Core Services & Characteristics of Rape Crisis Centers

Core Services & Characteristics of Rape Crisis Centers: A Review of State Service Standards Second Edition By Kris Bein 4 5

Table of Contents 7. Introduction 11. Method 14. Snapshot of Rape Crisis Center Services 17. Rape Crisis Center Service Philosophy Resource Sharing Project 20. Survivors Rural Sexual Assault Services 26. Rape Crisis Center Services http://www.resourcesharingproject.org/ to Individuals rural-sexual-assault-services 36. Community Services 43. Rape Crisis Center Organization & Operation Resource Sharing Project at the Iowa 52. Reccomendations for Future Coalition Against Sexual Assault Practice 1-515-244-7424 57. Synopsis of Core Services 60. References

This project was supported by Grant No. 2008-TA-AX-K043 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 and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women.

Distribution Rights: This tool may be reprinted in its entirety or excerpted with proper acknowledgement to the author, but may not be altered or sold for profit. 6 7 Introduction

What is a rape crisis center? and differences in sexual assault What makes rape crisis work dif- service provision across the coun- ferent from other social work? try. State service standards help Must rape crisis centers provide local rape crisis centers determine certain services to be a rape crisis what services must be provided at center? a minimum: the core services. This analysis of state service standards People have been organizing to details what services and methods serve victims of sexual violence are widely seen as core services of for forty years. In at least 1,300 rape crisis centers, and what ser- places across the country, commu- vices may be considered supple- nities have established rape crisis mental to those core services or centers. Because these rape crisis recommended practices. These centers were created locally, they core and recommended practices have each evolved differently, fit- look slightly different in each state, ting into the milieu of community but are strikingly consistent across needs and existing systems. State this sample. coalitions, in most places, sprang up as these local centers banded Rape crisis centers are commu- together to pursue statewide and nity-based not-for-profit agencies even national action. Local rape whose major purpose is provid- crisis centers and state coalitions ing advocacy and support services remain strong, independent voices to sexual violence survivors. They today, supported by the work of na- may be co-located with a domes- tional sexual assault organizations. tic violence shelter or other social Although these 1,300 rape crisis service agency; these dual/multi- centers and 56 state coalitions have service agencies often comingle evolved in unique circumstances, or merge their sexual violence and there are commonalities across the domestic violence services. RCCs field of sexual assault services. may provide more services than the core, depending on resources This document examines sev- and capacity. Whatever the con- eral states’ sexual assault service text or capacity of an RCC, the fo- standards to uncover similarities 8 9

cus is on supporting survivors and entities. The relationship between For the purposes of this document, eradicating sexual violence. RCCs coalitions, RCCs, state regulations, services are considered core when have different names or descriptors and other funder requirements play the standards explicitly require (“sexual assault services” as one ex- a strong role in the development rape crisis centers to provide that ample) but this document will re- of each state’s services and service service. Services are considered fer to them as rape crisis centers or standards. supplemental when the standards RCCs for consistency. explicitly make provision of that Core services are the essential service optional or when there is In many states, state service stan- services that make RCCs unique no clear mandate. Most states in dards dictate what services rape cri- service providers. Without these this sample—whether through co- sis centers (RCCs) provide, the way services, the agency would not be alition requirements, state funding services are provided, or who quali- a complete RCC. There is concur- eligibility, or state law—explicitly fies to provide services to sexual rence throughout the field on many require the provision of certain ser- violence survivors. Many, but not indispensable features and services to sexual violence survivors. all, states and territories have cre- vices provided by RCCs, and those What is required or optional varies ated state service standards to out- emerge in these pages. Services such by state, but some clear themes in line what services must be offered as advocacy and crisis intervention service emerge in this review. In a and how they must be provided. In emerge as necessary, or core, ser- few cases, the state standards serve most cases, adherence to standards vices. Supplemental services are as a best practice guide, but do not allows RCCs to be recognized as also important, but their presence place any requirements on their sexual assault service providers and or absence does not change the RCCs. Rather, these standards tell receive benefits through the coali- agency’s fundamental identity as RCCs how to provide a service, if tion or state government offices. a sexual assault services provider. the RCC chooses to provide that The level of benefit varies by state, A center that provides all the core service. In these cases, we consider and in some cases includes eligi- and supplemental services could be all of the services to be supplemen- bility for funding. In many states, considered a comprehensive rape tal in that state. such as Iowa, the RCC representa- crisis center. In many states, the co- tives write the service standards. In alition or state administrative office Sexual assault coalitions are other states, such as California and provide guidance on how to provide membership associations for lo- Kentucky, the standards come from supplemental services, but do not cal services providers, and often a state office or legislation. In some require the provision of such ser- advocates for improvements in states, standards written by the co- vices. laws, services, and resources for alition are then adopted by funding survivors of sexual violence and their service providers. Each state 10 11

Method and territory has a sexual assault There is much documentation are going through a major revision (SA) coalition: some are merged and dialogue in the field about and are not available at this time. with their domestic violence (DV) the function and nature of RCCs. coalitions. State sexual assault co- RCCs use many different sources RSP staff read and analyzed alitions coordinate statewide work and perspectives to arrive at their services standards from: and provide training and technical services and self-identity, with the • California state standards providing only one assistance to member rape crisis • Connecticut centers. State coalitions function as perspective. State service stan- public policy advisors and provide dards are the best record of official • Florida guidance to organizations assisting statewide definition of sexual as- • Hawai’i sexual assault victims; additional- sault services. This report investi- • Iowa ly, some manage contracts or pass gates state service standards to dis- funding through to local rape cri- cover the field’s definitions of the • Illinois sis centers. Many coalitions over- core services and characteristics of • Kentucky see service standards for member RCCs. This is not a scientific study, • Massachusetts but a compilation of information centers; the nature of the service • Michigan standards varies according to the from the field. It is a view into the function of the coalition. Coali- service standards of 20 states, as • Missouri tions with a stronger regulatory they were in 2012. • Nebraska function (e.g., pass-through coali- For this report, the National • New Hampshire tions) tend to have more detailed Sexual Assault Coalition Re- or stringent service standards. Co- • New York source Sharing Project sent a re- alition governance structures and • North Carolina quest for service standards to all outside influences also shape the 56 state and territorial sexual as- • Oregon development of the service stan- sault coalitions. Over the course • Pennsylvania dards. of a six-month collection period, • Tennessee twenty-three states responded; no • Vermont territory responded. Of the twenty-three responses, two reported • Washington that they did not have service stan- • West Virginia dards in their state, and twenty >> >> provided service standards. One reported that their standards 12 13

