Confab Seeks ​“Holistic” Rx To Gun Violence

Back in 2021, Connecticut implemented a first-in-the-nation law to make gun violence prevention services eligible for Medicaid reimbursement, which, at the time, was heralded as a major bipartisan breakthrough on an issue that had otherwise been deadlocked for decades.

Since then, those funds have supported programs in New Haven, which deliver wrap-around social services directly to gunshot victims and counseling to at-risk youth.

But the funding, which providers say is already too little, is now in the crosshairs of a Trump-backed effort to slash Medicaid spending across the board. And just last December, GOP Congressman Andrew Clyde of Georgia introduced a bill in the House of Representatives that targets the gun violence appropriations, potentially blocking Connecticut and six other states from billing Medicaid for the intervention services.

In response to the impending cuts and a possible all-out blockade, U.S. Rep. Rosa DeLauro convened a roundtable of about a dozen providers, city officials, gun violence survivors and advocates, and researchers to hear about how an abrupt reversal in federal policy would affect their work. 

The group met Thursday afternoon in the basement of the Yale School of Public Health at 60 College St. for a discussion that touched on a wide range of themes. 

Topics included the expected funding shortfall, data-gathering to maximize the efficacy of current programs, future convenings to coordinate a city-wide campaign to break cycles of violence, and ways of helping survivors cope with the physical and psychological damage that lingers after shootings. 

But more than anything else, the conversation emphasized, in the words of city Director of Community Resilience Tirzah Kemp, ​“thinking about the work holistically.” 

“I want us to reframe how we think about the victims, especially in brown and Black communities, that are impacted by gun violence,” she said at the meeting. ​“Everybody’s the victims. Every single person is the victim in the entire community.”

Working from that assumption, she said the city has built out a ​“victims-services support network” that helps communities that have been shattered by gun violence with broad-based support. ​“We connect with legal aid, provide advocacy for the family, we provide intensive coordinations,” Kemp said of the action plan that goes into effect after a shooting. ​“So we bring all the partners who are connected to this individual together to think about the wraparound services for everybody who’s involved.” 

The idea is to look at a whole ​“ecosystem” of factors — like housing insecurity, hunger, limited education, and mental health issues — that might contribute to a person’s exposure to gun violence. The leading program on that front is the Hospital-based Violence Intervention Program (HVIP) run out of Yale New Haven Hospital, which links emergency room patients with gunshot wounds to social workers and benefits, including mental health counseling and cash assistance.

“We have solutions that are working, and we are just seeing the glimmers of those solutions,” said James Dodington, a pediatric ER doctor and the medical director of the hospital’s Center for Injury and Violence Prevention, which coordinates a response team of social workers who meet bedside with shooting victims, as well as victims of sexual assault and domestic violence. 

With the Medicaid reimbursements and influx of federal American Rescue Plan funds, the center has been working with community providers and the city on treating gun violence as a systemic medical issue rooted in economic and social conditions. ​“None of this would be possible without really tectonic shifts that have happened in the last few years to make this ecosystem work.” 

As the federal government shifts again, this time away from the funding streams that have helped these programs run, DeLauro urged the providers, community members, and city officials to push back. ​“You are the external pressure. I work in an institution that responds to external pressure. You see how in 48 hours they turn something around,” she said of the Office of Management and Budget memo freezing federal aid issued on Monday and rescinded Wednesday. ​“They had no business being into this, but nevertheless they felt the heat.”