Where Is This Happening?

National Landscape

Hospital-based violence intervention programs now operate in hospitals across more than 30 cities, with the field expanding steadily since the early 2010s and accelerating notably between 2022 and 2025. The Health Alliance for Violence Intervention (HAVI), the national membership organization for hospital-based programs, has tracked consistent field growth; a 2023 Academic Medicine paper noted the field encompassed “nearly 40 hospital-based violence intervention programs in urban communities” at the time of publication, with new programs launching in additional cities in the years since. Concentration remains in Level 1 Trauma Centers in major urban areas, but state-level infrastructure is emerging in Virginia and other states that is beginning to close the gap with community and rural hospitals.

The geographic picture is uneven, with documented programs concentrated in major urban medical centers and significant gaps in rural and community hospital settings.¹

Major Urban Programs

Chicago, University of Chicago Medicine Violence Recovery Program The VRP is the national model for scale and replication. Founded in 2018 when UChicago Medicine opened its Level 1 adult trauma center on the South Side, the program has now served more than 11,000 patients and families. In 2023 alone, the program engaged nearly 2,000 patients, two-thirds of whom had gunshot wounds. The VRP runs approximately 20 violence recovery specialists around the clock, connects patients to more than 60 community-based social and behavioral health agencies, and operates Recovery Legal Care, an embedded civil legal assistance program, alongside the core HVIP services. Director Dwayne Johnson, named to that role in 2024, has led the program’s national training function. The city’s $3 million public health investment, administered through Dr. Simbo Ige’s Chicago Department of Public Health, targets the 15 neighborhoods that account for roughly half of Chicago’s gun violence.²

Louisville, Pivot to Peace Louisville’s Pivot to Peace program, operated through the city’s Office of Violence Prevention in partnership with Goodwill and Volunteers of America, combines hospital-based intervention at University of Louisville Hospital with community-based CVI in four neighborhoods. Between 2024 and 2025, the hospital-based component enrolled 628 patients presenting with gunshot wounds or stab wounds, with 85% agreeing to speak with an intervention specialist. In the first half of 2025, violent crime in the four Pivot to Peace neighborhoods fell 62% compared to the same period over the previous four years. Mayor Craig Greenberg has credited the program as a central component of his city’s decline in homicides, which were down 22% in 2025 compared to the same point in 2024, and is running for reelection in 2026 with public safety as a primary platform.³

Atlanta, IVYY Project, Grady Memorial Hospital Launched in January 2023 by Dr. Randi Smith, a trauma surgeon and Emory University faculty member, the IVYY Project (Interrupting Violence in Youth and Young Adults) operates out of Grady’s Marcus Trauma Center, Atlanta’s only Level 1 Trauma Center. The program has worked with more than 650 participants and their families, providing food, housing assistance, and mental health support through the bedside-clinic-community model. Less than 2% of enrolled patients have returned with a gunshot wound, compared to a national standard of 30-40%. The program received a $2 million Department of Justice grant under the Office of Justice Programs Community Violence Intervention and Prevention Initiative.⁴

Minneapolis, Next Step, Hennepin County Next Step has helped nearly 1,000 survivors of gun violence reduce reinjury and re-hospitalization. The program documented reinjury rates falling from a five-year historical baseline of 41% to 3% in its first year of operation. Director Kentral Galloway described the challenges the program addresses: “survivors often face challenges (people are traumatized, so helping them deal with their trauma) everything from victims having a hard time sleeping or eating to not wanting to leave their house or go to certain areas of the city, to working with their families to make sure they have cooler heads, and don’t go back out in the community and do something irrational.”⁵

Milwaukee, Project Ujima, Children’s Wisconsin Project Ujima is embedded in the emergency department of Children’s Wisconsin, connecting children and families to resources that help them overcome the traumatic effects of violent events. The team, composed of physicians, social workers, public health nurses, mental health support staff, and volunteer peer counselors, is deployed when a young patient is admitted because of violence. Director Lamicka Lovelace described the immediate activation: “They will meet the family right there in the emergency room to talk about services and resources. It’s letting them know that, yes, you did go through this traumatic incident, but hoping that through our resources and interventions, you can get through this.”⁶

New York City — Citywide HVIP System New York City announced that its hospital-based violence intervention programs, which collectively treat over 3,500 patients for violent trauma with about two-thirds receiving violence interruption, prevention, and community services, have “implemented a unified, multidisciplinary approach to treating victims of violent trauma” across five participating city hospitals and are expanding to all six of the public health system’s Level 1 trauma centers. NYC announced it is expanding to all six of its public health system’s Level 1 trauma centers.⁷

Philadelphia — Penn Trauma / University of Pennsylvania Penn Trauma’s violence intervention program is one of the more recently documented major city programs. A physician at Penn Trauma articulated the program’s rationale in terms that have become a widely-cited description of what discharge without HVIP support actually looks like: “for so many of our patients, discharge home is not a success if their home isn’t safe because the shooter knows where they live… if their injury puts them out of work and now they are behind on rent and at risk of eviction… if they have nightmares and flashbacks and don’t feel safe leaving the house… if they can’t get to their follow-up appointments because they have no transportation.”⁸