The RSP did not collect any This paper will explore the other documents, and did not themes, commonalities, and di- conduct interviews or surveys. vergences in this sample’s service All the standards in this sample standards to help us understand came from state coalitions, with how the field thinks about core the exception of California, Ken- and supplemental services. In this tucky, Massachusetts, New York, review and analysis, all references North Carolina, and Washington. to states or service standards refer Standards from those six states only to the service standards exam- came from state regulation or law. ined in this review. Many states use It is unknown what role the state different terms for similar services. coalitions played in shaping the Where the tasks and activities of service standards in those states. different terms are clearly similar, Hawai’i created best practice stan- as is the case of institutional advo- dards for RCCs and other systems cacy and systems advocacy, they such as law enforcement. All other are combined for analysis. In some standards focused exclusively on cases, this is difficult to determine. RCCs. These issues, and more, are discussed in the analysis of themes. Ten of the states in this sample The chart at the back summarizes have large metropolitan areas. Ev- the core and supplemental services ery state in this sample has a rural defined by this sample of service area, and three are designated rural standards. states statutorily through VAWA. Six dual DV/SA coalitions are represented, and eight stand-alone SA coalitions. One dual coalition and two state offices combine sexual violence and domestic violence service standards; all other dual coalitions and state offices have stand-alone sexual violence service standards. 14 15

Snapshot of RCC Services Advocacy Institutional Advocacy/ Crisis Intervention “Supporting and assisting a Systems Change victim/survivor to define needs, “A timely response…to an “The agency advocates for social explore options, and ensure rights individual presenting a crisis re- change by addressing community are respected within any sys- lated to sexual violence.” (Florida conditions which adversely affect tems.” (New Hampshire Coalition Council Against Sexual Violence) sexual violence victims/survivors Against Domestic and Sexual Vio- • Active listening, empathy and with other organizations lence) working toward the elimination • Teach or reinforce coping • Medical of sexual violence.” (Washington skills • Legal Coalition of Sexual Assault Pro- • Reduce current trauma • Accompaniment grams) symptoms • General • Advocating for groups of • Provide information survivors, not specific Counseling & Therapy survivors Support Groups • Professional training “Supporting the victim’s recov- “[The purpose is to] foster a • Community task forces ery process through listening, en- sense of regaining control, pro- (SARTs, etc) couraging, validating, reflecting, mote an understanding of the ef- giving resources, and providing a fects of sexual violence, and assist safe counseling environment.” (Il- Prevention & Awareness with finding resolution concern- linois Coalition Against Sexual As- ing the sexual victimization” (West “Each member center will be sault) Virginia Foundation for Rape In- an active community resource formation and Services). • Education/explanation providing information, outreach, support, and training. In addi- • Groups exchange information, • Exploring options tion, each member center shall be share techniques for problem • Trigger plans actively involved in community- solving, and explore feelings • Planned interventions and goals based committees regarding sex- • May be run by advocates or ual abuse.” (Connecticut Sexual counselors • Use of specific modalities and Assault Crisis Services, Inc.) techniques • May be curriculum-based; • Community awareness events open or closed; short-term or • Prevention Education ongoing programs 16 17 Rape Crisis Center Service Information & Referral Philosophy “A source for information and For all the standards examined standing sexual violence, trauma, referral for victims, significant in this sample, the understanding and working with survivors in spe- others, and the community on of or approach to sexual violence is cific standards on advocacy and sexual assault…[with] an updat- grounded in social justice. The lan- intervention practices. Missouri ed resource system for staff and guage about social justice is some- begins their service standards with volunteers” (Tennessee Coalition times subtle, sometimes overt, but guiding principles, including, to End Domestic and Sexual Vio- it is a strong underlying theme to lence) the RCC approach to sexual as- “Violence against wom- • Referrals to other community sault. Many traditional mental en is rooted in the institu- service providers that can health treatments and social work tional imbalances of power support survivors practices are based in the medi- between men and women, • Information to the public on cal model of diagnosing problems in sex-role stereotyping, in sexual assault and sexual and treating symptoms. The social gender based values and assault services justice-based model of interven- in misogyny” (Missouri tion holds that clients are inher- Coalition Against Domes- ently whole, strong people who are tic And Sexual Violence not at fault, but who might benefit [MCADSV], p. ii). from support after sexual violence. The Nebraska Domestic Vio- There is variation of social jus- lence Sexual Assault Coalition be- tice models used in the standards gins their standards with this infor RCCs, but very few of the stan- struction: dards omitted a theoretical frame- “It is important for pro- work for understanding sexual grams to use an empower- violence. The service standards ex- ment model for service pro- amined all have sections on phi- vision that actively supports losophy, approach, guiding prin- each individual’s right to ciples, or ethics that used terms self-determination. We seek like “empowerment,” “victim-cen- to empower those we serve tered,” “without blame,” or “trau- with accurate information” ma-informed.” Some go further in (Nebraska Domestic Vio- defining a framework for under- lence Sexual Assault Coali- 18 19

tion [NDVSAC], p. 1). discussed the gendered nature of able-ism, and the like. These ex- violence, typically using terms like periences of oppression shape our The commitment to a social jus- “violence against women” in phi- worldview, and the world’s view tice framework shows up in many losophy and service. One state in of us. They also shape our access places in the various standards ex- this sample requires first respond- to resources and systems. Sexual amined. The topic requirements ers to be female; a few more ex- violence happens in this context in training curricula most clearly press a preference for females but of real people’s lives. Most of the revealed certain values, even in did not have mandates. standards address anti-oppression states with less value-laden stan- work to some degree in their guid- dards overall. Training require- Nobody exists outside the con- ing principles, ethical codes, or ments included such items as “em- text of their culture or life experi- other sections. More specific di- powerment philosophy specific ences. Every day, we each have dif- rection on anti-oppression work to domestic and sexual assault; ferent experiences and struggles and cultural competence is dis- historical, psychological, and so- with various forms of oppression: cussed below. cietal-cultural aspects of domes- racism, classism, homophobia, tic and sexual violence” and “the need for social change necessary to eliminate violence against women” (Michigan Domestic Violence Snapshot of and Sexual Assault Prevention and Treatment Board [MDVSAPTB], Common Philosophies p. 19, and Tennessee Coalition to End Domestic and Sexual Vio- • A Social Justice Approach: • Support survivors’ choices and lence [TN Coalition], p. 13). - Victim-centered ability to control life - Anti-oppression The values of self-determina- - Emplowerment • Provide services to ALL tion, autonomy, and fully informed survivors choice are also visible in the expec- • Specifically trained workers tations surrounding documenta- • 24-hour access tion, client consent, grievances, • Free and information and referral • Confidential Services services. These will be discussed • Maintain Community Presence in further detail below. A good number of this sample expressly 20 21 Survivors

