Hospital Gun-Violence Funding at Risk
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Hospital-Linked Violence Intervention Programs Address Gun Violence as a Public Health Crisis
Table of Contents
- Hospital-Linked Violence Intervention Programs Address Gun Violence as a Public Health Crisis
- Q&A: hospital-Linked Violence Intervention Programs & gun violence
Published: March 7, 2025
From Personal Trauma to Community Support: A Story of Intervention
Erica Green’s journey into violence prevention began seven years ago when she learned of her brother’s shooting via a Facebook post. Her frantic search for details at a Denver health hospital, the city’s safety-net system, was met with resistance until Jerry Morgan, a violence prevention professional with the At-Risk Intervention and Mentoring program (AIM), intervened.
Green recalls, “I was distraught and outside, crying, and Jerry came out of the front doors.” Morgan’s timely arrival and support made a profound impact. “It made the situation of that traumatic experience so much better. After that, I was, like, I wont to do this work,” Green said.
Today,Green is the program manager for AIM,a hospital-linked violence intervention program.This program, a partnership between Denver Health and the Denver Youth Program, has expanded to include Children’s Hospital Colorado and the University of colorado Hospital.
The Public Health Approach to Gun Violence Prevention
AIM is part of a growing network of hospital-linked violence intervention programs nationwide. These programs address the social and economic factors contributing to violence, such as inadequate housing, job loss, and neighborhood safety concerns. This approach aligns with a public health approach to stopping gun violence.
These programs have demonstrated success. One in San Francisco reported a “fourfold reduction in violent injury recidivism rates” over six years. However, shifts in federal policy have created uncertainty about long-term funding.
John Torres, associate director for Youth Alive, stated, “We’ve been worried about, if a domino does fall, how is it going to impact us? there’s a lot of unknowns.”
Gun Violence: A Leading Cause of Death
Federal data reveals that gun violence has become a leading cause of death among children and young adults, contributing to over 48,000 deaths in 2022. Chethan Sathya, a pediatric trauma surgeon and NIH-funded researcher, emphasizes that “It’s killing so many people,” highlighting the urgency of addressing gun violence as a health care issue.
Research indicates that violent injury increases the risk of future incidents, with the risk of death rising significantly after the third violent injury, according to a 2006 study in The Journal of Trauma: Injury, Infection and Critical Care.
Intervention in the Emergency Room
Benjamin Li, an emergency medicine physician and AIM medical director at Denver Health, believes the ER is an ideal setting for intervention. “If you are just seeing the person,patching them up,and then sending them right back into the exact same circumstances,we know it’s going to lead to them being hurt again,” Li said. “It’s critical we address the social determinants of health and then try to change the equation.”
Paris Davis, the intervention programs director for Youth Alive, explains that intervention might involve “helping them relocate out of the area, if that’s allowing them to gain housing, if that’s shifting that energy into education or job or, you know, family therapy, whatever the needs are for that particular case and individual, that is what we provide.”
AIM outreach workers initiate these crucial conversations at the hospital bedside. Jerry Morgan,AIM’s lead outreach worker,describes these as “tough,nonjudgmental conversation[s]” aimed at understanding how patients ended up in their situation.
AIM then connects patients with resources to address their challenges, including returning to school or work, finding housing, attending court proceedings, and accessing healthcare appointments. “We try to help in whatever capacity we can, but it’s interdependent on whatever the client needs,” Morgan said.
Expanding Services: The REACH Clinic
Since 2010, AIM has expanded significantly, opening the REACH Clinic in Denver’s Five Points neighborhood. This community-based clinic offers wound-care kits, physical therapy, and behavioral, mental, and occupational health care. Bullet removal services are planned for the future,joining a growing movement of community-based clinics focused on violent injuries.
Ginny McCarthy, an assistant professor at the University of Colorado, describes REACH as “an extension of the hospital-based work,” providing holistic treatment and building trust with communities of color who have historically experienced racial biases in medical care.
A National Movement
Caught in the Crossfire, established in 1994 by Youth Alive in Oakland, is considered the first hospital-linked violence intervention program.The Health Alliance for Violence Intervention, a national network initiated by Youth ALIVE, has grown to include 74 hospital-linked violence intervention programs.
Fatimah Loren Dreier, the alliance’s executive director, draws a parallel between addressing gun violence and preventing infectious diseases. “That disease spreads if you don’t have good sanitation in places where people aggregate,” she said.
Dreier, also executive director of the Kaiser Permanente Center for Gun Violence Research and Education, emphasizes that “That is what health care can do really well to shift society. When we deploy this, we get better outcomes for everybody.”
Policy and Funding Landscape
The Health Alliance for Violence Intervention offers technical assistance and training and has successfully advocated for insurance reimbursement for their services.
In 2021, President Joe Biden issued an executive action that opened the door for states to use Medicaid for violence prevention. Several states, including California, New York, and Colorado, have passed legislation establishing a Medicaid benefit for hospital-linked violence intervention programs.
In the summer of 2024, then-U.S. Surgeon general Vivek Murthy declared gun violence a public health crisis, and the 2022 Bipartisan Safer Communities Act allocated $1.4 billion for violence-prevention programs through the following year.
However, in early February 2025, Mr. Trump issued an executive order instructing a review of Biden’s gun violence policies, creating uncertainty among federally funded programs.
AIM receives 30% of its funding from Denver’s Office of Community Violence Solutions, with the remainder from grants, including Victims of Crime Act funding.As of mid-February 2025, AIM’s funding remained unaffected.
