Happy New Year!

explosion-firework-pixelI do realize that January is almost over, so I’m a little late on the New Year’s Day greetings.  The month has passed by in a blur of snow and ice and busyness, and it doesn’t look like things are going to slow down any time soon.

The Commission had a productive 2016.  We welcomed our new leadership team last January, and we spent the spring reorganizing and pointing ourselves in a new strategic direction.  We will speak out on many topics as they come up, but our main focus is going to be on human trafficking issues, women’s health issues, and early literacy issues.

On the human trafficking front, we continued our partnership with the Criminal Justice Coordinating Council Statewide Human Trafficking Task Force.  Commissioner Julianna McConnell and I represent the GCW on the task force in different work groups, and we were both part of successful projects there.  The GCW assisted Public Service Commissioner Tim Echols with three Unholy Tours, two in Atlanta and one in Savannah.  These tours are educational opportunities for legislators and local leaders to see firsthand the neighborhoods that have the most human trafficking problems.  As we do every year, we participated in the Anti-Sex Trafficking Lobby Day sponsored by Street Grace, Georgia Cares, and others.

The most exciting news on the human trafficking issue in 2016 was the passing of Amendment 2, the Safe Harbor Law in November by Georgia voters.  The measure passed with an almost unheard of 83 percent of the votes.  This is a huge victory for human trafficking survivors and will ensure that victims across the state will receive the restorative services that they need.

In Health news, we continued our focus on osteoporosis education and had the pleasure of working with the Department of Public Health at their annual Falls Prevention Day event.  Commissioners Sharon Baker and Martha Long provided bone density screenings for event participants.  We are also continuing to keep an eye on Georgia’s rural healthcare crisis.

We are excited to announce that in September, Commissioner Sharon Baker was awarded the Hologic Inspiration in Women’s Health Award for Education at the Nurse Practitioners in Women’s Health Conference in New Orleans.  Congratulations to Commissioner Baker!  The award is well deserved.

As we turn the page to 2017, we have a new partnership and program to tell you about.  We will be working with the Department of Public Health on their “Talk With Me Baby” program, an early literacy initiative that has seen success in WIC clinics across the state.  The Colquitt County Family Connection Collaborative along with DPH launched the first “Talk With Me Baby” community-wide program.  We will be assisting DPH in their efforts to expand their program beyond community WIC clinics to all caregivers for infants and young children.  Commissioner Susan Whiddon will lead this project on our end.

We have some events coming up that you will want to know about.  February 28, 2017 will be the next Anti-Sex Trafficking Day at the Capitol.  You will want to join us for that.  Registration is free, but there is a small fee if you want to stay for lunch.  You’ll need to sign up for that ahead of time.  March 8, 2017 we will celebrate International Women’s Day, as we do every year.  Plans are still in the works, so check back with our events page for more information.

All of the commissioners at the Georgia Commission on Women wish you and your families a happy and healthy 2017.

 

Karla Jacobs is the chair of the Georgia Commission on Women and a member of the CJCC Human Trafficking Task Force.  She lives in Marietta with her husband, two kids, a dog, and some fish.

 

End Slavery Georgia Fills a Vital Need For Northwest Georgia

End Slavery Georgia's True Love Heals Luncheon

End Slavery Georgia’s True Love Heals Luncheon

One of my favorite books of 2016 was The Fractured Republic:  Renewing America’s Social Contract in the Age of Individualism by Yuval Levin.  I told everyone I know about the book—my grown nieces and nephews, my Facebook friends, people at church—and I think a few actually picked it up to read.  Levin really connects to where we are now in our diversifying society, and he speaks about this era we live in where many people have lost that connection to organizations in our communities that once gave us a shared sense of purpose.

Levin makes the case that our society has become so fractured and so focused on the individual that comprehensive top-down solutions from the federal government are no longer effective in solving the complicated and diverse problems we find in our local communities.  Real change and real solutions are going to come from the bottom up, solved by local people in the communities themselves.  I think he is on to something.

Community problems do not come any more complicated than those created by human trafficking.  The damage and destruction to the lives of women who are sold for sex cannot be overstated.  They endure addictions, unimaginable physical and mental abuse, and medical issues that must be addressed before they can be restored to health.  Poverty, addiction, and past traumas create a cycle that makes it difficult for victims to escape the hold of their traffickers.

