[House Hearing, 116 Congress] [From the U.S. Government Publishing Office] SOLVING AN EPIDEMIC: ADDRESSING HUMAN TRAFFICKING AROUND MAJOR EVENTS LIKE THE SUPER BOWL AND THE NEED FOR CROSS-JURISDICTIONAL SOLUTIONS ======================================================================= HEARING BEFORE THE SUBCOMMITTEE ON LEGISLATIVE AND BUDGET PROCESS OF THE COMMITTEE ON RULES HOUSE OF REPRESENTATIVES ONE HUNDRED SIXTEENTH CONGRESS FIRST SESSION __________ WEDNESDAY, DECEMBER 11, 2019 __________ [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Available via http://govinfo.gov Printed for the use of the Committee on Rules __________ U.S. GOVERNMENT PUBLISHING OFFICE 39-699 WASHINGTON : 2020 COMMITTEE ON RULES JAMES P. McGOVERN, Massachusetts, Chairman ALCEE L. HASTINGS, Florida, TOM COLE, Oklahoma, Vice Chair Ranking Republican NORMA J. TORRES, California ROB WOODALL, Georgia ED PERLMUTTER, Colorado MICHAEL C. BURGESS, Texas JAMIE RASKIN, Maryland DEBBIE LESKO, Arizona MARY GAY SCANLON, Pennsylvania JOSEPH D. MORELLE, New York DONNA E. SHALALA, Florida MARK DeSAULNIER, California DON SISSON, Staff Director KELLY DIXON, Minority Staff Director ------ Subcommittee on Legislative and Budget Process ALCEE L. HASTINGS, Florida, Chairman JOSEPH D. MORELLE, New York, ROB WOODALL, Georgia, Vice Chair Ranking Republican MARY GAY SCANLON, Pennsylvania MICHAEL C. BURGESS, Texas DONNA E. SHALALA, Florida JAMES P. McGOVERN, Massachusetts ------ Subcommittee on Rules and Organization of the House NORMA J. TORRES, California, Chair ED PERLMUTTER, Colorado, DEBBIE LESKO, Arizona, Vice Chair Ranking Republican MARY GAY SCANLON, Pennsylvania ROB WOODALL, Georgia JOSEPH D. MORELLE, New York JAMES P. McGOVERN, Massachusetts ------ Subcommittee on Expedited Procedures JAMIE RASKIN, Maryland, Chair DONNA E. SHALALA, Florida, MICHAEL C. BURGESS, Texas, Vice Chair Ranking Republican NORMA J. TORRES, California DEBBIE LESKO, Arizona MARK DeSAULNIER, California JAMES P. McGOVERN, Massachusetts C O N T E N T S ---------- December 11, 2019 Page Opening Statements: Hon. Donna Shalala, a Representative in Congress from the State of Florida and Member of the Subcommittee on Legislative and Budget Process............................. 1 Hon. Rob Woodall, a Representative in Congress from the State of Georgia and Ranking Member of the Subcommittee on Legislative and Budget Process............................. 2 Hon. Alcee Hastings, a Representative in Congress from the State of Florida and Chairman of the Subcommittee on Legislative and Budget Process............................. 3 Witness Testimony: Ms. Jean Bruggeman, Executive Director, Freedom Network USA.. 9 Prepared Statement....................................... 11 Ms. Katherine Fernandez Rundle, State Attorney, Miami-Dade County..................................................... 23 Prepared Statement....................................... 26 Dr. JoNell Potter, Clinical Professor, University of Miami & Vice Chair for Research, THRIVE Clinic..................... 32 Prepared Statement....................................... 34 Mr. Bill Woolf, Executive Director, Just Ask Prevention & Director, National Human Trafficking Intelligence Center... 36 Prepared Statement....................................... 39 Mr. Bob Rodgers, President and CEO, Street Grace............. 54 Prepared Statement....................................... 57 Additional Material Submitted for the Record: Statement from Congresswoman Wasserman Schultz dated December 11, 2019................................................... 6 Statement from Ms. Hanni Stoklosa, Executive Director, Co- founder, HEAL (Health, Education, Advocacy, and Linkages) Trafficking dated December 11, 2019........................ 61 Statement from American Hotel & Lodging Association dated December 10, 2019.......................................... 67 Statement from National Football League dated December 9, 2019....................................................... 70 Article by Laurie Anderson, UGA Today, entitled ``UGA receives $15.75M to combat human trafficking'' dated November 19, 2019.......................................... 89 Document entitled ``FY18 and FY19 TVPA Human Trafficking Funding Restriction'' by Freedom Network USA............... 92 Curriculum Vitae and Truth in Testimony Forms for Witnesses Testifying Before the Committee............................ 96 SOLVING AN EPIDEMIC: ADDRESSING HUMAN TRAFFICKING AROUND MAJOR EVENTS LIKE THE SUPER BOWL AND THE NEED FOR CROSS-JURISDICTIONAL SOLUTIONS [ORIGINAL JURISDICTION HEARING] ---------- WEDNESDAY, DECEMBER 11, 2019 House of Representatives, Subcommittee on Legislative and Budget Process, Committee on Rules, Washington, DC. The subcommittee met, pursuant to call, at 10:03 a.m., in Room H-313, The Capitol, Hon. Donna E. Shalala presiding. Present: Representatives Hastings, Morelle, Scanlon, Shalala, McGovern, Woodall, and Burgess. Ms. Shalala. The Subcommittee on Legislative and Budget Process of the committee on rules will come to order. I want to welcome the witnesses and thank them for being here today. I also want to thank my colleague and friend Alcee Hastings from Florida, the distinguished chair of the subcommittee, for his leadership, as well as the chair of the full committee, Mr. McGovern from Massachusetts. I appreciate you passing the gavel off to me for this hearing. I apologize in advance if I have to leave the room before we adjourn as I am managing a rule on the floor this afternoon. We are here today, first and foremost, to learn. With the help of this expert panel, we will learn about the issue of human trafficking. Human trafficking is a worldwide issue, with millions of men, women, and children forced into labor, the sex trade, drug smuggling, and other forms of exploitation. Large sporting events that draw huge audiences of out-of- town visitors often serve as magnets for human trafficking, fueling a multibillion dollar criminal industry. As this vile industry grows, municipalities, counties, States and countries around the world have expanded their efforts to combat human trafficking by focusing on these events. As we all know, the Super Bowl is being hosted in Miami next February. Sometimes dubbed the largest human trafficking event in the United States, the Super Bowl presents an opportunity to begin a conversation on human trafficking and highlight the efforts of Miami-Dade County and other communities across the Nation to eliminate this epidemic. The Super Bowl happens one day a year, but we must be vigilant about combating human trafficking every day. While the Super Bowl may bring increased incidents of tragedies like human trafficking, it also brings increased resources to counter the issues that arise from the event's presence. We need to examine the resources available in the effort to combat human trafficking in every community year-round. Today, we will learn about the complexities of combating human trafficking, the ways the Federal Government is assisting local law enforcement, and the additional resources that are needed for prevention. How do we make better laws? How do we deliver better Federal resources? How do we better provide support for survivors of human trafficking? I look forward to exploring these questions and learning from you as we seek to develop effective solutions. Thank you very much. The chair now recognizes the ranking member of the subcommittee, Mr. Woodall, for any opening statements he wishes to make. Mr. Woodall. Mr. Woodall. Thank you, Madam Chair, and thank you for your leadership on the issue. Thank you to Mr. Hastings for bringing us all together. You have got the Super Bowl coming. We, of course, in Atlanta had the Super Bowl going. And the kind of collaboration that came together in my home State is something that I am just incredibly proud of. I wish we didn't have to come together in that way. And I know we can always do better, and so I am very pleased that we have got such a distinguished panel to talk about that. You all don't know, but generally sitting in those chairs we have got the chairman and ranking members of whatever the committee of jurisdiction is. Ordinarily, we don't have outside witnesses. Our folks who testify in the Rules Committee are the chairman who is bringing legislation and the ranking member who is either collaborating on that legislation or vehemently opposed to that legislation. So, so often, we have a partisan conversation from that table. I am so looking forward today to a nonpartisan issue, something that we are all invested in. We may come to it from a different perspective, but we all have the same goal in mind. And that is certainly the way that Secretary Shalala has led in her time here on this committee, and I look forward to that leadership today. If Miami needs any advice and counsel, I don't want you to feel shy about coming to Atlanta. When it comes time to introduce our witnesses, I brought one of our very best from Atlanta, a gentleman who leads an absolutely fabulous organization that has a tremendous record of partnership. But I don't want to spend any more time hearing from someone who doesn't have expertise in this area. I would love to hear from folks who do, so I yield back. Ms. Shalala. Thank you. Chairman McGovern. Mr. McGovern. Thank you. And I want to thank both Chairman Hastings and Representative Shalala for bringing us together today on this very important issue. Chairman Hastings has been a leader in this fight against human trafficking for much of his career, using his other chairmanship at the Helsinki Commission to make a difference on an issue as difficult, complex, horrifying and important as this one, and I want to thank him for his leadership. And I also want to thank Representative Shalala for putting together this incredibly talented panel to help us at the Rules Committee learn about human trafficking nationally, but also as it impacts her district in Miami, Florida. You know, like Mr. Hastings, I have another chairmanship as well. I serve as the co-chair of the Tom Lantos Human Rights Commission with my colleague from New Jersey, Congressman Chris Smith. And for that chairmanship and, believe it or not, this chairmanship too, I work every day to promote these goals: That every person must be free, free of persecution, free from manipulation and free from coercion, and every person deserves dignity, respect, and autonomy to achieve the destiny of their choosing. And all of us, every single one of us plays a role in achieving a freer, fairer world. And so to our witnesses, I want to thank you for the work that you do to end human trafficking and to help survivors reclaim and reengineer their lives. There is hope in this story, and I thank you for sharing it with us. When any major event like the Super Bowl comes to town, Federal attention and resources flow into the community. And it is important for Congress to understand the role our Federal agencies play, how Federal resources are assisting local communities and how we can do more together to stop human trafficking. It is also important that we understand that human trafficking is a 365-day-a-year problem that requires a 365- day-a-year solution. We also know that human trafficking is a complex issue. As we here in Congress work to find solutions, we would be well-served to ask ourselves how our silos might inhibit our thinking about how to direct resources to help communities address trafficking. And so, again, this is an incredibly important topic, and I think we are all grateful that you have come here to give us your expertise and advice. So thank you, and I yield back. Ms. Shalala. Thank you. Mr. Hastings. Mr. Hastings. Thank you, Mr. Chairman. And I wish to especially thank my distinguished colleague, Ms. Shalala. When I see the person I call Donna all the time, I think of all the titles that she has, president and Secretary and now Congress people and whatever. It is sort of like at one point I was a judge and I was a lawyer and I had letters of doctorate, and people would ask me, say, what do you want to call me? I would say, ``Just call me often.'' That is all. So that is what we do with her. But I am especially pleased that she agreed to lead this morning's hearing, which marks the Subcommittee on Legislative and Budget Processes' second hearing of the 116th Congress. And I thank the chairman for letting us carry forth in that way. I am pleased to welcome our witnesses. I don't know all of you. I know the reputation of two of you, and I know one of you very well, who has hasn't aged a bit, and I am jealous, Katherine Fernandez Rundle. I am pleased to welcome them and grateful that they are here. We will hear from a number of experts, so I will keep my remarks brief. We are here today to address human trafficking around major events like the Super Bowl. And not meant to correct you very much, Madam Secretary, but you said the Super Bowl is one day a year. I have been at parties for the Super Bowl a week in advance and got hung over and was a week later as well. But we do need cross-jurisdictional solutions. And this morning's hearing is going to focus on the complexities of combating human trafficking and ways the Federal Government is assisting local law enforcement and additional resources needed to increase our prevention. The need for Congress to prioritize fighting this heinous form of modern day slavery is urgently clear. The United States has one of the highest rates of human trafficking in the world, but this is a local, not just a global problem. There have been incidents of trafficking identified in all 50 