lawful Permanent Resident

A foreign national in the United States who is residing under legally recognized and lawfully recorded permanent residence as an immigrant. Also known as a "Permanent Resident Alien," "Resident Alien Permit Holder," and "Green Card Holder."

Department of Homeland Security (DHS). Lawful Permanent Residents. Retrieved from https://www.dhs.gov/immigration-statistics/lawful-permanent-residents

Legal Services

Services provided to address legal needs, including information from or representation by civil attorneys and prosecutors. Categories include:

Legal Aid/Pro Bono Services
Criminal Justice Support/Advocacy
Law Enforcement Advocacy
Legal Assistance/Advocacy
Civil Legal Advocacy
Immigration Advocacy/Assistance
Victim Advocacy (Information and support provided to help client understand and exercise his or her rights as a victim of crime within the criminal justice process. Includes Vacating Convictions, crime victims’ rights and services, & Explanation of Legal Rights and Protections)

Adapted from:

NAS, Ellen Wright Clayton, Richard D. Krugman, and Patti Simon, Editors. Committee on the Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States. Retrieved from http://www.ojjdp.gov/pubs/243838.pdf

OVC TIMs Form and HHS Office of the Assistant Secretary for Planning and Evaluation. Study on HHS Programs Serving Victims of Human Trafficking.

Department of Justice (DOJ) (Caliber) Study, 2007, Evaluation of Comprehensive Services for Victims of Human Trafficking: Key Findings and Lessons Learned.

LGBTQ Individuals

Lesbian, Gay, Bisexual, Transgender, and/or Queer

National Institutes of Health (NIH). AIDS Info Glossary. Retrieved from https://aidsinfo.nih.gov/education-materials/glossary/3314/lgbtq.

Life Skills Support

Services to help clients achieve self-sufficiency; Includes but not limited to managing personal finances, self-care

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Living Situation

Client’s living situation in the past 30 days

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Medical Services

Medical Services: Services provided related to client’s medical health. This may include:

Substance Abuse
Alternative Health Therapies (Includes Acupuncture, Yoga)
OB-GYN
Pediatric Health
Sexual Heath
Sexual/Reproductive Health Education*
Primary Care
Forensic Medical Screening
Vision

Adapted from:

OVC TIMs Form and HHS Office of the Assistant Secretary for Planning and Evaluation. Study on HHS Programs Serving Victims of Human Trafficking.

Department of Justice (DOJ) (Caliber) Study, 2007, Evaluation of Comprehensive Services for Victims of Human Trafficking: Key Findings and Lessons Learned.

Mental Health Issues

Urgent and non-urgent mental health issues

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Mental or Behavioral Health Services

Services provided by a licensed mental health provider; Includes assessment and treatment. May include:

Supportive Counseling
Peer Support
Clinical Counseling
Therapy

Adapted from:

OVC TIMs Form and HHS Office of the Assistant Secretary for Planning and Evaluation. Study on HHS Programs Serving Victims of Human Trafficking.

Migrant Workers

A migrant agricultural worker is employed in agricultural employment of a seasonal or other temporary nature, and is required to be absent overnight from his permanent place of residence.

Department of Labor (DOL). Wage and Hour Division. Retrieved from https://www.dol.gov/whd/regs/compliance/whdfs77c.htm

National Child Abuse and Neglect Data System (NCANDS)

The National Child Abuse and Neglect Data System (NCANDS) is a voluntary data collection system that gathers information from all 50 states, the District of Columbia, and Puerto Rico about reports of child abuse and neglect.

NCANDS was established in response to the Child Abuse Prevention and Treatment Act of 1988. The data are used to examine trends in child abuse and neglect across the country, and key findings are published in HHS’ Children’s Bureau Child Welfare Outcomes Reports to Congress and annual Child Maltreatment reports.

Children’s Bureau, Administration on Children and Families (ACF). NCANDS. Retrieved from https://www.acf.hhs.gov/cb/research-data-technology/reporting-systems/ncands

National Electronic Interstate Compact Enterprise (NEICE)

The National Electronic Interstate Compact Enterprise is a cloud-based electronic system for exchanging the data and documents needed to place children across state lines as outlined by the Interstate Compact on the Placement of Children (ICPC). Launched in November 2013 as a pilot project with six states, NEICE significantly shortened the time it takes to place children across state lines, and saved participating states thousands of dollars in mailing and copying costs.

