The University of Chicago Medicine Violence Recovery and Reduction Wraparound Project - A-1) For historically underserved urban minority populations, hospitals serve as centers for wellbeing and as economic anchors. In urban areas like Chicago, hospitals are among the largest employers and have an extensive network of clinics and community partners that extend across multiple communities. Despite being an economic engine of the community, hospital trauma centers take on a substantial economic burden of violence. Firearm injuries alone account for approximately 174.1 billion dollars in the United States (Lee, Quaraishi, Bhatnagar, Zafonte, & Masiakos, 2014). Unfortunately, not only are many of the patients at the highest risk for victimization under-resourced and underinsured, but they are 45% more likely to be violently reinjured (Purtle, Dicker, Cooper, Corbin, Greene, Marks, et al., 2013). In 2009, a national network of Hospital-based Violence Intervention Programs (HVIPs) was created to professionalize prevention workers by establishing core competencies for crisis intervention and assertive case management (Fischer, Cooper, Marks, and Slutkin, 2020). HVIPs utilize a prevention science framework that examines structural root causes, leverages the cultural capital of credible messenger within the hospital setting to use teachable moments to promote trauma-informed care to violently injured patients, assess their immediate risk for reinjury and retaliation, and connect them to wrap-around services to help navigate a path towards psycho-social healing upon discharge (Monopoli, Myers, Paskewich, Bevans, and Fein, 2018; Purtle, Rich, Fein, James, and Corbin, 2015). The Violence Recovery Program, a HVIP established in 2018 at UChicago Medicine, is uniquely positioned to engage and recruit individuals and families who were just harmed by gun violence in the “golden hour” when individuals are more likely to respond to support services and risk mitigation. VRS are embedded in the pediatric and adult trauma bays to respond to all violent injury activations 24 hours per day, 7 days per week, 365 days per year. During or immediately following the crisis intervention stage, VRS assess for imminent risk of re-injury and for other socioecological needs, including need for direct interventions and service referrals mental, behavioral health, and social determinants of health resources (housing, food, transportation, employment, crime victim compensation (CVC) application support, medical needs, etc.). VRS also respond to family needs (e.g., connection to legal support, funeral services, CVC). The VRS work with the survivors to create a Life Empowerment Plan that includes referrals to the patients’ highest priority needs. Case management is activated to identify goals, progress towards goals, and ongoing case management needs. This proposal aims to use a design that features a comprehensive and collaborative approach to injury prevention that prioritizes victim advocacy and case management through the UCM VRP model along with a subcontract with Metropolitan Family Services (MFS) as the organizing street outreach community partnership to enlist local street outreach on behalf of this model. This multidisciplinary approach is needed to address social determinants of health and structural characteristics that often provide the context for interpersonal violence reinjury (Adams, Arabian, Edwards, & Tinkoff, 2020; Rosenblatt, Joseph, Derchert, Duncan, Joseph, Stewart, et al., 2019). The partnering agencies, UCM and Metropolitan Family Services, are committed to prevention efforts to benefit the populations living and working in their collective service areas. Our programmatic focus will be seven four codes- (60617, 60619, 60637,60649) that encompass the South Chicago and South Shore community areas. Through the proposed design, this new outpatient case management team work shoulder to shoulder with our inpatient team to execute the core functions of case management: assessment, planning, l