Service to sexual violence sur- Florida Council Against Sexual Vi- file that contains a PW-652 vivors is one of the primary func- olence [FCASV], p. 1) , or “sexual form, a service plan, and tions of RCCs. To know whom to assault victims” (California Gover- case notes. The contractor serve and whom not to serve, a nor’s Office of Emergency Services shall provide crisis services definition of sexual violence survi- [OES], p. 1). to the community served. vor or RCC client is required. First, Crisis not only includes the let us discuss the word “client.” Massachusetts directs programs victimization incident, but This sample was about evenly split to serve: also recent memory, disclo- on use of the term “client.” Many in Adult and adolescent sur- sure, triggering event, or any the field feel that “client” belongs vivors of any form of sexual legal proceeding or involve- to the traditional medical model assault including sexual ment. (Pennsylvania Coali- or the business world. Others find harassment, sexual threats tion Against Rape [PCAR], it a linguistically simple way to and intimidation, rape, at- p. 13) describe the survivors of violence tempted rape, incest, sexual and significant others to whom Finally, the Illinois Coalition assault by intimate partners, Against Sexual Assault determines: we provide professional services. child sexual abuse, sexual Others prefer “service recipients.” exploitation, sexual traf- A person generally be- No standards in this sample have ficking, starling, and other comes a client when the cen- adopted the currently preferred forms of unwelcome or co- ter has gathered enough in- term in mental health services, erced sexualized activity formation to assign a client “consumers.” Here, we will use “cli- (Sexual Assault Prevention identification number or the ent” and “survivor” interchange- and Survivor Services, Mas- person seeks additional ser- ably, however “client” is used more sachusetts Department of vices from the program sub- often as it encompasses significant Public Health [SAPSS], p. 6). sequent to crisis interven- others and survivors. tion services. In the case of The Pennsylvania Coalition advocacy, a person generally The majority of this sample did Against Rape requires: not have a detailed client defini- becomes a client when the tion section, but referred to “pri- A contractor shall iden- center provides telephone or mary and secondary victims” of tify an individual as a client in-person advocacy services sexual violence or assault (Con- if the individual is a victim related to medical care or re- necticut Sexual Assault Crisis of sexual violence, requests porting to law enforcement. Services, Inc. [CONNSACS], p. 2; services from the center, and “Victim” – Any person of if the center opens a case any age who seeks assistance 22 23

after being sexually assault- Children Some states encourage relation- ed. The sexual assault sur- ships with Child Advocacy Cen- vivor is referred to as victim There is a wide variation in the ters or other community service throughout these standards expectations and standards of ser- providers, while others do not. because the focus of services vice provision to children Some Some child-related state service is based upon the victimiza- standards do not broach the sub- standards are heavily influenced tion she has experienced (Il- ject at all, some require programs by state regulation or law or funder linois Coalition Against Sex- to serve adults and children, and requirements concerning any so- ual Assault [ICASA], p. 5-3). some require programs to serve cial services to children. teenagers, but not children less None of the standards ask for than thirteen years of age. Some evidence or corroboration of sex- states serve teenagers thirteen and Significant Others/ ual assault; some assert that staff over with the same services given Secondary Victims and volunteers must treat all cli- to adults, but RCCs must meet ents as credible. No state put limi- additional requirements in train- “Significant others also feel tations on services related to tim- ing, facilities, and services to serve the impact of sexual assault… ing or type of sexual assault. That children under thirteen. Tennes- A significant other is any per- is, survivors do not need to seek see, for example, mandates pro- son of any age who seeks as- services within a certain window grams to have sistance in dealing with their of time after the assault to be eli- own crisis/feelings as a result gible for services. Some states are “staff or volunteers of the sexual assault of a loved more explicit in this than others trained to meet the needs one” (ICASA, p. 5-3). are. Though every state is clear of minors; written policies about serving adults who have regarding the rights and re- “A significant other shall been sexually assaulted, there are sponsibilities of minors re- be defined as an individual differences in whether services are ceiving services;…appropri- of any age, other than the offered to other clients: children ate furniture and equipment victim, who has been af- and adolescents, significant oth- that would help put a minor fected by sexual violence, ers/secondary victims, and survi- at ease; [and] provision of an who requests service from vors who perpetrate violence. age-appropriate orientation the center and receives such for minor clients” (TN Co- service. A significant other alition, p. 3). includes a parent, guard- ian, spouse, partner, sibling, child, and/or close personal 24 25

friend of a victim of sexual we must also protect other clients violence” (PCAR, p. 13). at the agency. Additionally, RCCs generally do not provide offender There is variation regarding the services and are not qualified to amount of discussion on services provide sex offender counseling. A for significant others, ranging from few of the standards offer guidance no direction to detailed regulation to RCCs on this issue, generally di- on what services significant others recting programs to provide brief may receive. No state barred or dis- emotional support and a referral to couraged serving significant oth- other services: ers. At minimum, most encourage crisis intervention or information “survivors or their friends and referral for significant others. or family members who have Some allow for or encourage full been sexually abusive shall services to significant others, espe- be offered only brief referral cially those of child victims. to appropriate accountability and treatment services and may not receive survi- Survivors who vor services” (SAPSS, p. 6). perpetrate violence Most of the standards did not address perpetration by survivors. A sad, but not unusual, reality of rape crisis work is that some survivors also perpetrate violence, both sexual and domestic. RCCs sometimes learn of survivors’ perpetration from the survivors themselves, sometimes from a report from a victim or law enforcement, and sometimes from staff or shelter guests’ eyewitness ac- counts in shelter. RCCs want to be able to support all survivors, but 26 27

