NEEDS ASSESSMENT OF A REGIONAL HUMAN TRAFFICKING TASK FORCE By Lauren Vollinger A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of Psychology – Master of Arts 2018 NEEDS ASSESSMENT OF A REGIONAL HUMAN TRAFFICKING TASK FORCE ABSTRACT By Lauren Vollinger Human trafficking is a global crime involving the use of force, fraud, and coercion to exploit individuals for commercial sex and labor. Survivors of human trafficking have physical health, mental health, and other life needs that must be addressed to give them opportunities to rebuild their lives. There are few organizations that offer comprehensive services to meet all these needs which forces survivors to seek out services from multiple organizations in the community and puts them at risk for not having their needs met. Organizations that assist human trafficking survivors face many barriers that must be identified and addressed to facilitate optimal service provision and coordination. This study conducted a needs assessment of organizations serving human trafficking victims to identify barriers and generate potential solutions to service provision challenges. According to Altschuld & White’s analytic process, there is low overall service availability for survivors of human trafficking and organizations in this area should prioritize Youth & Family, Health, Substance Abuse, and Education / Vocation services. Organizations in this study experienced structural barriers, such as limited connections to other agencies and difficult referral processes, when serving human trafficking survivors. Service providers also faced organizational barriers, such as lack of staff that specialize in treating survivors of human trafficking and having services available on-site. Implications of these findings include more prevention services, such as a youth drop-in center and educational interventions, a more centralized referral process, and human trafficking-specific funding streams as part of ideal service provision when working with survivors of human trafficking. ACKNOWLEDGEMENTS It took the intellectual and emotional support of numerous people to bring this project to fruition. First, I’d like to thank my committee members, Dr, Rebecca Campbell, Dr. Ignacio Acevedo-Polakovich, and Dr. Caitlin Cavanagh. Your thoughtful feedback and advice helped shape this project and my skills as a researcher. Becki, I’m so grateful you agreed to advise a near stranger with a research topic outside your own. Your flexibility, advice, and support were invaluable when navigating around and through the challenges this project presented. To my friends and family, I cannot express how noticed and appreciated your encouragement was throughout this process. To Sara, Dani, Hannah, and McKenzie, and many others who have been there to commiserate, encourage, and energize – with both caffeine and words – when I needed them most. To Brittney, who reminded me of the potential, power, and importance a good “montage moment” holds. To Mom, Dad, Allison, Andrew, Elizabeth, and “the grandmas” who provide me with the reassurance, love, and understanding that allows me to keep doing the work that means so much to me. Thank you for reminding me what is important in life. Finally, I’d like to thank the participants that devoted their time and expertise to this project. Your enthusiasm and dedication to helping survivors truly inspires me. I am grateful to you for sharing your knowledge with me and with others looking to make a difference. iii TABLE OF CONTENTS LIST OF TABLES ......................................................................................................................... vi LIST OF FIGURES ...................................................................................................................... vii INTRODUCTION ...........................................................................................................................1 LITERATURE REVIEW ................................................................................................................3 Types of Human Trafficking ........................................................................................................3 Sex trafficking ......................................................................................................................3 Labor trafficking ..................................................................................................................4 The Needs of Human Trafficking Survivors ................................................................................5 Physical health .....................................................................................................................5 Mental health .......................................................................................................................7 Life and sustainability ..........................................................................................................8 Challenges in addressing the needs of survivors .................................................................9 CURRENT STUDY.......................................................................................................................12 Phase I: Preassessment—A Community-Based Practicum Project ...........................................14 Phase II: The Current Study .......................................................................................................16 METHODS ....................................................................................................................................18 Sampling .....................................................................................................................................18 Procedure ....................................................................................................................................19 Measure ......................................................................................................................................19 Organizational information ................................................................................................19 Needs assessment ...............................................................................................................19 Current state .......................................................................................................................20 Ideal State...........................................................................................................................21 Analyses .....................................................................................................................................21 Research questions 1a and 1b: Current state......................................................................21 Organizational group – level scores .......................................................................22 Research questions 2a and 2b: Prioritization of need ........................................................25 Research questions 3a and 3b: Ideal state ..........................................................................27 RESULTS ......................................................................................................................................28 Research Question 1a: What is the Current State of Service Provision for Human Trafficking Victims in each Organizational Group? .....................................................................................28 Criminal Justice group .......................................................................................................28 Youth Services group .........................................................................................................28 Gender-based Violence group ............................................................................................29 Human Services group .......................................................................................................29 Health group.......................................................................................................................29 iv Research Question 1b: What is the Current State of Service Provision for Human Trafficking Victims in the Tri-County Area? ................................................................................................30 Research Question 2a: What are the Service Sector Needs at the Organizational Group Level when Service Human Trafficking Victims? ...............................................................................31 Criminal Justice group .......................................................................................................32 Youth Services group .........................................................................................................33 Gender-based Violence group ............................................................................................34 Human Services group .......................................................................................................35 Health group.......................................................................................................................36 Research Question 2b: What are the Service Sector Needs at the Tri-County Level when Serving Human Trafficking Victims? ........................................................................................37 Research Question 3a and 3b: What do Staff Members in Each Organizational Group Perceive as the Ideal State of Service Provision to Address the Needs of Human Trafficking Victims? 3b: What do Staff Members Perceive as the Ideal State of Service Provision to Address the Needs of Human Trafficking Victims in the Tri-county Area? .................................................38 Youth and family ...............................................................................................................39 Youth and family summary ...............................................................................................42 Physical and mental health .........................................................................................................42 Physical and mental health summary .................................................................................45 Education / Vocation..........................................................................................................45 Education / Vocation summary ..........................................................................................47 Substance abuse .................................................................................................................47 Substance abuse summary .................................................................................................49 DISCUSSION ................................................................................................................................51 Summary of Key Findings .........................................................................................................51 Limitations .................................................................................................................................53 Implications for Practice, Policy and Research ..........................................................................55 APPENDIX ....................................................................................................................................59 REFERENCES ............................................................................................................................105 v LIST OF TABLES Table 1. Description of Needs Assessment Phases ........................................................................16 Table 2. Hypothetical Tri-County Need Dimension Means by Service Sector .............................24 Table 3a. Needs Prioritization Decisions for High Current Availability Scores ...........................26 Table 3b. Needs Prioritization Decisions for Low Current Availability Scores ............................26 Table 4. Need Dimension Ratings by Service Sector ....................................................................30 vi LIST OF FIGURES Figure 1. Criminal Justice Group Needs Prioritization Decisions .................................................32 Figure 2. Youth Services Group Needs Prioritization Decisions ..................................................33 Figure 3. Gender-based Violence Group Needs Prioritization Decisions .....................................34 Figure 4. Human Services Group Needs Prioritization Decisions .................................................35 Figure 5. Health Group Needs Prioritization Decisions ................................................................36 Figure 6. All Tri-County Area Needs Prioritization Decisions .....................................................38 vii INTRODUCTION Human trafficking is a global problem involving the use of force, fraud, and coercion to exploit individuals for commercial sex and labor (United States, 2000). This crime is difficult to detect because victims are often abused and exploited in private and/or by psychological means (Di Nicola, 2007). Although it is challenging to precisely determine the prevalence of human trafficking, the number of confirmed human trafficking cases reported to the National Human Trafficking Resource Center (NHTRC) rose from 7,565 cases in 2016 to 8,524 cases in 2017 (NHTRC, 2017). This increase underscores the importance of research and practice that focuses on human trafficking. Human trafficking survivors have physical health, mental health, and other life needs that must be addressed to give them opportunities to rebuild their lives. Many survivors experience physical health problems while they are being trafficked that require long-term care and follow up, such as substance abuse addictions, sexually transmitted infections, and complications from multiple abortions (Lederer & Wetzel, 2014; Muftic & Finn, 2013; Turner-Moss, Zimmerman, Howard, & Oram, 2014). In addition, most survivors who escape struggle with psychological problems such as post-traumatic stress disorder (PTSD), depression, and anxiety (Hickle & Roe- Sepowitz, 2014; Lederer & Wetzel, 2014; Muftic & Finn, 2013; Sabella, 2011). These health issues, along with other life needs such as housing, employment, and legal remedies, can rarely be addressed by one organization, so survivors often have to seek help from multiple social service agencies to address their needs (Baker & Grover, 2013; Clawson & Grace, 2007). Social service agencies that assist human trafficking survivors face numerous organizational and structural barriers that hinder their ability to adequately address the needs of survivors. Organizational barriers include limited funding, staffing, and training. Structural 1 barriers include lack of service coordination among organizations and lack of human trafficking- specific services in an area. If these needs are not identified and addressed, then survivors may “fall through the cracks.” Social service agencies that serve victims of trafficking need to be aware of what services other agencies in their area offer and work towards coordinating service delivery. To that end, a needs assessment of agencies providing services to human trafficking victims was conducted to identify their structural and organizational barriers. 2 Types of Human Trafficking LITERATURE REVIEW Sex trafficking. The Trafficking Victims Protection Act (TVPA)1 defines human trafficking and describes the two main forms of trafficking: sex trafficking and labor trafficking. The TVPA defines sex trafficking as occurring when “a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age.” Sex trafficking occurs in settings such as on the streets, in brothels, strip clubs, massage parlors, or in individual homes (National Human Trafficking Resource Center (NHTRC), 2015). While these settings can operate legally, they foster opportunities for sexual exploitation and a business front for traffickers. For instance, a massage parlor may have sex trafficking victims providing legitimate massages to some clients, but also force them to perform sexual services on others. (Raymond & Hughes, 2001). Sex trafficking that occurs on the street resembles prostitution because the trafficker, often a pimp, maintains control over victims through fear, coercion, and threats of force. The most common techniques for recruiting victims into sex trafficking are finesse pimping and guerilla pimping (Williamson & Prior, 2009). Finesse pimping, also known as “Romeo pimping,” involves psychologically manipulating victims, often female, into sex trafficking by providing them with love, attention, basic needs, shelter, or expensive material gifts. The pimp or trafficker acts like a caring significant other to the victim and coerces them to sell sexual services to demonstrate their devotion and to repay the trafficker. The trafficker eventually becomes abusive and coercive while isolating the victim from any personal 1 The TVPA was passed in the United States in 2000 with the intent of addressing human trafficking through prevention, protection, and prosecution initiatives to both United States (U.S.) and non - U.S. citizens (United States, 2000). 3 relationships. This method of trafficking is similar to the cycle of abuse that occurs in domestic violence (Roe-Sepowitz, Hickle, Dahlstedt, & Gallagher, 2014). Finesse pimping is common among runaway youth who do not have access to resources to meet their basic needs. Traffickers offer youth places to stay, or initiate dating relationships where they provide a sense of love and extravagant gift-giving to make them emotionally dependent before and during the time they are trafficked. The second major sex trafficking recruitment tactic is guerilla pimping. This is where victims are forced into sex trafficking through physical violence, threat of force, and intimidation (Williamson & Prior, 2009). An example would be abducting a victim and forcing them into sex trafficking. Finesse pimping can turn into guerilla pimping. This is particularly common when victims fail to meet the expected monetary quota for their trafficker, who then deprives victims of shelter or becomes physically abusive (Williamson & Prior, 2009). It is important to note that while these descriptions cover the most common contexts in which sex trafficking occurs, they are not exhaustive. For example, in addition to the previously mentioned examples of sex trafficking, any case of child pornography or child prostitution is an instance of sex trafficking (State, 2016). Labor trafficking. The second major form of human trafficking outlined in the TVPA is labor trafficking, which it defines as “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.” Labor trafficking occurs in multiple settings and includes domestic and commercial tasks such as nannying, housekeeping, beauty services (e.g., nail and hair salons), agricultural work, food service staffing, construction work, factory work, and janitorial work (National Human 4 Trafficking Resource Center (NHTRC), 2015; Sabella, 2011). As with the recruitment techniques used in sex trafficking, fraud and coercion are parts of the recruitment process for labor trafficking. Many labor trafficking victims discovered in the U.S. are from countries outside the U.S. and were lured into illegal work through the promise of better education or employment opportunities (Banks & Kyckelhahn, 2011; Owens et al., 2014). Labor trafficking victims often incur “debt” from their recruiters or traffickers on their journey into the country or by living in housing provided by their trafficker. This debt is used to assert control over victims by threatening to seize their home or a family member’s home or by seeking out their family members to repay their debt if they leave the trafficker’s employment. While the TVPA differentiates sex trafficking and labor trafficking, they may not be mutually exclusive experiences. For example, a person is a labor trafficking victim if they are subjected to working long hours in a strip club for little to no pay. However, this person can also be considered a sex trafficking victim if they are forced to perform commercial sex acts. Sexual violence and rape are tactics used in labor trafficking to assert control and keep victims in fear of escaping their situation. This is important