States and Washington, D.C., and centers of major events, tourism, and entertainment, including California, Texas, and Florida are among the major destinations for human trafficking victims. I am painfully aware that my home State of Florida is facing this epidemic on a daily basis and have long fought to boost both awareness and prevention efforts for this very reason. And the State attorney of Miami has done some forward- leaning things that I am sure she is going to tell us about at the instance of working with attorney general of the State of Florida. They did some incredible work and stood up a building even. It is estimated that half of Florida's trafficking victims are under 18 years old, with children from high-risk backgrounds being the most vulnerable to exploitation and trafficking. In September, Florida's State Board of Education approved a new rule to require K through 12 students to learn about the dangers posed by traffickers. However, there is still much to do to address this epidemic in Florida and across our Nation. That is why, without going into great detail, I have introduced several bills, as have many of my colleagues, and I won't mention them in the interest of time. But in September, I have worked with ECPAT-USA, a leader in fighting child sex trafficking, to introduce an important guide which helps Members of Congress effectively begin to discuss and address cases of new trafficking in their respective jurisdictions. As presentations for the Super Bowl continue in Miami, it is imperative that we do everything we can to better understand how we can protect our communities and our children from the horrors and trauma of human trafficking. Today's hearing is a vital step in that direction. And, Madam Chair, with your permission, I would like to introduce into the record a statement of our colleague Debbie Wasserman Schultz and also her statement in support of the effort that she has made, states hundreds of trafficking cases last year, she says, and south Florida is one of the worst epicenters for this heinous crime. The Congresswoman is currently working on legislation which mandates trafficking awareness and intervention training to hotel employees. And I will footnote right there. This isn't only in hotels. We need to pay attention to other places where this activity flourishes, particularly around bars. And it also requires the development and display of public materials on human trafficking in lodging facilities. Most importantly, it will include a provision of enforcement so that hotels will be held accountable or have an opportunity to amend their wrongdoing. With no objection, I would like to formally enter the statement for the record. Ms. Shalala. Without objection. [The information follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Mr. Hastings. Thank you very much, Madam Chair. Ms. Shalala. Dr. Burgess. Dr. Burgess. Thank you, Chairman Shalala. I apologize. I am going to have to go to another meeting, but I did want to--and I will submit these questions in writing, but I want to just speak to them just if I could to give you some context and background. Like Mr. Hastings, until last year, I was on the Helsinki Commission. I was removed because we lost a seat because we lost Members of the House. Long story. But part of that time-- Mr. Hastings is quite correct. Human trafficking is something that we took testimony on. And some of the most compelling testimony that I heard was one morning when we had two witnesses from Central America, who were speaking through translators, and they had been brought to this country and trafficked and used for the worst purposes, but they were trafficked by family members. And so, particularly for Dr. Potter--now, the focus of the hearing was, why isn't our healthcare system doing a better job of detecting this? I got defensive, and, you know, why aren't people telling us the truth when they come to see us as doctors. But I think even just an awareness that this could happen and a patient where they are not allowed to speak for themselves. They are never allowed to be alone with the provider in any way, shape, or form. Some of these things ought to be red flags and ought to be conveyed, whether it is through our professional organizations or medical schools, but this is, unfortunately, something that all of us could see during a typical practice time. And, Mr. Rodgers, again, just the same thing. I mean, these were ladies who were trafficked by transnational gangs, but then their family members were involved in their trafficking. And I won't be here, but I will look forward to your testimony on how we are able to perhaps deal with that and intercept that. So thank you, Madam Chairman. I will yield back. Ms. Shalala. Mr. Morelle. Mr. Morelle. I want to thank you both, Mr. Chairman, and my colleague Representative Shalala as well as Chairman McGovern for organizing this. I know that in New York, when I was a State legislator, we took a number of steps at the State level to provide resources for victims and also to strengthen State laws. This is clearly a Federal and international problem and deserves a Federal response. So I just appreciate the witnesses being here, and I am looking forward to their testimony. So thank you. Ms. Shalala. Thank you very much. Let me introduce our witnesses. Jean Bruggeman is executive director of the Freedom Network USA, a coalition that provides services to survivors of human trafficking in the United States. Katherine Fernandez Rundle is the Miami-Dade County State Attorney. In this role, she leads the Human Trafficking Task Force, a cooperative multiagency law enforcement effort. Dr. JoNell Potter is clinical professor at the University of Miami, vice chair for research at the THRIVE Clinic. She has built a comprehensive model of healthcare for survivors of human trafficking. Bill Woolf is executive director of Just Ask Prevention and director of the National Human Trafficking Intelligence Center. Just Ask Prevention is a leader in educating communities on strategies to identify and respond to human trafficking. And Bob Rodgers is president and CEO of Street Grace, which focuses on countering commercial sex exploitation of children through faith-based prevention and policy. We will start with you. Ms. Bruggeman. Thank you. Mr. Hastings. Get your microphone. Just press it, and the green light will come on. STATEMENT OF JEAN BRUGGEMAN, EXECUTIVE DIRECTOR, FREEDOM NETWORK USA Ms. Bruggeman. Thank you for the IT assistance. Chairman McGovern, Secretary Shalala, Ranking Member Woodall, Congressman Hastings, committee members and staff, thank you for the opportunity to discuss the need to address human trafficking in the United States. I am Jean Bruggeman, executive director of Freedom Network USA. I am an immigration attorney by training, with 20 years of experience in addressing violence and exploitation, including human trafficking, within the United States. Freedom Network USA was established in 2001 and is now the Nation's largest coalition of human trafficking service providers, and we are a leader in human trafficking training and technical assistance and policy advocacy. Our 68 members are NGOs and individuals that provide services to and advocate for the rights of trafficking survivors here in the United States. Our members include survivors themselves as well as former prosecutors, civil and criminal attorneys, and social service providers, who work with over 2,000 trafficking survivors each year. I have provided detailed recommendations in my written statement, but I will summarize those briefly now. The unfortunate truth is that no jurisdiction in the United States is successfully and comprehensively addressing human trafficking, which includes compelled work in a wide variety of industries, both legal and illicit. While it is important to note that there has been an increased understanding of sex trafficking across the United States, labor trafficking, especially child labor trafficking, continues to be mostly ignored. While trafficking can happen to anyone anywhere in the U.S., there are clear patterns. Some populations are at higher risk. Immigrants are most often victims of labor trafficking with, for example, predominantly women exploited in domestic work and men in agriculture. Girls and young women, both U.S. citizen and foreign nationals, as well as LGBTQIA youth are more likely to be exploited by sex traffickers. However, our understanding of the full complexities of victim populations is incomplete, and some of our policy efforts are unintentionally exacerbating this problem. The focus on child sex trafficking, while laudable and important, has, unfortunately, created a dangerous feedback loop. The Preventing Sex Trafficking and Strengthening Families Act of 2014, for example, specifically requires the identification and reporting of child sex trafficking only in the child welfare system. Therefore, the data suggests that child labor trafficking does not exist and does not need further attention and efforts. This demonstrates how important it is to design approaches and solutions that both focus on the most prominent problems without ignoring or excluding any victims. While the Super Bowl brings us here today, it is not the cause of human trafficking, and trafficking will not end when the players leave the field or Mr. Hastings gets over his hangover. Human trafficking, as you have already noted, is a 24/7, 365 days a year crime. It is happening in our homes, our stores, our restaurants, our fields and factories and on our streets all across America. We can, however, use the energy and attention of sporting events to bring attention and resources to this issue, but we must do so responsibly, focusing on the true facts before us. The U.S. has been focusing efforts on human trafficking since the passage of the 2000 Trafficking Victims Protection Act. The President's Interagency Task Force, or PITF, has brought agencies together from across the government to collaborate and coordinate, and yet you know that there is more work to be done. Funding for services for trafficking survivors has increased from the initial authorizations of about $5 million each for DOJ and HHS to over $100 million for 2020. Investigations and prosecutions are up, with State laws allowing for more jurisdictions to bring cases. However, services continue to be insufficient and focus on short-term services instead of long-term recovery. Prosecutions of labor trafficking are stagnant at best, and too often law enforcement resources designated for sex trafficking are squandered on arresting sex workers and buyers without identifying a single trafficking victim or the high-level traffickers who remain in operation. Survivors continue to be arrested for the crimes they commit that their traffickers have forced them to commit, only to then be trapped in a cycle of dependency and poverty by those criminal records while they are denied legal relief from these charges. We have also failed to address primary prevention in a comprehensive way to change the factors that are putting people at high risk of human trafficking. In fact, many policies have increased the risk for immigrants, LGBTQIA community members, and people living in poverty across the United States. We must continue to focus on more comprehensive solutions to not only meet the needs of those who have been victimized, but to change the systems that make this crime so pervasive in the first place. Thank you for your commitment to a comprehensive approach to human trafficking in the U.S., and I look forward to your questions. [The statement of Ms. Bruggeman follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Ms. Shalala. Thank you very much. Ms. Fernandez Rundle. STATEMENT OF KATHERINE FERNANDEZ RUNDLE, STATE ATTORNEY, MIAMI- DADE COUNTY Ms. Fernandez Rundle. Good morning, Madam Chair Shalala and Chairman Hastings. It is a real treat to be in front of you, two people that I have thought of so highly all these years. So thank you very much. And, Chairman McGovern, thank you so much for hosting this. And to all the members of this committee, thank you for putting such a spotlight on this issue and for hosting this today, having this hearing. My name is Katherine Fernandez Rundle, and I am the State Attorney for Miami-Dade County, Florida. Throughout my career, I have seen the effects of many horrific crimes, but it wasn't until 2012, when I read that Florida was reported to be number three, the third in the United States in the number of victims of human trafficking, and Miami-Dade was number one, which is my county, and I realized that this crime was happening in our own backyard, and we didn't see it. And I have since learned if you are not looking for human trafficking, you are not going to see human trafficking. So our experience is that human trafficking does not limit itself to stereotypes that are depicted in the movies. It occurs in hotels, massage parlors, even licensed storefronts. It affects every single one of our communities, rich or poor, every ethnicity, every race, every gender, and, most importantly, it is primarily targeting our children and our youth. I am happy to report we have come a long way since 2012, and my office has worked with over 700 victims of human trafficking, and we have been able to file over 619 criminal human trafficking-related cases. Our victims are ages as low as 12 years old. Human trafficking we all know, because you have been paying good attention to this for many years, it is ugly, and it is often an inhumane crime of exploitation. Not surprisingly, the