FY 2021 Annual Performance Plan and Report - Goal 3 Objective 2

Fiscal Year 2021
Released March, 2020

Goal 3. Objective 2: Safeguard the public against preventable injuries and violence or their results

Injuries and violence affect all Americans regardless of an individual's age, race, or economic status. Preventable injuries and violence—such as falls, homicide stemming from domestic violence, and gang violence—kill more Americans ages 1 to 44 than any other cause, including cancer, HIV, or the flu.31 Hospitalizations, emergency room visits, and lost productivity caused by injuries and violence cost Americans billions of dollars annually.

Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual's functioning and mental, physical, social, emotional, or spiritual well-being. The Department supports multiple trauma-informed care initiatives to integrate a trauma-informed approach into health, behavioral health, and related systems to reduce the harmful effects of trauma and violence on individuals, families, and communities.

The Office of the Secretary leads this objective. The following divisions are responsible for implementing programs under this strategic objective: ACF, ACL, CDC, IHS, OASH, and SAMHSA. In consultation with OMB, HHS has determined that performance toward this objective is progressing. The narrative below provides a brief summary of progress made and achievements or challenges, as well as plans to improve or maintain performance.

Objective 3.2 Table of Related Performance Measures

Maintain the percentage of domestic violence program clients who have a safety plan (Lead Agency - ACF; Measure ID - 14D)

  FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 FY 2021
Target 90% 90% 90% 90% 90% 90% 90% 90%
Result 93% 91.9% 89.6% 92.8% 93.4% 05/31/20 05/31/21 05/31/22
Status Target Exceeded Target Exceeded Target Not Met Target Exceeded Target Exceeded Pending Pending Pending

Family Violence Prevention and Services Act grantee data for fiscal years 2017 and 2018 show that more than 90 percent of domestic violence program clients reported improved knowledge of safety planning as a result of grantee efforts. These data correlate with other indices of longer-term client safety and well-being.32 Since many program participants receive short-term crisis assistance and would not expect to report significant change, consistently achieving a higher than 90 percent benchmark is unrealistic. In FY 2021, ACF will continue to implement its improved data quality checks to ensure data accuracy as well as work with the grantees to identify ways to promote domestic violence safety.

Decrease the percentage of children with substantiated or indicated reports of maltreatment that have a repeated substantiated or indicated report of maltreatment within six months (Lead Agency - ACF; Measure ID - 7B)33

  FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 FY 2021
Target 6.10% 6.30% 6.20% 6.30% 6.74% 6.50% Prior Result - 0.2PP Prior Result -0.2PP
Result 6.50% 6.40% 6.50% 6.90% 6.70% 10/31/20 10/31/21 10/31/21
Status Target Not Met Target Not Met but Improved Target Not Met Target Not Met Target Met Pending Pending Pending

In FY 2017, the rate of repeat child maltreatment increased from 6.5 percent to 6.9 percent. In FY 2018, the rate decreased to 6.7 percent. In FY 2020 and FY 2021, ACF will continue to identify and implement ways to support states in their efforts to care for children and families who are experiencing a crisis, while ensuring the safety of children. The renewed emphasis on prevention efforts may also lead to improved performance in this area.

Increase Intimate Partner (Domestic) Violence screening among American Indian and Alaska Native (AI/AN) females (Lead Agency – IHS; Measure ID – 81)

  FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 FY 2021
Target N/A N/A N/A N/A 41.6% 41.6% 41.5% 37.5%
Result N/A N/A N/A N/A 38.1% 36.3% 01/31/20 01/31/21
Status N/A N/A N/A N/A Target Not Met Target Not Met Pending Pending

Domestic and intimate partner violence has a disproportionately large impact on AI/AN communities. AI/AN women experience intimate partner violence at higher rates than any other single race or ethnicity in the United States. Screening for intimate partner (domestic) violence provides the ability to identify victims and those at risk for injury. The Intimate Partner (Domestic) Violence screening measure supports improved processes for identification, referral, and treatment for female victims of domestic assault. In FY 2018, IHS began reporting the Intimate Partner (Domestic) Violence screening measure using the IHS Integrated Data Collection System Data Mart (IDCS DM). FY 2019 represents the second year of IDCS DM reporting; IHS continues to monitor and adjust to reporting system changes. Although several IHS Areas met or exceeded the FY 2018 and FY 2019 targets, IHS did not meet the national target of 41.6 percent. IHS is reviewing FY 2019 data and will reach out to the Areas and sites that met or exceeded the target to identify what is working well, capture lessons learned, and cultivate knowledge sharing across the Agency. IHS will also provide technical assistance and training to IHS health care providers and sites in completing the appropriate screening and injury assessments and IDCS DM reporting. IHS will provide outreach and assistance to tribal sites as requested.

In FY 2020 and FY 2021, IHS will offer additional Intimate Partner (Domestic) Violence trainings for health care providers for screening and injury assessment. IHS will also provide technical assistance to sites that did not meet the FY 2019 screening target and improve the data collection process for reporting results. In FY 2021, IHS will continue to support screening improvements for domestic violence among AI/AN females.

32 Bybee, D. I., and Sullivan, C. M. (2002). Strengths-based intervention resulted in positive change for battered women over time. American Journal of Community Psychology, 30(1), 103-132.

33 The program updated the FY 2016 actual result for this performance measure based on a technical correction to calculate the data based on the national population, which is consistent with previous results. The program updated the FY 2017 target due to this change.

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