1) Oregon SAE/SANE Certification Commission Standards 2017 ORS

Attachments

1) Oregon SAE/SANE Certification Commission standards

2017 ORS 147.403¹ Policies, guidelines and training requirements for providers of medical care to sexual assault patients

(1) Each hospital, emergency medical service provider, intermediate care facility, skilled nursing facility, long term care facility and residential care facility in this state shall adopt policies for the treatment or referral of acute sexual assault patients, if such policies are not otherwise provided for by statute or administrative rule.

(2)(a) Each hospital, emergency medical service provider, intermediate care facility, skilled nursing facility, long term care facility and residential care facility in this state that performs forensic medical examinations of sexual assault patients shall:

(A) Adopt, in addition to the facility’s own guidelines, if any, the State of Oregon Medical Guideline for Sexual Assault Evaluation of Adolescent and Adult Patients developed and published by the Attorney General’s Sexual Assault Task Force.

(B) Except as provided in paragraph (b) of this subsection, employ or contract with at least one sexual assault forensic examiner who has completed didactic training sufficient to satisfy the training requirement for certification by the Oregon SAE/SANE Certification Commission established by the Attorney General.

(b) Paragraph (a)(B) of this subsection does not apply to a hospital that performs forensic medical examinations only of sexual assault patients who are minors. A hospital described in this paragraph may use physicians, physician assistants licensed under ORS 677.505 (Application of provisions governing physician assistants to other health professions) to 677.525 (Fees), naturopathic physicians licensed under ORS chapter 685 and nurses to conduct the examinations in consultation with a social worker trained in assisting sexual assault victims who are minors. [2011 c.511 §2; 2014 c.45 §28; 2017 c.356 §19]

Note: See note under 147.401 (Sexual assault response teams).

1 Legislative Counsel Committee, CHAPTER 147—Victims of Crime and Acts of Mass Destruction, https://www.oregonlegislature.gov/bills_laws/ors/ors147.html (2017) (last accessed Mar. 30, 2018).

2 Legislative Counsel Committee, Annotations to the Oregon Revised Statutes, Cumulative Supplement 2017, Chapter 147, https://www.oregonlegislature.gov/bills_laws/ors/ano147.html (2017) (last accessed Mar. 30, 2018).

3 OregonLaws.org assembles these lists by analyzing references between Sections. Each listed item refers back to the current Section in its own text. The result reveals relationships in the code that may not have otherwise been apparent.

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2) Oregon Statute requiring the district attorney in each county shall organize a SART (Sexual Assault Response Team)

2017 ORS 147.401¹ Sexual assault response teams (1) The district attorney in each county shall organize a sexual assault response team to consist of:

(a) A representative of the district attorney’s office;

(b) A representative of a prosecution-based victim assistance program or unit;

(d) At the discretion of the district attorney, a representative of the county sheriff’s office or a representative of local law enforcement agencies or both;

(e) A representative of a nonprofit agency or program that receives moneys administered by the Department of Human Services or the Department of Justice and that offers safety planning, counseling, support or advocacy to victims of sexual assault; and

(f) Other persons the district attorney considers necessary for the operation of the team or as recommended by the team.

(2) Each team must meet:

(a) At least quarterly at a time appointed by the district attorney of the county; and

(b) Independently of the county’s multidisciplinary child abuse team.

(3)(a) Each team shall develop and adopt protocols addressing the response to adult and adolescent sexual assault victims in the county.

(b) Protocols adopted pursuant to paragraph (a) of this subsection may incorporate by reference, in part or in whole, protocols relating to child sexual abuse developed pursuant to ORS 418.747 (County teams for investigation). [2011 c.511 §1]

Note: 147.401 (Sexual assault response teams) and 147.403 (Policies, guidelines and training requirements for providers of medical care to sexual assault patients) were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 147 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.

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1 Legislative Counsel Committee, CHAPTER 147—Victims of Crime and Acts of Mass Destruction, https://www.oregonlegislature.gov/bills_laws/ors/ors147.html (2017) (last accessed Mar. 30, 2018).

2 Legislative Counsel Committee, Annotations to the Oregon Revised Statutes, Cumulative Supplement - 2017, Chapter 147, https://www.oregonlegislature.gov/bills_laws/ors/ano147.html (2017) (last accessed Mar. 30, 2018).

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3) OAHHS in partnership with Oregon SATF webcast, “Sexual Assault: New Regulations & Laws” on June 20, 2018 for hospital staff.

SEXUAL ASSAULT NEW REGULATIONS & LAWS

June 20, 2018

HOUSEKEEPING ITEMS

The phones are muted. • Please DO NOT put your line on HOLD. We will open up the phone lines for questions. There is also a “chat” function if you would like to communicate with the facilitator. This webcast will be recorded and distributed.