victims typically are the most vulnerable. They primarily are children and youth. And our experience in Miami is that over 34 percent of these cases--of course, that fluctuates as they come and go--involves victims under the age of 18, as you were pointing out earlier, Mr. Hastings. The remaining 66 percent were really between the ages of 18 and 24. So you are really talking about very young folks, and 90 to 92 percent of them are female. Our cases involve local victims that include children and youth from our schools and from our parks and from our foster care system. Human trafficking is no doubt a public health and mental health threat to our children and our youth. Rescuing human trafficking victims requires much more, though, than just locating them and physically removing them from their predators. Most have no home, no safe home to return to. They have no clothing, other than what is on their back when you rescue them, and many have not eaten or slept in days. Many have been beaten, drugged, raped, isolated, branded, threatened with retaliation, stripped of all their dignity and their identity. Their mental, physical, and emotional injuries are so profound, many are unable to heal and rebound without any substantial or sustainable resources and assistance. When proper services are not provided, many of these victims end up back on the streets, where traffickers are just waiting for them to save them and restart that sexual exploitation and violent abuse cycle. For us in prosecution and law enforcement, we have learned that we needed to develop new methods of investigation and prosecution and develop a network of victim services. Our human trafficking prosecutions have become victim-focused and not reliant on the victim. What we have tried to do is create a community safety net of partnerships in all different silos that will assist us with the housing, the physical and the mental health needs, and getting them reintegrated into society. You will hear today from our great colleague here to my left from the THRIVE Clinic, such an integral and valuable partner of ours. The key, though, is to find the long-term sustainable resources that are really necessary to address the victims throughout a pendency of a prosecution. This is a constant struggle for us, and it is a constant struggle for them. In 2018, we opened our Institute for Coordination, Advocacy and Prosecution of Human Trafficking. We call it ICAP. It is one building that is dedicated solely to combating human trafficking, with the goal of creating a single doorway that focuses on efforts that include prosecutors, law enforcement, all our victim services, all our community partners. They say it takes a village. Well, that is what we tried to do. We tried to build a village, and we have created one. Miami is very collaborative, we are a great community in that respect, but we would not have become a national model without all our community service providers. It is not just about law enforcement. And large-scale events like the Super Bowl that we are all talking about today, our limited resources are even more strained. So Super Bowl LIV is taking place in my community in less than 2 months. And while we have been preparing for the surge that this may bring, we could use more help. We fear that traffickers will be coming to our city to make money during the Super Bowl, because that is what it is. It is all about money. It is about selling our children and youth for money. But to protect our most vulnerable and to rescue and transport them in, what we have tried to do as a community is create training and very costly messaging about what is human trafficking and what everyone in the community should be looking for. We have also tried to create a good reporting method and then have rapid response teams that can respond out to the community that consists of not just law enforcement but medical professionals, to have them on standby, to have prosecutors on call, to have housing readily available, food, clothing, and a whole host of other services. So we are looking at the Super Bowl as an opportunity. It is an opportunity that is going to give us an opportunity to have an aggressive and comprehensive awareness campaign that we have developed. We have just created a new hotline. It is called 305-FIX-STOP. It stands for fix it, stop it, and it will have text and hashtag capabilities. The goal is, upon receiving that call into that one hotline, we will have a rapid-response team, depending on the circumstances, of course, that will be dispatched right out to investigate immediately and/or rescue that victim and pull them into that network of care coordinators and services. The campaign will be launched by--was launched by the Women's Fund last month. It is a community wide. We have 35 municipalities in our reach, from the airport, seaport, truck stops to billboards to public transportation sites. Hopefully, we can serve for the rest of the community, the rest of the world, if you like, as a demonstration to other communities on how to attack crime, especially when there are these major events. But as I have heard said here, it doesn't end just there. They are going to leave. Super Bowls come and go. And so what we are going to need to do is make sure that what we have built we are able to sustain long after the Super Bowl leaves us. And so, for this long 365-days-a-year problem that we have, we are now talking about how we are going to sustain that past that. So I thank all of you so much. I have put some paperwork here. I am going to try to stick to my time limit. We know where we need to go with this. And so I thank you so much, as our Federal Government and our Federal Representatives, for listening to us, inviting us here today, and I look forward to continuing this conversation. [The statement of Ms. Fernandez Rundle follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Ms. Shalala. Thank you very much. Dr. Potter. STATEMENT OF JONELL POTTER, CLINICAL PROFESSOR, UNIVERSITY OF MIAMI & VICE CHAIR FOR RESEARCH, THRIVE CLINIC Ms. Potter. Good morning, Madam Chair, Chairman Hastings, Chairman McGovern, committee members, your amazing staff, thank you for the opportunity to speak to you today. I am a professor of clinical obstetrics, gynecology, and reproductive sciences, pediatrics, and nursing at the University of Miami in Miami, Florida. My career began in the early 1980s, when the HIV epidemic emerged in Miami. I led the design of comprehensive multidisciplinary models of care to help the women and children living with HIV access healthcare services. This experience taught me to listen to my patients. The patients taught me about fear, abandonment, and stigma. They also taught me about the incredible strength of the human spirit. We were able to build models of care that helped these vulnerable populations live healthy lives, and what we learned in Miami spread to clinics across the country. Six years ago, I was contacted by local law enforcement and members of the Human Trafficking Task Force in Miami to provide medical care for victims that they had identified. What I encountered in my exam room led me on a new journey. I realized these survivors, often taken as young children, had experienced years of abuse and medical neglect and had tremendous healthcare and mental health needs. Their healthcare needs were, frankly, beyond the scope of anything that we had in place. And I took on a new mission. I am here to speak with you today because, since then, we have established a comprehensive model of healthcare for survivors of human trafficking. At the University of Miami, along with our partners at Jackson Health System, we developed one of the first clinics in the Nation to help survivors access healthcare and mental health services. We saw this as an emergency and we responded. The clinic is called THRIVE. We provide medical, primary, and specialty care, mental health and behavioral care services to address the very unique needs of this population, who are deeply impacted by poverty, housing insecurity, food insecurity, and illiteracy. Many of the survivors have had little or no education. Most have no identification or records of any kind. Many have never had any healthcare or proper nutrition. They have all suffered from trauma, from being held captive in one way or another. Our healthcare model is designed on the basic principles we developed listening to the survivors. Trust is critical. The most important issue for survivors is building trust. They have been brainwashed by their traffickers and taught not to trust anyone. We start by deliberately developing a trusting relationship. Patient navigators add safety and support. Getting care can be overwhelming. We employ navigators, usually survivors who have reentered the workforce who chaperone the patient through every visit. No waiting rooms. Waiting rooms make our patients too nervous. Having their name called out to come to the desk in a public place is very frightening for them. We admit and discharge every patient inside the exam room. We have reengineered the medical model. Specialists come to the clinic. Our patients cannot negotiate multiple medical appointments in multiple facilities, but most of the care they need comes from specialists. So the physicians and nurses at Jackson Health System and the University of Miami come to the same familiar clinic room every time to see the patients. We take a medical history only once. Repeating their history retraumatizes our patients. So we take a medical history only once and ask all the providers to review it before they see the patient. We have learned that no medical history is routine. Survivors often cannot or do not want to remember. Their stories change over time as they are able to share and trust. They are not lying. They have blocked out the trauma to survive. Every patient needs comprehensive care. Our patients have physical injuries and illnesses that have been untreated for years. They have bones that were broken a decade ago. They have never seen a dentist. They need coordinated comprehensive healthcare. Extensive mental healthcare is essential. All of our patients, every one of them has posttraumatic stress with all of the classic symptoms: flashbacks, nightmares, anxiety, depression, suicide attempts. What these survivors need most is mental healthcare, and there are simply not enough available. We are just beginning, but we have already seen results. Some survivors relapse, but most do not. They are successfully reengineering their lives. Our clinic has been replicated in another Florida community. We are collaborating and sharing best practices with a program in Texas and Atlanta. Atlanta has called us to replicate our model there. So, in closing, I just want to reiterate what my colleagues have already said and what you already know. Human trafficking exists in every State in our Nation. I urge you to support funding to establish medical demonstration projects designed to evaluate the most effective model of medical and mental health aftercare for survivors of human trafficking. Thank you for the opportunity today, and I look forward to your questions. [The statement of Ms. Potter follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Ms. Shalala. Thank you very much, Ms. Potter. Mr. Woolf. STATEMENT OF BILL WOOLF, EXECUTIVE DIRECTOR, JUST ASK PREVENTION & DIRECTOR, NATIONAL HUMAN TRAFFICKING INTELLIGENCE CENTER Mr. Woolf. Madam Chair, honorable members, good morning. It is, indeed, a privilege to be here, sitting next to these highly respected experts in the field of human trafficking, and quite humbling. I started my career almost 20 years ago as a Fairfax County police officer, first working as a patrol officer, then graduating to a detective assigned to work in the gang investigations unit. It was during the course of one of my investigations into the notorious MS-13 gang that I first encountered human trafficking. My experience was similar to so many other law enforcement officers when they encounter their first case. I had no idea what I was looking at. As I became aware of what I would later learn was human trafficking, my initial belief was that it was just prostitution. I had never received any training or education surrounding the issue of human trafficking. Those words had not been a part of my academy instruction, and so the concept was quite foreign, much like I believed something such as human trafficking was simply a foreign problem. Sadly, this lack of training for law enforcement is still a problem today, with some estimating less than 5 percent of law enforcement in the United States have received adequate identification and response training. My eyes were quickly opened to the reality and prevalence of this horrible crime. That reality: Human trafficking is exploiting men, women and children alike, yes, in foreign lands, but, more disturbingly, right here in the United States. The land of the free has become one of the top three countries of origin for modern day slaves. Human trafficking is not just a threat to the most urban areas of our country, but is impacting some of the most remotest areas as well. Traffickers are exploiting technology to gain access to potential victims right in their own communities, their own schools, and even their own homes. I have had the honor of working alongside more than 200 victims of human trafficking during the course of my career as a law enforcement officer, alongside victim services professionals, and in my capacity as the executive director of the Just Ask Trafficking Prevention Foundation. Their