American Public Human Services Association (APHSA) and Administrators of the Interstate Compact on the Placement of Children (AAICPC). National Electronic Interstate Compact Enterprise. Retrieved from http://www.aphsa.org/content/AAICPC/en/actions/NEICE.html

National Human Services Interoperability Architecture (NHSIA)

The National Human Services Interoperability Architecture (NHSIA) proposes a framework to facilitate information sharing, improve service delivery, prevent fraud, and provide better outcomes for children and families. NHSIA offers a foundation for common understanding, interoperability, standards, and reuse.

Children’s Bureau, Administration on Children and Families (ACF). National Human Services Interoperability Architecture (NHSIA) Definition. Retrieved from https://www.acf.hhs.gov/nhsia-definition

Native Americans

“American Indian or Alaska Native” refers to a person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment

Census Bureau. The American Indian and Alaska Native Population. Retrieved from http://www.census.gov/prod/cen2010/briefs/c2010br-10.pdf.

Number of Sexual Partners (Excessive)

Five or more sexual partners in the last twelve months

Centers for Disease Control and Prevention (CDC). Key Statistics from the National Survey of Family Growth. Retrieved from https://www.cdc.gov/nchs/nsfg/key_statistics/n.htm

Personally Identifiable Information

Personally Identifiable Information (PII) is information which can be used to distinguish or trace an individual's identity, such as their name, social security number, biometric records, etc. alone, or when combined with other personal or identifying information which is linked or linkable to a specific individual, such as date and place of birth, mother’s maiden name, etc.

U.S. General Services Administration (GSA). Rules and Policies - Protecting PII - Privacy Act. Retrieved from https://www.gsa.gov/portal/content/104256

Physical Health Issues

Urgent and non-urgent medical issues

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Polyvictimization

Polyvictimization can be defined as having experienced multiple victimizations of different kinds, such as sexual abuse, physical abuse, bullying, and exposure to family violence. This definition emphasizes different kinds of victimization, rather than just multiple episodes of the same kind of victimization, because this appears to signal a more generalized vulnerability.

Office of Juvenile Justice and Delinquency Prevention (OJJDP) and Centers for Disease Control and Prevention (CDC). National Survey of Children’s Exposure to Violence, Polyvictimization: Children’s Exposure to Multiple Types of Violence, Crime, and Abuse. Retrieved from https://www.ncjrs.gov/pdffiles1/ojjdp/227744.pdf

Primary Type of Trafficking

Sex
Labor
Both Sex & Labor
Unknown

Office on Trafficking in Persons (OTIP) in Partnership with Office on Women’s Health (OWH). “Human Trafficking Data Element Worksheet.”

Public Benefits

Benefits for which client is enrolled. May include (but is not limited to):

Food stamps
General assistance
Temporary Assistance for Needy Families (TANF)
Women, Infants, and Children (WIC) for client’s children
Child care subsidy for client’s children
Social security disability
Medicare
State-specific health benefits

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Administration on Children and Families. “Client Status at Intake.”

Racial/Ethnic Minorities

American Indian or Alaskan Native
Asian or Pacific Islander
Black
Hispanic origin
Multiracial
White
Other Race or Ethnicity

U.S. Census Bureau. 2010 Census Interactive Form. Retrieved from http://www.census.gov/2010census/about/interactive-form.php

Refugees

Under United States law, a refugee is someone who:

Is located outside of the United States
Is of special humanitarian concern to the United States
Demonstrates that they were persecuted or fear persecution due to race, religion, nationality, political opinion, or membership in a particular social group
Is not firmly resettled in another country
Is admissible to the United States

A refugee does not include anyone who ordered, incited, assisted, or otherwise participated in the persecution of any person on account of race, religion, nationality, membership in a particular social group, or political opinion.

Department of Homeland Security (DHS). Refugees. Retrieved from https://www.uscis.gov/humanitarian/refugees-asylum/refugees

Reproductive/

Sexual Health Services

Services provided related to client’s reproductive and/or sexual health; Includes but is not limited to HIV testing, STI screening and treatment, pregnancy testing, prenatal services

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Runaway Youth

Runaway youth: Youth who have left home without parental/caregiver permission and stay away for one or more nights. A runaway episode has been defined as being away from home overnight for youth under 14 (or older and mentally incompetent) and for two or more nights for youth 15 and older. Research suggests that the experience of youth running away from home is often episodic rather than chronic with youth running away for short periods of time and returning home, in some cases multiple times.

