When you suspect a patient is being trafficked or when the patient discloses that they are a victim of human trafficking, the first step is to provide medical care while ensuring the patient’s immediate safety and privacy.
If the patient is in immediate, life-threatening danger, follow your organization’s policies for reporting to law enforcement. Whenever possible, try to work with the patient in deciding to contact law enforcement. Follow mandatory state reporting laws related to abuse of children, older adults, or a person with a disability. This includes reporting if a child is not accompanied by an adult.
Encourage patients to call or text the National Human Trafficking Hotline if they want to talk to someone or need help.
- National Human Trafficking Hotline phone: 888-373-7888
- National Human Trafficking Hotline text: 233733
If the patient believes it is dangerous to have the numbers written down, help them memorize the numbers. A common technique is to break the phone number into smaller segments, such as 888-37-37-888. The text number 233733 spells BeFree.
3.1 Best Practices for Survivor-Centered, Multidisciplinary Referrals
Best practices for referrals of human trafficking survivors focus on a survivor-centered, multidisciplinary approach. This means prioritizing the survivor's autonomy, safety, and individual needs while coordinating services both inside and outside the healthcare setting.
3.1.1 Internal Healthcare Referrals
Each healthcare organization should have a team that is responsible for managing all internal referrals. Continuity of care is critically important for a patient who may be in a dangerous or precarious situation.
The referring provider should introduce the survivor to the next provider (e.g., the social worker) to maintain trust and continuity. Using this sort of “warm handoff” is more supportive of a patient than simply providing a phone number, address, or website.
Coded language or abbreviations such as HT for human trafficking protect the survivor's privacy and prevent easy identification by unauthorized staff. Internal referrals should be flagged for special handling including increased security awareness. Access to referrals should be restricted only to essential personnel.
3.1.2 Community Partner Referrals
It is essential that healthcare organizations have formal partnerships in place with community-based organizations that have proven expertise in:
- Victim advocacy and trauma-informed care.
- Emergency housing/shelter.
- Legal aid (for issues like T Visas*, victim compensation, or vacating criminal records).
- Cultural competency to serve diverse populations.
*T Visa: (T nonimmigrant status) provides legal protection and temporary stay in the U.S. for victims of severe human trafficking, allowing them to remain, work, and potentially get a Green Card while helping law enforcement investigate trafficking crimes.
Provide survivors with information about what each group offers and allow them to choose. Referrals to community partners must be handled with extreme caution and respect for the survivor's autonomy. Be sure to get the survivor’s consent before sharing information or making referrals. Never make an involuntary referral (unless legally mandated, such as for a minor).
Consent must be (Ft Bend Antitrafficking Collective, 2025):
- Informed: The person understands what info will be shared, with whom, why, and for how long.
- Voluntary: Services or safety cannot be conditioned on saying yes.
- Time-Limited: The consent expires after a defined time or event.
- Documented: Ideally written; verbal allowed only in emergencies with follow-up documentation.
Provide the National Human Trafficking Hotline (1-888-373-7888) discreetly as a confidential, external resource that can be accessed when the patient feels safe.
Document that the community-based organization received a referral, whether the survivor connected with the organization, and if services have started. Prioritize referrals that meet the survivor's immediate needs:
- Safety/housing, shelter access.
- Food, clothing, and basic necessities.
- Legal/immigration to protect their status.
3.1.3 Multidisciplinary Care Coordination
Multidisciplinary care coordination means there are policies and procedures that coordinate services between all service providers. A designated case manager or social worker is the primary point of contact for the survivor and the hub for all internal and external referrals. This person prevents duplication of services and ensures seamless transitions between service providers.
Routine case consultation meetings involving the healthcare team and community-based partners allow providers to review the survivor’s progress, identify emerging needs, and adjust the plan of care. The plan should document the survivor’s self-identified goals and preferences, not just clinical recommendations. The plan must be flexible and evolve as the survivor moves through the stages of recovery.
3.2 Mandated Reporter Obligations for Suspected Child Abuse, Abuse of Older Adults, and Individuals with a Disability
Certain professionals are mandated to report known or suspected abuse, neglect, or exploitation of vulnerable populations. The legal specifics of who must report, what they must report, and the reporting timeline vary by state. Healthcare and social service providers are nearly universally included as mandated reporters in both child and adult protection laws.
3.2.1 Child Abuse and Neglect (Child Protective Services)
The Child Abuse Prevention and Treatment Act (CAPTA) requires that every state implement statutory requirements for the mandatory reporting of child abuse and neglect. Professionals must report when they have reasonable cause to suspect that a child is being or has been abused or neglected. This suspicion does not require proof or a full investigation.
The state's interest in protecting the child supersedes the parent's or the child's wish for confidentiality in most circumstances. Reports must be made immediately, often within hours, to the state's Child Protective Services (CPS) hotline or to law enforcement.