While federal and state governments play a vital role in ensuring policies are in place to aid victims and punish traffickers, the job of helping victims recover falls to state and local communities and NGOs to provide care.  Levin’s model of local involvement in problem solving provides a framework for addressing the unique needs of each community.

Local communities hold the keys to addressing big problems like human trafficking, and End Slavery Georgia’s compelling story is a case study in why this is true.  Douglas Crumbley, Pastor of Journey Church in Rome, Georgia, tells the story of how the human trafficking issue became very personal to him and inspired him to reach out to other leaders in Rome to create the End Slavery Georgia organization.

A few years ago, a women’s Bible study group was meeting at Journey Church one evening, and the members noticed a young woman hanging out in the church parking lot.  A couple of ladies went outside to check on her, and she told them she had not had anything to eat and was hungry.  They fed her, and once she had eaten, she asked if she could spend the night in the church parking lot because she felt safe there.

As the young woman’s story unfolded, they learned that she had escaped human traffickers in Dekalb County when a john left the usually locked door to her room open.  She made her way to Rome and Journey Church.  Doug’s daughter took the young woman into her home for many months, and he was able to see up close what the road to recovery looked like for this young trafficking victim.

Doug felt the call to find a way to help more young women, like the one who landed on the church doorstep, find their way back to health.  He reached out to local business leader, Thom Holt, for advice on the business side of starting a non-profit.  After initially being reluctant to jump into a field he had no experience in, Thom finally came onboard, and the two began to build End Slavery Georgia from the ground up.

The learning curve has been steep and long—Thom told me they are working 15 hour days—but they have energized their community around the idea of being a bright spot of hope for trafficking victims in Northwest Georgia.  On Wednesday, December 7, 2016 they hosted a packed house at a fundraising luncheon.  They are looking to raise $400,000 to build a residential treatment facility in Rome.  Residential facilities in Georgia are few and far between and right now are only located in the Metro Atlanta area.  The End Slavery Georgia facility will be an important addition to the portfolio of services available in our state.  They found a gap in services, and now they are filling it.

This is Yuval Levin’s problem solving model in action—neighborhoods, churches, schools working with the local community to find solutions to tough problems and building up from there.  These communities are idea incubators, and as they learn through trial and error, they can lead others to solving similar problems in different places.  We live our lives at the local level in our towns and cities, so it makes sense that we know best how to help ourselves.

End Slavery Georgia is a testament to what a few people with a heart for their community can do.  If you are in the Rome, Georgia area, jump in and give them a hand.

 

Karla Jacobs is chair of the Georgia Commission on Women and a member of the CJCC Statewide Human Trafficking Task Force.  She lives in Marietta with her husband, two kids, a dog, and some fish.

Human Trafficking: A Statewide Problem That Needs A Statewide Solution

Photo by Todd Rehm

Photo by Todd Rehm

We have more to consider on the Georgia ballot this year than candidates for local, state, and national offices.  There are also four amendments to the Georgia constitution to think about as well.  I encourage you to do your research ahead of time so you will be prepared to make informed choices.

Amendment 2 is the one I want to talk about here because the state fund and the commission that the amendment creates are key components in Georgia’s statewide strategy to combat child sex trafficking in our state.  If you are unaware of the scope of this issue in Georgia, I have previously written about it here, here, and here.  On Thursday, October 27, 2016, Senator Renee Unterman and Representative Mary Margaret Oliver hosted a press conference at the State Capitol to outline past efforts to combat the child sex trafficking problem in our state as well as to encourage Georgia voters to support Amendment 2.

The extent of the problem in Georgia is daunting because Atlanta regularly appears on various lists as one of the Top 10 cities in the nation for child sex trafficking.  However, sex trafficking in Georgia is not only found in Atlanta.  The internet, including websites like Backpage.com, has moved the trafficking issue outside of large cities to every corner of our state.  Georgia Cares, the state’s intake agency for child victims, reports victim referrals from more than 100 counties in all regions of Georgia.

Child sex trafficking is not just an Atlanta problem.  It is a statewide problem that requires a statewide solution.

As alarming as the problem is here in Georgia, we are fortunate to be a state that is leading the nation in both tackling the problem and providing services for its victims.  This has been a team effort spanning almost a decade and involving Georgians from the law enforcement community, the GBI, the Attorney General’s office, legislators, and victim services providers.  Strong support from the highest levels of state government–the Governor, Lieutenant Governor, and Speaker of the House–has ensured that Georgia has laws on the books to punish those who exploit our children as well as to provide restorative services for our most vulnerable victims.