Youth.Gov. Federal Definitions. Retrieved from http://youth.gov/youth-topics/runaway-and-homeless-youth/federal-definitions

Safety Planning

Services provided and activities surrounding client protection and safety planning.

A safety plan is a personalized, practical plan that can help a person avoid dangerous situations and know the best way to react when s/he is in danger (i.e., physical violence or emotional abuse). This plan includes ways to remain safe while in a relationship, planning to leave, or after s/he leaves. Safety planning involves how to cope with emotions, tell friends and family about the abuse, take legal action, etc. Safety planning can occur with victims, friends and family members — anyone who is concerned about their own safety or the safety of another.

National Domestic Violence Hotline. What is Safety Planning? Retrieved from http://www.thehotline.org/2013/04/what-is-safety-planning/

Sex Trafficking

The recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act which is induced by force, fraud, or coercion. Any child under the age of 18 who has been subjected to a commercial sex act is a victim of trafficking regardless of force, fraud, or coercion.

Trafficking Victims Protection Act (22 USC 7102)

Sexual Assault

Sexual assault is any type of sexual contact or behavior that occurs without the explicit consent of the recipient. Falling under the definition of sexual assault are sexual activities as forced sexual intercourse, forcible sodomy, child molestation, incest, fondling, and attempted rape.

Department of Justice (DOJ). Sexual Assault. Retrieved from https://www.justice.gov/ovw/sexual-assault

Sexual Health Needs

Reproductive/sexual health issues

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Sexual Orientation

Straight
Lesbian or gay
Bisexual

National Institutes of Health. “Developing and Implementing Questions for Collecting Data on Sexual Orientation and Gender Identity.” Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25162618

State of Primary Residence

State of residence, as of time of service.

Statewide Automated Child Welfare Information System (SACWIS)

States are encouraged to create statewide automated child welfare information systems (SACWIS) to establish electronic case files that include data to be reported in compliance with the requirements of the Adoption and Foster Care Analysis Reporting System (AFCARS).

Health and Human Services (HHS), Child Welfare Information Gateway. SACWIS Reviews.

Retrieved from https://www.childwelfare.gov/topics/management/practice-improvement/reviews/external/federal-monitoring/sacwis/

Substance Abuse Services

Services related to treatment of substance and/or alcohol abuse;

Includes assessment and treatment

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Substance/
Alcohol Abuse

Alcohol or substance abuse problems

Administration on Children and Families. “Evaluation of Domestic Human Trafficking Demonstration Projects, Service Categories on Program-Collected Data Forms.”

Task Force

Human Trafficking Task Force (or Multi-Disciplinary Anti-Human Trafficking Task Force): A grouping of individuals and organizational resources that provide leadership, direction, and support for collaborative efforts among law enforcement and diverse victim service providers in order to respond effectively to human trafficking. Task force members may include, but are not limited to those listed below:

State/local/tribal law enforcement (police, sheriffs, etc.);
Non-governmental victim service organizations (social or legal service providers), who serve victims of trafficking;
U.S. Attorney’s Office (the designated Assistant U.S. Attorney);
Federal law enforcement agencies (Homeland Security Investigations and Federal Bureau of Investigation);
State Attorney General’s Office;
State, district and/or Tribal prosecutor’s office;
Additional victim service organizations, nongovernmental organizations, legal services providers and social service agencies including those with expertise in serving immigrants and refugees, runaway and homeless youth, American Indians/Alaska Natives and the LGBTQ community
Federal, state, and local regulatory agencies (Bureau of Alcohol, Tobacco, Firearms and Explosives, Internal Revenue Service, state licensing departments and regulating bodies, etc.);
Federal or state civil labor enforcement agencies (Department of Labor, Equal Employment Opportunities Commission, etc.); and
Other critical partners, as identified by the applicants (including criminal justice system victim/witness coordinators/specialists on local, state, tribal and federal levels, state monitor advocates, legal services organizations, faith-based organizations, child welfare agencies, juvenile justice systems, etc.).

Office on Trafficking in Persons (OTIP). “Federal Human Trafficking Terms.” February 2016.

The National Information Exchange Model (NIEM)

The National Information Exchange Model (NIEM) is a common vocabulary that enables efficient information exchange across diverse public and private organizations. NIEM connects communities of people who share a common need to exchange information in order to advance their mission.