stories are complex and heartbreaking. They have been exploited by boyfriends or girlfriends, those that have used the guise of love to manipulate them into this lifestyle. They have been exploited by gangs, who have learned that human trafficking is more profitable and less risky than other crimes. They have been exploited by lures of employment and even in some cases by their own family members. I would like to recognize my friend and a member of the Just Ask board of directors, Barbara Wilson, who is with us here today. Ms. Wilson is a survivor of sex trafficking here in the United States. Starting at the age of 12, Barbara was sex trafficked by her own mother, enduring abuse and exploitation and ultimately running away from home, only to be taken advantage of by many others. She became addicted to drugs and survived on the street for many years until she was finally able to pull herself out of that situation. Barbara is more than a survivor; she is a thriver. She has gone on to become a successful woman with a beautiful daughter and enviable career. But Barbara did not have anyone to turn to during her exploitation. She didn't know where to go, and because of that I would say that, at a minimum, we as a society were complicit in her exploitation. I am also honored to have here with me Susan Young, who serves as the director of our parent Coalition to End Human Trafficking. Susan's daughter was lured and manipulated and ultimately trapped by MS-13 gang members into a life of sexual exploitation and servitude starting at the age of 14. These monsters assaulted her, forced her to engage in commercial sex acts, and injected her with multiple drugs as a means to control her. When Susan and her husband found out and tried to intervene, the gang went after their 3-year-old daughter. Susan, her daughter, and her family have literally been to hell and back, although Susan might tell you that she will never fully return from that hell as it will live with her for the rest of her life. In her case, her daughter attempted to seek help from school officials 22 times. All 22 times, the school took no action to stop the abuse. We as a society were again complicit in the exploitation. There are many social determinants that lead to someone being drawn into a life of exploitation. Much research has been done identifying at-risk populations: those that come from disjointed home lives, those in the very broken foster care system, victims of prior abuse, those that are economically challenged or homeless, those that are bullied or have low self-esteem. So many social issues have a direct or indirect correlation to the pervasive exploitation of human trafficking. One social issue in particular is that of the opioid epidemic. Drugs have become inextricably linked to human trafficking. Traffickers use these drugs to manipulate, control, and trap victims. In even more disturbing cases, adults, parents will become addicted to these drugs and then sell their own children in order to fuel that addiction. One of our team members with us here today, George Swanberg, is a drug addiction expert and helps guide our understanding in developing comprehensive prevention programming. Human trafficking is truly a complex issue, from the social determinants that create victim vulnerabilities to addressing the demand for these illicit services, challenges in deploying effective training for frontline professionals, availability of resources to support victims, and the lifelong challenges these survivors face. Considering the tremendous impact trafficking has on its victims, much of which you have heard about from my colleagues today, I ask you, what are we doing to prevent these atrocities from happening in the first place? I believe the key to combating the epidemic of human trafficking is through prevention. Events like the Super Bowl bring a much-needed awareness to the issue. There is much hype surrounding sporting events with claims that human trafficking increases exponentially as a result. While the research is inconclusive, it is important that we seize these opportunities to educate the public on the realities of human trafficking and dispel the myths with a call to extend this awareness throughout the entire year. Prevention is truly possible. One young lady that I had the privilege of working with, a young lady by the name of Maria, was 17 years old when she was being drawn into trafficking. Someone she believed to be her boyfriend was luring her in through coercion and lies. And, fortunately, she went to school and went through a program, a prevention program that Just Ask had put together. She realized what was happening as a result of that program and was empowered to report to her parents. Law enforcement got involved, and the bad guy was arrested, and she was never exploited. Prevention is possible. This is but one example of the effective lifesaving efforts that our foundation and other NGOs working in the prevention space do on a day-to-day basis. We are just beginning to scratch the surface of addressing the issue of human trafficking. It is really going to be the next generation to bring about real change if we provide them with the tools and resources that they need. I am so proud to have members of the Just Ask Student Advisory Council here with me today: Cora, Ashna, Maya, Paige and Alex. These young women and men provide guidance and leadership to us at Just Ask to make sure our message is relevant and effective. And I hope that you share in my gratitude and pride in these leaders, who have taken a stand to safeguard their communities and their generation. On the eve of the 20th anniversary of the passing of the Trafficking Victims Protection Act, I call upon all of us to take action. Provide us working in the field with tools, resources, and support that we need to expand our successes and bring an end to human trafficking. The witness of Barbara and Susan here today are a testament to resiliency and strength of the human person, but it is also a call for us to stand up, with the noble goal of not one more victim. And these students stand ready to carry on that charge. I would like to thank Representative Shalala and the committee members for offering the opportunity to address human trafficking, with the sincere hope that this is the beginning of a meaningful conversation, not the end. We can end this if we would help these students, who are willing to stand up and do something. I commend you all for your commitment to safeguarding our communities and look forward to an ongoing partnership. If I may just for the record offer my daughter Emma a happy 11th birthday today. Thank you. [The statement of Mr. Woolf follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Ms. Shalala. Thank you, Mr. Woolf. And thanks for bringing your posse with you. Mr. Rodgers. STATEMENT OF BOB RODGERS, PRESIDENT AND CEO, STREET GRACE Mr. Rodgers. Yes. Madam Chair, honorable members of the committee, good morning. Thank you for the opportunity to be with you today, addressing the issue of sex trafficking. I know we can all agree it is a shame that organizations like these and Street Grace have to exist and that these conversations are even necessary. However, for Street Grace and many of the organizations in the fight, there is good news. We have never been more encouraged. Together, we are making meaningful, and we are making measurable progress. I am grateful for the committee's willingness to deal with this issue directly and at the highest levels to keep it in the forefront. This is how real progress is made. I have never met anyone in favor of sex trafficking, but I meet people every day who aren't aware of what it is and they are not aware that it is occurring in their neighborhoods and in their communities. My exposure came as a graduate university president, but today I have the distinct honor of serving as the President and CEO of Street Grace. We were launched in 2008 as a result of the faith community coming together with a collaborative response for the growing issue of sex trafficking, child sex trafficking in Atlanta and throughout the State of Georgia. Today, we have offices in four States, and over the last 2 years have partnered with more than 10 attorneys general around the country. We are led and informed by a survivor advisory board that puts their hands, their eyes, and their life experience on everything that we do. Since context matters, I thought it would be important for you to know the lens that we see the issue through. One, we are Christ-centered; two, we are child-focused; and, three, we are demand-centric. Additionally, all of our initiatives rest on at least one of three pillars. Prevention and protection of children: Every year, especially the last 3 years, we have had the opportunity to speak and present and educate 50,000 to 75,000 kids a year between the ages of 12 and 18. It is a remarkably powerful thing when you are sitting with a middle school or a high school student and you give language to this part of life and these things that can happen and you see a light bulb and a connection come on. We follow the old adage that the eyes can't see what the brain doesn't know. Second is policy. Street Grace is a leader in local and national policy recommendations that create a better framework for law enforcement to make arrests and for those that can be successfully prosecuted, also focusing on and continuing to create access to care for those who have been victimized by this crime while ensuring that the perpetrators, both the traffickers and the buyers of sex, who are also traffickers, face appropriate convictions and sentencing. And, third, pursuit: Including the use of artificial intelligence and learning chatbots, we sit here this morning, we have technology that is deployed in 15 cities and 8 States identifying bad actors who are attempting to purchase sex with children and disrupting those transactions. And let's be really clear. I don't mean to be offensive or disrespectful in any way, but I think it is very important that we call it what it is. Child sex trafficking is the exchange of something of value or money to rape a child. It must be stopped, and no child deserves this. I also mentioned, though, that this was an encouraging time to be in the fight against sex trafficking. I would like to briefly highlight a couple of those reasons. I am happy to comment further during the Q&A, if necessary. On this issue, around the country, we have moved from competition to a greater level of collaboration, where we are working together in support of a shared goal and cooperation. It is occurring between government, local, State, and Federal, NGOs, law enforcement, corporations, the Academy, faith communities, community groups, and more. Many States are benefiting from this now more than ever before. We just saw a very practical example of that earlier this year in Atlanta, when we came together to create a web of protection around our city as we hosted the Super Bowl. While we weren't perfect, it worked. Second, we continue to acknowledge that restorative care for those who have been victimized by this is critical. They need, as you have heard, and deserve the best and highest standards of medical care, mental healthcare, skills training, life support, education, and every other resource that we can possibly make available. Progress cannot be made without gold standard of care. There is no substitution. There is no second best. We have to lead in this area. We are doing a better job acknowledging that we will never end this issue by following it around and trying to put the broken pieces back together from those who have been impacted by it. While it is critical, it is not the solution. They deserve more, as do others, and we must look at this as the illegal business that it is and strategically work to dismantle it. We will never end sex trafficking one arrest, one rescue, one prosecution at a time. We have to scale up. The use of artificial intelligence, chatbots, and other technology allows us to keep pace with the traffickers and the tools that they use. Finally, there is a growing acceptance towards removing the cloak of anonymity towards the buyers of illegal sex. Laws are being passed around the country that allows for the arrest and exposure of those who are caught. This has to be included. For these meaningful reasons and more, we have cause for encouragement, and yet, as is always the case, there is more to do as we continue to make measurable progress and accelerate the rate of that progress. We must allocate additional funding for prevention and evidence-based demand reduction strategies. Historically and overwhelmingly and appropriately, funding has gone primarily towards restorative care. Because this is such a hidden crime, it requires proactive investigations. We need to do more to prioritize trafficking investigations among Federal law enforcement agencies, like the FBI and Homeland Security and others. We must include the rampant transnational and organized crime rings in the illicit massage industry. It is the second highest category of reported cases of sex trafficking in the United States of America. It is the safest place in the United States of America to purchase illegal sex. No one is better positioned than the Federal Government to address these large criminal enterprises. We also must look at the systemic approaches that can be used to cripple segments of the industry. The House took the lead on H.R. 2513, known as the Corporate Transparency Act. And while it is in the Senate now and they are considering