Academic Medical Center Programs

New Haven — Yale School of Medicine Yale’s program focuses specifically on children admitted to the emergency room with firearm injuries, providing psychiatric care, substance use treatment, and assistance with victim compensation and housing. The program has piloted unconditional cash stipends ($1,000 for family members of homicide victims, two payments of $500 for violence survivors) to cover immediate needs like transportation to safety, food, and medical costs. Dr. Kirsten Bechtel, physician and professor of pediatrics, has articulated the case for intervention: “Having hospital-based violence intervention programs can make the difference in the lives of our kids who are impacted by firearm homicides.” Connecticut became the first state to sponsor Medicaid reimbursement for community services to do violence intervention outreach, creating a sustainable funding mechanism for programs like Yale’s.⁹

Richmond — VCU Medical Center Dr. Michel Aboutanos, a Level 1 trauma surgeon, established VCU’s violence intervention program and has been central to its expansion to other Virginia hospitals. The program’s five-year recidivism rate of 3.6% compares to the national baseline near 50%. Virginia has since invested $8.5 million to support 12 HVIPs statewide, more than 8,000 violence victims served since 2019, and over $82.5 million in health care costs avoided.¹⁰

Sacramento — UC Davis Health Center UC Davis Health operates both a hospital-based violence intervention program and a connected Trauma Recovery Center. Violence intervention specialists meet patients at the bedside to “make sure these patients know there is hope and help,” then refer qualifying patients to the Trauma Recovery Center, which provides “long-term therapy and social services, and help with food, housing and employment.” Michele Knight, clinical psychologist and director of the Trauma Recovery Center, describes the program’s goal as eliminating barriers: “to be able to say, here, I can help you navigate, I can help you get back on your feet.”¹¹

Columbia, SC — Prisma Health Richland Hospital Prisma Health launched one of South Carolina’s first dedicated HVIPs, fielding a team of trauma surgeons, internal medicine physicians, psychiatrists, injury prevention specialists, and university researchers. The program’s explicit goal is “care for patients beyond the walls of the hospital by connecting them with community-based resources to improve their quality of life.”¹²

Emerging Programs

Louisville (see above) — Pivot to Peace: The most data-rich recent entrant in the documented field.

Mobile, Alabama — HALO The HALO program is a collaboration between the city, USA Health University Hospital, and the Mobile County Health Department. The program launched under former Mayor Sandy Stimpson (who left office November 2025) with the explicit goal of intervening “while they’re at the hospital” before patients return to the conditions that produced the injury. Dr. Ashley Williams Hogue, who oversees the hospital team, has described the program as a continuous journey: “This isn’t a one-time ‘what can we do to help you.’ This is a journey.”¹³

Austin/Travis County, Texas The Austin Travis County HVIP, reported on by KXAN in 2025, has already “served more than 350 people” since launching, notifying intervention specialists when a patient arrives “with evidence of violence, either a gunshot, a stab wound or signs of abuse.” The program connects patients to wraparound services including mentorship, job training, trauma recovery services, housing, food security, employment, and community support. Terra Tucker with Alliance for Safety and Justice has described the vision of connecting HVIP patients to Travis County’s Trauma Recovery Center as a “one-stop shop.”¹⁴

Harris County, Texas Harris County’s HVIP launched in late 2024 and had enrolled 44 patients in its first weeks of operation. It is connected to the broader Harris County HART (Houston Area Recovery Team) ecosystem.¹⁵

Pittsburgh — Focus on Renewal The Pittsburgh Reimagine Reentry program operates with a $50 million investment and connects to Focus on Renewal for post-hospitalization services. The program has implemented QR code notification: nurses scan a code to instantly notify the intervention team when a qualifying patient presents.¹⁶

Buffalo — Trauma Recovery Center + Pre-existing HVIP Buffalo’s first Trauma Recovery Center launched in direct partnership with a pre-existing HVIP. The design pairs hospital-based acute intervention with facility-based long-term therapeutic support.¹⁷

State-Level Infrastructure

Virginia has 12 programs statewide receiving $8.5 million in state grants in 2025. The Virginia Hospital and Healthcare Association reports the network has collectively reduced re-injury rates to 3% compared to a 40% national average.¹⁸

Connecticut was the first state to sponsor Medicaid reimbursement for community services to do violence intervention outreach, creating a sustainable funding pathway for programs like Yale’s that other states have not yet replicated.

Illinois has directed public health funding through Chicago to support HVIP expansion, and in 2023 granted UChicago Medicine’s VRP $99,000 for training and technical assistance to other Illinois hospitals.

Five states had elected as of early 2023 to use Medicaid to support community violence intervention programming (California, Connecticut, Illinois, Maryland, and Oregon), which creates a pathway for HVIP services that qualify under the peer support, psychological services, or case management criteria.¹⁹

Coverage Gaps

Programs are concentrated in Level 1 Trauma Centers in major urban areas. Community hospitals, rural hospitals, and suburban trauma centers are largely unserved. This means that a gunshot victim admitted to a hospital outside a major metro area has almost no access to HVIP services, regardless of their reinjury risk. Virginia’s statewide expansion is the clearest model for closing this gap through systematic state investment; most states have not replicated it.