States leverage Medicaid to address and prevent intimate partner violence

Intimate partner violence (IPV) is a public health crisis in California. Among California residents, 35 percent of women and 31 percent of men report experiencing violence from their partner at some point in their lives. In 2022, Medi-Cal began the five-year CalAIM initiative1 to transform Medi-Cal into a health delivery system that, among other objectives, supports whole person care and the social drivers of health.2 CalAIM presents many opportunities for Medi-Cal to adopt evidence-based strategies to meet IPV survivors’ needs, prevent IPV, and interrupt the intergenerational cycle of violence. At the request of Blue Shield of California Foundation, Mathematica conducted an environmental scan of state Medicaid agencies and their efforts to prevent IPV among Medicaid enrollees and provide support services to IPV survivors in Medicaid. Our research identified eight states implementing policies to address and prevent IPV by using contracts with managed care plans and/or through Section 1115 demonstrations. Two states featured in this report, North Carolina and Rhode Island, use 1115 Medicaid demonstrations to create comprehensive programs that test methods to address a range of SDOH, including IPV. This brief presents the results of the environmental scan and highlights key practices that Medi-Cal should consider as it works to implement CalAIM and address IPV in California, including recommendations in the following areas: program authorities and monitoring, health-related social needs (HRSN) screening and trust, referral networks and platform privacy, covered services and supports.