similar legislation under the name the Illicit Cash Act, this could quite possibly help us with the stroke of a pen do more to dismantle the illicit massage industry in the United States of America overnight than all of the NGOs' combined efforts could do over the next 10 years. We need your leadership and your support. We need to continue to create and pass legislation that allows those who have been victimized by this horrible crime to have civil recourse against all parties who knowingly and financially benefited by this activity or passively allowed it to occur. We must continue to expand the statute of limitations that allows someone who has been victimized to pursue criminal charges and damages. And we need to continue to create expungement and vacatur laws, providing access and legal help for those who have been victimized by this. As you are probably aware, in recent months grant funding to survivors to provide legal support to help clear their criminal records so that they can move forward and establish careers and move on with life has been eliminated or dramatically reduced by this administration. We must continue to focus on restorative care solutions as well as evidence-based demand reduction strategies. We are capable of doing both. Simply put, much good is occurring, and there is much left to do, but the pace of progress is accelerating, and it seems like a tipping point could be in sight. Thank you. [The statement of Mr. Rodgers follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Ms. Shalala. Thank you, Mr. Rodgers. I would like to insert three documents into the record. The first is written testimony from HEAL Trafficking. HEAL is a network of 35 countries, over 3,100 trafficking survivors, and multidiscipline professionals that focus on education and training, protocol development, research, and providing direct services to victims of human trafficking. The second is a statement from the American Hotel and Lodging Association on their No Room for Trafficking Campaign, which unites the industry around a comprehensive approach to fight human trafficking in the hotel sector. And the last statement for the record is a letter from the National Football League on their effort to utilize Super Bowl as a platform to promote awareness about human trafficking. Without objection. [The information follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Ms. Shalala. Mr. Woodall, would you like to start the questioning? Mr. Woodall. I thank you very much, Madam Chair. Ms. Shalala. Excuse me. Let me acknowledge the presence of our colleague from Pennsylvania, Representative Scanlon. Mr. Woodall. Thank you, Madam Chair. For us in Atlanta, it was 11 days of the Super Bowl, and Street Grace was a part of a Federal, State, local and NGO collaborative team. We called it the Metro Atlanta Exploitation and Human Trafficking Task Force. And it resulted in those 11 days in about 169 arrests. Mr. Rodgers. That is right. Mr. Woodall. Including 26 traffickers and 34 individuals trying to purchase sex with minors. It also led to the rescue of nine adults and nine minors, I believe the youngest of which was 14. Mr. Rodgers. Right. Mr. Woodall. That is a record of enforcement that I hope Miami does not match, because I hope the problem is not escalating. I hope the tipping point that Mr. Rodgers talked about is, in fact, among us. But I want to talk about what the four corners of the debate are. Mr. Rodgers, you mentioned civil recourse. And certainly getting the lawyers involved is--money talks. But I heard Mr. Woolf's testimony. I believe 22 times a victim went to the local school system seeking help, did not find help. When you talk about something as deliberately heavy-handed as civil recourse against folks who passively allow abuse to occur, do you have something as serious as allowing a lawsuit against that local school system in order to promote that, lawsuits against doctors who passively allow that to occur? Is that the level of necessity that we have come to? Mr. Rodgers. No, I can't speak specifically to that, but in our impression of what we are looking at, that is not the case. We are looking for people who--the key word for us is ``knowingly'' and ``benefited from.'' So what we are talking about is an example over and over again that you can run across where the front desk clerk or the manager at a local motel has been allowing this to occur on property while they have either been receiving cash, you know, under the table or they have just passively allowed it to occur and not wanting to get involved. So it is primarily targeting those who, A, knowingly and have financially benefited from. Mr. Woodall. And I know you were talking about massage parlors or some of the research and the reports that are coming out locally. Are those large criminal enterprises? Are we going to find 15 or 20 of those massage parlors connected? Are those individual smaller sex trafficking shops, in your experience? Mr. Rodgers. The recent research that was done by Polaris I believe earlier this year/late last year indicated that there were about 9,000-plus illicit massage businesses around the United States of America, accounting for about $2.5 billion to $3 billion in annual revenue. Those are overwhelmingly owned by more--the individual owner, whoever that might be, owns more than one. And they also have likely two of--at least one of three businesses: A dry cleaners, a laundromat, a restaurant or a nail salon, and that is where they funnel and traffic the illegal money that comes from--the majority of them are run by organized crime in some way, shape or form, from our experience. Mr. Woodall. Doctor, I wanted to ask on Dr. Burgess' behalf, you heard him express his concerns about giving that minor time to be alone with a provider to make that report. Do you have, so we can get that on the record, a response to his very serious concern? Ms. Potter. Absolutely. When Representative Burgess was speaking, I was thinking about his story as a missed opportunity. It was a missed opportunity in healthcare. And I am happy to say that most healthcare professionals, a lot of service industries have licensed professionals. And State legislatures are working hard to mandate continuing education on human trafficking. Education and awareness is the key. I have been doing this for 6 years, and it is amazing to me how many people do not understand what human trafficking is and what to do if it is in front of them. Doctors are not equipped to care for the survivors that we are seeing today. We don't know best practices. We don't know best approaches. I have sent a patient to the emergency room at 2 in the morning and called the ER to speak to the attending physician about my case that was in the ER. And the attending physician says: Could you stay on the phone, because I want to talk to you about a case that I had a couple days ago that I thought could have been a trafficking victim, and I am not sure what to say because if I bring it up, they will run. I am not sure what to do and who to refer to. HEAL Trafficking, the memo that was put into, she has an online website where they do massive education. There are protocols online that can be downloaded about what ERs can do to increase the awareness. We talked a little bit about trauma-informed care. Trauma- informed care, survivor-informed care, what I call human trafficking-informed care. In Massachusetts, for example, they are working at Brigham and Women's to make the entire hospital trauma-informed. Because human trafficking is hidden in plain sight, it is not like you know who the victims are. So it is the words that you use and the language that you use as a provider to let the patient feel safe. We are all trained to isolate the patient. There are tricks that you can use. If the chaperone won't leave them, you send the patient for an x-ray that is not really ordered and get them away from the trafficker, and then you put a note in the bathroom and ask them for a sample in the bathroom. So we are learning all of these tricks about how to educate healthcare professionals, but educate the world. Everyone in this room today, all of the stories that you have heard, we are counting on you to go back to your dinner parties, to go back to your families and tell the stories that you have heard today so that we increase awareness and education and everybody starts to think about the victims and if they see something they call the human trafficking hotline. Mr. Woodall. We do spend a lot of time talking about response. During the Super Bowl, every billboard in Atlanta was ``see something, say something,'' not in a terrorist context but in a human trafficking context. It is easier to get dollars out of Congress for a response, because if you see a problem everybody wants to solve that problem. What I am hoping you can tell me, to your point, Mr. Rodgers, to so many of your points, response is critical and must happen, but prevention would have been better. What is the best dollar that we spend so that you don't have a prosecution in your courtroom, so that Fairfax County isn't involved in making arrests, so that we don't get the negative policy feedback loop. It may be different for each of you, but if we know, what is the best dollar we spend on prevention? Ms. Fernandez Rundle. Thank you. That is such a complicated question with a very broad answer, but I think that what you are hearing today is that it is not just one area. Prevention is critical, but prevention happens at different intersections, right? So it can be at the home level. It can be at the neighborhood level. It can be in your doctor's office. It could be your first arrest. It could be the arrest of somebody else. There are so many intersections that we need to prevent what is happening at each intersection. So it is really all of the above. And one of the things that is so challenging about this area is that it is so complex. And, for instance, neuroscience today is teaching me and I think a lot of us that what we are dealing with is something that is so neurologically different from what we ever learned about as professionals or had witnessed as professionals. And so now we are all trying to build some trauma-informed responses at all those different intersections so that we can be very preventive, that we can be also very punitive with the traffickers. So what Mr. Rodgers, for instance, was describing about massage parlors, you know, that is about money also. But, you know, what he was talking about is we now know that trauma is so deep and hard for these victims to tell their stories, or like I think one of them said, they are not lying. We now know, because of the new neuroscience that is only, what, like 20 years new that we are learning about the brain, we now understand they are not lying. So we don't have to rely on them, because they are going to be cross-examined and they are going to be called a liar, and Mom's not going to believe them and all those horrible things. But what we now can do is we can look at money laundering, for instance. So what Mr. Rodgers was talking about is pertinent I think to this discussion, because we know that we have to take care of that victim, but at the same time we can go after the traffickers in the massage parlors and the dry cleaners if, in fact, that is where they are laundering their money from those illegal acts. That was a long answer, but---- Mr. Woodall. So often when folks say it is a complex question, what that leads me to conclude is that, yes, Miami- Dade is going to have to try something, Gwinnett County is going to try something different, Fairfax is going to try something different; but I am going to be stuck, as a Federal legislator, responding with that block grant that lets you use it as you see fit. Have you seen, Jean, a place that we have underfunded that you can point to? Ms. Bruggeman. Well, I think there are many--as you stated, I think there are many levels to what would be effective prevention. I think that there is actually, sort of taking a step back even further, going further upstream is where the real work hasn't started. And that involves comprehensive immigration reform. That involves looking at guest worker visas and including visa portability for workers. What we see is that a majority of labor trafficking victims enter on a legal visa that was given to them by the U.S. Government that tied them to an employer, who then abused them and used the U.S. legal system to entrap them. So when we change the system that the traffickers are using to exploit the workers, then we protect the workers. When we make housing affordable across the country, what we see is that a lot of people who are entrapped in sex trafficking engaged first in sex work in order to pay their rent and pay their medical bills. If they could just pay their rent because housing was affordable, then they wouldn't be put in a desperate situation where they were willing to take employment that was dangerous and difficult. So I think it is actually the fundamentals of keeping our community safe. And when we keep our community safe from all sorts of violence and exploitation, that is when we truly protect them from human trafficking as well. It is not as pinpointed, so it is much more difficult to get through Congress, and it is the real work that needs to be done, because I think that is the work that would address the problems that all of us are seeing where people are being put at risk by systems. Mr. Woolf also mentioned the foster care system and the challenges. What we see is that time and time again our youth are