2 Oregon Association of Hospitals & Health Systems

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Sexual Assault: New Regulation & Laws

Attorney General’s Sexual Assault Task Force

Before We Begin… The materials you have received were created by the Oregon Attorney General's Sexual Assault Task Force (ORSATF) for the purposes of this training. Please do not reproduce this material without consultation of the ORSATF. If you share or present information from this presentation, please give written credit to the ORSATF noting the training was taken from and the date. Note the statistics, information, and best practices change regularly, and information may become outdated after the training.

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Webinar provided on June 20, 2018

Disclaimer: This session is intended to provide general information. The contents do not constitute legal advice and should not be relied upon as such. 5

Overview  SART Protocol Provide or transfer statute Review SB795/Personal Representative What changed What stayed the same Community‐based, Tribal‐Based, District Attorney‐based advocacy response Oregon SAVE Fund Anonymous Kits Making a plan

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Welcome

Nicole Broder, SANE Coordinator Michele Roland‐Schwartz, Executive Director

Oregon Attorney General’s Sexual Assault Task Force

Formed in 1999 by Attorney General Hardy Myers at the request of a group of advocates and multidisciplinary responders in order to organize statewide efforts to address adolescent and adult sexual assault in Oregon. The SATF incorporated into a 501(c)(3) non-profit, non-government organization in 2003. Mission: The effective prevention of and response to sexual violence through collaborative, comprehensive, survivor-centered strategies.

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Oregon Attorney General’s Sexual Assault Task Force

SATF membership is comprised of approximately 100 Oregonians who serve on our Task Force Advisory Council, which is made up of 8 subcommittees, reflective of our multi-disciplinary spirit.

Offender Criminal Medical Campus Management Justice Forensic SUBCOMMITTIES

Legislative Victim Prevention Men’s Public Policy Response Education Engagement

Next Task Force Meeting: August 2, 2018 RSVP to [email protected]

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SART Statute ORS 147.401 Sexual Assault Response Teams The district attorney in each county shall organize a sexual assault response team to consist of: (a)A representative of the district attorney’s office; (b)A representative of a prosecution‐based victim assistance program or unit; (c)A sexual assault forensic examiner; (d)At the discretion of the district attorney, a representative of the county sheriff’s office or a representative of local law enforcement agencies or both; (e)A representative of a nonprofit agency or program that receives moneys administered by the Department of Human Services or the Department of Justice and that offers safety planning, counseling, support or advocacy to victims of sexual assault; and (f)Other persons the district attorney considers necessary for the operation of the team or as recommended by the team.

SART Statute ORS 147.401 Sexual Assault Response Teams (2)Each team must meet: (a)At least quarterly at a time appointed by the district attorney of the county; and (b)Independently of the county’s multidisciplinary child abuse team. (3)(a) Each team shall develop and adopt protocols addressing the response to adult and adolescent sexual assault victims in the county. (b)Protocols adopted pursuant to paragraph (a) of this subsection may incorporate by reference, in part or in whole, protocols relating to child sexual abuse developed pursuant to ORS 418.747 (County teams for investigation). [2011 c.511 §1] Note: 147.401 (Sexual assault response teams) and 147.403 (Policies, guidelines and training requirements for providers of medical care to sexual assault patients) were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 147 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.

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147.403 Hospital Responsibilities 147.403 Policies, guidelines and training requirements for providers of medical care to sexual assault patients. (1) Each hospital, emergency medical service provider, intermediate care facility, skilled nursing facility, long term care facility and residential care facility in this state shall adopt policies for the treatment or referral of acute sexual assault patients, if such policies are not otherwise provided for by statute or administrative rule. (2)(a) Each hospital, emergency medical service provider, intermediate care facility, skilled nursing facility, long term care facility and residential care facility in this state that performs forensic medical examinations of sexual assault patients shall: (A) Adopt, in addition to the facility’s own guidelines, if any, the State of Oregon Medical Guideline for Sexual Assault Evaluation of Adolescent and Adult Patients developed and published by the Attorney General’s Sexual Assault Task Force. (B) Except as provided in paragraph (b) of this subsection, employ or contract with at least one sexual assault forensic examiner who has completed didactic training sufficient to satisfy the training requirement for certification by the Oregon SAE/SANE Certification Commission established by the Attorney General.

