Hospitals Struggling to Implement 2013 Law Requiring Better Access to Forensic Exams

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A Police Foundation study on a sexual assault kits reform law in Texas found implementing the law has been harder than expected. Better protocols and training, along with the utilization of technological advances, are critical to help sexual assault victims.

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“Most people think that any hospital emergency room will collect evidence for a sexual assault kit, but that’s not true. While SB1191 attempted to remedy this, its implementation has been rocky," said Torie Camp, a project consultant.

Texas Sexual Assault Kit Evaluation Project Proposes Multi-Step Solutions

Hospitals should consider improving protocols and training opportunities while exploring technological advances to ensure sexual assault survivors in Texas have universal access to high-quality, comprehensive medical forensic exams.

The first report of findings on the impact of SB1911 released today by the Police Foundation has found that implementing the law that intended to improve access to high-quality medical examinations proved to be much harder than anticipated.

The study, which was part of the Texas Sexual Assault Kit Evaluation Project, Effects of SB1191 on Accessibility of Sexual Assault Forensic Exams in Texas, recommends top nursing officials convene to identify solutions that could provide better access to competent forensic exams for sexual assault victims. Given the lack of academic research and evaluation of the impact of state legislative reform efforts, the Police Foundation partnered with the National Center for Victims of Crime and the Joyful Heart Foundation to establish the Texas Sexual Assault Kit Evaluation Project.

Potential solutions include:

  • Creating protocols for transferring victims to other facilities for a forensic exam
  • Creating a network of mobile SANEs (nurses certified as Sexual Assault Nurse Examiners) who are on-call and can perform exams at a number of hospitals
  • Exploring telemedicine options whereby a nurse performing an exam at a remote hospital could be supervised in real time by an experienced nurse stationed elsewhere

Over the past two years, the Project has conducted research to study the effects of SB1191: how the law has impacted the accessibility of high-quality medical forensic examinations, challenges faced by emergency department staff, and approaches being used to implement the requirements of the law across Texas.

Susan Howley, Director of Public Policy at the National Center for Victims of Crime, said: “SB 1191 represented a bold effort to improve the response to victims of sexual assault. But this research uncovered complexities at the local level that kept the law from having the desired effect.”

After a sexual assault, victims typically undergo a medical forensic examination to collect evidence in a sexual assault kit. However, many victims are unable to access these examinations, as they are not performed at all Texas hospitals.

In 2013, Texas legislators passed a major reform law to ensure access to high-quality medical forensic examinations for all sexual assault survivors. SB 1191 included two major provisions: first, it required that all hospitals collect forensic evidence from a sexual assault survivor, if requested; and second, it required that all hospitals develop a plan to train staff on sexual assault forensic evidence collection.

Although the lawmakers who drafted SB1191 intended to expand access to high-quality forensic exams across all hospitals in the state, the implementation of the law has coincided with the more centralized provision of these exams in fewer hospitals. The findings released today suggest that medical and criminal justice professionals often hesitate to have non-designated staff provide forensic examinations, resulting in patients being transferred to the nearest hospital with a SANE program.

Project researchers – Robert Davis (Chief Social Scientist, Police Foundation), Torie Camp (project consultant), Susan Howley (Director of Public Policy, National Center for Victims of Crime), Dr. William Wells (Professor, Sam Houston State University), and Ilse Knecht (Director of Policy and Advocacy, Joyful Heart Foundation) – conducted semi-structured interviews with key emergency department staff at 18 hospitals across three diverse counties in Texas. This approach offers an in-depth assessment of how SB1191 has been implemented statewide.

Effects of SB1191 offer lessons learned and next steps not just for Texas, but also for other states across the country pursuing reform.

“Most people think that any hospital emergency room will collect evidence for a sexual assault kit, but that’s not true,” Camp said. “While SB1191 attempted to remedy this, its implementation has been rocky. Rape victims should call ahead to their local rape crisis center or law enforcement department to learn which hospital or local clinic will provide them with the specialized treatment they deserve.”

The Police Foundation is a non-partisan, non-profit organization that has been at the cutting-edge of research into the most effective and efficient policing practices for more than 45 years, and provides the understanding of that research to departments and agencies across the nation.

For background and more information about the Texas Sexual Assault Kit Evaluation Project, please visit http://www.texassak.org.

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Rob Davis
@PoliceFound
since: 02/2014
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