Law enforcement officers and lawmakers have focused on increasing penalties for child sex traffickers and ensuring that children are granted victim status by the court system and are not treated as criminals.  Training programs across the state equip our local law enforcement officers to identify victims and investigate cases to ensure convictions of the people who traffic them.  Meanwhile, local non-profits have stepped in to provide services to trafficked children to help them restore their lives.

Sex trafficking victims are subjected to extensive mental and physical abuse and require a wide range of services to restore them to health.  As much as 80 percent of victims are addicted to drugs and need rehab, many have suffered trauma and require counseling, and others have had their education interrupted and need help getting a GED or additional job training.  Victims sometimes need residential housing if their families cannot provide proper care or if they are at risk from retaliation by their pimps.  These services are expensive—an average of $80,000 per child—and demand for these services is on the rise.

Sen. Renee Unterman and Rep. Mary Margaret Oliver Photo by Todd Rehm

Sen. Renee Unterman and Rep. Mary Margaret Oliver
Photo by Todd Rehm

Our statewide community and law enforcement training programs are bearing fruit as more victims are identified and rescued from their traffickers.  Heather Stockdale, CEO of Georgia Cares, reported at the press conference that they have had 469 youth referred to them for services in 2016.  Additional services are needed for children with unique needs such as young boys, pregnant youth, LGBTQ youth, and youth with low IQ.

Georgia’s reputation as an innovator in fighting sex trafficking is tied in part to our statewide response to the problem.  Amendment 2, the Safe Harbor Amendment, is a vital component in ensuring that funds are available across the state for victim services.  Taxes on adult entertainment establishments as well as additional fines added to the judgments against convicted traffickers will generate approximately $2 million per year.  The service providers in local communities can then apply to the commission for grants from the fund to help them deliver the treatment needed by trafficking victims.

Amendment 2 gives Georgia voters an opportunity to be a partner in the fight against child sex trafficking across our state.  Please vote Yes when you go to the polls this election.

Together we can #EndIt.

You can watch the video of the Thursday, October 27, 2016 press conference on Facebook at Safe Harbor Yes.

 

Karla Jacobs is the chair of the Georgia Commission on Women and a member of the CJCC Statewide Human Trafficking Task Force.  She lives in Marietta with her husband, two kids, a dog, and some fish.

Walk Through History at Georgia’s New Echota Historic Site

ne-legislature-webThere is a crispness to the October morning air in Georgia now that signals the seasons are finally turning the corner into fall.  Leaves will shift their colors soon to the golds, oranges, and reds that lure folks to the mountains and clog the winding roads with leaf peepers out to take in the scenery.

Touring through the mountains in the fall is a great time to check out some of Georgia’s smaller state parks.  One of my family’s favorites is the New Echota Historic Site in Calhoun.  New Echota was the capital of the Cherokee Nation from 1825 until 1838 when the U.S. government forced the Cherokee to relocate to Oklahoma in what became known as the Trail of Tears.

By the time the Cherokee Nation founded New Echota, their culture looked very similar to that of the European settlers who were their neighbors.  They adopted the same dress and became farmers, businessmen, and politicians.  They were also the first Native American tribe to create their own alphabet.  In 1827, the Cherokee ratified the Cherokee Constitution modeled after the U.S. Constitution, and created a government that was similar to our own—an executive, a legislature with an upper and lower house, and a supreme court.  The Cherokee Phoenix newspaper, published in both English and Cherokee, had a circulation that included not just the Cherokee Nation but the United States and parts of Europe as well.

ne-print-type-webVisitors to the New Echota Historic Site can see 12 original and reconstructed buildings on the site today.  You can walk through the Council House and Court House, visit a reconstructed farmstead with barns and outbuildings, see Missionary Samuel Worchester’s home, and get a look inside the restored Vanns Tavern.  Our favorite was the reconstructed print shop with a working printing press from that era.

The Visitors Center is not to be missed.  It tells the story of the Cherokee Nation and its capital through exhibits and a 20-minute film on the history of the Cherokee at New Echota.  It is a tale of progress, hope, and great betrayal.  It portrays a dark time in the history of our nation and our state, and it is one we all need to know and remember.