RCC Services to Individuals Centers must attempt to ing answered by someone on their re-contact all clients/survi- island and is not being routed to vors within three working the mainland” (Hawai’i Coalition 24-hour Crisis days after first contact/crisis Against Sexual Assault [HCASA], Intervention intervention services if indi- p. 13). Provision of in-person cri- cated by the needs of the cli- sis intervention is detailed in only This was the category with per- ent…A minimum of 45 % of a few of the standards, and often haps the most varied definitions clients/survivors receiving conflated with other services, such and services. A good working first contact/crisis interven- as counseling, medical advocacy, definition comes from Florida: “a tion services must receive or general crisis intervention. timely response by a trained staff follow-up services (OES, p. member or volunteer to an indi- 2). vidual presenting a crisis related to sexual violence…to reduce the All states in this sample con- Advocacy level of trauma experienced as a sider a 24-hour telephone hotline result of sexual violence by assist- a core service. Even states with Broadly speaking, advocacy is ing victims in strengthening their minimal regulations on other is- “supporting and assisting a vic- coping skills through empathic re- sues have detailed hotline require- tim/survivor to define needs, ex- sponse.” It is “short-term; may be ments. States have many clear plore options, and ensure rights episodic” and may include “infor- requirements on availability, the are respected within any systems mation about the effects of sexual maximum allowable time lapse with which the victim/survivor violence and possible reactions; between initial contact and con- interacts” (NHCADSV, p. 48). general information about medical nection with the agency if using Pennsylvania simply defines all and legal issues; offering advocacy an answering service, plans for advocacy as facilitating “the cli- and information about other ser- hotline failure, training, and other ent’s negotiation of the different vices available in the community; facets. A few standards allow for systems encountered as a result active listening and empathic re- testing of hotlines, but this is rare. of being impacted by sexual vio- sponding; exploring options; and, Hawai’i shapes hotline standards lence” (PCAR, p. 14). The level of referral to 24 hour sexual violence to meet special geographic con- detail on advocacy tasks among hotline” (FCASV, p. 3). California siderations: “Every island should the standards varies considerably. has a unique requirement for cen- have a 24-hour sexual assault hot- Some standards discuss advocacy ters to attempt to turn hotline con- line that is a local number…callers only in the context of emergency tacts into regular clients: can be certain that their call is be- response, while others allow for a wider range of advocacy tasks. 28 29

There is generally more detail and forensic exam; information sonnel regarding medical is- focus on medical advocacy than about medical care/con- sues as related to the sexual legal advocacy across this sample. cerns, including assistance assault/abuse. Services in- with needed follow-up; sup- clude provision of informa- port at medical exams and tion and resources regard- appointments, and; informa- ing the victim’s rights and Medical Advocacy tion and/or assistance with options regarding follow-up Washington defines medical ad- Crime Victim Compensa- services. Medical advocacy vocacy as: tion applications (Washing- also includes corresponding ton Office of Crime Victim with the victim or medical Acting on behalf of and in Advocacy [OCVA], p. 4). personnel regarding specific support of victims of sexual concerns about the victim’s abuse/assault on a 24-hour Illinois explains, case (ICASA, p. 5-15). basis to ensure their interests The advocate provides in- Several states particularly direct are represented and their person support and informa- rights upheld… To assist the programs to provide information tion to sexual assault victims and resources on post-coital con- victim to regain personal at medical facilities. With power and control as s/he traception and HIV testing and victim permission, the ad- prophylaxis. Many states differen- makes decisions regarding vocate stays with the victim medical care and to promote tiate accompaniment from advo- throughout the exam and cacy, consider it a task within the an appropriate response evidence collection process from individual service pro- umbrella of advocacy, or require and provides follow-up ser- programs to provide only accom- viders. [It] may vary sig- vices and referrals. The pri- nificantly depending upon paniment but not ongoing medi- ority of the advocate is with cal advocacy. The intention of the client’s medical needs as re- the victim, not the medical lated to the sexual assault. states that use the term accom- facility…Individual medical paniment is to provide in-person All activities and services are advocacy services include client-focused and case spe- emotional support or support- telephone and in-person ive presence to survivors during cific…[including] assistance contacts with sexual assault/ in making informed deci- medical exams, police interviews, abuse victims and their non- and other legal processes (though sions about medical care and offending significant others the preparations needed, in- most often in medical exams). and contact with emergency However, in all cases, the line be- cluding referral for possible room or other medical per- 30 31

tween accompaniment and advo- information, referrals, and be considered information and re- cacy is unclear or not defined. For requested accompaniments ferral in another state, or counsel- the purposes of this document, to any investigations, inter- ing or medical/legal advocacy in accompaniment is a task under views, court hearings, and yet another. Iowa, in one of the few the umbrella of advocacy services. other proceeding related detailed examples of general advo- to the sexual victimization cacy, calls for: [to] assist the individual in Legal Advocacy receiving dignified, victim- a written plan for pro- centered treatment within viding ongoing advocacy Legal advocacy focuses largely the law enforcement and to assist sexual assault vic- on law enforcement and criminal criminal justice system as it tims in meeting their ad- justice proceedings, though most relates to sexual victimiza- ditional needs in access- states allow for information and tion” (West Virginia Foun- ing services not provided referral on civil matters. Expecta- dation for Rape Information by the program, including tions run from providing legal re- and Services [FRIS], p. 6). but not limited to legal ser- ferrals to substantial involvement vices; housing (transitional, in supporting survivors through le- The level of detail on legal ad- temporary, permanent); fi- gal proceedings. New Hampshire’s vocacy varies considerably, though nancial assistance; mental definition of advocacy includes some level of legal advocacy is gen- health services; alcohol and “24-hour access to law enforce- erally considered a core service. other drug treatment and re- ment accompaniment…ongoing covery programs; immigra- criminal justice system support… tion assistance; healthcare; accompaniment for criminal sex- General Advocacy/ employment; and parenting ual violence, domestic violence Other Advocacy/ assistance (Iowa Coalition and stalking cases, referral to legal Against Sexual Assault [Io- services…and information and Case Management waCASA], p. 31). referral on related civil processes” The majority of the states in this Hawai’i directs programs to have (NHCADSV, p. 27). Advocacy in sample focus only on medical and a caseworker, who will “actively West Virginia: legal advocacy, but a few attend to coordinate a variety of services on “facilitates the client’s in- other advocacy issues or case man- their client’s behalf and serve as a teraction with law enforce- agement. This is a murky point central point of contact for the sur- ment and the criminal jus- because the tasks covered under vivor when she needs assistance or tice system through support, general advocacy in one state may has questions” (HCASA, p. 24). 32 33