National Information Exchange Model. About NIEM. Retrieved from https://www.niem.gov/about-niem

Total Number of Human Trafficking Clients and Direct Services Staff

Total full time employees (FTE), total human trafficking direct service FTE, total clients, total estimated human trafficking clients

Office on Trafficking in Persons (OTIP) in Partnership with Office on Women’s Health (OWH). “Human Trafficking Data Element Worksheet.”

Trafficking Information Management System (TIMS)

The Trafficking Information Management System (TIMS) is designed to assist Office for Victims of Crime Trafficking Service Grantees in gathering, recording, analyzing, and reporting data. This tool can serve as a central repository of information related to all activities under the OVC human trafficking grant initiative and enables OVC grantees to organize, standardize, and centralize data collection efforts on a wide variety of core performance measures.

Office of Justice Systems, Office for Victims of Crime. Trafficking Information Management System. Retrieved from https://tims.ovcttac.gov/Default.aspx?ReturnUrl=%2f

Unaccompanied Alien Child

An unaccompanied alien child (UAC) is one who has no lawful immigration status in the United States; has not attained 18 years of age, and with respect to whom; 1) there is no parent or legal guardian in the United States; or 2) no parent of legal guardian in the United States is available to provide care and physical custody.

Office of Refugee Resettlement (ORR). Who We Serve. Retrieved from https://www.acf.hhs.gov/orr/resource/who-we-serve-unaccompained-alien-children

US Citizens

U.S. citizens are:

Any individual born in the United States, Puerto Rico, Guam, the Commonwealth of the Northern Mariana Islands, the U.S. Virgin Islands, American Samoa, or Swain’s Island; or foreign-born children under age 18 residing in the U.S. with their birth or adoptive parents, at least one of whom is a U.S. citizen by birth or naturalization; or individuals granted citizenship status by the Department of Homeland Security.

7 CFR 273.4(a)(1), 18 USC 1015(e), 62 Federal Register (FR) 61345+

Venue Victim Has Been Trafficked At

Agriculture-related venues:

Farm/Ranch
Boat/ Ocean/Lake/ Fishery

Bar/Cantina/Restaurant
Beauty Salon/ Spa
Bus Station/Truck Stop
Carnival
Casino
Child Care Facility
Construction Site
Dance/Strip Clubs
Educational Setting
Escort/Delivery Service
Factory
Hotel/Motel-Based
Mine/Quarry
Massage Parlor
Internet / Pornography
Juvenile detention facility, jail, prison
Natural Disaster
Residence:
- Residential Brothel
- Diplomatic Residence
- Non-relative Home
- Foster Home
- Residential Placement/ Congregate Care
- Residential group home
- Relative’s Home
Retail Sales
Shelter
Street-Based (e.g., travelling sales crews, forced peddling or begging ring)
Webchat

Adapted from:

Victim Identification Status

If identified, identified by:

Self (Statement of victim)
Family or Friend
Law Enforcement:

Federal (ICE/HIS, FBI, DoS/Diplomatic Service)
State
Police/sheriff (local)
State Attorney General
Prosecutor – Federal
Prosecutor – County
Prosecutor – State
Tribal

Service Provider:
- Rape Crisis
- Domestic Violence Shelter
- Human Trafficking Organization
- Homeless Shelter
- Youth Service Provider
- Legal Services
- Mental Health Clinic
- Safety Net Provider (e.g., free clinic, federally qualified health center, rural health clinic, lookalike, disproportionate share hospital, nurse managed clinic, HIV/AIDS clinic)
- Public Health Clinic or Department
- Free standing family planning clinic
- Hospital
  - Emergency department (ED)
- IHS Hospitals and Clinics
Child Welfare:
- Child Protective Service agency (CPS)
- Foster Home
- Adoption Program

Educator/Teacher/School
Employer

Prospective Victim:

Victim located in area suspected for human trafficking
Call to National or local hotline seeking help for victim
Previously served for Human Trafficking
Direct contact by service provider, but without status

Louisiana Department of Children and Family Services (DCFS). Relative to Human Trafficking, Trafficking of Children for Sexual Purposes, and Commercial Sexual Exploitation Report, (February 2016).

