Intimate Partner Violence Implementation Toolkit

Why IPV Education, Screening & Response Matters

Intimate Partner Violence (IPV) is a significant and preventable public health issue affecting individuals and families across California. It is not only a social issue—it is a critical health issue with measurable impacts on clinical outcomes, care engagement, and health equity.1

1 in 3

women experience IPV during their lifetime (national data). Rates are significantly higher among individuals facing economic instability, housing insecurity, disability, or behavioral health conditions.

1 in 6

men experience IPV during their lifetime. IPV disproportionately affects communities of color and communities experiencing systemic inequities.

Health Consequences of IPV

to IPV is associated with the following health outcomes, all of which fall within the scope of Medi-Cal managed care:2

Adverse Health Outcomes

  • Maternal morbidity and mortality
  • Preterm birth and low birth weight
  • Depression, anxiety, and substance use disorders
  • Chronic conditions including hypertension and cardiovascular disease
  • Increased emergency department utilization
  • Poor engagement in prenatal and postpartum care
  • Adverse childhood experiences (ACEs) and long-term developmental impacts on children

How Health Plans Step In

Because many individuals experiencing IPV interact with the health care system—particularly during pregnancy, postpartum, and preventive care visits—Managed Care Plans (MCPs) and their provider networks play a vital role in offering education, support, and connecting members to supportive services.

DHCS Policy Alignment

The USPSTF recommends routine screening for IPV in women of reproductive age, including those who are pregnant and postpartum (Grade B recommendation).3 Screening must be paired with universal prevention education, trauma-informed and healing-centered responses, culturally responsive education, and meaningful referral pathways.

USPSTF Grade B IPV Screening Recommendation

People Experiencing IPV: A Priority Population for California Regulators, Public Purchasers, and Payers

DHCS and Covered California requirements related to IPV.

DHCS Guidance45How MCPs Embed Requirements in Core Operations
Incorporate IPV training within provider networks to promote universal IPV education in health settings.Embed CUES-based IPV education into provider onboarding and annual training; track completion as a network monitoring and credentialing metric.
Reframe services in a trauma-informed context for pregnant and postpartum members experiencing ACEs, IPV, community violence, and racism.Adopt trauma-informed, healing-centered standards across perinatal care management; update staff scripts, protocols, and QI expectations accordingly.
Incorporate IPV screening into Medi-Cal assessments performed by providers and clinical care managers.Add a validated IPV screening to PHM risk-stratification, care-management, and ECM assessments, with standardized documentation and coding practices.
Build partnerships with IPV CBOs to serve as ECM and Community Supports providers.Execute contracts/MOUs with IPV/DV CBOs and add them to the ECM and Community Supports provider network and closed-loop referral directory.
Create and enhance IPV-related member-facing communications and outreach materials.Develop trauma-informed, multilingual member materials and safe outreach channels reviewed by survivors and CBO partners.
Redesign how Medi-Cal pays for maternity care to reward value-based care aligned with Birthing Care Pathway goals.Align provider incentives and value-based payment to Birthing Care Pathway IPV goals, tying payment to education and support.
Covered California RequirementWhat MCPs Embed in Operations
Provide mandatory zero-cost annual IPV screenings and counseling for adolescent and adult women, aligned with Affordable Care Act (ACA) preventive-services guidelines.6Configure benefit design so IPV education, screening, and counseling carry $0 cost-share; verify claims adjudication waives cost-sharing and co-payments.
Track and submit patient-level data for the Social Need Screening and Intervention (SNS-E) HEDIS measure under updated individual-market contracts.7Build data capture for SNS-E reporting; embed social-need and IPV education, screening, and support in EHR and assessment tools; and establish the patient-level submission pipeline.
Provide a year-round Special Enrollment Period (SEP) and confidentiality protections for domestic abuse survivors.8Operationalize survivor privacy protections (e.g., confidential communications, alternative EOB routing, and year-round SEP support) and train enrollment and member-services staff.

Birthing Care Pathway

The Birthing Care Pathway creates an explicit accountability framework for perinatal IPV. MCPs are expected to integrate IPV education, screening, and response into prenatal and postpartum workflows, not as a stand-alone initiative, but as a core component of whole-person perinatal care. Look for the birthing pathway callout throughout this toolkit for perinatal-specific guidance.

CalAIM Policy Alignment

The 2026 CalAIM policy guidance embeds IPV screening and response, in addition to MCPs building partnerships and contracts with IPV/DV providers as a part of the ECM provider network.

DHCS CalAIM Enhanced Care Management Policy Guide, January 2026

  1. Steele-Baser M, Brown AL, D’Angelo DV, et al. Intimate Partner Violence and Pregnancy and Infant Health Outcomes — Pregnancy Risk Assessment Monitoring System, Nine U.S. Jurisdictions, 2016–2022. MMWR Morb Mortal Wkly Rep 2024;73:1093–1098. DOI: http://dx.doi.org/10.15585/mmwr.mm7348a1  ↩︎
  2. Steele-Baser M, Brown AL, D’Angelo DV, et al. Intimate Partner Violence and Pregnancy and Infant Health Outcomes — Pregnancy Risk Assessment Monitoring System, Nine U.S. Jurisdictions, 2016–2022. MMWR Morb Mortal Wkly Rep 2024;73:1093–1098. DOI: http://dx.doi.org/10.15585/mmwr.mm7348a1  ↩︎
  3. U.S. Preventive Services Task Force. Screening for Intimate Partner Violence and Caregiver Abuse of Older or Vulnerable Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2025. doi:10.1001/jama.2025.9009.  ↩︎
  4. California DHCS. CalAIM Population Health Management Policy Guide. Framework for MCP population-health management and use of quality measures to monitor PHM implementation. DHCS PHM Policy Guide ↩︎
  5. California DHCS. All Plan Letter 26-005. Current maternity guidance requiring MCPs to incorporate IPV screening into comprehensive risk assessment during pregnancy and postpartum, with safe disclosure without the intimate partner present. DHCS APL 26-005  ↩︎
  6. 45 C.F.R. § 147.130 (ACA Section 2713 preventive services, no cost-sharing); Health Resources and Services Administration, Women’s Preventive Services Initiative recommendation on screening and counseling for interpersonal and domestic violence (updated for plan years beginning 2026); California SB 406 (Pan, 2020), codified at Cal. Health & Safety Code § 1367.002 and Cal. Insurance Code § 10112.2, requiring California-regulated plans to cover USPSTF/WPSI-recommended preventive services without cost-sharing. ↩︎
  7. National Committee for Quality Assurance (NCQA), Social Need Screening and Intervention (SNS-E), HEDIS Measurement Year 2023+, reported via the Electronic Clinical Data Systems (ECDS) standard; Covered California Qualified Health Plan Individual Market Issuer Contract, social needs screening and reporting requirements. ↩︎
  8. 45 C.F.R. § 155.420(d)(9) (special enrollment period for exceptional circumstances, including domestic abuse/spousal abandonment); Covered California, “Domestic Abuse or Spousal Abandonment” Qualifying Life Event guidance, coveredca.com.  ↩︎

To top