Counseling and Therapy Many more states consider short- reactions to the trauma term counseling core but therapy and facilitating a return to The states in this sample do not an enhanced or optional service. pre-trauma functioning… all consider provision of coun- Some, like California, mandate Sexual Assault Therapy en- seling or therapy a core service. access to longer-term counseling: compasses Sexual Assault Short-term counseling is deemed “Centers must make long-term Counseling and entails more core much more often than long- counseling services available. This in-depth, process-oriented term therapy is. Definitions of means to provide the service or to work for adults or more ex- counseling, and therapy vary quite make arrangements through other periential work for children. a bit and sometimes overlap with agencies or individuals” (OES, p. Sexual Assault Therapy is crisis intervention or support 3). A few have detailed guidelines most often aimed at helping groups. Counseling or supportive for referring to therapists. Some the victim identify longer- counseling is usually described as states have superseding laws or term life patterns and cop- short-term, solution- or action- regulations concerning licensure ing mechanisms, or estab- focused, and less intensive inter- or education for all counselors; lished survival skills. Sexual ventions. Therapy is described these are reflected in the respective Assault Therapy may work as longer-term, more intensive sexual assault service standards. Il- on more process-oriented and more in-depth intervention. linois describes the difference be- internal changes. The goal Therapy, in the standards, typi- tween counseling and therapy: of Sexual Assault Therapy cally requires a practitioner with is for the victim to be able an advanced or specialized de- Sexual Assault Counsel- to utilize the insight gained gree. Some states allow advocates ing is victim-centered coun- to promote healthy internal to provide very limited counseling seling with the goal of sup- and external changes. Sexual services. Guidelines generally ad- porting the victim’s recovery Assault Therapy is typically here to standard counseling prac- process through listening, (but not always) longer-term tices, ethics, and theories; this is encouraging, validating, re- work (ICASA, p. 5-24—5- reflected in job descriptions, case flecting, giving resources, 25). plans, intervention modalities, and and providing a safe coun- expectations of duration. Quite a seling environment. Sexual few states considered counseling Assault Counseling is seen a supplemental service, requir- as working with the victim ing programs to have community on current issues, normal- referrals but not a staff counselor. izing and validating her 34 35

Support Groups Individuals meeting in a ing, but do not require both (New safe, supportive, non-judg- York Public Health Law, section Support groups are a different mental environment on a 206(15), p. 2).Therapeutic groups service than therapy, and differ- regular, scheduled basis to are considered supplemental ser- ent yet than therapeutic groups. exchange information, share vice by most of the standards, if Similar to the differences between techniques for problem solv- they are considered at all. short-term counseling and long- ing, and explore feelings re- term therapy, support groups are sulting from sexual violence. groups run by a trained facilitator [The purpose is to] foster a or peer, while therapeutic groups sense of regaining control, are facilitated by counselors with promote an understanding advanced degrees. Very few of the of the effects of sexual vio- standards discussed therapeutic lence, and assist with finding groups. Standards typically require resolution concerning the a trained staff or volunteer to fa- sexual victimization (FRIS, cilitate support groups. Some of p. 9). the standards for support groups also require a Master’s degree for Vermont directs centers to “of- facilitators, indicating some over- fer support groups…whenever the lap in the definitions of therapeutic program determines that support and support groups. It is common groups are an appropriate peer sup- practice in the field to use curricula port strategy in their service area for support groups. However, the and there are a sufficient number standards in this sample did not of service users to form a group” address curricula or other content (Vermont Network Against Do- issues for support groups. Rather, mestic and Sexual Violence [Net- the standards dealt with the basic work], p. 10). As with counseling framework of groups and access to and therapy, there is no consensus groups. West Virginia defines sup- among this sample on whether pro- port groups as: vision of support groups is a core service. Some standards, like New York, mandate programs to provide individual or group counsel- 36 37

Community Services

Services directed at institutions, These community services are all of these various definitions and groups or the community as a not defined uniformly across the vocabularies, there are common whole, rather than individual sur- states. The divisions between these themes. vivors are community services. In- categories are generally unclear; For many states, the link be- formation and referral, prevention there is little agreement on any tween community work and sur- education, community awareness, distinct definitions of the tasks vivor services is clear: programs professional training, and institu- or categories within community cannot effectively serve survivors tional or systems advocacy are the services. The standards use terms unless survivors know the RCC most commonly described activi- like systems change, institutional exists and is welcoming. When ties within this broad category. The advocacy, professional training, survivors seek help after sexual vi- standards in this sample do not community awareness, preven- olence, they typically do not come deem particular community ser- tion education, and social service to RCCs first. Rather, they seek vices core as often as they do indi- advocacy to describe the various medical care, spiritual guidance, vidual services. However, a com- services for institutions and com- material resources, or the support munity presence of some type can munities sometimes using dif- of friend, if they seek help at all. be considered an agreed-upon core ferent terms to describe the same If service providers, community service, whether it is through com- activity. Outreach, social change, leaders, spiritual leaders, and gen- munity education, public service and activism are some other terms eral community members know announcements, or institutional used under this umbrella. Further about sexual violence and the relationships. Connecticut, for ex- confusion arises from the fact that RCC, they can be a bridge for the ample, mandates “each member a few states call individual crimi- survivor to the RCC. Thus, RCC center will be an active community nal justice or medical advocacy community work vitalizes and resource providing information, with clients “systems advocacy.” strengthens our survivor services. outreach, support, and training. Prevention education is becom- California makes this link explicit: In addition, each member center ing a well-defined activity in the “at a minimum, centers must serve shall be actively involved in com- field, but there is still much over- the same number of sexual assault munity-based committees regard- lap with community awareness victims as there are cases of forc- ing sexual abuse” (CONNSACS, p. or other terms in the state service ible rape reported to law enforce- 3). standards. Notably, professional ment agencies in the center’s ser- education and institutional advo- vice area” (OES, p. 2). cacy do not necessarily go hand- in-hand; some states required one but not the other. However, within 38 39

Information and Referral to have “an updated resource sys- under prevention education. New tem for staff and volunteers…Staff Hampshire requires: Information and referral service and volunteers are trained to use standards describe how providers the resource system” (TN Coali- Member programs shall make referrals to other commu- tion, p. 5). Iowa expects the “extent develop and maintain rela- nity services, and provide general of program involvement in educa- tionships with schools and information and resources about tion/outreach will be such that the youth organizations to pro- healing. As mentioned previously, program is viewed as a vital mem- mote awareness of sexual the line between information and ber of the community. The devel- violence, domestic violence, referral services and general advo- opment of education/outreach and stalking within their cacy is often blurry. In some states, methods should be guided by and catchment area. Member where fulltime advocates or coun- reflect the diversity and character program utilizes, at a mini- selors may not be the norm, refer- of the community. For example, mum, research or science rals to community advocacy ser- written and broadcast service in- based programs and curri- vices or counseling services are in formation might be made available cula and whenever possible, the domain of information and re- for non-English speaking popula- evidence-based curricula ferral services. A few states require tions to match the diversity of the and materials (NHCADSV, annual updating of a resource and community” (IowaCASA, p. 27). p. 44). referral provider manual. Most re- Massachusetts, in one of the quire that more than one referral broadest approaches to preven- be given, and some had prohibi- tion education, directs programs tions or limits on referring to ser- Prevention Education to include “community leadership, vices provided by board members There is great variation among education, mobilization, and orga- or volunteers. Connecticut stipu- the states on prevention education nizing to promote healthy sexual- lates what community services requirements. Within its preven- ity and relationships, and prevent must be in the agency’s resource tion education standard, Pennsyl- sexual assault across the lifespan” listings, from counseling and vania differentiates presentations (SAPSS, p. 1). dentistry to LGBTQ services and from training; presentations “in- housing (CONNSACS, p. 2). Ten- form the public,” while trainings nessee RCCs, as the “source for in- “develop skills” (PCAR, p. 15). formation and referral for victims, Community Awareness Some states, such as Pennsylvania significant others, and the commu- and Iowa, include systems change Michigan, like many states, re- nity on sexual assault,” are required or social change advocacy as a task quires community education “that 40 41