Children As Victims of Human Trafficking
Under Michigan law, any child who has been recruited, enticed, harbored, transported, provided or obtained for forced labor is a victim of labor trafficking. Labor trafficking can include, but is not limited to, domestic servitude, forced labor in restaurants or salons, forced agricultural labor or debt bondage. Michigan law includes a provision that allows the identification of child victims of labor trafficking, regardless of the presence of force, fraud or coercion, keeping these children in line with sex trafficking victims (MIHHS, 2017a).
3.2.2 Adults, Older Adults, and Individuals with Disabilities (Adult Protective Services)
Vulnerable adult laws cover older adults and individuals with physical or mental disabilities who are unable to care for themselves or protect themselves from harm. Reporting requirements typically cover abuse, neglect (by a caregiver or self-neglect), abandonment, and financial exploitation.
Adult Protective Service (APS) laws often include provisions for respecting the adult’s self-determination and autonomy. In many states, if a competent adult is a victim of abuse but chooses not to accept services or legal intervention, adult protective services may be limited in their ability to intervene, unless the adult lacks capacity and is in danger. While not abuse by another person, self-neglect is often reportable, and APS can intervene to offer resources.
Reports are made to the state's Adult Protective Services or a designated elder/disability abuse hotline, typically within a short timeframe (e.g., 24-48 hours). Law enforcement is often a required report only for crimes like sexual or serious physical assault.
3.2.3 The Role of Law Enforcement
Law enforcement is the first responder when there is a threat of immediate physical harm. Law enforcement personnel investigate the alleged abuse, neglect, or financial exploitation as a potential crime. They gather evidence, identify perpetrators, and pursue arrest and prosecution.
In many jurisdictions, mandated reporters are required to report to both Protective Services and law enforcement if the suspected abuse constitutes a felony or serious physical or sexual assault (particularly for child abuse). Representatives from law enforcement execute protective orders, remove alleged perpetrators from the home, and provide physical security for CPS/APS workers during difficult investigations.
The critical distinction is that Protective Services focus on safety and family or individual welfare, whereas law enforcement personnel focus on crime and legal accountability. Providers must be aware of when a report requires dual notification to meet their full legal obligation.
3.3 Local, State, and National Resources
Source: VA.gov. Public domain.
Identifying and responding to human trafficking requires access to a strong network of specialized resources. Below are key national, state, and local resources available for survivors, providers, and those wishing to report tips.
3.3.1 Michigan State and Local Resources
Michigan Human Trafficking Commission (MHTC)
Offers a specialized training for health professionals developed with the Wayne County Medical Society. It includes a one-hour video to help providers recognize warning signs.
https://www.michigan.gov/mhtc
VOICES4 Hotline
A confidential, anonymous 24/7 hotline (866-238-1454) for survivors and those supporting them, offering immediate crisis counseling and local referrals.
https://www.michigan.gov/voices4
Sexual Assault Nurse Examiner (SANE) Services
Providers can locate specialized forensic nurses through the Michigan SANE Services Directory to assist with medical and evidentiary exams.
MDHHS Human Trafficking Page
Provides links to assistance programs including Medicaid, housing services, and refugee assistance for survivors.
https://www.michigan.gov/mdhhs/adult-child-serv/abuse-neglect/human-trafficking
LARA Training Requirements
The Department of Licensing and Regulatory Affairs (LARA) mandates a one-time human trafficking training for all Michigan healthcare licensees.
https://www.michigan.gov/lara/bureau-list/bpl/licensing-requirements-help-guides
3.3.2 Clinical & Educational Tools
UM Human Trafficking Collaborative
Offers a free continuing education module that covers clinical scenarios, trauma-informed care principles, and the “PEARR” screening tool.
https://humantrafficking.umich.edu/
Michigan State Medical Society (MSMS)
Offers courses specifically designed to fulfill LARA's training standards.
https://www.msms.org/
3.3.3 Regional & Local Resources
Southeast Michigan
Avalon Healing Center (Detroit): Provides 24/7 crisis medical services and relocation assistance.
https://avalonhealing.org/ (313) 964-9701
Oakland County TIP Line
Providers can report suspected crimes directly to the Oakland County Sheriff at 248-858-0411.
3.3.4 West & Southwest Michigan
Battle Creek / Kalamazoo Area Anti-Human Trafficking Coalition
Connects providers to local protocols and procedure training.
https://www.kaahtc.org/ 888 3737-888
Kent County Essential Needs Task Force
Local coordination and reporting resource via the Kent County Sheriff.
https://entfkent.org/
3.3.5 Northern Michigan & UP
Hope Shores Alliance (Alpena)
Provides medical advocacy across Alcona, Alpena, Iosco, Montmorency, and Presque Isle counties.
https://hopeshores.org/ (989) 356-6265
Copper Shores Community Health (Houghton)
Features a SART team and SANE-trained nurses for the Western Upper Peninsula.
https://www.coppershores.org/ (906) 523-5920