SB795 – How we got here

ORS 147.425

Access to services

Access to information

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147.425 Personal Representative (2) A victim of a person crime, who is at least 15 years of age at the time the crime is committed, may select a person who is at least 18 years of age as the victim’s personal representative for purposes of this section. The victim may not select a person who is a suspect in, or a party or witness to, the crime as a personal representative. (3) Except for grand jury proceedings and child abuse assessments occurring at a child advocacy center recognized by the Department of Justice, a personal representative may accompany the victim to those phases of the investigation, including medical examinations, and prosecution of the crime at which the victim is entitled or required to be present. (4) A health care provider, law enforcement agency, protective service worker or court may not prohibit a personal representative from accompanying a victim as authorized by subsection (3) of this section unless the health care provider, law enforcement agency, protective service worker or court believes that the personal representative would compromise the process.

SB 795 Personal Representative Strengthens language to require that an advocate be called for every exam

Advocate must clearly inform patient that their services may be declined at any time

If law enforcement has not called advocacy, it is the responsibility of medical staff to dispatch an advocate

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Informed Consent

SB 795 What Changed?

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(1)Upon a sexual assault victim’s decision to participate in a medical assessment, as soon as practicable and in a manner consistent with the county’s sexual assault response team protocols adopted under ORS 147.401 and the protocols and procedures of the county multidisciplinary child abuse teams described in ORS 418.747, the provider of the medical assessment or, if applicable, a law enforcement officer shall contact a victim advocate and make reasonable efforts to ensure that the victim advocate is present and available at the medical facility in which the medical assessment occurs. (2) A victim advocate contacted under subsection (1) of this section: (a) Shall clearly inform the victim that the victim may decline the services of the victim advocate at any time; and (b) May not impede the medical assessment, the provision of medical services to the victim or the collection of evidence. (3) As used in this section, “medical assessment” has the meaning given that term in ORS 147.395.

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SB 795 What stayed the same?

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CURRENT PRACTICE SB 795 AND LAW

(2) A victim advocate contacted under subsection (1) of this section: (a) Shall clearly inform the victim .An advocate’s role is to provide that the victim may decline the information so victims can make services of the victim advocate at informed choices about services. It is any time; and currently our practice to respect the victim’s autonomy, including whether to decline our services. (b) May not impede the medical .ORS 147.425 Personal Representative assessment, the provision of law: personal representative can’t be medical services to the victim or excluded unless it is believed they the collection of evidence. would compromise the process

Community Autonomy (1)Upon a sexual assault ORS 147.401 victim’s decision to participate in a medical assessment, as soon as practicable and in a  County specific manner consistent with the county’s sexual assault Multi‐disciplinary SART response team protocols Meets quarterly adopted under ORS 147.401 and the protocols and Develop & adopt a protocol procedures of the county multidisciplinary child abuse teams described in ORS 418.747

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Community Based Non‐Profit Victim Assistance Program

Tribal Advocacy Program Other?

Varied Advocacy Response

What is the spirit of SB795?

Survivor Centered

Options Promote Autonomy

Consent

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SAVE Fund and Other Legislation

This project was supported by Grant No. 2015‐WR‐AX‐0007 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women.

ORS 147.395‐425 147.395 Definitions 147.397 Payment of costs; form; provider reimbursement; rules 147.399 Sexual Assault Victims’ Emergency Medical Response Fund 147.403 Policies, guidelines and training requirements for providers of medical care to sexual assault patients 147.425 Personal representative

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147.399 SAVE Fund Oregon Department of Justice, Crime Victim Services Division Valerie Smith runs the SAVE Fund ◦ 503‐378‐5348 ◦ [email protected] https://www.doj.state.or.us/crime‐victims/for‐medical‐ providers/save‐fund‐information‐for‐medical‐providers/ Intended to make medical assessments available to patients who have experienced sexual assault in Oregon

SAVE Fund Available to any patient who was sexually assaulted in Oregon ◦ Patients assaulted outside of Oregon must go through that state’s CVC and other victims services Available regardless of insurance status ◦ Covered services will not be billed to insurance ◦ Other services (i.e. labs, imaging, wound care, off‐site prescriptions) may be billed to insurance Available regardless of reporting status Separate from Crime Victims Compensation

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Within 168 hours (1 week), covers: Medical assessment STI prophylaxis (does not include HIV nPEP) Pregnancy test Emergency contraception Antiemetic Five counseling sessions

Within 120 hours (5 days), covers: All services on previous page Evidence collection

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147.397 Anonymous Kits (2) The department may not deny payment under this section for any of the following reasons: (a) The victim of a sexual assault has not reported the assault to a law enforcement agency. (b) The identity of a victim of a sexual assault is not readily available to the department because forensic evidence has been collected from the victim and preserved in a manner intended to protect the victim’s identity.