As you head into the mountains to take in the scenery of a beautiful fall day in Georgia, take some time to learn a little about the history of the area and the people who once called it home.  You will be glad you did.

 

Karla Jacobs is chair of the Georgia Commission on Women.  She lives in Marietta with her husband, two kids, a dog, and various fish.

Domestic Minor Sex Trafficking Victims Need Safe Harbor

Deidre Harrison of SWAHT speaks during the Savannah Unholy Tour

Deidre Harrison of SWAHT speaks during the Savannah Unholy Tour

Better behaved than New Orleans and more demure than Charleston, Savannah takes its place among the great Southern grandes dames as a city of beauty, hospitality, and charm.  Laid out with an engineer’s precision, old Savannah is beautiful in the way of all intricately designed things.  Spanish moss draped live oaks give this historic town a feeling of mystery and a sense of place.  It is a personality unto itself.

Savannah is a city of 136,000 people with a metro area of about 2.5 times that.  It is not a small town, but it is not a big city either.  A port city, Savannah and Chatham County are home to major manufacturers, and the Army’s Fort Stewart is nearby.  Tourism is booming with millions of visitors bringing around $1.5 billion into the local economy each year.

Savannah’s small city status does not make it immune to big city problems, however.  Human trafficking, and the suffering it brings, touches this community too.

In 2013, federal, state, and local authorities dismantled an international sex trafficking ring with roots in Mexico and Central America and operations based out of Savannah.  Operation Dark Night, as the investigation was called, rescued 12 victims and resulted in the convictions of 23 defendants.  The ringleader, Joaquin Mendez-Hernandez, also known as El Flaco, was sentenced to life in prison for exploiting dozens of women.

Members of the sex trafficking ring enticed young women and girls from Mexico and other Latin American countries to come to the United States on the promise of work and prosperity.  What the young women found instead was a life of abuse and slavery.

Organization members forced these women to perform sex acts with as many as 50 men a day.  They were threatened, beaten, and made to go without food and sleep until they met their quotas.  One victim reported being pregnant and lying face down on the floor when a trafficker jumped on her back to force her to have a miscarriage.  Other victims reported being forced to become pregnant by organization members so those children could be used to threaten the women into submission.  Pimps from Florida to North Carolina traded the women amongst themselves like pieces of property.

This was modern day indentured servitude.  The women saw very little of the money they made, if they saw any at all.  They were working off a debt that would never be repaid.  Meanwhile, the ringleader, Mendez-Hernandez, was making enough money to send $1,500 a week to his family back in Mexico.

Operation Dark Night was the largest sex trafficking investigation prosecuted in the Southern District of Georgia.  Multiple organizations at the federal, state, and local level, led by U.S. Immigration and Customs Enforcement’s (ICE) Homeland Security Investigations, cooperated in the investigation.  “It is reprehensible that an international sex trafficking organization set up shop within our very own communities,” stated United States Attorney Edward J. Tarver.  “This organization destroyed the lives of many victims through fear, violence, and intimidation, all for the love of money.  Those responsible will now pay the price in federal prison.”

In addition to sentencing Mendez-Hernandez to life in prison, U.S. District Court Judge B. Avant Edenfield ordered him to pay $705,000 in restitution to the victims.

Many consider Operation Dark Night to be a benchmark in the investigating and sentencing of human traffickers.  With all eyes on Atlanta as a known human trafficking hub, many Georgians do not realize that investigations like this one are busting up rings in other areas of the state.

Human trafficking is a statewide problem that requires a statewide solution.  At the heart of that solution are our efforts to help human trafficking victims, like the ones freed in Operation Dark Night, to reintegrate into our communities.

The Georgia Legislature has given voters an opportunity to participate in helping child sex trafficking victims put their lives back together.  The November ballot will ask voters to decide on several amendments to the state constitution.  Amendment 2 on the ballot, the Safe Harbor amendment, will create a fund, and a commission to administer that fund, to help pay for rehabilitation services for domestic minor sex trafficking victims in our state.  Victim service providers will be able to access those funds through grants to help victims of trafficking statewide receive the medical, counseling, and education services they need to reintegrate into their communities.

According to ICE Director John Morton, “ICE investigates a wide array of crimes, but the trafficking of women and girls for prostitution is among the most sinister.  Few crimes so damage their victims and undermine basic human decency.  Our fight against this evil must be relentless, both here and abroad.”