running away from the foster care system and would prefer to trade sex on the street than to go back to the foster care system. Until we fix that, the kids keep running away from it and into the arms of anyone who will take them. So that is on us to fix that system I think, as Mr. Woolf pointed out. Ms. Fernandez Rundle. If I may, can I piggyback on that issue, the foster care system? About 45 percent of our victims, our experience in Miami, come from the foster care system. So, when you are talking about prevention, one of the areas that we can have some well-developed preventative strategies would be when they are really, really young in the home, and we start to see that there are dynamics that aren't working, and they are ending up in our foster care system, whether it is temporarily or a couple weekends, or then it goes to a couple weeks and then a couple months. And they tend to be runaways, like you say, and throwaways. A lot of them tend to be kids that nobody wants except these traffickers want them. So, you know, that is another area I just wanted to piggyback on on her talking about the foster care system. Mr. Woodall. Doctor. Ms. Potter. I just want to also add, that is about half of the population, but many of my patients are coming from regular suburbia, middle class homes, and they are being lured because they want things. And the traffickers entice them. They will trade sex for phones, things like that. And the internet, the internet is a big problem. We were speaking in Palm Beach, and after we presented some work, a judge raised his hand, and he said: That was my granddaughter, right? So they were lured on the internet. So prevention, educating the youth, you know, mandating education about how to stay safe in schools is critical. Mr. Woodall. Mr. Woolf. Mr. Woolf. Mr. Woodall, yes, sir. If I can just respond and add onto what Dr. Potter pointed out. And I think that if you are asking how do we best use our dollars the right way, I think absolutely, it is educating our young people. Even though we know that all ages are targeted by traffickers, if we look at it in the sense of inoculating against a particular threat, right, where we can give them that education early on. I have worked with so many victims that came and said, I just didn't know. I didn't know what I was getting myself into, or I didn't know how to describe what was happening to me. I didn't know who to turn to for help. And we have got to put those skills and resources and give those tools to our young people so that they are empowered to be able to stand up and protect themselves and their peers. Education is cheap. I commend Florida for the steps that they have taken to mandate it in their classrooms. But this is something that is called on by the Department of Education, Health and Human Services has asked for this, and yet we are not seeing it get the traction. And many communities around the country say: Well, we haven't had that many cases, so do we really need to make this a priority? And I think the answer is yes, and that needs to come from your leadership. Mr. Rodgers. Just one quick comment. I agree with everything that my colleagues have said. And so this is not an agreement. If it was my dollar, I would figure out how to divide it amongst education and demand reduction, evidence- based demand reduction. When a buyer of sex has to pause because there is a 50/50 chance that they are going to get caught, it stops. But when there is a 1 percent chance, ``that is never going to be me.'' Mr. Woodall. Thank you all. Thank you, Madam Chair. Ms. Shalala. Thank you. Representative Scanlon. Ms. Scanlon. Thank you, Chairwoman Shalala, for convening this subcommittee hearing today, and special thanks to all of you for coming. This is actually something that I had an interest in before coming here for a couple reasons. First off, my district in southeastern Pennsylvania contains all five of Philadelphia's professional sports teams as well as a major international airport, an East Coast port, Amtrak, regional rail, a large stretch of I-95. So a lot of infrastructure that can be used to facilitate human trafficking. And the other reason I was interested is because before coming to Congress, I was head of a pro bono program for a large law firm where we provided legal services to a lot of underserved populations, and human victims or survivors of human trafficking were certainly a large part of that. We represented victims from around the world who have been lured to the U.S. with promises of employment. We represented an order of Catholic nuns who repurposed their convent to become a halfway house or a place of refuge for victims. And we represented foster care youth and other people who our social safety net had failed. So, certainly, I am aware of the connections and look forward to your helping us figure out what we can do about it. And I am also grateful to Mr. Woodall, because I was aware that Atlanta had really stepped up its game. I had seen a lot of the materials in the airport there. But with regards to the airport, we have heard--airports, we have heard stories from time to time passengers or people in the air industry being able to disrupt trafficking. And I know that there is some Federal legislation or regulation that requires some training and posting of signs. But, you know, we have seen what happens when there is mandatory training or posting of signs. What can we do to step it up? And I think, Ms. Fernandez Rundle, you might have something on that. Ms. Fernandez Rundle. Yes, thank you very much for asking that question. I think that anything that we can do in education and awareness is always going to get us much further than any reaction, right? So I think that all the mandatory training that we have now passed in Florida, that you have mandated at the Federal level, is all having an impact. I mean, just, you know, somebody pointed out to me 10 years ago when the Super Bowl was in Miami, 10 years ago, the NFL wasn't talking about human trafficking. They are talking about human trafficking. And I am not saying we don't have a long way to go, we do. But just even talking about the issue. And everything the Federal Government has done, that you have done, and the State government has done to constantly every year pass legislation and some funding and appropriations, this says: This matters, and we want you, hotel industry, we want you, the education system, and we want you to be talking about training, have curriculums built, medical system. All of the medical professionals in Miami are incredible. They all want to know what are the protocols? What are the standards of care? How do we get involved? What are we going to do when they all come to our emergency rooms and urgent care centers? So I think that kind of conversation constantly, and even though there are a lot of different professionals working at it, if we are all really focused on it together as an infrastructure, I think we have to say to ourselves, we are making a difference and we can make a difference. And we need to be super supportive of each other, because if we all stay in our own silos, we are not going to get it done. We have to get into each other's lanes, and we have to really work with each other and around each other and include each other and embrace each other. So I hope that answers your question. Ms. Scanlon. Jean. Ms. Bruggeman. Yeah, I would just like to add I think it is also important what we have seen is some really amazing work done by community-based organizations across the country. For example, in my written testimony, I talked about Damayan, a Filipino-based worker collective that works to educate Filipino domestic workers throughout New York. What we see, especially in immigrant communities that are very vulnerable to different forms of human trafficking, is that general public information campaigns aren't successful at reaching those workers, especially domestic workers who are isolated in their homes. And so having community-based organizations educate using peer education methods. In Florida, the Coalition of Immokalee Workers has an amazing program that educates agricultural workers in the fields in Florida using a peer education model with an opportunity to report violations that has virtually eliminated labor trafficking in the tomato fields in Florida. So I think it is also, you know--as Mr. Woolf was talking about the importance of peer education and school-based education and the peer educators that he uses in his own program, in the same way with other communities that are at high risk, really working within those communities to provide culturally relevant, linguistically appropriate direct contact and information. Building that trust, as we have heard about this morning, is critically important. Ms. Scanlon. I am a little curious about how the impact of the administration's hardline enforcement or seeking out of immigrants for deportation, et cetera, how that has impacted human trafficking, because certainly what I have seen in the past when people have been lured to the U.S. with promises of employment or if they are here with any question about their legal status, then that becomes an instrument of control that people are profiting off of, that they are basically held in servitude because they are afraid that they are going to be arrested. So what can we do to disrupt our government becoming the enabler of these people who are putting others in slavery? Ms. Bruggeman. Yeah, that is a current challenge right now. What we are seeing is that immigrant victims are more hesitant to come forward. Those who come forward to local service providers, the legal service providers in our network report that the immigrant victims who will come and tell them about their situation will not report to law enforcement. They even fear right now filing for immigration relief, the T visa that Congress created. Now the new policies of the administration have made the T visa harder to get, and they have extended a memo which then threatens with deportation anyone who applies for a T visa and whose application is found lacking in any way or they are unable to respond to any questions for whatever reason. They will be subject to immediate deportation if their application is denied, in a complete reversal of policy. So this is terrifying the immigrant community. Our members have reported that victims have come forward to them and said: I will go back to the trafficker. It is not safe for me to come away right now. What can we do to disrupt that? I think we have to change these policies. We have to reach out to our immigrant communities and tell them that we know that they are hardworking, honest people who are trying very hard to support their families and loved ones, just like everyone else. And we have to protect them from these really painful and abusive practices. Ms. Scanlon. Even before the recent administration policy, there was an issue with the T visas and the U visas that do provide a path to legal entry, that they were capped. I mean, we helped many people apply for these visas, and the wait time was now moving into years, and 7 years, 8 years, 9 years. So even people who were trying to comply with our laws were unable to, and so, therefore, they remained in this limbo and subject to deportation. Is that your experience as well? Ms. Bruggeman. Yes. That continues to be a problem. I think most Americans think that there is a legal path to citizenship for anyone who works hard and tries and complies with the law, and that is simply untrue. The U visa cap has been reached every year, and the wait list now to even be considered for approval is over 10 years. So that is something Congress could certainly look into, raising that cap to allow more U visas each year. U visas are for victims of a wide variety of crimes and requires certification from law enforcement. So a U visa is only eligible, is only available to someone who has come forward and been helpful to a law enforcement investigation or prosecution and the law enforcement agency, on their own accord with no requirement, has certified that that is true. We have law enforcement agencies across the U.S. who choose not to certify even when victims of violence have assisted in an investigation or prosecution. So it is a very high standard. It is an incredibly high bar, and we are limited by numbers. The T visa has a lower ceiling, but it has never been reached. So the problem with the T visa is not that we are running out of T visas. It is that the adjudication process, which used to be completed within 6 to 9 months, if you look at the historical averages that USCIS has published online, is now over 2 years. For that application, we are talking about less than a thousand applications a year. They simply made changes to their adjudication process to slow down adjudications of visas, including the T visa, which leaves then victims of trafficking who have come forward, who have put their lives at risk, who have complied with every request of our government in limbo for over 2 years and then with the threat of deportation hanging over their head. So those things together are leading to a place where people are unwilling to come forward at this time. So those are all policy changes. A legislative change it is not needed there. Perhaps some oversight into why the Department of Homeland Security has chosen to make these policy changes specifically against this population might be helpful. Ms. Scanlon. Thank you. One more thing for Mr. Rodgers. You mentioned the fact--this is more of a domestic enforcement issue--that