(5) Providers of medical assessments that seek reimbursement under this section shall: (a) Maintain records of medical assessments that protect the identity of victims of sexual assault and keep confidential the identity of victims who have not reported the sexual assault to a law enforcement agency; (b) Store forensic evidence collection kits and transfer custody of the kits to a law enforcement agency having jurisdiction over the geographic area where the provider is located; and (c) Cooperate with law enforcement agencies to develop and implement procedures that protect the identities of victims while allowing retrieval and assessment of evidence collection kits and related evidence.

*Important: Anonymous kits will not be tested unless the patient makes a report to police.

24 HOUR CRISIS & SUPPORT LINE/LÍNEA ceDE 24 HORAS PARA CRISIS Y APOYO To speak with an advocate, call our Hope Line Capacity People My Sisters’ Place Materials Resources Protocol

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SART Protocol ‐ Make a plan! Get to know your partners Attend SART meetings Invite your local advocacy program to staff meetings Develop protocols for facility to include patient care and transfer Familiarize yourself and key partners with the statutes covered today

Photo credit: Lab/Shul 36

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SANE Training Opportunities

Questions?

Nicole Broder [email protected]

Michele Roland‐Schwartz [email protected]

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4) List of Oregon hospitals that have a SANE program or affiliation Oregon SANE Programs Oregon Providers paid by SAVE Employers listed by Oregon‐certified SANEs Oregon SANE Certified Salem Hospital Asante Ashland Community Hospital Asante Rogue Regional Medical Center 144 Good Shepherd Asante Rogue Regional Medical Center Baker County Health Department Samaritan Sarah's Place Asante Three Rivers Medical Center Bay Area Hospital Providence Medford (Jackson County SART) Bay Area Hospital CHI Mercy Health Asante Rogue (Jackson County SART) Columbia Memorial Hospital Legacy Emanuel Asante Ashland (Jackson County SART) Good Samaritan Regional Medical Center Good Samaritan Med Center Legacy Good Samaritan (RSI‐PDX) Good Shepherd Medical Center Good Shepherd Hospital Legacy Emanuel (RSI‐PDX) Kaiser Permanente Jackson County SART Legacy Mt Hood (RSI‐PDX) Legacy Emanuel Hospital Kaiser Permanente Westside Med Ctr Adventist (RSI‐PDX) Legacy Good Samaritan Hospital & Medical Center Lebanon Community Hospital OHSU (RSI‐PDX) Legacy Meridian Park Hospital Legacy Health Providence Portland (RSI‐PDX) Legacy Mt Hood Medical Center Maxim Healthcare Providence St. Vincent (RSI‐PDX) Legacy Silverton Hospital McKenzie Willamette Hospital Providence Milwaukie (RSI‐PDX) McKenzie Willamette Medical Center Mercy Medical Center Providence Willamette Falls (RSI‐PDX) Mercy Medical Center Mid‐Columbia Medical Center Providence Newberg (RSI‐PDX) Mid Columbia Medical Center OHSU Kaiser Sunnyside (RSI‐PDX) Oregon Health & Science University One Community Health Kaiser Westside (RSI‐PDX) Peace Harbor Medical Center OSU Student Health Services Silverton (RSI‐PDX) not 24/7 Portland Adventist Medical Center Peace Harbor Hospital Providence Hood River (RSI‐PDX) not 24/7 Providence Hood River Memorial Hospital Peacehealth Sacred Heart Providence Seaside (RSI‐PDX) not 24/7 Providence Medford Medical Center Portland State University St. Charles Prineville (RSI‐Central) Providence Milwaukie Hospital Providence Health St. Charles Redmond (RSI‐Central) Providence Newberg Hospital Providence Hood River Memorial St. Charles Bend (RSI‐Central) Providence Portland Medical Center Providence Medford Providence Seaside Hospital Providence Milwaukie Hospital Providence St Vincent Medical Center Providence Portland Medical Center Providence Willamette Falls Medical Center Sacred Heart Riverbend Sacred Heart Medical Center Salem Hospital Sacred Heart Riverbend Samaritan Albany General Hospital Salem Hospital Samaritan North Lincoln Hospital Samaritan Albany General Hospital Samaritan Pacific Communities Hospital Samaritan Lebanon Community Hospital Silverton Hospital Samaritan North Lincoln Hospital Sky Lakes Medical Center Samaritan Pacific Communities Hospital St. Alphonsus Baker City St Charles Medical Center (Bend) St. Charles Medical Center St Charles Medical Center (Redmond) St. Alphonsus Med Ctr Ontario St Charles Medical Center (Prineville) Tillamook Co General Hospital St Charles Medical Center (Madras) Willamette Valley Medical Center Tuality Community Hospital Wallowa Memorial Hospital 4000 Kruse Way Place, Bldg. 2, Suite 100 23 Lake Oswego, Oregon 97035 503-636-2204 Fax 503-636-8310