to remember when considering the impact both types of trafficking have on survivors, and the needs that they will have if they are able to escape their trafficking situation. The Needs of Human Trafficking Survivors Physical health. Most human trafficking survivors have physical and mental health issues while being trafficked that persist after they escape their traffickers. Unless they are extremely severe or hinder traffickers’ profits, survivors’ health conditions frequently go untreated while they are being trafficked (Lederer & Wetzel, 2014; Muftic & Finn, 2013; Turner- Moss et al., 2014). To understand survivors’ health issues, Lederer and Wetzel’s (2014) 5 conducted a mixed methods study with 107 female domestic sex trafficking survivors that escaped their traffickers. Sixty-seven percent of survivors contracted some form of sexually- transmitted disease or infection while being trafficked, and 44% reported at least one pregnancy while being trafficked. Of the women that had at least one pregnancy, 38% reported having at least one forced abortion. Sixty-eight percent of women that had at least one abortion while being trafficked reported their abortions occurred at clinics, 16% reported going to hospitals, and 14% reported having abortions done in "other" locations, such as an abortionist's home, doctor's office, and a back alley. Other researchers have found higher than usual rates of substance use and abuse among sex workers (e.g., Lederer & Wetzel, 2014; Mutic & Finn, 2013). For example, Muftic and Finn’s (2013) study also found that domestic sex workers and trafficking victims have higher rates of drug and alcohol abuse than international trafficking victims. Furthermore, women who were in the sex industry for longer amounts of time, trafficked or not, were more likely to have higher rates of addiction than women in the sex industry for less time (Muftic & Finn, 2013). Lederer and Wetzel (2014) also found that substance abuse was a health concern for sex trafficking victims. Of the victims in their sample, 84% used alcohol or drugs while being trafficked and 28% reported being forced to abuse substances by their traffickers. Drug use among labor trafficking victims has been shown to be much lower than among sex trafficking survivors. Less than 1% of labor trafficking victims endorsed cannabis or heavy alcohol use in one study’s population (Turner-Moss et al., 2014). While substance abuse can be a preexisting condition, it can become a lasting consequence of sex trafficking if drugs are forced onto victims or if they are used for psychological numbing of trauma (Cecchet & Thoburn, 2014; Lederer & Wetzel, 2014). Abusing substances, particularly intravenously, puts individuals at risk for 6 various health problems, such as HIV and Hepatitis C, and creates a physiological dependence that traffickers can exploit. While labor trafficking has similar physical and mental health impacts as sex trafficking, it also presents unique challenges. Turner-Moss et al. (2014) conducted a study examining 35 case records of labor trafficking survivors receiving services from a nongovernmental organization when they were no longer being trafficked. During the time participants were being trafficked 40% reported experiencing violence, 57% reported they received no health and safety information at work, and 46% were not provided with safety equipment. Thirty percent of participants stated that their work environments were unsafe and likely to result in injury or illness, and 43% of respondents reported being deprived of medical care while being trafficked. After escaping their trafficking situation 81% of participants reported one or more symptoms of poor physical health and 30% reported four or more co-occurring symptoms. The most common symptoms in this sample of labor trafficking survivors were headache, back pain, fatigue, vision problems, and dental pain. A systematic review of health consequences suffered by labor trafficking survivors found health problems reflective of poor living and working conditions (International Organization for Migration, 2009). Chemical hazards, poor ventilation, sanitation issues, sleep deprivation, high-risk equipment, and extremely long work hours all contribute to health consequences of labor trafficking. However, some health consequences that manifest out of these conditions are also common in non-trafficked laborers, such as dehydration, respiratory problems, joint problems, and exhaustion (International Organization for Migration, 2009). Mental health. Multiple studies have found that trafficking survivors experience high rates of psychological problems such as depression, suicidal ideation, addiction, anxiety, and post-traumatic stress disorder (PTSD) as a consequence of sex trafficking (Hickle & Roe- 7 Sepowitz, 2014; Lederer & Wetzel, 2014; Muftic & Finn, 2013; Sabella, 2011). Lederer and Wetzel’s (2014) study found that when survivors were asked about the presence of roughly thirty psychological symptoms and disorders, 96% reported an average of ten psychological problems after they escaped their trafficking circumstances. The most common psychological symptoms and disorders reported were depression (81%), shame/guilt (71%), flashbacks (64%), and PTSD (62%) (Lederer & Wetzel, 2014). In addition, Turner-Moss et al. (2014) found that 57% of labor trafficking survivors endorsed post-traumatic symptoms after being trafficked. Labor trafficking survivors are also impacted by depression and anxiety after escaping their trafficking situations (Oram, Stockl, Busza, Howard, & Zimmerman, 2012; Owens et al., 2014; Turner-Moss et al., 2014). When comparing across groups of sex workers, Muftić & Finn found that domestic sex trafficking victims reported suicidal ideation more often than domestic sex workers and international trafficking victims. This was exacerbated by length of time in the sex industry making outcomes worse for women who were in the industry longer (Muftić & Finn, 2013). Over twenty percent of survivors in Lederer & Wetzel’s (2014) study attempted suicide after escaping their trafficking situation. Many studies cite substance use as a coping mechanism for trafficking survivors as a way to self-medicate with drugs and alcohol to numb the pain or trauma so treatment is both a physical and mental health need survivors will have to address upon escaping their trafficking situation (McClain & Garrity, 2011; Cecchet & Thoburn, 2014). Life and sustainability. People who leave their trafficking situation must typically urgently find housing (Aron, 2006; Baker & Grover, 2013; Clawson, Dutch, Solomon, & Goldblatt, 2009). This is especially likely if the survivor did not have stable housing or lived outside of the U.S. prior to being trafficked. Securing housing for trafficking survivors can be made more difficult by some the health conditions that survivors are more likely to experience. 8 For example, Clawson and Grace (2007) found that substance abuse often excluded survivors from being able to access services or stay in shelters. Survivors may have legal needs that they wish to address after getting out of trafficking such as immigration status for international trafficking survivors (Aron, 2006). Legal advocacy services can assist survivors when filing for T Nonimmigrant Status (T-visa). T-visas are visas specifically created to aid trafficking victims to settle any immigration issues that face due to being trafficked (Health & Human Services USA, 2012). Although T-visas are beneficial to trafficking survivors, the process of obtaining T-visa status can take months or years and requires the cooperation of the survivor if prosecuting their trafficker (Aron, 2006; Health & Human Services USA, 2012). Securing housing for trafficking survivors during this process is necessary for them to successfully achieve T-visa status. Survivors will typically need to obtain legal employment. Many survivors report that gainful employment is a more important immediate need to them than mental healthcare (Lynch & Mason, 2014). However, human trafficking survivors may not have job training, basic life skills, and competency in speaking English which are necessary to obtain and maintain gainful employment (Johnson, 2012). If survivors experience the barriers described above when going through the T-visa process it can affect their ability to obtain employment since legal immigration status is necessary for international trafficking survivors (Aron, 2006; Health & Human Services USA, 2012). Therefore, it is crucial that housing, legal, and employment needs be addressed simultaneously when serving human trafficking survivors. Challenges in addressing the needs of survivors Survivors’ successfully recovery can be best fostered by facilitating access to services and supports that help them effectively address their multiple needs (Johnson, 2012). However, 9 the complex and overlapping needs of survivors often create significant barriers that hinder this process. Survivors can be forced to navigate a large number of social, legal, and health services, making them vulnerable for insufficient care (Davy, 2015). Powell et al. (2018) outlined a conceptual framework of barriers relevant to addressing the needs of human trafficking survivors. At the core of this framework is service availability; the most fundamental barrier survivors encounter is that needed services they need are unavailable. Even when services are available, survivors may still encounter organizational and structural barriers (Powell et al., 2018). Organizational barriers include limited funding, staffing, and training. Structural barriers include lack of service coordination among organizations, and lack of human trafficking-specific services. The findings form recent research illustrate the importance of coordination among human trafficking service providers (Baker & Grover, 2013; Clawson & Dutch, 2008; Clawson et al., 2003; Clawson & Grace, 2007; Kim, Park, Quiring, & Barrett, 2018). In their national needs assessment study of organizations providing services to victims of human trafficking survivors, Clawson and colleagues (2003) found that ineffective coordination with federal (44%) and local (39%) agencies were major barriers to providing services. These researchers also found that about 50% of the organizations were able to meet some, but not all, needs of trafficking victims. More specialized services, such as sexual assault and prostitution recovery services, had more difficulty meeting survivor needs than larger, less-specialized organizations because the larger organizations had more departments that they could refer victims to within the organization. To address these system-level challenges, some communities have created specialized case management programs designed to facilitate communication across multiple organizations that serve human trafficking victims. Davy (2015) reviewed evaluations of such programs and 10 found that the needs of victims at all three collaborative victim support programs changed over time. Once basic needs such as emergency housing, food, clothing, and safety were addressed, victims were able to shift their focus on their recovery from their trafficking situation and utilize mental health, employment, and education services to rebuild their lives (Davy, 2015). However, these needs could not all be met at one organization. Case managers at the collaborative victim support programs were responsible for addressing victims’ needs by coordinating service referrals when the needs of survivors were unable to be met "in-house" at the programs. Therefore, all three evaluations emphasized collaboration and networking as primarly components of success in the victim support programs. One of the main barriers to effective service provision reported in the evaluations was "insufficient organizational capacity and resources” (Davy, 2015). In addition, when referrals needed to be made the service delivery process was poorly coordinated and survivors were not able to access the help they needed (Davy, 2015). 11 CURRENT STUDY Human trafficking survivors must navigate a “fragmented patchwork of care” with numerous service providers to address the extensive needs they experience upon escaping their trafficking situation (Powell et al., 2018, p. 257). Powell’s (2018) conceptual model outlines multiple service delivery barriers, but little is known about the specific needs of each service sector (i.e., housing services, substance abuse, and mental health treatment, etc.) that survivors must access in their recovery process. Working in collaboration is a necessity for organizations serving human trafficking victims, but doing so is not without its challenges (Clawson et al., 2003; Davy, 2015; Powell et al., 2018). Specific organizational and structural barriers must be identified so they can be addressed to improve a community’s response to trafficking survivors. Therefore, the current study will be an assessment of service availability and coordination needs among organizations providing services to victims of human trafficking. A needs assessment is the process of identifying and prioritizing needs to develop strategies to address them (Altschuld & Kumar, 2010). Needs assessments vary widely in scope as they can be conducted informally by individuals or formally by researchers, evaluators, communities, institutions, or government agencies (Altschuld & Kumar, 2010). Despite the recent growth and development of trafficking-related research, there is still a dearth in knowledge about the needs of organizations providing services to victims of human trafficking. Needs assessments of services available to trafficking victims are necessary because they will help develop more targeted approaches to this issue particularly in under resourced areas. At the core of all needs assessments is the interest in identifying discrepancies between “what is” available and “what should be” available to inform strategies to close the gap between the two conditions. For example, in housing service availability for victims of trafficking, “what is” 12 would assess what shelters and transitional housing services are currently available at an organization or in the community. The “what should be” condition would assess what the ideal state of housing service availability would be to meet every need of trafficking victim such as, more shelters and affordable housing options in the community. Examining the differences between these conditions would reveal the service availability needs of housing service providers and relevant next steps towards meeting them. This study used a needs assessment process model developed by Altschuld and Witkin (2000). According to their process model, needs assessments are conducted in three phases; Phase I: Preassessment, Phase II: Assessment, and Phase III: Postassessment (Altschuld & Kumar, 2010). The Preassessment Phase (Phase I) consists of the initial familiarization with the issue or concern of interest. This stage takes advantage of existing data sources and aims to determine what is already known about the topic of interest. More in-depth information may be needed based on findings from the Preassessment Phase. The Assessment Phase (Phase II) gathers new data on the issue of interest and identifies high-priority needs. This stage focuses on “what is” and “what should be” conditions and the discrepancies between them. The Postassessment Phase (Phase III) consists of designing and implementing solutions to address the high-priority needs identified in Phase II. In each of these phases, Altschuld and Kumar (2000) recommend collecting data from multiple levels of analyses. Level 1 consists of the direct recipients of the services such as human trafficking survivors. Altschuld and Kumar (2000) state that the needs of individuals from Level 1 are the most important because it is their needs that Level 2 and 3 are trying to resolve. Level 2 consists of individuals or groups that provide services to a Level 1 group such as staff at the organizations serving human trafficking survivors. Level 2 stakeholders have direct contact with 13 Level 1 groups, so it is critical to include staff in a needs assessment, particularly if there are practical, ethical, or economic reasons why it may not be possible to survey Level 1 stakeholders directly. Level 3 focuses on the resources and supportive structures that enable Level 2 to provide services to Level 1 such as, buildings, facilities, transportation systems, salaries and benefits, or classrooms. Level 3 is important to assess because it gives information about the overall context in which Levels 1 and 2 live and operate. Phase I: Preassessment—A Community-Based Practicum Project Phase I preliminary data were collected from members of a tri-county human trafficking task force in Mid-Michigan as part of my first-year graduate practicum course project. The goal of this interagency task force is to coordinate service provision for human trafficking victims and consists of representatives from local organizations that provide assistance to human trafficking survivors such as, local law enforcement, faith-based organizations, nongovernmental organizations, housing services, foster care, legal professionals, gender-based violence organizations, healthcare professionals, and vocational training organizations. During this phase, I met with individual service providers (i.e., Level 2 stakeholders) in the tri-county area to discuss the challenges they were facing in their organization. From these discussions, I learned that it would be difficult to work directly with human trafficking victims (i.e., Level 1 stakeholders) during this Preassessment Phase or in subsequent phases. It would be difficult to access a sufficient number of human trafficking survivors at the organizations in the task force. More importantly, it would be inadvisable to interview survivors as many would be expected to be in the early stages of their recovery, and participation in a research interview could be distressing to them. According to the World Health Organization’s (WHO) “Ethical and Safety Recommendations for Interviewing Trafficked Women” protocol interviewers should “treat each 14 woman and the situation as if the potential for harm is extreme until there is evidence to the contrary” (Zimmerman & Watts, 2003). Therefore, for the Presassessment Phase, and all subsequent phases of this needs assessment, the members of the task force and I readily agreed that it would be inadvisable to try to interview human trafficking victims. In the Preassessment Phase, it also became clear that that Level 3 needs—resources and supportive structures—would not be a primary focus because none of these needs were mentioned in any of the task force members’ responses. Therefore, the scope of the Preassessment Phase and subsequent phases focused on Level 2 (staff) only. The task force chairperson and I identified the need to collect pilot data of victim demographics to include in upcoming city and state grant proposals to fund task force activities. In addition, task force members indicated a gap in knowledge about service availability for trafficking survivors in the tri-county area. Therefore, I created a preliminary survey based on the goals identified by the task force chairperson and members that asked respondents to estimate the amount of confirmed and suspected human trafficking victims their organization served in the past year, the demographics of these victims, what services trafficking victims need most, and the extent to which those services are available in the tri-county area. This Qualtrics survey was disseminated to task force members through e-mail and asked members to respond on behalf of the organization they represented. Preliminary findings from this pilot provided some insight into the population of victims seeking help in the tri-county area. In addition, this survey contributed preliminary data indicating that service providers felt the needs of trafficking victims were not being met in their service area. The preliminary survey did not ask any further questions about why service providers felt the needs of trafficking victims were not being met, which prompted the needs assessment to continue onto Phase II as the current study. 