Victim’s Relationship to Traffickers

Current or former spouse
Current or former intimate partner
Employer
Family member or relative
Family Friend
Friend
Guardian
Acquaintance/Person briefly known
Recruiter
Gang Member
Spiritual Advisor

Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control. Sexual Violence Surveillance: Uniform Definitions and Recommended Data Elements. Retrieved from https://www.cdc.gov/violenceprevention/pdf/sv_surveillance_definitionsl-2009-a.pdf

Victims of Human Trafficking (Domestic)

Victims of human trafficking who are U.S. citizens or lawful permanent residents (green card holders)

Office on Trafficking in Persons (OTIP) in Partnership with Office on Women’s Health (OWH). “Human Trafficking Data Element Worksheet.”

1 This survey is a paper format of the content for an electronic survey. Once this content is approved, the survey will be programmed for testing before distribution to stakeholders.

2 All highlighted terms will have a hover-over definition (as defined in the Appendix) in the electronic survey.

3 The Trafficking Victims Protection Act of 2000 and its reauthorizations, and the Preventing Sex Trafficking and Strengthening Families Act of 2014 authorize HHS to collect data on human trafficking, evaluate the impact of anti-trafficking programs, and carry out other research on human trafficking (22 USC 7103, 22 USC 7109(a), 42 USC 679).

4 National Human Trafficking Hotline. “Recognizing the Signs.” Retrieved from https://humantraffickinghotline.org/what-human-trafficking/recognizing-signs

5 Office on Trafficking in Persons (HHS). “Fact Sheet: Identifying Victims of Human Trafficking.” Retrieved from https://www.acf.hhs.gov/otip/resource/fact-sheet-identifying-victims-of-human-trafficking

6 Administration for Children, Youth and Families (HHS). “Guidance to States and Services on Addressing Human Trafficking of Children and Youth in the United States.” Retrieved from https://library.childwelfare.gov/cwig/ws/library/docs/gateway/Blob/88109.pdf?w=NATIVE%28%27SIMPLE_SRCH+ph+is+%27%27Guidance+to+States+and+Services+on+Addressing+Human+Trafficking+of+Children+and+Youth+in+the+United+States.%27%27%27%29&upp=0&rpp=25&order=native%28%27year%2FDescend%27%29&r=1&m=1

7Centers for Disease Control and Prevention (CDC). “About the CDC-Kaiser ACE Study: Data and Statistics, ACES Definitions.” Retrieved from https://www.cdc.gov/violenceprevention/acestudy/about.html.

8 Children’s Bureau, Administration for Children, Youth and Families (HHS). “Child Welfare and Human Trafficking.” Retrieved from https://www.childwelfare.gov/pubPDFs/trafficking.pdf

9Centers for Disease Control and Prevention (CDC). “YRBSS Questionnaires.” Retrieved from https://www.cdc.gov/healthyyouth/data/yrbs/questionnaires.htm

10Centers for Disease Control and Prevention (CDC). “YRBSS Questionnaires.” Retrieved from https://www.cdc.gov/healthyyouth/data/yrbs/questionnaires.htm

11Centers for Disease Control and Prevention (CDC). “YRBSS Questionnaires.” Retrieved from https://www.cdc.gov/healthyyouth/data/yrbs/questionnaires.htm

12 U.S. Department of Labor. “Guidance on the Protection of Personal Identifiable Information.” https://www.dol.gov/general/ppii

13 U.S. Department of Labor. “Guidance on the Protection of Personal Identifiable Information.” https://www.dol.gov/general/ppii

14 SOAR: Stop, Observe, Ask, Respond to Human Trafficking. “A Training for Health Care and Social Service Providers.” 23 Aug. 2016.

File Type	application/msword
Author	Brown, Nakia
Last Modified By	Sarah Wineland
File Modified	2017-04-19
File Created	2017-04-18

Form 1 OTIP DCP Survey Questionnaire

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

Attachment A_OTIP DCP Survey Questionnaire_FINAL

Human Trafficking Data Collection Pilot

OMB: 0970-0401

Contents

Survey Introduction

Consent

Survey Questionnaire

Human Trafficking Indicators in the Populations You Serve

Your Organization’s Data Collection

Protecting Client/Program Participant Information

Demographics on the Populations You Serve

Human Trafficking Data

Services and Needs

Organization Operating Budget and Costs

Data Storage

Data Sharing

Data Reporting and Analysis

Organization Characteristics

Final Thoughts

APPENDIX: Human Trafficking Data Collection Terms