funding has been withdrawn to help survivors of human trafficking expunge their record so that they can move on from their lives. Can you talk a little bit about that? Mr. Rodgers. There were some grants that were available that would allow folks who have come out of the life and been rescued to it to be able to apply for legal support for funding that would allow them legal support to expunge their records, to erase criminal, you know, charges that were against them while this was occurring and they were being victimized, so that they could more swiftly move forward and earn a career, get a job, and transition into a way of supporting and caring for themselves. That is probably, at least in our experience, outside of the mental health issue of it that is an ongoing basis, probably the single greatest challenge that survivors of trafficking face when they are trying to stand on their own two feet and move forward, you know, is the financial ability to take care and provide. Ms. Shalala. Let me ask, Ms. Fernandez Rundle, how you handle that kind of thing? Ms. Fernandez Rundle. Actually, Florida has the ability in State law to move to vacate, a vacatur, in other words, to go in and take that record and eliminate it for that person. So we do that as an office. If we feel it is appropriate and the victim was coerced or a lot of the crimes occurred--robbery is a big one. They will steal from the person that is buying them, and they might get charged with robbery or theft. And then, as we understand that case better, we then have the ability to go with that victim into court and change the record, really eliminate it from the record. Ms. Scanlon. Am I correct that some of the funding for that is in the VAWA Act, which hasn't been reauthorized. Is that correct? Mr. Rodgers. That is my understanding, yes. Ms. Scanlon. That is Violence Against Women Act that the House passed months ago. Okay. Ms. Shalala. Absolutely. Ms. Scanlon. I yield back. Ms. Shalala. Kathy Fernandez Rundle, let me ask you, because you are the prosecutor here, how you build a case, because everybody has talked about the trust of the victim in terms of providing services, but you provide some services as part of your efforts to build a case. And you mentioned that sometimes you have to build the case without the victim. Ms. Fernandez Rundle. That is correct. Thank you for asking that question, because it is really the key component to successfully rescuing a victim and having a successful prosecution. So what we have done, our experience has been working is that the person that builds that initial trust--and I think you have met them, because you have been out to our center--are these incredible angels. I don't know where they get the depth of passion to do it. But they are the ones who go out 3 o'clock in the morning, and they build a bond with that victim right then and there, and brings them into our center, where--we are not a shelter. We are an advocacy center. And they can just relax for a few minutes and think about their experience, think about their rescue. And the bond is then with that care coordinator. And that is not a cold police station. It is not somebody in uniform necessarily, right? We might send an investigator out there. And then, with that, once we get them into all the services that we have talked about here, we are then able, not always, but many times we are able to convince that victim to move forward with the prosecution. Oftentimes, they run. You could start a prosecution and they change on you. So that is why in this packet you will see, I think it is like page 15 of our PowerPoint that we submitted, we look at everything. We go to digital evidence, so that we don't have to retraumatize that victim again, because you have heard us all say this. We now know neurologically that when you are relying on that victim, lots of things are going to happen. They could run on you. They could lie to you. They could be ashamed. They could be all of the above. And so they are not going to come forward. So what we have to do, as prosecutors and lawyers, and other people in the system like you were talking about, how do you ask these questions of them? We look to digital evidence. We look at phone records, text messages, hotel records, massage parlors, their financial records. We even now have strip clubs and gentlemen's clubs that are coming to us, as a prosecutors' office, saying: How can we help you do some undercover operations within our organization? So I don't know if that answers your question, but it is a very--we found a pathway that is working for us. And one of the things I think I heard Mr. Woodall talking about is, what is the takeaway here? One of the things that I think we would all like is some research, right, that would tell us are our strategies working? What are the best evidence-based strategies for prevention, for treatment, for medical services, for trauma treatment, for prosecution, for immigration? What does that look like? What do we need the takeaways? And I think the Federal Government can be very helpful to us in looking at some of the different pockets. I mean, you know them better than I do, but, HHS and Office Against Violence Against Women. And there are a whole host of different places that you could help us also understand better what are the strategies that are working, what strategies should we be implementing that can work. And so that would be a wonderful place that you could really be a contributing major player in changing this landscape. Ms. Shalala. Mr. McGovern. Mr. McGovern. First of all, thank you. I apologize. I had to leave briefly to testify before another committee. But, as I mentioned before, I co-chair the Tom Lantos Human Rights Commission. We did a hearing on trafficking a few years ago. And, you know, many of the same challenges that were highlighted a few years ago still exist today. You know, this is a complicated issue. It is more than about a block grant, right? It is more than about education and awareness. It is more than about better training doctors. It is more than about, you know, a lot of these things that we have all talked about. More than a study even, right? I mean, although those are all very, very important. But there are systemic challenges that persist that make it very, very difficult. We talked about immigration. I mean, I hear over and over. If you are being illegally trafficked, you know, sex trafficked or you are being exploited for labor and you are an undocumented immigrant, I mean, you don't come forward because you will be revictimized again, you know. You will be deported. And we do not have a system right now, no matter how we want to talk about it, that is at all compassionate when it comes to people who find themselves in that situation. The same with people who are trafficked in sex. You know, not just undocumented immigrants but, I mean, you know, a very few years ago people were saying that, you know, that the people who were being arrested and prosecuted, you know, were the ones who were being caught in the act and not the person who was exploiting them. And yeah, you can--and I think there are cases where you can vacate convictions, but those are tough, right? And so, you know, if you don't have access to affordable housing and you have a kid or two kids you are trying to support, and you get arrested and then you have a record, who is going to hire you, right? I mean, and it is the--and these are--I know that they are difficult challenges to try to overcome, but there are systemic problems that need to be overcome. You talked about the affordability of housing and decent work that pays a livable wage. So we also have to be mindful of that, that, you know, passing an additional block grant in and of itself is not going to solve this problem. It may help. It may provide some relief. And even the education and awareness program, I mean, you know, will be helpful, but, you know, we need to change our system's approach to this. Otherwise, it is going to continue to happen, because victims don't want to be revictimized, and they shouldn't be, I mean. And so I appreciate all of your testimony here, and I think there are some concrete suggestions that you have passed on to us that I think we can pursue legislatively. But we have to open our eyes a little wider up here too and not be satisfied that, if we do one component here, that somehow we have solved the problem. We have been talking about this issue for a long time, and it is still a challenge. But I appreciate very much you coming to the Rules Committee, and I learned a lot here today. So thank you. I yield back. Ms. Shalala. Thank you. I am going to yield to Mr. Hastings. I have to go to the floor to---- Ms. Fernandez Rundle. Good place to go. Mr. Hastings [presiding]. One of the things that happens when we schedule things, you don't know what is going to overtake it. Mr. Woolf, I apologize to you for having been out of the room during your testimony, but after I watched the Heat beat the Atlanta Hawks last night, I did read--in overtime I might add. I did read most of your testimony, and one thing that jumped out at me that has not been said here this morning, and that is that the life expectancy of a person that is trafficked is 7 years. That should ring a bell throughout the community that is trying to do something about this. In addition, the implication of homelessness. I have been a proud $25 contributor to Covenant House for well on 40 years, and the same for Women in Distress. That is another area that needs to be developed, for those of you that are in the nonprofit sector, is getting smaller donors who may very well be continuously interested in the problem. The other thing that we haven't talked about, probably won't have the time to, is the implication of drugs writ large, not just opioids, which is the fashion of the day, but prescription drugs. I learned when I was a juvenile judge from a young man that all he had to do--he was handsome as all get- out. He could go in somebody's house and use the bathroom and come out with drugs that he could sell on Fort Lauderdale Beach. It was kind of interesting. And toward that end, I want to make two other statements, and then if you all would wrap up with any comment that you may offer to us and also anything that you did bring in writing. We are making a record, and we will provide that to you as well as to our colleagues here. I don't mean this to be offensive, but when I was in the sixth grade in Altamonte Springs, Florida, at a Rosenwald Elementary School, which was four schools. The boys and girls were separated when we went to use outdoor facilities, but in Mayday activities and physical education, we were so few, and so the principals and teachers would bring us together. I say this as a proponent of early education. And what I mean early, I mean early education. We ignore what our children see and hear a lot, and sex becomes a taboo subject. Most of us men in this room learned about sex not so much from our daddies but in the streets. But in that area, two words that I have never forgotten came up one day in the boys and girls physical education class with Mr. Hamilton. One was pediculosis and the other was dysmenorrhea. That is from sixth grade. And you wouldn't think that far back in the forties that teachers were mindful of illuminating children about crabs and painful menstruation of women. The other thing is a direct dig at men, who need the greatest amount of education, particularly young men. And by young, I am talking about sixth grade, the same as myself, and even below. The great majority of the trafficking that you all see and that we see, the pimps, the gangbangers usually are men and some women associated as decoys and involved with them for a year. And when the family thing enters, as Dr. Burgess talks about, that becomes an added tragedy. But I am a full proponent of Florida's program and an advocate nationwide. Ms. Scanlon and I on another jag unrelated to trafficking, we believe that we need to restore teaching of civics in our schools. And it is just regrettable what we have left on the table. I might add I think television in a larger way could do more to help us in this arena. But you all have been illuminating, and it is deeply appreciated, but I would appreciate it if either or all of you would address the implication of drugs and how that impacts this awesome thing that we are confronted with called human trafficking. Ms. Fernandez Rundle. Yes. Thank you for asking that question, because drugs is a key component of enabling the trafficking to occur. A second way that it is, is that oftentimes we find the traffickers are using the victims to sell drugs during the day, and then they are forcing them at night to sell their bodies. So they are so integrally intertwined that one of the things we try to do in law enforcement from that level, because that is what we are trying to do is be proactive, is actually find means and ways to follow the drugs, is one of the options for us to get to the victims. So I am glad you brought that up to make that clear. And, also, sometimes the law enforcement funding dollars will follow drugs where they might not follow human trafficking per se. So, when we combine those two and we make our case clear that they are intertwined and interwoven with each other and the crime, it also assists law enforcement in those kind of sting operations or undercover operations, and it takes them to broader ways to investigate. Mr. Hastings. Mr. Woodall, do you have anything additional? Mr. Woodall. We talked about early