raises the community’s awareness for social change around professionals to provide victim- of the causes, implications, and sexual abuse/assault issues, centered services and to intervene appropriate community response both within the agency and on the behalf of the victim within to…sexual violence (MDVSAP- in the community at large… their own institution” (FRIS, p. TB, p. 7). Other states, like North Evidence that the agency 11). Some states specifically iden- Carolina, incorporate publication participates (through mem- tify medical and criminal justice and provision of brochures and bership or other evidence of personnel as targets of professional other written materials on ser- involvement) in statewide training, but most leave the audi- vices, community resources, and/ and national groups to im- ence for RCCs to determine. or general sexual assault informa- prove service for individual tion (North Carolina Council for clients, identify gaps in ser- Women/Domestic Violence Com- vice, advocate for needed Institutional Advocacy/ mission, p. 12). Some states refer change, and share training to community awareness activities and other resources (OCVA, Systems Advocacy/ – which are somewhat conflated p. 11). Relationships with with institutional advocacy – as Institutions social change. Washington, for example, explains, Professional Training Advocating for change in the system responses to all survivors The agency/program ad- Of the states that address profes- or large clusters of sexual violence vocates for social change sional training, most list it as a task survivors, not individual cases, is by addressing community under prevention education/com- an important component of anti- conditions which adversely munity awareness or institutional violence work. The mandated ac- affect sexual abuse/assault advocacy. However, a few pull it tivities for institutional relation- victims/survivors and with out as a separate task. Professional ships generally include networking other organizations working training in these states is normally agreements and attempts to partic- toward the elimination of directed at law enforcement, pros- ipate in Sexual Assault Response sexual violence…[demon- ecutors, medical personnel, so- Teams, Multi-Disciplinary Teams, strated by] Written evidence cial service personnel, and other or community task forces of some that shows that the agency institutional allies. West Virginia sort. Most of this sample, however, provides a mechanism for directs programs to provide “edu- leaves the specific activities and staff, volunteers, clients and cation, evaluation of skills, and the targeted institutions to the indi- their families to advocate building of skills to prepare allied vidual center’s discretion. Califor- 42 43

RCC Organization & Operation

nia explains agency coordination: The services provided to sexual Missouri proclaims that “sexual “Centers must establish themselves violence survivors compose the violence programs are account- as active participants in local pub- quintessential defining features of able to the survivors requesting lic and private service networks rape crisis centers. However, the or receiving services” (MCADSV, in order to provide for timely and methods and structuring of service p.ii). Third, as a grassroots move- comprehensive responses to sexual provision merit discussion here as ment, advanced degrees or exten- assault victims’ needs” (OES, p. 5). well. These features provide addi- sive traditional clinical experience Likewise, Florida cites the impor- tional insight and perspective into are not often required of workers. tance of a “ a permanent, client- the work of RCCs. Thus, state service standards are centered system which offers, or not based on an assumption of assures access to, a comprehensive other, overriding conduct codes continuum of core and enhanced Accountability (although many direct workers to sexual violence services, which obey codes from applicable state is mutually accountable despite Accountability is not a specific and regulatory bodies) or training individual changes over time in service or action, but is an essential such as social work degrees and regulations, procedures or people feature of RCCs for a few impor- licensing. This has led to the gen- who provide services” (FCASV, tant reasons. First, some federal, esis of sexual assault-specific train- p. 6). Iowa holds that “programs state, and local funders, licensing ing standards and conduct codes can enhance effectiveness through bodies, and other regulatory bod- that hold workers and agencies establishing relationships with ies require and/or reward good accountable. A variety of tasks, other providers in the commu- business practices and sound client products, and procedures evince nity…Whenever possible, written service techniques. Demonstrating RCC accountability, as illustrated protocols and interagency agree- accountability and responsibil- in this sample of states. The level ments are to be established for co- ity builds trust and respect in the of accountability or evaluation for ordinated community responses eyes of community members and all the services varies considerably to victimization, such cooperative funders. Second, rape crisis work is from state to state. New Hamp- agreements can be used to further a client-centered, survivor-driven shire’s standards, for example, re- common goals across programs in field. One facet of client-centered quire that “the crisis line will be the community” (IowaCASA, p. service is transparent, responsible tested once per quarter and tests 26). service, as seen in the provision will be reported in the monitor- of information on grievance pro- ing visit/report” (NHCADSV, p. cedures and client rights to all cli- 25). Vermont requires, “programs ents, or high training standards. will establish written principles or 44 45

a written code of ethics for behav- Continuing Education with SA survivors. Other states ior of staff towards persons they base supervision requirements on service. The principles or code of These regulations also vary job title (e.g. counselors and thera- ethics may not conflict with the widely, though some amount is re- pists) or types of clients served Network’s mission and principles” quired in nearly all the standards. (e.g., child therapists get different (Network, p. 6). The enforcement mechanisms are or more intensive supervision than largely unclear. adult therapists do). Accountabil- ity, agency policies, procedures, Initial Training by-laws are up to date and in force; Supervision, Record Agency uses good business prac- The amount of training employ- ticesThis is noted in most, though ees and volunteers must receive Review, Counseling not all standards Some have de- before interacting with clients Plans and Service tailed guidelines, while the major- varies across states, from twenty Documentation ity has simple directives. to forty hours. There is also great variation in the window for com- Much of this is consistent with pletion of training. Some states generally accepted counseling Adherence to applicable require a portion of training be- practice. The collected standards fore any contact with survivors vary widely in the amount of de- state and federal laws, and the remainder of training to tail and structure provided. How- such as confidentiality, be completed within a longer pe- ever, the emphasis on client-driven licensure, and counseling plans is somewhat of riod, while others require the en- mandated reporting tire training to be completed be- an RCC specialty and is an impor- fore any contact with survivors. A tant departure from classic mental This is noted in most, though few states had slight variations in health modalities. Many states in not all of the standards. The de- training requirements based on the this sample directed programs to gree of detail varies widely, from a services provided (e.g., different create case plans with survivors. directive to follow applicable state topics are required to work on the For counseling supervision and law to detailed interpretation and hotline than provide advocacy). A review, some states use a loose for- guidance on application. A handful few others required minimal train- mula: everyone gets at least one of standards include ethical codes ing for administrative staff or staff hour of supervision per month, or ethical guidelines; the standards that would have little to no contact but this increases based on the more commonly direct programs with survivors. amount of contact the worker has to have their own written ethical 46 47