15 Table 1. Description of Needs Assessment Phases. Level 1: Primary direct recipients of the services Level 2: Secondary individuals or groups that provide services to a Level 1 group Level 3: Tertiary resources and supportive structures that enable Level 2 to provide services to Level 1 Phase I: Preassessment Initial familiarization with the issue using existing information and data sources. Practicum Project: Phase II: Assessment Collects new data to focus on “what is” and “what should be” conditions and the discrepancies between them. Current Study: Phase III: Postassessment Designs and implements solutions to address the high- priority needs identified in Phase II. • Informal meetings with service providers in tri-county area • Survey creation and dissemination • How many HT survivors they served in past year, survivor demographics, risk factors associated with HT survivors in their area, services with waitlists, information-sharing and referral network questions 1. Current state of service provision - Organizational level - Tri-county level 2. Assessment of needs - Organizational level - Tri-county level Ideal state of service provision - Organizational level - Tri-county level 3. Phase II: The Current Study Based on preliminary findings from Phase I, the current study was conducted at Phase II (Assessment Phase) and focused on Level 2 of need. The current study examined the service provision and availability needs of organizations serving human trafficking survivors in a tri- 16 county area. Based on previous research on service provision for human trafficking survivors, no single organization can handle every need a survivor has so a networked approach to care is required (Clawson et al., 2003; Davy, 2015; Powell et al., 2018). Because organizations must collaborate with one another to adequately address the needs of trafficking victims this study compared the “what is” available conditions and the “what should be” available conditions of organizations across the interorganizational tri-county network. Consistent with Phase I procedures, the Phase II interviews inquired about needs at the organizational level of analysis and there was one interview per organization. The research questions this study aimed to answer were: 1a. What is the current state of service provision for human trafficking victims in each organizational group? 1b. What is the current state of service provision for human trafficking victims in the tri- county area? 2a. What are the service sector needs at the organizational group level when serving human trafficking victims? 2b. What are the service sector needs at the tri-county level when serving human trafficking victims? 3a. What do staff members in each organizational group perceive as the ideal state of service provision to address the needs of human trafficking victims? 3b. What do staff members perceive as the ideal state of service provision to address the needs of human trafficking victims in the tri-county area? 17 Sampling METHODS All organizations affiliated with the mid-Michigan regional human trafficking task force in Phase I were asked to participate in this study. Organizations were identified through 1) the task force resource guide of services in the tri-county area (n = 25) and 2) member directory from attendance rosters of regional human trafficking task force meetings (n = 6). These 31 organizations were screened prior to being interviewed for Phase II to ensure they were indeed eligible for this study. The sole inclusion criterion for this study was that an organization provided assistance to human trafficking victims in the counties the task force represented. In the context of this study “assistance” meant providing direct service provision or facilitating access or referrals to services. Individuals at each organization were contacted by phone or email and asked the following screening questions: 1) “Is your organization located in Ingham, Eaton, or Clinton county?” 2) “Has your organization ever provided direct services, given assistance, or given referrals to human trafficking victims?” 3) If “no,” they were asked “Would your organization be able to provide direct services, assistance, or give referrals to human trafficking victims if they came to your organization?” Organizations that answered “no” to either the first or last screening questions were excluded from the study. Additional exclusion criterion for this study was any organization not listed on the task force attendance rosters or in the resource guide. These criteria captured organizations that were already actively involved in serving trafficking survivors but limited the inclusion of organizations that may have just started providing services to survivors after the resource guide was distributed or organizations who were unable to send representatives to attend the monthly task force meetings. After screening, 28 organizations met inclusion criteria and were contacted to participate in the study. 18 Procedure I contacted the 28 organizations to obtain the name and preferred contact information of the person at their organization with the most knowledge on human trafficking. This was done to keep a consistent frame of reference rather than limiting the sampling to a given ranking or position within the organizations. That is, I was interested in the perceptions of organizational representatives with the most knowledge about serving human trafficking victims. In some organizations this was a case manager and in other organizations it was a program director. Each organization was responsible for designating the participant to represent their organization. I contacted the indicated staff members via e-mail or phone to ask if they wanted to participate in the study on behalf of their organization. If the staff member agreed to participate, I set up a time to conduct the interview. A second and third e-mail or phone call was sent to individuals or organizations that did not respond to prior requests. After three communication attempts, I stopped contacting that organization. Fifteen organizations were interviewed for this study for a 54% response rate. I was the sole interviewer for this study and conducted interviews in person or over the phone, depending on the respondent’s preference. Interviews were recorded and transcribed using transcription software through rev.com. Measure Organization information. Respondents were asked to provide the name of the organization they represented and their job title at their organization. Needs assessment. Respondents were asked questions about the following seven service provision sectors: youth & family, housing, legal, immigration, physical & mental health, substance abuse, and education / vocation. These sectors were created based on data collected 19 during the Preassessment Phase about services in the area and service recommendations from the reviewed literature above. The needs assessment consisted of both closed-ended and open-ended items. Current state. Participants were asked to answer triple-scaled needs assessment items for each service provision sector (Altschuld & White, 2010). Triple-scaled items asked respondents about the importance, current availability, and feasibility of providing that service at their organization. These items were closed-ended and participants responded using a five-point Likert scale (i.e., not at all, a little bit, somewhat, quite a bit, to a great extent). The first triple-scaled item was, “to what extent does your organization currently provide _____ services to human trafficking victims.” This was answered with the five-point Likert scale described above. Participants were asked to follow-up on the first triple-scaled question by responding to an open-ended question to describe the current state of service provision at their organization. Next, participants were asked to respond to a closed-ended question about the percentage of time/resources their organization allocates to providing that service. Finally, participants were asked to answer a closed-ended item about the frequency their organization currently provides _____ service to human trafficking victims (e.g., daily, 2-3 times / week, once a week, 2-3 times /month, once a month, once every - other month, once every 6 months, once in the past 12 months). These follow-up questions to the initial triple-scaled item gave a more detailed description of the extent of current availability of each service sector at the organization. The second triple-scaled item was, “how important is it for your organization to provide ______ services to human trafficking victims.” This was answered with the five-point Likert scale described above. Participants were asked a follow-up open-ended question about why it is 20 or is not important to offer that service at their organization. This gave a more comprehensive understanding of how that service is valued at the organization. The third triple-scaled item was, “how feasible is it for your organization to provide _____ services to human trafficking victims.” This was answered with the five-point Likert scale described above. Participants were asked a follow-up open-ended question about why it would or would not be feasible to offer this service at their organization. This item provided further insight into barriers that prevent optimal service provision at the organization. Ideal state. Participants were asked to answer a closed-ended item about the extent they would like their organization to provide ___ service to human trafficking victims. This was answered on a five-point Likert scale (i.e., not at all, a little bit, somewhat, quite a bit, to a great extent). Then, participants were asked to rate the frequency with which they would like their organization to provide this service on a five-point Likert scale (e.g., daily, 2-3 times / week, once a week, 2-3 times /month, once a month, once every - other month, once every 6 months, once in the past 12 months). Finally, participants were asked open-ended items prompting them to describe the ideal service provision they would like their organization to offer and the percentage of time/resources they would like their organization to allocate to providing that service as open-ended items. These items gave a more detailed description of what service providers perceive as the ideal state of service availability conditions to meet the needs of trafficking survivors. Analyses Research questions 1a and 1b: Current state. The current state of service provision at the organizational group and tri-county level was determined by a descriptive analysis of the triple-scaled needs assessment items (i.e., importance, current availability, and feasibility). The 21 triple-scaled needs assessment items were asked for each service category to determine needs at the organizational group level and the tri-county level (Altschuld & White, 2000). Data were reviewed prior to analysis for missing data. One respondent had missing data because they did not provide answers for some service sector triple-scaled items. This did not affect the sample size but these missing data were omitted from the organizational group and tri-county means calculations. Each service sector response ranged from 1 (“not at all”) to 5 (“to a great extent”) for importance, current availability, and feasibility of each service (e.g., housing, substance abuse, immigration, etc.). Consistent with scoring recommendations by Altschuld and White (2000), ratings and means below 3 were considered “below average” on the corresponding dimension (i.e., importance, current availability, and feasibility). A rating or mean over 3 was considered “above average” and ratings or means of 3 were considered “average.” Organizational group - level scores. Individual organizations were combined into five “Organizational Groups” for analysis. 1) The Criminal Justice Group (n=3) contained organizations that were law enforcement departments, agencies, or were part of the court system. This group consisted of one law enforcement department and two juvenile justice representatives. 2) The Youth Service Group (n = 3) contained organizations that exclusively or predominantly served youth under the age of 18. This group contained one youth outreach and transitional housing shelter and two organizations that served youth in the foster care system. 3) The Gender-based Violence Group (n = 3) consisted of organizations that specifically served survivors of gender-based violence such as sexual assault, domestic violence, or sex trafficking. 4) The Human Services Group (n = 4) contained organizations that provided a variety of supportive services to human trafficking survivors. These organizations provided services such 22 as vocational training, food banks, and linkage to service referrals. 5) The Health Group (n = 2) consisted of organizations that primarily provided mental or physical health services. This group contained one mental health organization and one substance abuse detox facility. Thus, the five Organizational Groups answered questions about all 7 service provision sectors in order to develop a comprehensive view of the needs within this tri-county area. Two organizational group-level scores were calculated. The first score was the service sector mean of the importance, current availability, and feasibility ratings for organizations in each group. This score was obtained by calculating the mean of all the raw need dimension ratings from every organization in the organizational group (i.e. Criminal Justice, Youth Services, Gender-Based Violence, Human Services, and Health) for each service sector (i.e., Youth & Family, Housing, Legal, Immigration, Physical & Mental Health, Substance Abuse, Education/Vocation). The second score was an overall organizational group mean score for importance, current availability, and feasibility ratings across all service sectors within the organizations in the group. This score was generated by calculating the mean of the importance, current availability, and feasibility ratings across all service sectors within each organizational group to describe each group’s general level of need. Tri-county-level scores. Two tri-county-level scores were calculated (Table 2). The first score was the tri-county service sector mean scores for the importance, current availability, and feasibility across all organizations in the tri-county area. This score was calculated by averaging importance, current availability, and feasibility means for every service sector at each organization in the tri-county area. 23 Table 2 contains the hypothetical analysis of the tri-county-level scores. The data in the table are the hypothetical means for the triple-scale items for all organizations in the tri-county sample. For example, the current availability means for Youth and Family services from all 15 organizations in the sample was averaged to generate the mean current availability of youth and family services score for the tri-county area, or 2.48. This process was also done to calculate the importance and feasibility of Youth and Family scores in the tri-county area resulting in means of 3.61 and 4.33 respectively. This process was then repeated for all the other service sectors. These tri-county service sector mean scores reflect what services are the most or least important, currently available, and feasible for organizations in the tri-county area. A second score was calculated to get the overall tri-county mean score for importance, current availability, and feasibility means across all organizations within the tri-county area. This score was generated by averaging all the tri-county service sector mean scores across the entire tri-county area for importance, current availability, and feasibility. In Table 2, the current availability score for the tri-county area was obtained by calculating the mean of current availability scores from all service sectors (i.e., youth & family, housing, legal, etc.). This score reflects the overall level of service availability in the tri-county area. This process was then repeated to calculate overall importance and feasibility scores for the tri-county area. Table 2. Hypothetical Tri-County Need Dimension Means by Service Sector Needs Dimension Group means by service sector (SD) All Tri-County Organizations Youth & Family (n = 15) Housing (n = 15) Legal Immigration (n = 15) (n = 15) Physical & Mental Health (n = 15) Substance Abuse (n = 15) Education / Vocation (n = 15) Mean Scores Tri- county group means 24 Table 2. (cont’d) Current Availability Importance 2.48 Feasibility 4.43 2.21 2.64 4.25 4.88 4.79 2.16 3.52 4.98 2.32 3.11 1.67 2.55 2.37 2.45 1.67 2.69 2.66 2.84 3.20 3.36 3.61 4.33 Research question 2a and 2b: Prioritization of need. Needs were identified at the organizational group and tri-county level using the results from the means described above. The previous results provided a singular mean score for each needs dimension as a way to start conceptualizing needs for organizational groups and the tri-county area. The next step in Altschuld and White’s (2000) analytic process was to compare these means to pre-specified metrics that will help prioritize needs. Tables 3a and 3b contain matrices that determined which services were prioritized as needs. The scales in the matrices refer to ratings and mean scores so the tables were used in the same way at both the organizational group and tri-county level. Table 3a was used when current availability ratings were high (i.e., above 3) whereas Table 3b was used when current availability means were low (i.e., below 3) at the organizational group and tri- county level. In some cases, the current availability means were exactly 3 and therefore did not indicate which matrix should be used to prioritize need. When this was the case, the low current availability matrix was used to prioritize need. When current availability means were high, or above average, (Table 3a) and importance means were low, the service being assessed was not considered a need. When importance means and feasibility means were high, there was no need for further action because it is likely that the service being assessed was already being implemented either at the organizational group or tri- county level. However, when importance means were high and feasibility means were low it may be necessary to inquire about the capacity of the organization/s to continue offering the service in the Postassessment Phase. 25 Table 3a. Needs Prioritization Decisions for High Current Availability Scores 5 e c n a t r o p m I 4 3 2 1 Does the organization have the capacity to sustain service provision? (Phase III) No action needed on these services Services rated here require no Services rated here require no further action further action 1 2 3 4 5 Feasibility Table 3b. Needs Prioritization Decisions for Low Current Availability Scores e c n a t r o p m I 5 4 3 2 1 Further information needed about ideal conditions required to offer these services (Phase III) Organization should focus on these services (Current Study: Reference Phase II qualitative data) Services rated here require no Services rated here require no further action further action 1 2 3 4 5 Feasibility 26 When current availability means were low, or below average, (Table 3b) and importance means were also low the service being assessed was not a prioritized need. Overall, if the average importance mean was high and the current availability mean was low the service was considered a need for the organizational group or tri-county area. There were two needs determination decisions based on feasibility means within the high importance and low current availability rating. When feasibility means were high it was decided that organizations should focus their efforts on providing these services. When feasibility means were low it was determined that organizations or communities should continue onto the Postassessment Phase to identify what resources and conditions are required to be able to offer these services in the future. Research questions 3a and 3b: Ideal state. Finally, to understand each of the prioritized needs at the tri-county level, a qualitative thematic analysis was conducted on the open-ended questions that pertained to that need. The analysis was informed by the process outlined by Altschuld & White (2010). First, I reviewed and compiled the portions of the transcripts that discussed the prioritized service sector needs at the tri-county level. Again, since previous research indicated that organizations rarely work alone to address the needs of trafficking survivors I analyzed the service availability needs of the tri-county interorganizational network. In other words, I read the sections of the interview transcripts from all 15 organizations that discussed the service sectors identified as being in need. Next, I identified categories that described the data. Finally, I reviewed the categories to create themes that described the ideal state of service provision at the organizational and tri-county levels and the barriers service providers face when trying to provide the ideal services. 