intervention. I did want to enter into the record, Mr. Chairman, the State Department, as part of its Office to Monitor and Combat Trafficking in Persons, has given the University of Georgia a grant to continue some work that it is doing in the Sierra Leone at the very front end of the trafficking chain. I just want to make that part of the record. Mr. Hastings. Without objection. It has been mentioned that all over the place in any field that data drives policy. And, regrettably, there was mention here of some jurisdictions that don't even want to keep statistics. Believe it or not, what I found on the international level, particularly in the 57 countries of the Helsinki Commission, that a lot of them don't want to keep data in this arena. And I won't mention their names. Russia. It is amazing how reluctant they are. I also would like to compliment one of my colleagues that has been a longtime leader in this arena, and that is Chris Smith from New Jersey. All of you may have come across his name in a variety of activities, but he has been substantially involved in this arena, perhaps more than any of us. Final statement, Ms. Bruggeman. Ms. Bruggeman. Thank you. I think it is important to keep in mind, as you just pointed out, the importance of data and the collection of data. And I think it is also important to keep it into a helpful context. Crimes like human trafficking, just like child abuse, sexual abuse, domestic violence, are going to be undercounted and underreported, regardless of our best efforts. And so I think we have to be very creative in the way that we look at the data and not rely on only our law enforcement data or prosecution data. Also look at data from service providers regarding the number of survivors that they are seeing and interacting with. Some research studies that can show us examples of, you know, deep prevalence studies in one location that can be used to extrapolate and estimate the prevalence and the types and needs of the survivors. And, also, following on a comment that was made previously about the need for evidence-based practice, one of the comments I included in my written testimony is that, in the domestic violence and sexual violence fields, we have nationwide research centers and we have statewide coalitions that are funded primarily through HHS and CDC that guide us with best practices, with policies and procedures, and with advocating on behalf of survivors. And that is something that remains missing in the human trafficking field. We don't have a similar dedicated space in which we can invest in those best practices and then promulgate them forward to help States and localities. And I think they struggle when finding which are the right partners that we should be working with? What are the best practices in service provision? How do we know who is the right partner for us to work with? What are our investigatory practices? How can we rely collaboratively? So I would say looking really strategically at how to invest in building that analysis of evidence-based practices across the human trafficking field is a critical step forward. Thank you. Mr. Hastings. Ms. Fernandez Rundle. Ms. Fernandez Rundle. Yes, thank you. And to underscore that point, because I think we did make that point earlier. That is such a key component, moving forward, to really develop evidence-based--research on evidence-based strategies, what works, what doesn't work. And then you need the therapy piece. Now that we have neurological new science, right, neuroscience that can guide us, what kinds of therapies are we implementing and employing for a lot of these victims? And for those of us that are professionals, how do you ask a question? You know, how do you get them to tell you what happened to them without traumatizing them? So there is a lot of work to be done in that field. I also want to say that, you know, from where we sit in Miami, in any event--and I know your DA in Fulton County, I spoke with him as well--it needs collaboration. So wherever you take the Federal Government, you want to take it to a community that is collaborative, where people aren't in their own lanes, but instead they are working with each other. They are collaborating. They are sharing information. I can tell you I could not do my job in protecting my community if I didn't have THRIVE Clinic and Project Phoenix for my homeless victims. There are just so many not-for- profits, and law enforcement has 35 police departments. So, if we are not all working together and helping each other, then we are not going to be able to combat this huge complex problem. The other thing I would say about that is it is big and it is complex and we have all talked about that, but if we can save one child at a time, that is okay. That is okay to reach for that. And then, in conclusion, what I would ask in furtherance is, you know, you talked about data, Chairman Hastings. And I always listen to you, because you are always so wise. One of the things we don't have in local law enforcement, okay, is we don't have a database of sharing intelligence information. So one of the things we find is Miami is a destination city. Orlando is. You know, Las Vegas is. And so they do this circuit. And we may not know what is going on in Las Vegas, our local law enforcement, and they don't know what is going on with us. Why aren't we tracking those bad guys? Why don't we have that intel about who they are and what their patterns and what kinds of victims are they preying on and so on and so forth. That could be something that you could help us develop. And last but not least, I would say that in so many communities the prosecutor can be galvanizing and help, especially if it is one that has a lot of different police departments and local and Federal law enforcement. If we can empower and give resources to local prosecutors' offices, I think that would go a long way to helping the whole community, because sometimes that is what they need. They need that courtroom piece, that law enforcement piece, that connected care coordinator piece that will get them to great places like THRIVE. And so I think that would be an important thing that you could sort of be a leader on in getting a message out to all of the communities that have prosecutors, both Federal and State, that you want them to have these kinds of units. And, again, I thank you so much for hosting this today, and I hope that if you want to call on us individually at any time, I hope that you will. Thank you. Mr. Hastings. Dr. Potter, I did read late some of your stuff too. And two things jumped out at me, and that was the broken bone and the fact that many of these people, for obvious reasons, are not taken to the dentist. And I can't imagine anything worse than having a toothache and not being able to be treated. There was so much more, but just those things jumped out at me. Dr. Potter. Ms. Potter. So just imagine when you are trying to reengineer your life and get your life back on track. All of us have been sick. When you are sick and you don't feel good, you can't do much more, right? Mr. Hastings. Right. Ms. Potter. So thank you for the opportunity to summarize what we have heard today. And I spent a lot of time traveling around the country, educating other health professionals and, honestly, anyone that will listen. And I would like to say that what we heard today about prevention and identifying victims is what I call part one, and what I call part two is the aftercare. And I came today specifically to speak to you about the aftercare. I hope that you have a sense of what a great partnership we have with law enforcement, Homeland Security, our State and Federal prosecutors and the major tertiary care center and the health systems that we have in south Florida. We work hand in hand on this issue, and I hope that was clear to all of you today. Almost all of our referrals and the reason why I am here today is because of law enforcement. They came to me with survivors and said: We need your help. And as Ms. Rundle pointed out, they come with nothing, just the clothes on their back. They have no friends. They have no family. They have no one. And in terms of what they need, we know that there is a lot of work to do, a lot of evidence-based medicine that needs to be done to develop a standard of care, primarily for the behavioral healthcare needs that they have. The physical stuff is pretty straightforward. We just need access to multispecialties. They have head injuries. I have a patient right now with amnesia, because she was beat with the gun. And so neurology and all of that technology we have, and we can help them if we have models of care in place. The needs of the survivors are very complex, in terms of healthcare and behavioral health. And most of them have been getting their episodic healthcare in emergency rooms, and it is not effective, and it is at great financial cost. We have just done research on our emergency room, looking at the victims and how often they access the ER before and after THRIVE, and we have reduced the emergency room visits by 50 percent. And it is a huge cost saving to the health system by just establishing a primary care clinic. When you talk about ``if you had a dollar, how would you break it up,'' I say 50 cents for part one and 50 cents for part two. We believe that demonstration projects can help establish standards of care for survivors. And they can be replicated in every city in this country, at least the principles that I presented here, so that all practitioners who come into contact with a victim or a potential victim know what to say and know what to do to help them achieve wellness. Thank you so much. Mr. Hastings. Mr. Woolf. Mr. Woolf. Thank you, Mr. Hastings. I just want to just echo all the comments that you made relative to education and the younger the better. I couldn't have said it any better myself, and I appreciate your comments very much. I think that as we look at this issue, I think we really can look at the words of Benjamin Franklin: An ounce of prevention is worth a pound of cure. And I think that that is really the answer to this issue, starting as young as we possibly can and really being able to empower our communities, our society, our young people, to have the voice that they need. I oftentimes reflect back on a conversation I had with my eldest son several years ago. He was 9 years old at the time. We were in the car. I had just gotten off of a work phone call. And he looks at me and he says: Dad, what is human trafficking? And I said: Man, how do I explain to a 9-year-old what human trafficking is, right? He hears me talking about it all the time on the phone. And so I start stumbling through this conversation with him. And he stops me--and I will never forget this. He stops me, and he says: Dad, I think what you are trying to say is you give a voice to those that can't speak. And I said: Son, I couldn't have explained it any better myself. And those wise words of my 9-year-old son echo in my head every day that I go to work. And I challenge you all to take that as well, to give a voice to those that are voiceless, to give them the tools, the skills, and the resources, to invest in education, because it really is the way that we are going to make a change. I echo the sentiments of my other colleagues up here who say: Listen, we have got to establish standards. There is lots of training out there, but is it quality training? And we hear a lot about awareness training. And I would encourage all of us to add the word ``awareness and response training.'' We make people aware, but we don't give them the ability to respond and to help those that may be in trouble, whether they are in the process of being manipulated into a situation or whether they are actually being exploited. We have got to give a voice to the voiceless. So thank you. Mr. Hastings. Mr. Rodgers. Mr. Rodgers. We all know this is a very complex issue. We have said it repeatedly. And there is no silver bullet. So I think it is important for us to remind ourselves not to be reluctant to do the next right thing, because it doesn't solve the entire problem. And so I want to challenge us to keep doing that. Comprehensive solutions very rarely come out of the gate all at the same time in a synchronized swimming kind of way. So let's keep doing one more right thing together. I was very encouraged by what Chairman McGovern just said a minute ago, even if that wasn't his intention, in the fact that we have said and had some of these conversations for 10 years. And I think he is exactly right. I mean, even longer. But I think the time has come for us to put on a new lens and a new paradigm around this issue and pull chairs up around the table and have a comprehensive solution and discussion about what we can do and how we can do it and start, because the statistics are our kids. Mr. Hastings. Right. In the Helsinki Commission, I am very fond of at some point turning to the audience, but time won't permit today, but I do thank you all for your patience. I am sure that a lot of questions arise in your minds, and it is deeply appreciated. And, Mr. Woolf, your 9-year-old has moved on up but I have a 9-year-old and an 8-year-old granddaughter, and proof of what I was talking about about early intervention, both of them are taking artificial intelligence in the third grade. I couldn't spell artificial intelligence in the third grade. Mr. Rodgers. That is right. Mr. Hastings. We are adjourned. Thank you. [Whereupon, at 12:27 p.m., the subcommittee was adjourned.] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]