guidelines. All the state standards telephone and in-person crisis A minimum of at least emphasize the importance of con- intervention; Iowa, for example, the equivalent of one full- fidentiality separately from other specifies response should be “with- time Certified Sexual Abuse ethical or legal concerns (see bein 15-30 minutes for urban and as Counselor must be em- low for more detail). soon as possible for rural” (Iowa- ployed by the Center. Only CASA, p. 30). Most states required Certified Sexual Abuse that a live person answer the crisis Counselors will provide in- Educational telephone, although there was wide dividual and group counsel- variation in the allowable meth- ing to victims and training requirements for ods for receiving and responding to staff and volunteers. Sexu- employees to calls. Most states that allowed al Assault Crisis Centers are the use of answering services have strongly encouraged to have The majority of this sample had clear guidelines on parameters of two out of every five em- no standards on educational de- use. ployees certified as Sexual gree requirements for employees. Abuse Counselors. Any Sex- This seems to be in keeping with ual Assault Victim Counsel- the grassroots, social justice ori- Coverage for sexual or that is providing 25% or entation of the field, in that many more time to sexual assault rape crisis centers were founded assault clients in dual victims, regardless of years on a peer-helping model that es- agencies of experience or licensure, chewed clinical degrees. Those that is required to be a Certified did have requirements typically Many states cover the qualifi- Sexual Abuse Counselor (Io- only covered degree requirements cations for providing service to waCASA, p. 47). for therapists and counselors. sexual assault survivors in their training requirements or person- However, most standards do not nel requirements, but do not ad- discuss staffing patterns for sexual Response times and dress the issues of service parity in assault services in dual/multi-ser- usage of answering dual domestic violence/sexual as- vice agencies. sault agencies. A few states, in rec- services or outside ognition that many RCCs are dual/ services multi-service agencies, mandate coverage specifically for sexual Many, though not all, have violence survivors. Iowa requires: guidelines on response time for 48 49

on a regular basis. Written The only cost allowed regarding Confidentiality documentation must be kept the hotline in any of this sample Policies may or may not clearly detailing communications. was a toll for the call. However, reference state code, but confiden- Incorporate a marketing mix many states require toll free ho- tiality is explicitly discussed in all such as press, radio, internet, tline services, including toll free policies reviewed. About half this and television in public rela- TTY access. sample supplies detailed guide- tions campaign. Take the lines on documentation, releases, lead role in being the prima- allowable disclosures, and expec- ry resource in the commu- Cultural Competence, tations for board, staff, volunteers, nity for providing informa- and clients (the other half had brief tion about sexual violence. Anti-Oppression, and policies or referred the reader to Network with a wide range Non-Discrimination documents not in this review of of organizations/groups in- Standards diverge in extent, standards). Many emphasize con- cluding business, religious, placement, and language, but all fidentiality as a guiding principle. civic, educational, commu- specifically include some remarks nity, and other professional on non-discrimination and diver- groups (FRIS, p. 14). sity. The most minimal message Agency Identity was simply a non-discrimination policy; the most comprehensive Several states instruct RCCs to Cost promote themselves as the com- standards require specific training and/or require the profile of munity sexual assault crisis agency Most in this sample required all the board/staff to be representative (through networking agreements, or some of the services to be pro- of the local community. A hand- public service announcements, vided free of charge. Only a few ful of states have additional state- and the like) or require clear agen- provided no guidance on this is- ments on religious non-affiliation cy identification as a sexual assault sue. The most common free ser- of RCCs. Washington allows for service provider (e.g. using the vices were crisis intervention, ac- specific services and activities be- words “sexual assault” or “rape cri- companiment, and advocacy; the yond core services that are direct- sis center” in publications or when most likely to be subject to a fee ed at marginalized communities. answering the crisis line). For ex- was counseling/therapy. In many Hawai’i encourages programs to ample, West Virginia’s standards cases, a number of free sessions (of “be in tune with local culture” as require programs to: any service) had to be provided be- many Native Hawaiians are more fore the center could assess a fee. Publicize available service 50 51

comfortable with “traditional rienced discrimination for all staff healing practices” (HCASA, p. and volunteers. A handful of states 30). Some require publications to consider access to emergency or printed in the most common lan- temporary housing a core service. guages in the community. Others Iowa includes multicultural out- direct programs to diversify or at- reach (which includes help with tempt to diversify their staff and VAWA self-petitions and U-Visas), board. Finally, all the standards and transportation. Several states directed programs to be in compli- also have detailed ethical codes ance with the requirements of the for RCC workers. North Carolina’s Americans with Disabilities Act; programs must reserve one seat on a few explicitly required TTY or the board of directors for a sexual other methods to make the crisis assault survivor, though the sur- line accessible to deaf survivors. vivor is not mandated to disclose their history to the entire board.

Other Noteworthy Activities and Features A few states include medical exams in their enhanced services, though the details are scant. Illi- nois allows for annual “advocacy forums” that are optional, and requires centers to provide an annual education and activism plan. Cali- fornia requires quarterly participa- tion in SART or MDT meetings as well as other systems or institutional advocacy activities. California also requires annual “human rela- tions” training on serving people who have been oppressed or expe- 52 53