27 RESULTS Research Question 1a: What is the Current State of Service Provision for Human Trafficking Victims in each Organizational Group? Table 4 contains the means of each triple-scale need dimension (i.e., current availability, importance and feasibility) by service sector for all organizational groups and for all organizations in the tri-county area. The top portion the table reflects the organizational group data (i.e., Criminal Justice, Youth Services, Health, etc.) with each column in the table representing the organizational group means for each service sector (i.e., Youth & Family, Housing, Legal, etc.). The final column on the far right of the table is the overall organizational group mean for each triple-scale need dimension. The columns in the last few rows are the tri- county averages of every organization’s service sector triple scale need dimension measures with the final column on the far right being the overall tri-county averages across all service sectors. Criminal Justice group. The current availability means for all service sectors in the Criminal Justice group were averaged which revealed that overall service availability was low for this organizational group (M = 2.48, SD = 1.50). The average level of importance scores across all service sectors for organizations in this group was high (M = 3.61, SD = .83) with the average level of importance for Youth and Family services being the highest across all organizations (M = 4.33, SD = .58). Finally, the average level of service provision feasibility across all service sectors in this group was high (M = 3.61, SD = .83). Youth Services group. The mean current availability score was high when averaging across all service sectors means given by organizations in the Youth Services group (M = 4.10, SD = .63). The average level of importance scores for organizations in this group was high (M = 28 4.50, SD = .87). Finally, the average level of service provision feasibility in this group was also high (M = 4.21, SD = .91). Gender-based Violence group. The current availability of services was low when averaging all service sector means for organizations in the Gender-based Violence group (M = 2.52, SD = 1.02). The average level of importance scores for organizations in this group was high (M = 3.79, SD = .99) with the average level of importance being the highest for Physical & Mental Health services across all service sectors (M = 5.00, SD = .00). The average level of service provision feasibility in this group was high (M = 3.14, SD = .98). Human Services group. The current availability of services was averaged across all service sectors to reveal that current availability was for organizations in the Human Services group low (M = 2.14, SD = .94). The average of all service sector importance means for organizations in this group was low (M = 2.90, SD = 1.26) with the average level of importance for Immigration services being the lowest across all organizations (M = 1.67, SD = 1.16). Finally, the average of service provision feasibility means across all service sectors in this group was low (M = 2.52, SD = .94). Health group. The current availability means were averaged across all service sectors for organizations in the Health group to reveal low overall current availability of services for this group (M = 2.00, SD = .82). The average of all service sector importance means was low for organizations in this group (M = 2.36, SD = .94) with the average level of importance for Legal and Immigration services being the lowest of all service sector averages (M = 1.00, SD = .00; M = 1.00, SD = .00). Finally, the average of service provision feasibility means in this group was low (M = 2.21, SD = .91). 29 Research Question 1b: What is the Current State of Service Provision for Human Trafficking Victims in the Tri-County Area? The average of current availability means for all service sectors across all organizations in the tri-county area of services was low (M = 2.56, SD = .55). The average of importance means for all service sectors across all organizations was high for the tri-county area (M = 3.32, SD = .65) with the average of importance means being the highest for Youth and Family services when compared to all other service sectors (M = 4.21, SD = 1.25). Finally, the average of service provision feasibility means was high for the tri-county area (M = 3.11, SD = .43). Table 4. Need Dimension Ratings by Service Sector Needs Dimension Current Availability Importance Group means by service sector (SD) Criminal Justice Organizations Mean Scores Youth & Family (n = 3) Housing (n = 1) Legal (n = 1) Immigration (n = 1) Physical & Mental Health (n = 1) Substance Abuse (n = 1) Education / Vocation (n = 1) 2.33 (1.53) 3.00 (n/a) 3.00 (n/a) 3.00 (n/a) 1.00 (n/a) 3.00 (n/a) 2.00 (n/a) 2.48 (1.50) 4.33 (.58) 4.00 (n/a) 4.00 (n/a) 4.00 (n/a) 2.00 (n/a) 4.00 (n/a) 3.00 (n/a) 3.61 (.83) Feasibility 4.33 (.58) 4.00 (n/a) 4.00 (n/a) 4.00 (n/a) 2.00 (n/a) 4.00 (n/a) 3.00 (n/a) 3.61 (.83) Youth Services Organizations Youth & Family (n = 4) Housing (n = 3) Legal (n = 3) Immigration (n = 2) Physical & Mental Health (n = 3) Substance Abuse (n = 2) Education / Vocation (n = 3) 4.67 (.58) 4.50 (.71) 3.50 (2.12) 3.50 (2.12) 5.00 (.00) 3.50 (2.12) 4.00 (1.41) 4.10 (.63) 5.00 (.00) 5.00 (.00) 3.00 (1.41) 3.50 (2.12) 5.00 (.00) 5.00 (.00) 5.00 (.00) 4.50 (.87) Current Availability Importance Feasibility 5.00 (.00) 5.00 (.00) 3.00 (2.83) 3.00 (2.83) 5.00 (.00) 4.00 (1.41) 4.50 (.71) 4.21 (.91) Gender-based Violence Organizations Youth & Family (n = 2) Housing (n = 3) Legal (n = 3) Immigration (n = 3) Physical & Mental Health (n = 3) Substance Abuse (n = 3) Education / Vocation (n = 3) 2.00 (.00) 3.67 (1.53) 2.33 (.58) 1.00 (.00) 4.00 (1.00) 2.33 (2.31) 2.33 (2.31) 2.52 (1.02) 4.50 (.71) 4.00 (1.00) 4.67 (.58) 2.67 (1.16) 5.00 (.00) 3.00 (2.00) 2.67 (1.16) 3.79 (.99) Current Availability Importance Feasibility 2.00 (.00) 3.33 (2.08) 4.67 (.58) 3.33 (1.53) 4.00 (1.00) 2.33 (2.31) 2.33 (2.31) 3.14 (.98) 30 Table 4. (cont’d) Youth & Family (n = 3) Housing (n = 3) Human Services Organizations Legal (n = 3) Immigration (n = 3) Physical & Mental Health (n = 3) Substance Abuse (n = 3) Education / Vocation (n = 3) 3.67 (1.16) 2.33 (2.31) 1.33 (.58) 1.00 (.00) 2.00 (1.00) 1.67 (.58) 3.00 (2.00) 2.14 (.94) 4.67 (.58) 4.00 (1.73) 2.00 (1.73) 1.67 (1.16) 3.33 (1.16) 1.33 (.58) 3.33 (1.53) 2.90 (1.26) Current Availability Importance Feasibility 4.00 (1.00) 1.33 (.58) 2.00 (1.73) 1.67 (1.16) 2.67 (1.53) 2.67 (1.53) 3.33 (2.08) 2.52 (.94) Youth & Family (n = 2) Health Organizations Housing (n = 2) Legal (n = 2) Immigration (n = 2) Physical & Mental Health (n = 2) Substance Abuse (n = 2) Education / Vocation (n = 2) 2.50 (2.12) 2.50 (2.12) 1.00 (.00) 1.00 (.00) 2.50 (2.12) 3.00 (2.83) 1.50 (.71) 2.00 (.82) 3.00 (2.83) 3.00 (2.83) 1.00 (.00) 1.00 (.00) 3.00 (2.83) 3.00 (2.83) 2.50 (2.12) 2.36 (.94) Current Availability Importance Feasibility 3.00 (2.83) 2.50 (2.12) 1.00 (.00) 1.00 (.00) 3.00 (2.83) 3.00 (2.83) 2.00 (1.41) 2.21 (.91) Youth & Family (n = 14) Housing (n = 12) All Tri-County Area Organizations Legal Immigration (n = 12) (n = 11) Physical & Mental Health (n = 12) Substance Abuse (n =11) Education / Vocation (n = 12) 3.00 (1.52) 3.08 (1.62) 2.00 (1.21) 1.64 (1.29) 2.92 (1.68) 2.55 (1.70) 2.75 (1.66) 2.56 (.55) 4.21 (1.25) 3.83 (1.47) 2.75 (1.71) 2.36 (1.43) 3.67 (1.67) 3.00 (1.84) 3.42 (1.62) 3.32 (.65) Current Availability Importance Feasibility 3.64 (1.55) 3.58 (1.68) 2.75 (1.87) 2.45 (1.64) 3.25 (1.66) 3.00 (1.73) 3.08 (1.68) 3.11 (.43) Research Question 2a: What are the Service Sector Needs at the Organizational Group Level when Serving Human Trafficking Victims? The following results present the prioritized needs for each organizational group using Altschuld and White’s method. The triple scale current availability, importance, and feasibility scores from Table 4 are presented on the need dimension matrices. Service sectors with high current availability scores (i.e., under 3) are presented in green in the matrices. Service sectors with moderate current availability scores (i.e., exactly 3) are presented in orange and low current availability scores (i.e., below 3) are presented in red. Service sectors presented in red or orange text in the top, right quadrant of the matrices were classified as being a need for that organizational group. 31 Criminal Justice group. Figure 1 reflects where each service sector falls in the matrix based on the need dimension means for Criminal Justice organizations. Youth and Family, Housing, Legal, Immigration, and Substance Abuse services were identified as being a need for criminal justice organizations because they had low to moderate current availability, high importance, and high feasibility. Education / Vocation services were on the margin of being considered a need for this group of organizations because although this service sector had low current availability, it only had moderately important and feasibility mean scores. The group means across all service sectors indicated there was an overall need in service provision for organizations in the Criminal Justice group because the overall current availability mean was low and importance and feasibility mean scores were high. Figure 1. Criminal Justice Group Needs Prioritization Decisions 32 Youth Services group. Figure 2 shows where the need dimension means lie in the matrix for Youth Services organizations. No service sectors were identified as being a need for Youth Service organizations because every service sector had high current availability means. The group means also indicated there was not an overall need in service provision for organizations in the Youth Services group because the overall current availability mean was high and importance and feasibility mean scores were also high. Figure 2. Youth Services Group Needs Prioritization Decisions 33 Gender-based Violence group. The need dimension means are reflected in Figure 3 for Gender-based Violence organizations. The Legal service sector was identified as being a need for gender-based violence organizations because it had low current availability means and high importance and feasibility means. The group means across service sectors indicated there was an overall need in service provision for organizations in the gender-based violence group because the overall current availability mean was low and importance and feasibility mean scores were high. Figure 3. Gender-based Violence Group Needs Prioritization Decisions 34 Human Services group. Figure 4 reflects where the need dimension means fall in the matrix for Human Services organizations. Education / Vocation services were on the margin of being considered a need for this group of organizations because this service sector had moderate current availability and high importance and feasibility. The group means across all service sectors indicated there was not an overall need in service provision for organizations in the Human Services group because the overall current availability mean was low and importance and feasibility mean scores were also low. Figure 4. Human Services Group Needs Prioritization Decisions 35 Health group. Figure 5 demonstrates where the need dimension means fall in the matrix for Health organizations. No services were identified as being a need for the health organizations. Youth & Family, Physical & Mental Health, and Substance Abuse services were on the margin of being considered a need for this group of organizations because they had low or moderate current availability mean scores and moderate importance and feasibility mean scores. The group means across all service sectors indicated there was not an overall need in service provision for organizations in the Health group because the overall current availability mean was low and importance and feasibility mean scores were also low. Figure 5. Health Group Needs Prioritization Decisions 36 Research Question 2b: What are the Service Sector Needs at the Tri-County Level when Serving Human Trafficking Victims? Figure 6 reflects where the need dimension means fall in the matrix for all organizations in the tri-county area. Youth & Family, Physical & Mental Health, and Education / Vocation services were identified as being needs for the tri-county area because they had low to moderate current availability scores and high importance and feasibility scores. Substance Abuse services were on the margin of being considered a need for this group of organizations because this service sector had a low current availability mean score and moderate importance and feasibility mean scores. The group means across all service sectors indicated there was an overall need in service provision for organizations in the tri-county area because the overall current availability mean was low and importance and feasibility mean scores were high. Figure 6. All Tri-County Area Needs Prioritization Decisions 37 Research Question 3a and 3b: 3a. What do Staff Members in Each Organizational Group Perceive as the Ideal State of Service Provision to Address the Needs of Human Trafficking Victims? 3b: What do Staff Members Perceive as the Ideal State of Service Provision to Address the Needs of Human Trafficking Victims in the Tri-county Area? The need dimension matrices revealed Youth & Family, Physical & Mental Health, and Education / Vocation services as being needs for the tri-county area with Substance Abuse services approaching need. This section is organized into four sections for each of the tri-county needs. Within these sections are five subsections that describe the qualitative data provided by respondents from each of the organizational groups. Select stakeholder perspectives will be presented to further illustrate select tri-county needs. Youth and family. Organizations in the Criminal Justice group described the ideal state of Youth & Family service provision within their organizations as an extension of the services they already provide. More specifically, these organizations wanted to sustain their existing services and add preventative interventions, such as educational groups for youth about healthy relationships. Groups in the Criminal Justice group stressed the importance of increased collaboration, specifically when tracking prior service provision and law enforcement involvement when working at the tri-county level. One respondent gave the following suggestion: But in a perfect world, something like that where you've got one system, one tracking system, whether it is an app or maybe it's some sort of a protected online portal. Something like that. Where then it's start to finish. That way we're not ... CPS can't send us a report. And we can't send them parts of our report. You know, I don't know what all those requirements are. … But I've had that with different organizations before where just because we're law enforcement or whatever, they can't share and vice versa. Which makes it a whole other layer of added or duplicated work, too. 38 When discussing ideal services at the tri-county level, Criminal Justice organizations mentioned non-justice system alternatives for youth such as a drop-in center or a local residential facility specifically for trafficking victims. One respondent stated, “But when I talk about ‘we push kids into trafficking situations,’ we really do as a system. And we recognize that. … So yeah, a drop- in center, a place where kids can go that's safe in our community when they make a mistake or want to run.” Criminal Justice organizations cited restrictive information-sharing policies across agencies, strict licensing restrictions for serving youth, and lack of time to fully collaborate as the main organizational and structural barriers to providing the ideal services to trafficked youth. The ideal state of service provision at organizations in the Youth Services group was described as having more resources than are currently available such as, additional funding and increased transportation. In addition, organizations emphasized the need for specialized trainings and services to address the needs of trafficking victims. One respondent in the Youth Services group described the importance of trainings at their organization: Then once again, just the trainings because we are serving such a small specialized ... It's such a specialized program that there aren't a lot of trainings that really hit the nail on the head regarding what our foster families, what our staff are going to be experiencing. Organizations in the Youth Services group that specifically worked with youth involved in the foster care system stated the need for more therapeutic foster homes and trainings for foster parents that care for trafficked youth. When speaking about the ideal service provision at the organizational and tri-county level, organizations in this group stressed the need to keep youth in the community rather than refer them to services far outside the community. One respondent from the Youth Services group suggested the following: But like I said, maybe like a structure or a residential, something here to keep them in the community, to try to make it a little less of a struggle for them. I think, like I said with the last, with one of the two, she ended up running away from the facility, and it's in Detroit, 39 so, that was obviously fearful for us, but we were able to get her back safely. But I think it's, you're pulled away from the community and that makes it difficult for them. Organizations in the Youth Services group that specifically serve youth in foster care discussed the need to make existing services available to youth after they age-out of the system. Collaboration, coordination of resources, and stronger task force presence were topics central to ideal tri-county service provision. Respondents also wanted schools to become more involved in prevention efforts and for organizations to increase their existing collaboration with law enforcement. Organizations hope these practices will ameliorate structural barriers and lead to more streamlined referrals and service provision. Organizational barriers to providing ideal services included limited funding and transportation. Organizations also cited lack of staff as a barrier because human trafficking case are time intensive and monopolize most of case workers’ time. Most of the organizations in the Gender-based Violence group stated their organization would not be able to specialize in offering Youth & Family services however, they said they would ideally have human-trafficking advocates that could assist both adult and youth victims. Organizations in this group described ideal tri-county service provision as having a more centralized referral process, increased information sharing, and increased access to resources when serving youth and families. Organizations from this group would ideally like to have better connections to housing services, schools, and youth service agencies. Additionally, organizations in the gender-based violence group would ideally like the local task force to be more visible and have more of a presence in the community. One respondent said, “I would like to see a lot of collaboration. I'd like to see more collaboration too from the trafficking coalition. I've heard they're doing a lot of good things but haven't really seen a lot in the community yet.” Funding restrictions and technicalities were cited as barriers to providing ideal services to youth. One 40 respondent explained, “Even with us if you identify as human trafficking but you don't say you were sexually assaulted or you don't identify it as domestic violence, we can't ... We can give you resources, but we ourselves can't provide you with our services.” Geographic isolation of the organizations and inadequate transportation availability were also seen as barriers. Overall, organizations in the Human Services group stated they ideally see their organizations as being able to fill the gaps in service other organizations cannot address. When