Fostering Positive Health Outcomes After the Forensic Exam Karen D. Carroll, RN, SANE-A, NY-SAFE Associate Director, Bronx SART

Resources SANE Development and Operations Guide Dr. Linda LeDray, PhD, RN, FAANSANE Development and Operations Guide Dr. Linda LeDray, PhD, RN, FAAN National Training Standards For Sexual Assault Medical Forensic Examiners USDOJ Violence Against Women OfficeNational Training Standards For Sexual Assault Medical Forensic Examiners USDOJ Violence Against Women Office

History of SANE Program Development Memphis, TN 1976, Minneapolis, MN 1977, Amarillo, TX 1979Memphis, TN 1976, Minneapolis, MN 1977, Amarillo, TX programs were established between 1980 and 1989, 73 additional programs between 1990 and 1996, 86 programs were identified in October 1996 listing of SANE Programs published in JEN10 programs were established between 1980 and 1989, 73 additional programs between 1990 and 1996, 86 programs were identified in October 1996 listing of SANE Programs published in JEN There currently 81 SANE/SAFE/SART programs listed in the 2004 NYS Protocol ManualThere currently 81 SANE/SAFE/SART programs listed in the 2004 NYS Protocol Manual

SANE Value Statement Sexual assault victims have the right to immediate, compassionate and comprehensive, medico-legal evaluation and treatment by a specially trained professional who has the experience to anticipate their needs during a time of crisis.

SANE Program Goals To protect the sexual assault victim from further harmTo protect the sexual assault victim from further harm To provide crisis interventionTo provide crisis intervention To provide timely, thorough and professional forensic evidence collection, documentation and preservation of evidenceTo provide timely, thorough and professional forensic evidence collection, documentation and preservation of evidence To appropriately refer rape victims for immediate and follow up medical care and follow up counseling To enhance the ability law enforcement agencies to obtain evidence and successfully prosecute sexual assault cases

Sexual Assault Response Team (SART) Model The Sexual Assault Response Team (SART) Model, developed in California, involves a coordinated response. This SART concept is based on the belief that a team response helps prevent a victim from reporting the account of the assault repeatedly. It also helps prevent confusion among professionals trying to meet the needs of the rape victim as she/he progresses through the health care and criminal justice systems.

The Sexual Assault Resource Team Model Other parts of the country have modified the initial SART Model to better meet the needs of their community while trying to maintain the concept that the SART Team fosters. While the team members meet regularly and communicate routinely about cases, they do not actually respond at the same time. They function cooperatively, not conjointly, which is why some choose to refer to themselves as a resource team not a response team.

Barriers to Positive Health Outcomes Access to follow up health care/ who will provide it?Access to follow up health care/ who will provide it? Limited knowledge of follow up servicesLimited knowledge of follow up services Procedures for arranging follow up careProcedures for arranging follow up care Lack of ongoing communication between SAFEs and follow up service providersLack of ongoing communication between SAFEs and follow up service providers HIPPA constraints/sharing of valuable informationHIPPA constraints/sharing of valuable information

Barriers…. Limited evaluation of current protocolsLimited evaluation of current protocols Limited long term contact with patients to assess health outcomes (patient satisfaction surveys)Limited long term contact with patients to assess health outcomes (patient satisfaction surveys) SAFE Examiner steps outside her/his roleSAFE Examiner steps outside her/his role Limited training on trauma and/or sexual assaultLimited training on trauma and/or sexual assault Different ideas of how to measure successDifferent ideas of how to measure success –Philosophical –Funders