Georgia voters have the opportunity to provide funds to help heal the wounds of trafficking in our youngest victims.  I encourage you to vote yes on Amendment 2 to provide Safe Harbor for the children of Georgia.

The Georgia Commission on Women would like to give special thanks to Public Service Commissioner Tim Echols for hosting an Unholy Tour in the Savannah area.  Events like this shine a light on the fact that human trafficking is not just a big city problem.  It touches communities big and small across our state, and we must all come together to ensure victims get the help they need.

 

Karla Jacobs is the chair of the Georgia Commission on Women and a member of the CJCC Statewide Human Trafficking Task Force.  She lives in Marietta with her husband, two kids, a dog, and some fish.

Asking Hard Questions Now Will Give Peace When Life Gets Tough

This year I read a book entitled, “Being Mortal” by Dr. Atul Gwande.  I don’t remember who recommended it to me, but it articulated many of my observations, experiences, and feelings based on my decision to pursue a career in nursing.  When I was a 20 year old student, I was assigned to care for individuals with incurable diseases, unexpected injuries, or sudden death.  It didn’t take long for me to discard the invincibility mindset that is typical of younger people.  It made me a believer that death and dying is real and doesn’t always give a warning notice or only happen to the elderly.

Our society promotes denial of these realities by removing everyone except health care professionals from the unpleasant sights and chores associated with taking care of a deteriorating or expiring body.  I worked in a nursing home the last three years of my career.  This experience made it impossible to deny the many scenarios that can be present at the end of life.  For those outside the health field, the initial brush with death usually results from a health crisis within the family.  We are rudely awakened from our denial by a tsunami of issues that we have never contemplated.

We are unprepared for all the questions that haven’t been addressed and decisions that must be made while in crisis mode.  Now, we have to deal with the problem and want information, even if we are frightened of the subject matter.

If we are uncomfortable with someone else’s death, the thought of examining or preparing for our own death is too startling to consider. Unfortunately, this ostrich approach robs us of having any control on the setting where we will be treated, the type of care we might receive, or determination of our preferences regarding how intensive we want our treatment to be.  The legal and financial chaos our irresponsibility causes may take years to untangle.

So, I increasingly wonder why we are so reluctant to find an expert in end of life that would be the equivalent of a CPA to help us with our taxes. As the saying goes, “Nothing is certain but death and taxes.”  Both are inevitable experiences.  To seek an expert to assist with our personal tax issues is considered intelligent.  Having an expert help guide us through the end of life paperwork and questions is avoided and almost viewed superstitiously as casting an unpleasant spell that will make our death more imminent.

Just try to have a conversation with someone about whether they have stated their preferences for their last days, or if their will or advance directives are completed.  This will quickly result in a change of topic.

So we remain a people uncomfortable talking about the subject of dying, even with those we love the most.  Being an informed patient, having all documentation in place and having it shared with relatives or our surrogate decision-makers prior to a crisis, can make our life and everyone else’s much less stressful.  It may be our greatest gift to our children.

We all know that in a matter of minutes the world as we know it can be shattered.  One phone call can confirm an incurable disease or notify that a loved one was killed in an automobile accident.  Yet we deny the fact that the mortality rate for EVERYONE is 100%.

If illness or death occurs in our circle of acquaintances, we frequently feel very uncomfortable about what to say or do. So, we frequently avoid them and say nothing.  This leaves our closest friends and relatives isolated and feeling lonely in a time of desperate need to talk about their deepest hurts and concerns.

I encourage everyone to “suck it up” and get the facts, paperwork, and skills to be a better decision-maker regarding their own critical life decisions and learn to be better communicators with all those individuals most dear to us. Come join The Women’s Information Network, Inc. on September 27, 2016 for our workshop entitled:  “Life:  The Final Chapter….Write Your Own Ending.” This seminar is designed to provide the documents that need completion, ways to communicate about this topic and resources in our community to provide assistance when needed.  For more information go to www.infoforwomen.org   Registration is $20.  Students  $10.

 

Sharon Baker is a member of the Georgia Commission on Women.  She is a retired nurse practitioner and is President and Founder of the Women’s Information Network, Inc.  She lives in Rome, Georgia.

Overalls and Pencil Skirts

Congressional Secretaries, 1920 Source: Wikimedia Commons, Public Domain

Congressional Secretaries, 1920
Source: Wikimedia Commons, Public Domain

I was born in overalls, or more accurately, I was raised in them. The moment I had the ability to think and move for myself, I ran full speed ahead to the most functional, albeit fashionable, OshKosh pair.  They fit unbelievably.

