1. Jane Doe Rape Kit Act: Meeting the Challenge

2. Objectives: Gain a better understanding of the Violence Against Women Act thru Historical perspective Overview of evidence collection for Jane Doe Current legislative direction in Texas Discuss the effects of VAWA and its recent changes Options for victims Return to your communities and assist with implementing a plan of care to address these special needs patients.

3. Violence Against Women Act of 2005 Directed towards provision of services Education Crisis Services Funding for certain services Victims rights Military provisions Protocol for evidence collection

4. Violence & Trauma in Texas: 2006 120 persons lost their lives to domestic violence/ trauma 186,868 documented family violence events 16,968 children required emergency shelter (not counting those sent to other family members)

5. Sexual Assault Response Teams Law enforcement Hospitals SANEs Advocacy (Rape Crisis) Prosecution Victims Assistance

6. Evolution of Jane Doe Military Response Required training of combined military forces Use of SARC Restricted vs. Non- Restricted reporting

7. Anonymous Reporting Victim has the right to a medical forensic exam at NO cost to the victim. They are not required to notify or cooperate with law enforcement.

8. Effects on the Emergency Department Must have a written plan to provide for services Patient does not have to be transferred if SANE is not available Who will perform the forensic medical exam in the absence of a SANE? Who will pay if law enforcement does not? How will the evidence (Kit and clothing) be stored and monitored?

9. One plan shared Williamson County Sexual Assault Response Team (SART) Began discussions in February 2008 Stakeholders represented different interests Team approached task with victims in mind December 2008: Protocol written and approved January 16, 2009 first Jane Doe case presented to local ED.

10. Lessoned learned Importance of establishing common goal Communication All stakeholders hold equal vote Victim, patient, survivor centered

11. Plan Sexual assault algorithm Training for ED nurses and doctors Provision for caring for SA patients Involvement of Rape Crisis Center Dual registration Medical record Forensic record Cold storage with security measures Chain of custody Limitations on storage

12. Shared experience 45 days in Many more victims than expected More likely to have exam with evidence collection if they dont have to report to LE. Failure to report to LE leave nurse with the emotional responsibility Law enforcement key component to successful closure.

13. In Closing Carefully consider how these trauma victims will be managed If you do not have a SANE program, insure that you are in Federal compliance Failure to comply could cost Texas millions in STOP Grant funding.

14. Questions: 512-422-8502 vbarefoot@hotmail.com Vangie Barefoot RN, BSN, CA-CP SANE, CEN, SANE-A, CFN, CMI-II