Some in Colorado hope a new firearms and ammunition excise tax, projected to generate $39 million annually for victim services, could provide a new funding source.Though, revenues are not expected until 2026, and allocation details remain unclear.
Catherine Velopulos, trauma surgeon and AIM medical director at the University of colorado hospital in Aurora, acknowledges that “any interruption in federal funding, even for a few months, would be ‘very arduous for us.'” However, she remains optimistic due to bipartisan support for AIM’s work.
Velopulos concludes, “People want to oversimplify the problem and just say, ‘If we get rid of guns, it’s all going to stop,’ or ‘It doesn’t matter what we do, as they’re going to get guns, anyway,'” she said. “What we really have to address is why people feel so scared that they have to arm themselves
Q&A: hospital-Linked Violence Intervention Programs & gun violence
Published: March 7, 2025
Understanding Hospital-Linked Violence Intervention Programs
What are hospital-linked violence intervention programs?
Hospital-linked violence intervention programs are initiatives that address the root causes of violence by intervening directly with victims of violence in hospital settings and providing ongoing support. These programs recognize violence, particularly gun violence, as a public health issue and tackle the social, economic, and environmental factors that contribute to it.
These programs address social determinants of health such as inadequate housing,job loss,and neighborhood safety concerns. By connecting patients to resources that alleviate these issues—like housing assistance, job training, and mental health services—they aim to reduce the likelihood of future violence.
What is the goal of intervening in the emergency room?
The goal is to break the cycle of violence. Emergency rooms provide a critical opportunity to reach individuals at a vulnerable time. Instead of just treating the immediate injury, intervention programs address the underlying issues that led to the violent incident, offering a path toward long-term stability and safety. Benjamin Li, an emergency medicine physician, emphasizes that simply patching someone up and sending them back to the same circumstances sets them up to be hurt again.
Effectiveness and Impact
Are these programs effective?
Yes, studies show promising results.For exmaple, a program in San Francisco reported a ”fourfold reduction in violent injury recidivism rates” over six years. By addressing the root causes of violence and providing support to victims,these programs can significantly reduce the likelihood of repeat incidents.
How do these programs support victims of violence?
These programs offer a range of services tailored to individual needs. According to Paris Davis, intervention may involve “helping them relocate out of the area, if that’s allowing them to gain housing, if that’s shifting that energy into education or job or, you know, family therapy, whatever the needs are for that particular case and individual, that is what we provide.” Support can include:
- Relocation assistance
- Housing support
- Education and job training
- Family therapy
- Legal assistance
- Healthcare access
What is the REACH Clinic and what services does it offer?
The REACH Clinic,an extension of AIM in Denver’s Five Points neighborhood,offers extensive community-based care,including:
- Wound-care kits
- Physical therapy
- Behavioral,mental,and occupational health care
- Planned bullet removal services
Ginny mccarthy describes REACH as a way to provide holistic treatment and build trust with communities that have historically experienced biases in medical care.
Funding & Policy Landscape
How are these violence intervention programs funded?
Funding sources vary. AIM, for example, receives 30% of its funding from Denver’s Office of Community Violence Solutions, with the remainder from grants, including Victims of Crime Act funding. Though,federal policy shifts can create uncertainty.
What policy changes have impacted these programs?
Key policy changes include:
- 2021: President Biden’s executive action opened the door for states to use Medicaid for violence prevention.
- 2022: The Bipartisan Safer Communities Act allocated $1.4 billion for violence-prevention programs.
- Early February 2025: Mr. Trump issued an executive order instructing a review of Biden’s gun violence policies, creating funding uncertainty.
The potential impact of policy changes on federal funding remains a significant concern for these programs.
What is the potential impact of funding interruptions?
Catherine Velopulos, trauma surgeon and AIM medical director, acknowledges that “any interruption in federal funding, even for a few months, would be ‘very arduous for us.'” This highlights the vulnerability of these programs to funding fluctuations and the potential disruption to critical services.
Are there option funding sources being explored?
Yes,Colorado is exploring a new firearms and ammunition excise tax,projected to generate $39 million annually for victim services. However, revenues are not expected until 2026, and allocation details remain unclear.
The Bigger Picture
Why is gun violence considered a public health crisis?
Federal data shows that gun violence is a leading cause of death among children and young adults, causing over 48,000 deaths in 2022. Chethan Sathya, a pediatric trauma surgeon, emphasizes the urgency of addressing gun violence as a health care issue due to its devastating impact.
What is the role of hospital-linked programs in the broader effort to reduce gun violence?
Hospital-linked programs are a critical component of a comprehensive approach to reducing gun violence. By addressing the social determinants of health, providing support to victims, and working to change community norms around violence, these programs can definitely help to create safer and healthier communities.fatimah Loren Dreier draws a parallel between addressing gun violence and preventing infectious diseases, highlighting the role of healthcare in shifting society.
How widespread are these hospital-linked violence intervention programs?
The Health Alliance for Violence Intervention, a national network initiated by Youth ALIVE, has grown to include 74 hospital-linked violence intervention programs.
Key Takeaways
| Aspect | Details |
|---|---|
| Program Focus | Addresses violence as a public health issue by targeting social determinants of health. |
| Intervention Point | Emergency rooms and community-based clinics (e.g., REACH Clinic). |
| Services Offered | Housing, job training, mental health services, legal assistance, wound care, and more. |
| Funding Sources | Combination of local government funds, grants (e.g., Victims of Crime Act), and potential future sources like excise taxes. |
| Policy Considerations | Impact of executive orders and Medicaid benefits for violence prevention. |
| National Network | Health Alliance for Violence Intervention supports and expands these programs nationwide. |