Like the quintessential poster child for the South, I climbed magnolia trees and caught lightning bugs in them, and despite my mother’s pleas, I snuck snails into the pockets for later examination underneath my covers with a flashlight. In junior high, I wore a white pair of overalls with pink stitching to the movies & was kissed slowly against the musty, butter-soaked wall. I felt invincible.

Recently someone told me that I romanticize most moments in my life, and I suppose my blue jean memories echo that sentiment, but in my mind, my overalls were perfect. Being in them didn’t camouflage my parent’s difficulties with their marriage or our less than affluent upbringing, but they made me feel able to accomplish anything, fearless even.

Fast-forward twenty-something years, through my parent’s divorce and into my current life, forging through congested city-traffic and wearing pencil skirts in planes amongst politicians. As the political liaison for the Commission on Women, I’m not only honored to help represent the women in Georgia, but also to address the inescapable truths that come with being a female in this decade.

Nearly a century ago today, on August 26, 1920, the 19th amendment was made an official addition to the United States Constitution. Women’s inability to vote, a concept difficult for most millennials to grasp, was changed by a small, boisterous, group of rebel gal pals that came together in an effort to make America great.

As of late, being a woman tends to tastes bitter, not sweet like honeysuckles, and the slimiest thing I have been stuffing into my pockets for later examination is self-doubt, along with an inexcusable amount of receipts for half priced Pinot Noir from Trader Joe’s. In 2016, the pressure that women feel to be enough is at times, all consuming. Hollywood’s unrealistic perception of what is beautiful and social media facades are only a portion of the influencing factors that bind women to the notion that they have to be something other than authentic in order to be desirable.

I write this, not as a skeptic or a judgmental surveyor of the major flaw women have with comparison, but instead as someone who can feel diminished with insecurities daily due to something as fleeting as vanity. Elizabeth Cady Stanton, Lucretia Mott, Susan B. Anthony, and Alice Paul, the foremothers of women’s voice, were not consumed with what would be lauded as beautiful, but instead what would be accepted as just.

Today, on Women’s Equality Day, I can’t help but wonder what incredible things could be accomplished if women refused to let unrealistic standards and comparison be the thief of joy, and instead let differences bind them together to accomplish goals yet achieved. What if the women who fought tirelessly for women’s rights were reduced to how many ‘likes’ they obtained, or what filter camouflaged their tireless efforts? What if instead of teaching our daughters to fit into a glass slipper, we encouraged them to shatter a glass ceiling? What if we found freedom in the confidence within ourselves to be wholly our own, possessing power in the belief that by just being us, we have the power to speak up when someone judges based only on appearances?

When I was a little girl, clumsily running around in Georgia red clay-stained overalls, I didn’t wonder who would be looking, I was too focused on the genuine freedom and confidence I found in being completely myself. Happy Women’s Equality Day, ladies. I hope you can find the strength to put on your own pair of overalls today and feel capable, strong, beautiful, and able (because you absolutely are.)

 

Emily Bowers was appointed by the Commissioner of Labor, Mark Butler, in 2015 & serves as the liaison to the Georgia Commission on Women.  Begrudgingly a Millennial, Emily is passionate about travel, loved ones, and all things policy.  She lives in Atlanta.

Georgia’s Rural Hospitals Need Life Support

Phoebe Putney Memorial Hospital in Albany, GA Source: Wikimedia Commons, Public Domain

Phoebe Putney Memorial Hospital in Albany, GA
Source: Wikimedia Commons, Public Domain

Many of Georgia’s hospitals are in critical condition.  That is the message delivered by speaker after speaker at the Senate Health and Human Services Committee hearing at the Georgia Capitol on August 22, 2016.

Our rural hospitals are struggling.  Forty-one percent of them are working with a negative operating budget, and that number is expected to climb past 50 percent in the next few years.  In the past couple of years, five rural hospitals have closed in Georgia and others have scaled back services, leaving patients in the communities they serve to have to travel farther for medical care.  Cash-strapped community hospitals are unable to purchase the newest technology or update their aging buildings, so many people in those communities choose to drive to hospitals in bigger markets under the impression that newer stuff means better care.  A few hospitals have so little cash on hand that they have struggled to meet payroll at times.