describing how they would do this, one organization said, What they're not able to do, maybe we could say, "Well, let's do the other part." I always like the idea of expanding services and collaborating with other agencies. You don't have to recreate the wheel if it's there. You could add another spoke to it. That's what I would really like it to be. Organizations in the Human Services group also stated they would like to be better connected to housing and gender-based violence organizations and to have human trafficking advocates on staff to help coordinate services with those organizations. At the tri-county level, respondents stressed the need to address youth homelessness and youth aging out of foster care. The ideal circumstances to do so would include expanding services and establishing a youth drop-in center. These organizations also called for the need to increase community awareness and provide more trainings to professionals so more youth human trafficking victims can be identified and receive services. The main organizational barrier to providing these ideal services was lack of funding. The ideal Youth and Family service provision described by organizations in the Health group would focus on addressing gaps in services that are not being met by other organizations in the area and would have specialized staff trained to work with human trafficking survivors. Now people are expected to get training around human trafficking. Even just knowing what to look for, or how to… we vet in our assessments. I think targeting those specific things is always useful. The more information we have, the more we try to weave that in. 41 The more supervisors are informed as we are hearing about situations, we can help staff be aware. Organizations in the Health group said ideal tri-county service provision would include more information sharing about best practices for serving trafficking victims and serving non justice- involved youth victims of trafficking as one respondent noted, “I think when kids aren't involved in court programming then we certainly need to figure out how to fill in the gaps there.” Barriers to providing these ideal services to youth and families included insurance acceptance limitations and lack of knowledge about best practices when working with human trafficking survivors. Youth and family summary. When looking across all organizations in the tri-county area similar themes emerged when discussing Youth and Family Services. First, a youth drop-in center was mentioned by multiple respondents all in different organizational groups (i.e. Criminal Justice, Youth & Family, and Vocational). Respondents stressed the need for youth to have a safe place to go in the community to get their basic needs met. Next, organizations from multiple service groups stressed the desire for a “one-stop shop” for service coordination where they would ideally make one call rather than multiple to find services and resources and to have human trafficking advocates on staff at their organizations to help navigate this. Finally, multiple organizations expressed the desire for the task force to have a greater presence in the community to increase awareness of human trafficking and to facilitate collaboration among service providers. Physical and mental health. The second service sector identified as being a need at the tri-county level was Physical & Mental Health. This section will review how each organizational group described the ideal Physical & Mental Health services at the organizational level, the tri- county level, and the barriers to implementing these services. Organizations in the Criminal Justice group exclusively referred physical and mental health services out to other agencies. 42 Respondents did not indicate taking these services on at their organizations in an ideal scenario. Additionally, organizations in this group did not discuss any desire to change their current referral processes. Organizations in the Youth Services group described having holistic therapeutic services available to trafficking survivors as part of their ideal service provision. One of the things that our housing managers does is she kind of combines [physical and mental health] and she does yoga with our young people at our shelter. So it's kind of both, a spiritual type thing. It just depends on the “gel” in the house. Are the kids really wanting to do it or not to kind of encompass both? A holistic [approach]. Organizations in the Youth Services group also emphasized that they would ideally have trauma- informed therapists that specialized in human trafficking treatments on staff and would expand the mental health services they offered in-house. When describing the ideal state of physical and mental health service provision at the tri-county level organizations noted the importance of fostering partnerships with dentists, other mental health clinics, and physical health clinics. One organization described a current practice that they would like to continue in their ideal state of service provision, And so, because we have a certain timeframe we have to meet for these kids to get in and then get their physicals, they keep appointments open for us. They keep slots available for us, so we can call them. Like we could call today and say, "We have three kids coming into care, they need to be seen," and they would get them in today or tomorrow. Respondents in the Youth Services group reported the biggest barrier to providing these ideal services was the general reluctance of people to accept therapy services. The ideal services respondents in the Gender-based Violence group envisioned for their organizations was focused predominantly on mental health. There was a large emphasis on having trainings, services, and counselors that specifically specialized in treating human trafficking survivors. 43 Maybe having someone a little bit more specialized, like we have one counselor who does more sexual assault, and one counselor who does more domestic violence. Maybe eventually have someone who does more related to [human trafficking] cases. At the tri-county level respondents from the Gender-based Violence group would ideally like there to be stronger partnerships with mental health organizations, hospitals, and universities in the area to provide the ideal services they envisioned. I think you know maybe I would maybe reach out to colleges or something like that, because one of my big dream is I'm right here with Michigan State right here and we have all these people going to school for this, that I would love to eventually have them maybe intern here. The organizational barriers mentioned by the Gender-Based Violence group included inadequate transportation to get to services, lack of space to provide services in the community, and lack of personal experience when interviewing and hiring therapists to work with trafficking survivors. When describing the ideal services for their organizations, respondents from the Human Services group expressed the need to have on-site staff available more often, preferably staff that specialized in human trafficking treatment. Respondents emphasized strengthening connections and collaboration with the medical field, particularly health clinics, to make services more readily available. “I don't know because I'm not really at the table with the hospitals and the medical field, but I definitely think that they would be probably exposed to a lot of possible referrals to [our] program.” Barriers to providing these ideals services were lack of personnel at certain organizations and the having to make multiple phone calls to find health services for survivors. Organizations in the Health group either did not provide services to adult victims of human trafficking or only provided these services when directly related to substance abuse detox. Therefore, these organizations did not provide qualitative data for this service sector. 44 Physical and mental health summary. Common ideal health services were mentioned across multiple service groups. First, multiple organizations highlighted the need for strengthened partnerships with medical providers, even going as far as to suggest having standby appointments on hold for intake exams. The next service multiple organizations mentioned in their responses was dental care. Some organizations mentioned creating or strengthening partnerships with local dentists while others expressed interest in mobile dental services for survivors. Finally, every service provider group emphasized the need for specialized therapists specifically trained to work with human trafficking survivors to be on staff and on-site at their organizations. Education / Vocation. The next service sector identified as being a need at the tri-county level was Education / Vocation. This section will review how each organizational group described the ideal Education / Vocation services at the organizational level, the tri-county level, and the barriers to implementing these services. Organizations in the Criminal Justice group either did not provide educational services to adult victims of trafficking or exclusively referred services out to other agencies. Respondents from this group were not interested in offering Education / Vocation services at their organizations and therefore, did not answer qualitative questions pertaining to this service sector. Organizations in the Youth Services group predominantly described the ideal state of Education / Vocation service provision in their responses for the Youth & Family services portion of the interview. However, when speaking about the young adults they serve these organizations stated they would ideally keep providing referrals to GED completion and educational services. The main barrier for providing those referrals is obtaining documents necessary for enrollment into the programs. “It's having victims who don't have identification, 45 who don't have birth certificates and the things that we need to get them in school. So sometimes we're doing all the work just to get them their necessary documents.” Ideal Education / Vocation services for organizations in the Gender-based Violence group would largely include hosting GED completion or educational programs in house. However, some organizations acknowledged strong existing partnerships with local organizations that provide these services and expressed interest in continuing to refer these services out. One of the barriers to providing ideal services and referrals for organization in the Gender-based Violence group was lack of knowledge about the education system and the challenges surrounding older people receiving their GED, I really would like better relationships with the schools and I haven't worked on that yet, so it's not that they haven't helped, but it took us forever just trying to contact the different schools to ask, "What do we do? How do we get this girl that has this?" and she's past the age of the state helping her because that's at 25, so that stopped. So how do we get her what she needs? Organizations in the Human Services group would ideally have GED and educational specialists on staff and on site to provide the Education / Vocation services they envision for their organizations. They would also add or expand computer labs at their organization for people to use. In the ideal state, organizations in this group would continue with their current referral process and secure funding for older people to get their GED. One respondent explained that funding and costly GED exams were the main barriers to providing education services to survivors of trafficking, “They’ve cut back the number of GED programs. 'Cause I had one, a completion program, but the funding was cut. So, I don't know how you get funding if you're not under, say, 26.” Logistics were also cited as being an organizational barrier such as, transportation to classes and finding childcare while a parent is attending class. 46 Organizations in the Health group exclusively made referrals out for Education / Vocation services and had no interest in providing those services at their organizations. Therefore, these respondents were not asked follow-up questions about the ideal state of service provision for Education / Vocation services. Education / Vocation summary. Overall, organizations in this study predominantly rely on outbound referrals for Education / Vocation services. However, organizations face common barriers when providing these referrals and when providing services. The common barrier mentioned in multiple services groups described the difficulty older adults face when trying to receive their GED. The next commonality among multiple service groups was having educational staff on-site as part of their ideal service provision plan. Finally, many service groups discussed the need to have stronger connections to outside schools and educators even if they are offering services at their organization. Substance abuse. The Substance Abuse service sector was on the margin of being considered a need because it had a low current availability score but moderate importance and feasibility scores. If the importance and feasibility means increased, even slightly, the Substance Abuse service sector would be considered a need in the tri-county area. This section will review how each organizational group described the ideal Substance Abuse services at the organizational level, the tri-county level, and the barriers to implementing these services. Organizations in the Criminal Justice group exclusively made referrals out for Substance Abuse services and did not express any interest in changing that process. Therefore, these organizations did not provide qualitative data for this service sector. Organizations in the Youth Services group predominantly described the ideal state of Substance Abuse service provision within their organizations as being the same as it currently 47 was. Organizations in this group stated they would ideally keep referring out to current partners, keep providing services at their own organization. When asked to describe the ideal services in the tri-county area organizations said they would like to work with more organizations that provide resources for substance abuse treatment such as, hospitals and government funders. Furthermore, organizations would ideally like these resources and placements into treatment to be available by making one phone call rather than multiple. One youth services organization described the barriers they experience when providing services, One barrier is always just being able to identify, because when it comes to some things you could tell that somebody is obviously under the influence. … That itself is huge just being able to [identify] and then the stigma behind just getting help. Organizations in the Gender-based Violence group described the ideal state of Substance Abuse service provision within their organizations as being sensitive to the traumatic experiences of human trafficking, sexual assault, and domestic violence survivors. Respondents suggested that specific support groups be offered at inpatient substance abuse treatment facilities for survivors of gender-based violence. Another respondent from the Gender-based Violence group suggested a substance abuse program that is even more tailored to the needs of trafficking survivors. At the tri-county level, respondents from the Gender-Based Violence group stressed the importance of establishing inpatient services in their community and consulting with former substance users to develop effective programming at their organization. A barrier to providing substance abuse services to human trafficking survivors is that the general Alcoholics Anonymous meetings available to survivors in their community are uncomfortable and can be triggering. In this area there's not a lot out there. I wanted my girls to go to AA and some of those meetings are just awful and one of my girls says, "I don't wanna go there. I don't want 48 them to reminisce about all their horror stories." And she said, "I can't sit there and listen to those. I want to go further," and so we really, that's why I said I would really like to create one because I don't think we're, I don't think our society is really, is creating places to help people. The most common Substance Abuse services organizations in the Human Services group would ideally offer are 12-step meetings and after-care support groups. In addition, these organizations would offer longer-term support following external treatment programs than what is currently being offered. One of the main barriers organizations in the vocational group noted was a person’s readiness to receive treatment services. Other barriers included finding qualified staff, funding, and determining whether people are eligible for services. Increased staffing characterized most of the ideal services described by organizations in the Health group. Respondents stressed that ideal tri-county service collaboration should emphasize aftercare housing availability. I think there needs to be more beds. Because if I have someone that wants to go to residential, I can't always get them a bed on the other side. And so they're detoxed, they go out, they use because they're waiting for a bed, it's not the most ideal. Same thing with housing. There's not enough housing. Health organizations stated funding and bureaucratic challenges as the main structural barriers to providing these services. One respondent from this group explained their lack of visibility in the community as a barrier, “I think we have good collaboration amongst the substance abuse providers in the area. Like we know about each other. I don't think we have the word out very well like, ‘Hello, we're here, come.’ So that's more of a marketing thing.” Substance abuse summary. Overall themes about substance abuse treatment needs in the tri-county area emerged. First, organizations are struggling with offering services to individuals that are not ready to accept them or are concerned with the stigma of receiving treatment. Although organizations from multiple service groups have strong outbound referral 49 processes for substance abuse treatment, there was a large interest in offering these services on- site. Furthermore, organizations across service groups were enthusiastic about offering substance abuse support and aftercare groups that are specifically developed for survivors of gender-based violence. 