Rare look inside command center assessing risk of death for domestic violence victims during a crisis

New funding will continue Domestic Violence Navigation Line services assessing, prompting resources

SAN ANTONIO – It all starts with a call from a Bexar County Sheriff’s deputy at a domestic violence scene, now trained to make life-saving phone calls.

“Once everything is calmed down, then they will go ahead and make the call to MEDCOM and ask the 11 questions that are considered the lethality assessment,” said Bexar County Sheriff’s Office Chief Nancy Sanford.

Those MEDCOM professionals take the phone calls at the Southwest Texas Regional Advisory Council (STRAC) Command Center. They directly speak with victims and ask those specific questions that make up a lethality assessment, determining the victim’s risk of dying due to domestic violence.

The MEDCOM professionals then deliver a score. Anything over a seven is deemed high risk. They relay that score to the deputy, who then offers the victim resource options.

Those resources start with the City of San Antonio’s Metropolitan Health District, or Metro Health.

“A seven or higher means that we are reaching out to that person inside of an hour, and we will repeatedly try to reach them. They are at risk, not only for experiencing domestic violence but for death,” said Metro Health Violence Prevention Manager Erica Haller-Stevenson.

Haller-Stevenson said they get, on average, 120 MEDCOM calls a month, and 25% are high-risk.

A primary difference with this protocol is that the case workers contact the victims. The victims do not need to carry the complicated burden of reaching out and asking for help.

“The first thing we do is make sure they’re in a safe place,” she said.

That may mean staying with family, friends, a hotel or the Battered Women and Children’s Shelter, which accepts big families and pets.

Transportation is provided to any of these places.

“After a person is stabilized into a safe place and they have their basic needs met, like food and being able to communicate with family members, we move into case management,” Haller-Stevenson said.

Those become long-term case managers.

“Do they have children that are with them or that they’re trying to reunite with? Do they have a job or need a job?” Haller-Stevenson said.

For any services Metro Health doesn’t provide, they connect clients with other organizations.

“That could be counseling. That can include legal services with the Family Justice Center or with Legal Aid, anything that they need. If we provide it directly, we’ll do that. If we don’t, we help them get that,” Haller-Stevenson said.

Many times, it’s the Center for Healthcare Services that steps in.

“Typically counseling for not only themselves but for the kiddos as well. Then, housing and any other type of service that we can connect them to either in the center or in the community,” said Center for Health Care Services Crisis Response Director Aimee Hicks.

The pilot program launched in 2021 with funding from the city and county and $500,000 from University Health. That money from UH funds the MEDCOM and STRAC services.

The city funding, which covered the Metro Health services, just expired.

So, in October, the Bexar County Commissioners Court voted to pick up that funding for $294,000. That will last through Dec. 31.

“This is a really good example of multiple organizations working together,” Haller-Stevenson said.

All the organizations involved agree that the point is to make victims realize they can become survivors.

“I think that’s just so important that the victim knows somebody cares, somebody is looking out for them, we’re going to keep them alive,” Sanford said.

If you or someone you know is in a dangerous relationship, there is a long list of resources on KSAT’s Domestic Violence page.

If you are in crisis you can:

- call 911

- call the Domestic Violence Hotline at 800-799-7233

- call the local Family Violence Prevention Services, which runs the shelter, Crisis Number: 210-733-8810, Programs and Administration: 210-930-3669

- call the Bexar County Family Justice Center at 210-631-0100.

About the Authors:

Courtney Friedman is a KSAT anchor and reporter. She has an ongoing series called Loving in Fear, confronting Bexar County’s domestic violence epidemic. She's also covered Hurricane Harvey, the shootings in Sutherland Springs and Santa Fe, and tornadoes throughout Texas. She’s a California native and proud Longhorn who loves calling SA home.

Before starting at KSAT in August 2011, Ken was a news photographer at KENS. Before that he was a news photographer at KVDA TV in San Antonio. Ken graduated from San Antonio College with an associate's degree in Radio, TV and Film. Ken has won a Sun Coast Emmy and four Lone Star Emmys. Ken has been in the TV industry since 1994.