Georgia ranks 4th in the nation in the number of uninsured patients, aggravating hospitals’ already precarious financial situations.  Medicaid recipients make up a large share of rural patients, and with Medicaid paying 20 cents on the dollar for services, you see a sizable chunk cut from local hospital revenues.  Add in the underinsured, which often show up in the bad debt column, and you have a toxic fiscal environment for our rural hospitals.

Solutions are hard to come by.  Georgia’s Hub and Spoke model for community care with regional hospitals and community service providers is showing promise.  Resistance to change is a big challenge, however, and more needs to be done to coordinate between service providers and communicate the value of receiving care in the local market to those in the community.  Many patients are managing multiple chronic conditions, and some require help beyond their medical issues.  This type of intensive case management is best handled at the local level.

The Rural Hospital Stabilization Committee is one organization that is studying the challenges facing our rural hospitals and will be reporting back to the Health and Human Services Committee throughout their pilot process.  Their goals are to help local hospitals increase market share while reducing Medicare readmissions, which come with a penalty, as well has improving access to primary care and reducing non-emergency care in the  communities they serve.  They have many tools in their toolbox and expect to make some inroads in the pilot communities.

The Georgia Chamber of Commerce has convened a health care access task force who will be reporting their findings as well.

In the meantime, rural hospitals will continue to do their best to meet the needs of their communities with the limited resources they have, and we will all continue to hope that they can hang on until state leaders can shape policies to fix what ails them.

 

Karla Jacobs is a member of the Georgia Commission on Women.  She lives in Marietta with her husband, two kids, a dog, and some fish.

Healthcare Providers Are the First Reponders for Many Human Trafficking Victims

L-R Dave McCleary, Alveda King, Renee Unterman, Laura Lederer, Julianna McConnell, Karla Jacobs

L-R Dave McCleary, Alveda King, Renee Unterman, Laura Lederer, Julianna McConnell, Karla Jacobs

One of the challenges in getting human trafficking victims the help they need is finding them to begin with.  Many trafficked women and children are hiding in plain sight and just need someone to ask the right questions to identify them.  Georgia Cares, the statewide organization coordinating care and services for child victims, reports that 90 percent of the children referred to them for services are enrolled in school.  In a study by Global Centurion, a non-profit focused on disrupting the demand side of human trafficking, 88 percent of survivors reported seeing a health care professional during the time they were being trafficked.

Global Centurion president and founder, Laura Lederer, joined Georgia lawmakers and local advocates for a lunch and learn hosted by Public Service Commissioner Tim Echols in early July.  Ms. Lederer gave a presentation focused on the toll human trafficking takes on the health of women and girls who are exploited and highlighted the unique role healthcare professionals can play in identifying victims and referring them to support services.

Substance abuse, violence, and reproductive health issues are closely entwined in the trafficking experience and often send victims into the path of healthcare professionals.  Survivors reported receiving care in hospital emergency rooms, Planned Parenthood clinics, urgent care clinics, women’s health clinics, and private doctors.

These points of contact provide an opportunity to identify trafficking victims and to refer them to the help they need, but first healthcare professionals need training in how to look for the critical signals—injuries from physical violence particularly head or facial injuries, signs of PTSD, multiple STDs, substance abuse, and multiple abortions, especially in younger patients.  A coercive and controlling “boyfriend” on the scene is also a warning sign.  Ms. Lederer recommends this training start in the professional schools and continue through certification.

Once healthcare providers identify a sex trafficking victim, they need to know the guidelines and protocols for referring victims to proper anti-trafficking organizations to coordinate their care.  These women and girls need the basics of food, clothing, and shelter, but they also may need specialized medical assistance, substance abuse programs, legal assistance, law enforcement assistance, and translation services.  In Georgia, we are fortunate to have a robust safety net that is working well, but we need to ensure that our healthcare providers know how to access it.

The health consequences of human trafficking continue for decades after girls and women leave the life, and we need more research into how to help survivors as they reintegrate into society and put their lives back together.  We need to better understand the unique challenges for the children who are born to these women during the time they are trafficked.  We need to address the ongoing psychological problems experienced by these women.  More than 80 percent report depression after trafficking; more than 60 percent show symptoms of PTSD.  We need research-driven best practices for helping women who have experienced the traumas of trafficking, and we need to continue to practice trauma informed care in helping survivors recover from their experience.