50 Summary of Key Findings DISCUSSION As human trafficking becomes more prevalent, service providers will be called upon more often to tend to the numerous needs survivors experience. Findings from previous literature established the needs of survivors and the needs of individual service sectors (i.e., mental health providers) but to date, no studies have examined the needs of multiple organizations that seek to coordinate services in the same geographic area (Clawson et al., 2003). Most results from the current study are consistent with prior literature about structural barriers (i.e., lack of service coordination among organizations and lack of human trafficking- specific services) when serving survivors of human trafficking. For example, participants in the current study reinforced the importance of coordination among organizations to address the structural needs for Youth & Family services (Davy, 2015). This was particularly important with Youth and Family services because of the added structural barrier of sharing information about minors across organizations, such as between foster care workers and law enforcement. This finding suggests that more work is needed to address structural barriers by building institutional relationships among organizations to make information sharing and subsequent service provision easier on both service providers and survivors. Organizations in this study experienced the above structural barriers despite knowing that human trafficking task forces existed in their area. To address these barriers, organizations emphasized the need for task forces to have a greater presence in the community, preferably through outreach and information sharing. This supports previous literature that recognizes the importance of task force involvement when coordinating service for trafficking victims (Kim et al., 2018). Although previous researchers studied the goals and expectations of task force 51 members who serve victims of human trafficking, there has not been research conducted on what non-members and the community overall expects from human trafficking task forces (Kim et al., 2018). Similar to the needs assessment conducted by Clawson and colleagues (2003), organizations in this study faced structural barriers during the referral process, such as having to make multiple phone calls for a referral. Respondents from both studies proposed having a centralized referral process for addressing these structural barriers to service provision. In addition to having a stronger task force presence to address this barrier, respondents in this study proposed a “one stop shop” for coordinating services among organizations in the tri-county area, such as a hotline with advocates to coordinate services. Participants in this study also experienced structural barriers when ideal services were not aligned with how treatment of human trafficking was framed in these counties. For example, this study focused on understanding intervention service needs, however multiple organizations underscored the need for preventative services as part of ideal service provision. This community predominately served youth victims of sex trafficking and presented prevention strategies to address that population. However, almost all the currently available services were intervention rather than prevention oriented. The most recommended preventative practices identified by participants were educating and involving school administrators and youth. Previous literature on domestic minor sex trafficking support these strategies particularly when educational preventative programs are done in a safe environment (Countryman-Roswurm & Bolin, 2014). Multiple participants from the current study acknowledged there was no such place in their community and were enthusiastic about creating a safe, youth-friendly place in the form of a drop-in center. Providing a drop-in center as a judgement-free space for youth to have access to 52 resources such as clean clothing, showers, and feminine hygiene products resonated with providers from multiple service sectors. This emphasized the prioritization of serving youth at risk for sex trafficking in the tri-county area. Finally, even when the patchwork of care was successfully navigated, providers still experienced organizational barriers (i.e., limited funding, staffing, and training) because available services did not always meet the specific needs of survivors. Specialized staff and services were a common request across all service sectors in this study. For example, organizations may have had therapists on site to provide mental health services, but survivors told service providers they did not feel the therapist understood their trafficking situation. Substance abuse support groups and meetings felt uncomfortable for survivors which led some organizations to consider hosting separate, survivor-only groups. In other cases, organizations had services available for sexual assault or domestic violence survivors but did not feel they could use them to fully meet the needs a trafficking survivor. Little research exists on whether there is a significant difference in treatment outcomes for human trafficking specific services when compared to more generalized services. However, given the findings of this study, population-specific services and continuum of care would be the most beneficial approach to overcome organizational barriers when serving trafficking survivors. Limitations This study had several limitations. The first limitation was the sampling frame. Some organizations mentioned collaborating or referring to organizations that were not listed on the resource guide. Future studies should not solely rely on resource guides as a sampling frame but should rather use them as a starting point for sampling and be flexible with snowball sampling to account for inaccurate, limited, or outdated resource guides. The next limitation was the 53 participation rate. Some organizations included in the resource guide did not respond to the researcher’s interview requests therefore were not included in the study. Two organizations (one police department and one GED completion organization) declined requests to be interviewed and the remaining 11 organizations did not respond to my emails or phone calls (2 education, 2 police departments, 2 legal services, 2 gender-based violence, 3 health organizations). This limited the amount of information this study could provide about the current state of service provision in those service sectors. For example, Health, Legal, and Education service sectors had low ratings in most of the organizational groups and at the tri-county level. This trend may have been avoided if there were more organizations from these sectors in this study. Some of the participants that were considered the most knowledgeable about human trafficking at their organizations belonged to a specialized section or department of a larger organization. This was a limitation because some respondents did not have complete information about services offered by other departments within their organization. Participants gave their perceptions and best estimates of service provision in other departments while others chose not to respond to those items at all. Future studies would benefit from having multiple respondents from larger organizations when necessary to collect the most accurate service provision data. Organizations in this study did not necessarily provide direct services to victims of human trafficking but rather, provided referrals. This is a limitation because data about referrals may have been measured and discussed more than direct service provision in the triple-scaled items. Participants in this sample did not always have direct services available at their organization but knew of and had well-established referral processes with other organizations to meet the needs of survivors. Some participants answered the triple scale items for the referral processes they had in place since that was their version of service provision at their organization. 54 Therefore, there is a possibility that the results from this study are reporting on the current state of referrals and direct services in the tri-county area. Future studies should explicitly keep items about referrals and direct services separate from one another or omit one construct from the survey entirely. Finally, this survey did not differentiate between labor and sex trafficking. This was a deliberate choice so services for both sex and labor trafficking survivors could be discussed but it became evident that sex trafficking was what providers in the area were most exposed to or familiar with. Because of this, the results of this survey do not contribute to the literature about addressing the needs of victims of labor trafficking. In addition, responses were mainly focused on serving female youth survivors of sex trafficking. This limitation may be influenced by the overrepresentation of organizations serving minors in the sample for this study. Future studies should attempt to minimize these effects by asking each survey item about sex and labor trafficking separately and having more equal representation of youth and adult service providers in the sample. Implications for Practice, Policy, and Research This results from this study found that although certain service sectors are doing well when it comes to serving human trafficking victims, others have more work to do. Youth organizations have the most services available for human trafficking survivors in the tri-county area whereas all other organizational groups have low service availability. According to Phase II of Altschuld & White’s analytic process, the overall state of services in the tri-county area is considered “in need” with Youth & Family, Physical & Mental Health, Substance Abuse, and Education / Vocation being the prioritized service sector needs. The community should focus on strengthening organizations belonging to the Criminal Justice and Gender-Based Violence 55 groups to best serve human trafficking survivors given their results from the Phase II analytic process. Phase III of Altschuld and Witkin’s needs assessment process model designs and implements solutions to address the high-priority needs identified in Phase II. Criminal Justice and Gender-based Violence groups should be prioritized because these organizations are most likely to be able to provide services to human trafficking survivors if they are allocated adequate resources to do so. Respondents from the Criminal Justice and Gender-Based Violence organizations already think it is both important and feasible to offer services to survivors of human trafficking, therefore strategies in Phase III should aim to strengthen the current availability of Youth & Family, Physical & Mental Health, Substance Abuse, and Education / Vocation services within these organizational groups. Results from the current study have direct implications for practice particularly for task forces and policymakers. First, organizations serving human trafficking survivors in this study wanted the local task forces to be more present in the community. Although this sample did not include all organizations serving trafficking survivors in the tri-county area, the task forces can use these findings as pragmatic next steps for strategic planning and continuous quality improvement efforts across their service area. In addition, it is important that the task forces make continuous outreach to service providers an integral part of their functioning, so they do not overlook organizations that can serve survivors. Needs assessments have been used to inform community coalitions and evaluate community capacity (Butterfoss & Kegler, 2009). The results of this study highlight that needs assessments are a promising methodology for other task forces, practitioners, and researchers to conduct community scans about human trafficking in their area. Not only do needs assessments 56 have the ability to identify service provision barriers and challenges they also have the power to identify demographics of human trafficking survivors, scope of the issue, and how the problem is being addressed in the community. For example, this study found that Youth Services organizations in this sample were providing services to human trafficking survivors more than any other service sector. This finding draws attention to the fact that, according to respondents in this sample, most trafficking victims accessing services in this area are minors and are victims of sex trafficking in particular. Whereas a needs assessment in a different community may discover that legal service organizations are serving victims most often and there are mostly adult victims of labor trafficking accessing services. This peripheral information can be gathered simultaneously during a needs assessment and has impactful implications for recommending successful, community-specific service provision strategies (Butterfoss & Kegler, 2009). The most pressing implication for policy is prioritizing and establishing specific state- level funding streams to provide services for victims of human trafficking. Participants in this study recalled times where funding restrictions prohibited them from providing services to survivors of sex trafficking. State-level funding should not only focus on intervention programs and services but should also prioritize funding preventative services that would benefit the community, such as youth drop-in centers. In addition, researchers suggest that separate service sector - specific funding streams should be prioritized (Chang & Hayashi, 2017). For example, separate funding streams should be created for criminal justice, gender-based violence, and health care agencies because the measurable outcomes of these systems can vary (Chang & Hayashi, 2017). This study was conducted in a state where there were not specific funding policies for serving victims of human trafficking. Future studies can expand upon this work by examining the needs of organizations in states where there are specific policies and funding 57 allocated to aid survivors of human trafficking and compare findings to findings from states without those policies. In conclusion, this study validates previous findings that victims of human trafficking have numerous needs and require multiple service sectors and organizations to meet those needs. Collaboration among organizations serving victims of human trafficking is a challenging but necessary process to ensure survivors get the services they deserve. Despite the recognition that survivors are consistently forced to navigate the patchwork of care to access services, more work is needed strengthen task force processes and interagency communication. This study demonstrates the utility of needs assessments to address organizational and structural barriers by highlighting service sectors that are in need of more resources or connections to other organizations in the area. 58 APPENDIX 59 INTRODUCTION: Needs Assessment Survey Thank you for agreeing to speak with me today. You have been asked to participate in this interview because you attended at least one meeting of the Capital Area Anti- Trafficking Alliance since it was created back in 2015. This interview is part of a needs assessment study so the purpose of our conversation today is to get an understanding of what supports and resources are currently being offered in the tri- county area for human trafficking victims. SECTION 1: ORGANIZATION INFO & TRAFFICKING DEFINITION What is the name of your organization? __________________________________________________________________ What is your job title / role at your organization? ________________________________________________________ 60 There are many ways to define human trafficking especially in different areas or context. We will be using the following definition in order to make sure every person that responds to our survey is responding about the same concept. For the purposes of this survey we will be relying on features of the Federal Trafficking Victims Protection Act (TVPA) to define human trafficking as: Sex trafficking: a circumstance in which a commercial sex act is induced 1) By force, fraud, or coercion, or 2) when the person induced to perform such act has not attained 18 years of age; or 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. *To be clear – in this interview I will be asking about the services that you offer to both minor AND adult human trafficking victims. Is your organization’s definition of "human trafficking" different from the one described?  Yes (1)  No (2) If “Yes”: How is your organization’s definition of human trafficking different? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 61 SECTION 2: YOUTH AND FAMILY First, we are going to talk about the youth and family services your organization currently offers to human trafficking survivors under the age of 18. This can include but is not limited to the following: outreach, after-school programs, foster care, shelter, family reunification, substance abuse treatment, mental health, physical health, legal services, immigration, education / vocation etc. Essentially, anything you offer to youth we will want to discuss in this section. Now, for these questions I’ll want you to think about the work of your organization overall: 1. Please describe the youth and family services your organization offers to trafficking victims under the age of 18. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 2. To what extent would you say your organization provides youth and family services to trafficking victims under the age of 18? □ 1 - Not at all (Go to 2b) □ 2 - A little bit (Go to 2a) □ 3 - Somewhat (Go to 2a) □ 6 - Quite a bit (Go to 2a) □ 5 - To a great extent (Go to 2a) 2a. About what percentage of your organization’s overall time/resources goes towards providing youth and family services to trafficking victims under the age of 18? ______________________________________________________________________ 62 2b. If “1 - Not at all”: How important do you think it is for your organization to provide youth and family services to trafficking victims under the age of 18? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 2c. Follow-up: Why is / why is it not important for your organization to provide youth and family services to trafficking victims under the age of 18? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 3. How frequently does your organization (provide youth and family services / give referrals for youth and family services) to trafficking victims under the age of 18? □ Daily □ 2-3 times / week □ Once a week □ 2-3 times /month □ Once a month □ Once every - other month □ Once every 6 months □ Once in the past 12 months 4. How feasible is it for your organization to (provide youth and family services / give referrals for youth and family services) to human trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 63 5. Follow-up: Why is it / is it not feasible for your organization to (provide youth and family services / give referrals for youth and family services) to human trafficking victims at this time? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 6. (SKIP IF NO SERVICES PROVIDED) How many staff work on (providing youth and family services / giving referrals for youth and family services) to trafficking victims under the age of 18 at your organization? ___________________________________________ (number) 6a. (SKIP IF NO SERVICES PROVIDED) Of these ____ (number from Q6) people, what percent of their time goes toward (providing youth and family services / giving referrals for youth and family services) to trafficking victims under the age of 18? (Please give percentage for each person) ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 7. (SKIP IF NO SERVICES PROVIDED) What training or expertise do staff (providing youth and family services / giving referrals for youth and family services) to trafficking victims under the age of 18 have? (Probes: Staff in-services? Degrees? Certifications? Personal experiences? Conferences? Workshops? CEUs? Seminars?) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 64 8. (SKIP IF NO SERVICES PROVIDED) What funding sources support youth and family services for trafficking victims under the age of 18 at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 9. (SKIP IF NO SERVICES PROVIDED) Who do staff work with in the community when they are (providing youth and family services / giving referrals for youth and family services) to trafficking victims under the age of 18? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 10. (SKIP IF NO SERVICES PROVIDED) What type of facilities (e.g. buildings, shelters, physical structures, etc.) are currently available through your organization to provide youth and family services to trafficking victims under the age of 18? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Now I want you to think about what the ideal conditions for providing youth and family services to trafficking victims under the age of 18 at your organization and what that would look like. 11. Please describe the ideal youth and family services you’d like your organization to provide for trafficking victims under the age of 18. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 65 12. To what extent would you like your organization to be providing youth and family services to trafficking victims under the age of 18? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 12a. About what percentage of your organization’s time/resources would you like to go towards providing youth and family services to trafficking victims under the age of 18? ______________________________________________________________________ 13. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How frequently would you like your organization to be providing youth and family services? □ □ □ □ □ □ □ □ Daily 2-3 times / week Once a week 2-3 times /month Once a month Once every - other month Once every 6 months Once in the past 12 months 14. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How many staff would you like to be working on providing youth and family services to trafficking victims under the age of 18? _____________________________ (number) 14a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Of these ___ (number from Q14) staff, what percentage of their time would ideally be spent providing youth and family services to trafficking victims under the age of 18? ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 66 15. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What level of funding would you need to provide the ideal youth and family services for trafficking victims under the age of 18 at your organization? (Probes: More, less) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 15a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Where would you like this funding to be allocated? (Probes: training, facilities, resources, staff, etc.) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 16. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Ideally, who would you like your staff to be connected with to offer the youth and family services you’re envisioning at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 17. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What facilities or physical structures (e.g. buildings, shelters, etc.) would be needed to provide the ideal youth and family services for trafficking victims under the age of 18 at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 67 18. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What do you see as the main barriers to offering the ideal youth and family services for trafficking victims under the age of 18 at your organization? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________________ _____________________________________________________________________________________ Now that we’ve spoken about the services you offer specifically to youth and families, the rest of this interview will be asking you about the services you provide to adult trafficking survivors. SECTION 3: HOUSING Next, we are going to talk about the housing services your organization currently offers to human trafficking survivors. This can include but is not limited to providing shelter at your organization, helping victims find housing (transitional or permanent), or providing referrals. For these questions I’ll want you to think about the work your organization does overall: 19. Please describe the housing services your organization offers to trafficking victims. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 20. To what extent would you say your organization provides housing services to trafficking victims □ 1 - Not at all (Go to 20b) □ 2 - A little bit (Go to 20a) □ 3 - Somewhat (Go to 20a) □ 6 - Quite a bit (Go to 20a) □ 5 - To a great extent (Go to 20a) 68 20a. About what percentage of your organization’s overall time/resources goes towards providing housing services to trafficking victims? ______________________________________________________________________ 20b. If “1 - Not at all”: How important do you think it is for your organization to provide housing services to trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 20c. Follow-up: Why is / why is it not important for your organization to provide housing services to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 21. How frequently does your organization (provide housing services / give referrals for housing services) to trafficking victims? □ Daily □ 2-3 times / week □ Once a week □ 2-3 times /month □ Once a month □ Once every - other month □ Once every 6 months □ Once in the past 12 months 22. How feasible is it for your organization to (provide housing services / give referrals for housing services) to human trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 69 23. Follow-up: Why is it / is it not feasible for your organization to (provide housing services / give referrals for housing services) to human trafficking victims at this time? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 24. (SKIP IF NO SERVICES PROVIDED) How many staff work on (providing housing services / giving referrals for housing services) to trafficking victims at your organization? ___________________________________________ (number) 24a. (SKIP IF NO SERVICES PROVIDED) Of these ____ (number from Q24) people, what percent of their time goes toward (providing housing services / giving referrals for housing services) to trafficking victims? (Please give percentage for each person) ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 25. (SKIP IF NO SERVICES PROVIDED) What training or expertise do staff (providing housing services / giving referrals for housing services) to trafficking victims have? (Probes: Staff in-services? Degrees? Certifications? Personal experiences? Conferences? Workshops? CEUs? Seminars?) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 70 26. (SKIP IF NO SERVICES PROVIDED) What funding sources support housing services for trafficking victims at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 27. (SKIP IF NO SERVICES PROVIDED) Who do staff work with in the community when they are (providing housing services / giving referrals for housing services) to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 28. (SKIP IF NO SERVICES PROVIDED) What type of facilities (e.g. buildings, shelters, physical structures, etc.) are currently available through your organization to provide housing services to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Now I want you to think about what the ideal conditions for providing housing services to trafficking victims at your organization and what that would look like. 29. Please describe the ideal housing services you’d like your organization to provide for trafficking victims. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 71 30. To what extent would you like your organization to be providing housing services to trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 30a. About what percentage of your organization’s time/resources would you like to go towards providing housing services to trafficking victims? ______________________________________________________________________ 31. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How frequently would you like your organization to be providing housing services? □ □ □ □ □ □ □ □ Daily 2-3 times / week Once a week 2-3 times /month Once a month Once every - other month Once every 6 months Once in the past 12 months 32. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How many staff would you like to be working on providing housing services to trafficking victims? _____________________________ (number) 32a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Of these ___ (number from Q32) staff, what percentage of their time would ideally be spent providing housing services to trafficking victims? ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 72 33. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What level of funding would you need to provide the ideal housing services for trafficking victims at your organization? (Probes: More, less) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 33a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Where would you like this funding to be allocated? (Probes: training, facilities, resources, staff, etc.) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 34. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Ideally, who would you like your staff to be connected with to offer the housing services you’re envisioning at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 35. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What facilities or physical structures (e.g. buildings, shelters, etc.) would be needed to provide the ideal housing services for trafficking victims at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 73 36. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What do you see as the main barriers to offering the ideal housing services for trafficking victims at your organization? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________________ _____________________________________________________________________________________ SECTION 6: LEGAL Next, we are going to talk about the legal services your organization currently offers to human trafficking survivors. This can include but is not limited to criminal justice (ex. police, probation, parole, prosecution, investigation) and civil justice (ex. Custody, expungement, divorce, orders of protection). I have a SEPARATE section for immigration after this so please hold off on talking about any of those legal services you may offer. For these questions I’ll want you to think about the work your organization does overall: 37. Please describe the legal services your organization offers to trafficking victims. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 38. To what extent would you say your organization provides legal services to trafficking victims □ 1 - Not at all (Go to 38b) □ 2 - A little bit (Go to 38a) □ 3 - Somewhat (Go to 38a) □ 6 - Quite a bit (Go to 38a) □ 5 - To a great extent (Go to 38a) 74 38a. About what percentage of your organization’s overall time/resources goes towards providing legal services to trafficking victims? ______________________________________________________________________ 38b. If “1 - Not at all”: How important do you think it is for your organization to provide legal services to trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 38c. Follow-up: Why is / why is it not important for your organization to provide legal services to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 39. How frequently does your organization (provide legal services / give referrals for legal services) to trafficking victims? □ Daily □ 2-3 times / week □ Once a week □ 2-3 times /month □ Once a month □ Once every - other month □ Once every 6 months □ Once in the past 12 months 40. How feasible is it for your organization to (provide legal services / give referrals for legal services) to human trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 75 41. Follow-up: Why is it / is it not feasible for your organization to (provide legal services / give referrals for legal services) to human trafficking victims at this time? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 42. (SKIP IF NO SERVICES PROVIDED) How many staff work on (providing legal services / giving referrals for legal services) to trafficking victims at your organization? ___________________________________________ (number) 42a. (SKIP IF NO SERVICES PROVIDED) Of these ____ (number from Q42) people, what percent of their time goes toward (providing legal services / giving referrals for legal services) to trafficking victims? (Please give percentage for each person) ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 43. (SKIP IF NO SERVICES PROVIDED) What training or expertise do staff (providing legal services / giving referrals for legal services) to trafficking victims have? (Probes: Staff in-services? Degrees? Certifications? Personal experiences? Conferences? Workshops? CEUs? Seminars?) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 76 44. (SKIP IF NO SERVICES PROVIDED) What funding sources support legal services for trafficking victims at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 45. (SKIP IF NO SERVICES PROVIDED) Who do staff work with in the community when they are (providing legal services / giving referrals for legal services) to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 46. (SKIP IF NO SERVICES PROVIDED) What type of facilities (e.g. buildings, shelters, physical structures, etc.) are currently available through your organization to provide legal services to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Now I want you to think about what the ideal conditions for providing legal services to trafficking victims at your organization and what that would look like. 47. Please describe the ideal legal services you’d like your organization to provide for trafficking victims. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 77 48. To what extent would you like your organization to be providing legal services to trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 48a. About what percentage of your organization’s time/resources would you like to go towards providing legal services to trafficking victims? ______________________________________________________________________ 49. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How frequently would you like your organization to be providing legal services? □ □ □ □ □ □ □ □ Daily 2-3 times / week Once a week 2-3 times /month Once a month Once every - other month Once every 6 months Once in the past 12 months 50. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How many staff would you like to be working on providing legal services to trafficking victims? _____________________________ (number) 50a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Of these ___ (number from Q50) staff, what percentage of their time would ideally be spent providing legal services to trafficking victims? ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 78 51. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What level of funding would you need to provide the ideal legal services for trafficking victims at your organization? (Probes: More, less) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 51a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Where would you like this funding to be allocated? (Probes: training, facilities, resources, staff, etc.) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 52. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Ideally, who would you like your staff to be connected with to offer the legal services you’re envisioning at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 53. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What facilities or physical structures (e.g. buildings, shelters, etc.) would be needed to provide the ideal legal services for trafficking victims at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 79 54. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What do you see as the main barriers to offering the ideal legal services for trafficking victims at your organization? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________________ _____________________________________________________________________________________ SECTION 5: IMMIGRATION Next, we are going to talk about the immigration services your organization currently offers to human trafficking survivors. This can include but is not limited to refugee services, visas, citizenship services, migrant worker services. For these questions I’ll want you to think about the work your organization does overall: 55. Please describe the immigration services your organization offers to trafficking victims. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 56. To what extent would you say your organization provides immigration services to trafficking victims □ 1 - Not at all (Go to 56b) □ 2 - A little bit (Go to 56a) □ 3 - Somewhat (Go to 56a) □ 6 - Quite a bit (Go to 56a) □ 5 - To a great extent (Go to 56a) 80 56a. About what percentage of your organization’s overall time/resources goes towards providing immigration services to trafficking victims? ______________________________________________________________________ 56b. If “1 - Not at all”: How important do you think it is for your organization to provide immigration services to trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 56c. Follow-up: Why is / why is it not important for your organization to provide immigration services to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 57. How frequently does your organization (provide immigration services / give referrals for immigration services) to trafficking victims? □ Daily □ 2-3 times / week □ Once a week □ 2-3 times /month □ Once a month □ Once every - other month □ Once every 6 months □ Once in the past 12 months 81 58. How feasible is it for your organization to (provide immigration services / give referrals for immigration services) to human trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 59. Follow-up: Why is it / is it not feasible for your organization to (provide immigration services / give referrals for immigration services) to human trafficking victims at this time? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 60. (SKIP IF NO SERVICES PROVIDED) How many staff work on (providing immigration services / giving referrals for immigration services) to trafficking victims at your organization? ___________________________________________ (number) 60a. (SKIP IF NO SERVICES PROVIDED) Of these ____ (number from Q60) people, what percent of their time goes toward (providing immigration services / giving referrals for immigration services) to trafficking victims? (Please give percentage for each person) ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 82 61. (SKIP IF NO SERVICES PROVIDED) What training or expertise do staff (providing immigration services / giving referrals for immigration services) to trafficking victims have? (Probes: Staff in-services? Degrees? Certifications? Personal experiences? Conferences? Workshops? CEUs? Seminars?) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 62. (SKIP IF NO SERVICES PROVIDED) What funding sources support immigration services for trafficking victims at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 63. (SKIP IF NO SERVICES PROVIDED) Who do staff work with in the community when they are (providing immigration services / giving referrals for immigration services) to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 64. (SKIP IF NO SERVICES PROVIDED) What type of facilities (e.g. buildings, shelters, physical structures, etc.) are currently available through your organization to provide immigration services to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Now I want you to think about what the ideal conditions for providing immigration services to trafficking victims at your organization and what that would look like. 83 65. Please describe the ideal immigration services you’d like your organization to provide for trafficking victims. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 66. To what extent would you like your organization to be providing immigration services to trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 66a. About what percentage of your organization’s time/resources would you like to go towards providing immigration services to trafficking victims? ______________________________________________________________________ 67. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How frequently would you like your organization to be providing immigration services? □ □ □ □ □ □ □ □ Daily 2-3 times / week Once a week 2-3 times /month Once a month Once every - other month Once every 6 months Once in the past 12 months 68. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How many staff would you like to be working on providing immigration services to trafficking victims? _____________________________ (number) 84 68a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Of these ___ (number from Q68) staff, what percentage of their time would ideally be spent providing immigration services to trafficking victims? ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 69. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What level of funding would you need to provide the ideal immigration services for trafficking victims at your organization? (Probes: More, less) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 69a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Where would you like this funding to be allocated? (Probes: training, facilities, resources, staff, etc.) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 70. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Ideally, who would you like your staff to be connected with to offer the immigration services you’re envisioning at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 85 71. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What facilities or physical structures (e.g. buildings, shelters, etc.) would be needed to provide the ideal immigration services for trafficking victims at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 72. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What do you see as the main barriers to offering the ideal immigration services for trafficking victims at your organization? