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. [endnote text= “
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:”]

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.

Pregnancy is one of the few times in a person’s life when they are in regular contact with the health care system. For someone experiencing violence at home, that appointment may be the only safe space they have — or the only chance someone has to ask if they are okay.

— Perinatal care manager, California Medi-Cal Plan

Health Consequences of IPV

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

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). 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 Birthing Pathway RequirementHow MCPs Embed requirements in Core Operations
Incorporate IPV training within provider networks to promote universal IPV education in health settingsEmbed CUES-based IPV education into provider onboarding and annual training; track completion as a network monitoring and credentialing metric.
Re-frame services in a trauma-informed context for pregnant and postpartum members experiencing ACEs, IPV, community violence, and racismAdopt 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 managersAdd 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 providersExecute contracts/MOUs with IPV/DV CBOs and add them to the ECM provider network and closed-loop referral directory.
Create and enhance IPV-related member-facing communications and outreach materialsDevelop 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 goalsAlign provider incentives and value-based payment to Birthing Care Pathway IPV goals, tying payment to education, support, referral, and follow-up measures.
Covered California RequirementWhat MCPs Embed in Operations
Mandatory zero-cost annual IPV screenings and counseling for adolescent and adult women, aligned with Affordable Care Act (ACA) preventive-services guidelinesConfigure 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 contractsBuild data capture for SNS-E reporting; embed social-need and IPV education, screening and support in EHR/assessment tools and establish the patient-level submission pipeline.
Provide a year-round Special Enrollment Period (SEP) and confidentiality protections for domestic-abuse survivorsOperationalize survivor privacy protections — confidential communications, alternative EOB routing, and year-round SEP support — and train enrollment and member-services staff.
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