I told a friend recently that working on the issue of human trafficking often feels like we are trying to bail out the Titanic with a teacup.  There are things each of us can do, though, to help victims become survivors.  Talk to your friends who are healthcare professionals and ask them if they have received training on identifying and treating trafficking victims.  Talk to your doctors and ask them if they have provided training for their staffs.  Encourage them to learn more.

This year, 2016, offers all Georgia voters an opportunity to be part of the solution.  The November ballot will have a proposed constitutional amendment called Safe Harbor, and children being trafficked in our state need for you to vote “Yes.”  This amendment will create a fund to provide rehabilitation services for child victims and a commission to oversee the funding.  The money for the fund will come from fines assessed to those convicted of trafficking offenses as well as a tax on adult entertainment establishments.  To insulate it from politics, the fund will be separate from the state budget.  That is why it is set up as a state constitutional amendment that voters must approve.

Healthcare professionals can truly be the first responders in the fight against human trafficking.  Encourage the ones in your life to learn how, and join me in voting Safe Harbor Yes in November.  Together we can #EndIt.

You can find a summary of the study results in the Beazley Insititute for Health Law and Policy Annals of Health Law, Winter 2014.

 

Karla Jacobs is the chair of the Georgia Commission on Women and a member of the CJCC Statewide Human Trafficking Task Force.  She lives in Marietta with her husband, two kids, a dog, and some fish.

Life: The Final Chapter, Write Your Own Ending

More people in the baby boomer generation are reaching age 65 – some 10,000 a day until 2030 (Pew Research Center, 2010). I happen to be one of those this year. As usual, each milestone for my generation causes social change. The most recent to attract my attention is the book Being Mortal by Dr. Atul Gwande. At first, I thought the primary reason for my interest was because of my occupation as a nurse practitioner, and how often I experienced the realities of Dr. Gwande’s book lived out in a nursing home where I worked prior to my retirement.

However, I soon learned that just like other previously unspoken topics, (think natural childbirth, fathers in the delivery room, menopause, sexual assault, etc.) my interest in death and dying is a trend. Boomers usually first get initiated into the end of life processes through the death of our parents or other family members. One thing gained from this experience is usually the certainty that we don’t want our last days to happen the same way. There are far too many loose ends.

When assuming responsibility for anyone during the end of life process, we are suddenly forced to realize how much we don’t know. For example: What legal/financial documents are needed or need completing? Where are they? What is the prognosis? What are the treatment options? How do I talk to someone who is dying? Where can I get help taking care of my loved one? How much will it cost? Does my insurance cover it?

Our society’s sanitation of dying and the discomfort with the topic has left us woefully unprepared for an event we know will inevitably occur. If we are sensible, we do not act like ostriches, but instead poke our heads out of the sand and explore this scary topic to learn the roadmap for what needs to be done before a crisis in our own life renders us unable to literally have a voice.

As with most issues of the boomers, we are not a passive group! Just as Lamaze classes taught us what to expect, more people realize that learning some details about an upcoming situation makes it less frightening. Having time to digest information and construct a personalized plan makes us calmer and feel more in control.

After reading Being Mortal by Dr. Atul Gwande, I began to seriously look for tools to help me articulate and document how I would like my “Last Chapter” to be. To my delight, I’m finding workbooks that pose many questions and situations that have helped me write my wishes and enabled me to share them with my sons.

Probably the most important question for anyone is, “what happens when I die?” Knowledge of common fears, wishes, symbols, language, and behavior can help all of us to glimpse the important journey from this life to the afterlife.

I’m finding the stories helpful on a very practical level and reassuring on a spiritual level. Join WIN in learning the answers to the questions you have not yet thought about asking.

On Tuesday, September 27, 2016, from 1 P.M – 5 P.M., The Women’s Information Network, Inc. is hosting an event called “Life: The Last Chapter – Write Your Own Ending.” The event will include a panel of speakers, a light lunch, and workbook outlining the important documents needed for end of life decisions. Following the presentations, all speakers will be available for an informal question and answer session during a reception with light refreshments.

Registration is required and the cost is $20.00. This fee includes lunch, the program, and a workbook of materials. Call 706-506-2000 to register. Visit www.infoforwomen.org for more details.

 

Sharon Baker is a member of the Georgia Commission on Women.  She is a retired nurse practitioner and is President and Founder of the Women’s Information Network, Inc.  She lives in Rome, Georgia.

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