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________________ _____________________________________________________________________________________ SECTION 6: PHYSICAL & MENTAL HEALTH Next, we are going to talk about the physical and mental health services your organization currently offers to human trafficking survivors. This can include but is not limited to counseling, therapy, psychosocial assessment (interviews, testing), dental services, or medical treatment (for current or preexisting injuries or conditions). I have a SEPARATE section for substance abuse treatment and detox after this section so please hold off on talking about any of those services you may offer for now. For these questions I’ll want you to think about the work your organization does overall: 73. Please describe the physical & mental health services your organization offers to trafficking victims. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 86 74. To what extent would you say your organization provides physical & mental health services to trafficking victims □ 1 - Not at all (Go to 74b) □ 2 - A little bit (Go to 74a) □ 3 - Somewhat (Go to 74a) □ 6 - Quite a bit (Go to 74a) □ 5 - To a great extent (Go to 74a) 74a. About what percentage of your organization’s overall time/resources goes towards providing physical & mental health services to trafficking victims? ______________________________________________________________________ 74b. If “1 - Not at all”: How important do you think it is for your organization to provide physical & mental health services to trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 74c. Follow-up: Why is / why is it not important for your organization to provide physical & mental health services to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 87 75. How frequently does your organization (provide physical & mental health services / give referrals for physical & mental health services) to trafficking victims? □ Daily □ 2-3 times / week □ Once a week □ 2-3 times /month □ Once a month □ Once every - other month □ Once every 6 months □ Once in the past 12 months 76. How feasible is it for your organization to (provide physical & mental health services / give referrals for physical & mental health services) to human trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 77. Follow-up: Why is it / is it not feasible for your organization to (provide physical & mental health services / give referrals for physical & mental health services) to human trafficking victims at this time? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 78. (SKIP IF NO SERVICES PROVIDED) How many staff work on (providing physical & mental health services / giving referrals for physical & mental health services) to trafficking victims at your organization? ___________________________________________ (number) 88 78a. (SKIP IF NO SERVICES PROVIDED) Of these ____ (number from Q78) people, what percent of their time goes toward (providing physical & mental health services / giving referrals for physical & mental health services) to trafficking victims? (Please give percentage for each person) ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 79. (SKIP IF NO SERVICES PROVIDED) What training or expertise do staff (providing physical & mental health services / giving referrals for physical & mental health services) to trafficking victims have? (Probes: Staff in-services? Degrees? Certifications? Personal experiences? Conferences? Workshops? CEUs? Seminars?) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 80. (SKIP IF NO SERVICES PROVIDED) What funding sources support physical & mental health services for trafficking victims at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 81. (SKIP IF NO SERVICES PROVIDED) Who do staff work with in the community when they are (providing physical & mental health services / giving referrals for physical & mental health services) to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 89 82. (SKIP IF NO SERVICES PROVIDED) What type of facilities (e.g. buildings, shelters, physical structures, etc.) are currently available through your organization to provide physical & mental health services to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Now I want you to think about what the ideal conditions for providing physical & mental health services to trafficking victims at your organization and what that would look like. 83. Please describe the ideal physical & mental health services you’d like your organization to provide for trafficking victims. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 84. To what extent would you like your organization to be providing physical & mental health services to trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 84a. About what percentage of your organization’s time/resources would you like to go towards providing physical & mental health services to trafficking victims? ______________________________________________________________________ 90 85. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How frequently would you like your organization to be providing physical & mental health services? □ □ □ □ □ □ □ □ Daily 2-3 times / week Once a week 2-3 times /month Once a month Once every - other month Once every 6 months Once in the past 12 months 86. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How many staff would you like to be working on providing physical & mental health services to trafficking victims? _____________________________ (number) 86a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Of these ___ (number from Q86) staff, what percentage of their time would ideally be spent providing physical & mental health services to trafficking victims? ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 87. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What level of funding would you need to provide the ideal physical & mental health services for trafficking victims at your organization? (Probes: More, less) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 91 87a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Where would you like this funding to be allocated? (Probes: training, facilities, resources, staff, etc.) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 88. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Ideally, who would you like your staff to be connected with to offer the physical & mental health services you’re envisioning at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 89. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What facilities or physical structures (e.g. buildings, shelters, etc.) would be needed to provide the ideal physical & mental health services for trafficking victims at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 90. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What do you see as the main barriers to offering the ideal physical & mental health services for trafficking victims at your organization? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________________ _____________________________________________________________________________________ 92 SECTION 7: SUBSTANCE ABUSE Next, we are going to talk about the substance abuse services your organization currently offers to human trafficking survivors. This can include but is not limited to rehabilitation, 12-step programs (such as AA, NA), detox services, substance abuse therapy / counseling. For these questions I’ll want you to think about the work your organization does overall: 91. Please describe the substance abuse services your organization offers to trafficking victims. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 92. To what extent would you say your organization provides substance abuse services to trafficking victims □ 1 - Not at all (Go to 92b) □ 2 - A little bit (Go to 92a) □ 3 - Somewhat (Go to 92a) □ 6 - Quite a bit (Go to 92a) □ 5 - To a great extent (Go to 92a) 92a. About what percentage of your organization’s overall time/resources goes towards providing substance abuse services to trafficking victims? ______________________________________________________________________ 93 92b. If “1 - Not at all”: How important do you think it is for your organization to provide substance abuse services to trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 92c. Follow-up: Why is / why is it not important for your organization to provide substance abuse services to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 93. How frequently does your organization (provide substance abuse services / give referrals for substance abuse services) to trafficking victims? □ Daily □ 2-3 times / week □ Once a week □ 2-3 times /month □ Once a month □ Once every - other month □ Once every 6 months □ Once in the past 12 months 94. How feasible is it for your organization to (provide substance abuse services / give referrals for substance abuse services) to human trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 94 95. Follow-up: Why is it / is it not feasible for your organization to (provide substance abuse services / give referrals for substance abuse services) to human trafficking victims at this time? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 96. (SKIP IF NO SERVICES PROVIDED) How many staff work on (providing substance abuse services / giving referrals for substance abuse services) to trafficking victims at your organization? ___________________________________________ (number) 96a. (SKIP IF NO SERVICES PROVIDED) Of these ____ (number from Q96) people, what percent of their time goes toward (providing substance abuse services / giving referrals for substance abuse services) to trafficking victims? (Please give percentage for each person) ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 97. (SKIP IF NO SERVICES PROVIDED) What training or expertise do staff (providing substance abuse services / giving referrals for substance abuse services) to trafficking victims have? (Probes: Staff in-services? Degrees? Certifications? Personal experiences? Conferences? Workshops? CEUs? Seminars?) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 95 98. (SKIP IF NO SERVICES PROVIDED) What funding sources support substance abuse services for trafficking victims at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 99. (SKIP IF NO SERVICES PROVIDED) Who do staff work with in the community when they are (providing substance abuse services / giving referrals for substance abuse services) to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 100. (SKIP IF NO SERVICES PROVIDED) What type of facilities (e.g. buildings, shelters, physical structures, etc.) are currently available through your organization to provide substance abuse services to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Now I want you to think about what the ideal conditions for providing substance abuse services to trafficking victims at your organization and what that would look like. 101. Please describe the ideal substance abuse services you’d like your organization to provide for trafficking victims. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 96 102. To what extent would you like your organization to be providing substance abuse services to trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 102a. About what percentage of your organization’s time/resources would you like to go towards providing substance abuse services to trafficking victims? ______________________________________________________________________ 103. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How frequently would you like your organization to be providing substance abuse services? □ □ □ □ □ □ □ □ Daily 2-3 times / week Once a week 2-3 times /month Once a month Once every - other month Once every 6 months Once in the past 12 months 104. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How many staff would you like to be working on providing substance abuse services to trafficking victims? _____________________________ (number) 104a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Of these ___ (number from Q104) staff, what percentage of their time would ideally be spent providing substance abuse services to trafficking victims? ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 97 105. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What level of funding would you need to provide the ideal substance abuse services for trafficking victims at your organization? (Probes: More, less) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 105a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Where would you like this funding to be allocated? (Probes: training, facilities, resources, staff, etc.) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 106. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Ideally, who would you like your staff to be connected with to offer the substance abuse services you’re envisioning at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 107. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What facilities or physical structures (e.g. buildings, shelters, etc.) would be needed to provide the ideal substance abuse services for trafficking victims at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 98 108. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What do you see as the main barriers to offering the ideal substance abuse services for trafficking victims at your organization? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________________ _____________________________________________________________________________________ SECTION 8: EDUCATION / VOCATION Finally, we are going to talk about the education / vocation services your organization currently offers to human trafficking survivors. This can include but is not limited to GED completion, computer / technology training, resume assistance, trade classes, or certifications. For these questions I’ll want you to think about the work your organization does overall: 109. Please describe the education / vocation services your organization offers to trafficking victims. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 110. To what extent would you say your organization provides education / vocation services to trafficking victims □ 1 - Not at all (Go to 110b) □ 2 - A little bit (Go to 110a) □ 3 - Somewhat (Go to 110a) □ 6 - Quite a bit (Go to 110a) □ 5 - To a great extent (Go to 110a) 99 110a. About what percentage of your organization’s overall time/resources goes towards providing education / vocation services to trafficking victims? ______________________________________________________________________ 110b. If “1 - Not at all”: How important do you think it is for your organization to provide education / vocation services to trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 110c. Follow-up: Why is / why is it not important for your organization to provide education / vocation services to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 111. How frequently does your organization (provide education / vocation services / give referrals for education / vocation services) to trafficking victims? □ Daily □ 2-3 times / week □ Once a week □ 2-3 times /month □ Once a month □ Once every - other month □ Once every 6 months □ Once in the past 12 months 100 112. How feasible is it for your organization to (provide education / vocation services / give referrals for education / vocation services) to human trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 113. Follow-up: Why is it / is it not feasible for your organization to (provide education / vocation services / give referrals for education / vocation services) to human trafficking victims at this time? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 114. (SKIP IF NO SERVICES PROVIDED) How many staff work on (providing education / vocation services / giving referrals for education / vocation services) to trafficking victims at your organization? ___________________________________________ (number) 114a. (SKIP IF NO SERVICES PROVIDED) Of these ____ (number from Q114) people, what percent of their time goes toward (providing education / vocation services / giving referrals for education / vocation services) to trafficking victims? (Please give percentage for each person) ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 101 115. (SKIP IF NO SERVICES PROVIDED) What training or expertise do staff (providing education / vocation services / giving referrals for education / vocation services) to trafficking victims have? (Probes: Staff in-services? Degrees? Certifications? Personal experiences? Conferences? Workshops? CEUs? Seminars?) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 116. (SKIP IF NO SERVICES PROVIDED) What funding sources support education / vocation services for trafficking victims at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 117. (SKIP IF NO SERVICES PROVIDED) Who do staff work with in the community when they are (providing education / vocation services / giving referrals for education / vocation services) to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 118. (SKIP IF NO SERVICES PROVIDED) What type of facilities (e.g. buildings, shelters, physical structures, etc.) are currently available through your organization to provide education / vocation services to trafficking victims? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Now I want you to think about what the ideal conditions for providing education / vocation services to trafficking victims at your organization and what that would look like. 102 119. Please describe the ideal education / vocation services you’d like your organization to provide for trafficking victims. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 120. To what extent would you like your organization to be providing education / vocation services to trafficking victims? □ 1 - Not at all □ 2 - A little bit □ 3 - Somewhat □ 6 - Quite a bit □ 5 - To a great extent 120a. About what percentage of your organization’s time/resources would you like to go towards providing education / vocation services to trafficking victims? ______________________________________________________________________ 121. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How frequently would you like your organization to be providing education / vocation services? □ □ □ □ □ □ □ □ Daily 2-3 times / week Once a week 2-3 times /month Once a month Once every - other month Once every 6 months Once in the past 12 months 122. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) How many staff would you like to be working on providing education / vocation services to trafficking victims? _____________________________ (number) 103 122a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Of these ___ (number from Q122) staff, what percentage of their time would ideally be spent providing education / vocation services to trafficking victims? ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ 123. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What level of funding would you need to provide the ideal education / vocation services for trafficking victims at your organization? (Probes: More, less) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 123a. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Where would you like this funding to be allocated? (Probes: training, facilities, resources, staff, etc.) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 124. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) Ideally, who would you like your staff to be connected with to offer the education / vocation services you’re envisioning at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 104 125. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What facilities or physical structures (e.g. buildings, shelters, etc.) would be needed to provide the ideal education / vocation services for trafficking victims at your organization? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 126. (SKIP IF THEY DON’T WANT SERVICES PROVIDED) What do you see as the main barriers to offering the ideal education / vocation services for trafficking victims at your organization? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________________ _____________________________________________________________________________________ SECTION 9: CONCLUSION Thank you so much for participating in this study. I really appreciate you taking the time to talk to me today. Do you have any questions for me? 105 REFERENCES 106 REFERENCES Altschuld, J. W. & Kumar, D. D. (2010). Needs Assessment KIT: Needs assessment: An overview (Vols. 1-1). Thousand Oaks, CA: SAGE Publications, Inc. doi: 10.4135/9781452256795 Altschuld, J. W. & White, J. L. (2010). 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