Recommendations

for Future Practice tions for special populations, such ral communities are poorer than as incarcerated victims or survi- their urban counterparts are. They vors who struggle with chemical tend to lack essential resources Service standards reflect cur- dependency. like comprehensive medical care, rent thought and best practices social services, or public trans- in the field, and as such, they are Alternative healing modalities, portation. For these reasons and living documents that grow and such as yoga, Somatic Experienc- more, rural RCCs do not operate change. As coalitions and mem- ing, art therapy, are becoming like urban programs. A few of the ber programs enhance or develop more popular as we learn more standards in this sample have spe- their service standards, there are about their efficacy for survivors. cific provisions for rural RCCs, but a few recommendations that may Standard setters can support the these are rare. Rural RCCs would bolster the response to sexual vio- emotional, spiritual, physical, and benefit from special consideration lence survivors. relational needs of survivors by encouraging programs to provide of their challenges and strengths a range of creative interventions. in service standards. For example, rural advocates tend not to spend Expand vision to They can also set guidelines for the competent and compassionate much time in offices, as rural sur- long-term and provision of various interventions vivors find it difficult to travel to complex service. and supports to help programs wherever the advocate is. Service make good decisions about utiliz- standards could set parameters for The aftermath of sexual violence ing alternative healing. ethics and safety when an advocate is neither neat nor simple. Many is working out of borrowed space survivors experience difficulties in other community programs or years after the sexual violence. Ad- the survivor’s home. Moreover, ditionally, many survivors do not Give special attention to managing confidentiality and tell right away. They may not have rural realities. dual relationships is a particular crisis needs, as currently identified challenge of rural communities, by the field, but do need support Every state and territory has where everyone knows everyone. and advocacy. Those who set stan- at least one rural community, Guidance from the standards on dards can aid survivors with com- and many have large rural areas. managing dual relationships and plex needs by setting expectations Rural communities have lower protecting confidentiality in rural for long-term, complex advocacy populations spread over a large settings would be a great support and counseling. It may also be use- geographic region. In most parts to rural advocates. ful to consider advocacy expecta- of the country and territories, ru- 54 55

Consider systems sider in constructing guidelines for ing. It is not recommended change work. these clients. that RCCs work with someone who is facing criminal charg- •What is the nature of the offense? es related to sexual violence, Systems change or institutional Was a domestic violence victim advocacy is present in some but not as it creates legal and ethical forced to sexually abuse her challenges for the program. all of the service standards. One of children? Was a developmen- the aspects that sets RCCs apart tally delayed adult acting out from other social services is our •How can we act ethically and with what was done to him? Was an compassion? determination to fundamentally adult survivor of child sexual change society. We want a society When we must refer a survivor abuse forced to abuse a sibling to sex offender treatment, it free of violence, and that means a in childhood? Was an adult sur- society with changed institutions. is important to consider how vivor acting with planned, ma- that transition is made. Clients Providing advocacy for survivors licious intent as an adult? These only, while helpful in the moment, may disclose current or past very different survivors re- violence to their counselor/ad- is likely to be frustrating for ad- quire very different responses. vocates and ultimately ineffective vocate because they trust the RCC and are looking for help. for survivors. It is recommended •How can we keep our center safe? that those who set standards pro- If possible, it is helpful to slow- If the RCC does provide ly transition the client, so they vide guidelines for systems change some survivor services to work. do not feel abandoned. Pro- these clients, the program grams should not serve both may want to set up guide- the client who perpetrated and lines to protect other clients. Make a plan for any victims of that client, and should follow any state report- survivors who also •What are we qualified and capable of ing laws for child abuse. perpetrate violence. doing? The mission RCCs is, primar- Sending these clients to sex of- ily, supporting survivors and fender treatment immediately may ending violence. RCCs may seem like the simplest or best solu- feel able to help the survivor tion, but it does not meet the needs with healing from sexual vio- of the client as a whole person. lence while they refer the sur- There are several questions to con- vivor to sex offender counsel- 56 57

Synopsis of Core Services Make allowances for The chart on the next page il- above discussion of services for lustrates the services that are core more information on definitions culturally specific rape or recommended in state service of services in this chart. In many crisis work. standards. states, the distinctions between types of service (prevention and Service standards, largely, are Services considered core in each community awareness for exam- authored by mainstream organiza- state are marked in blue. Services ple) are unclear or nonexistent. In tions for the benefit of mainstream that are recommended or supple- these cases, the boxes in the chart organizations. Culturally specific mental are marked in orange. The have been merged. organizations and tribal govern- box is left empty in cases where ments or organizations often find the service is not addressed by the that service standards do not fit state. their culture’s way of providing or interacting with RCCs. Hot- In some cases, it is difficult to lines, for example, are not used by determine the level of requirement all cultures, so requiring a hotline for a service, because the service would be a poor fit for that orga- definition is unclear (professional nization and community. As tribes training, for example) or there is are separate nations and have their not clearly directive language. In own unique issues and approach- these cases, the service is consid- es, state service standards may not ered recommended or supplemen- neatly apply to tribal work. Those tal. Other states, like Missouri, who set standards are encouraged have guidelines for provision of to find ways to support rape crisis various services, but do not explic- work in tribes. itly require the provision of any of those services. The standards in these states are directives for how to provide each service, if provided. Initial Training and Continuing Education hours were left blank if the standard did not refer to specific hours or left it unclear. See 58 59

Legend: Initial Traininghours Continuing Education hrs Core Systems Advocacy Professional Training Community Awareness Prevention Groups Support Counseling/Therapy Legal Advocacy Advocacy Medical General Advocacy Information & Referral Crisis Intervention Recommended

CA 40 12 CT 30 4 FL 30 6 HI IA 201 12 IL 40 6-12

KY 40 8

MA 35 6

MO 40 NC 20 NE NH 30 6 NY 40 OR 30

1 Workers in Iowa are PA 40 6 cross-trained with DV initially, and only eight TN 40 8 of these twenty hours must be sexual assault- VT 20 specific. Workers must obtain an additional 48 WA 30 12 hours of sexual assault training within their first year of work. WV 40 8 60 61

References Connecticut Sexual Assault Crisis Nebraska Domestic Violence Sexual Sexual Assault Prevention and Sur- Services, Inc (undated). Member Assault Coalition (2011). Nebraska vivor Services, Violence Preven- agency criteria and standards domestic violence sexual assault tion and Intervention Services, of operation. East Hartford CT: program standards. Lincoln NE: Massachusetts Department of author. author. Public Health (circa 2006). RFR: Community-based sexual assault Florida Council Against Sexual New Hampshire Coalition Against prevention and survivor services. Violence (undated). Florida sexual Domestic and Sexual Violence Boston, MA: author. violence program standards. Tal- (2007). Program standards. Con- lahassee FL: author. cord NH: author. State of California Governor’s Of- fice of Emergency Services Law Hawai’i Coalition Against Sexual New York Legislature. Approval Enforcement and Victim Services Assault (2011). Best practice of Rape Crisis Programs for the Division, (2010). Service standards standards for the delivery of sexual Purpose of Rape Crisis Counselor for the operations of rape crisis assault services in Hawaii. Hono- Certification. New York Public standards. Sacramento CA: author. lulu HI: author. Health Law, section 206(15), Sub- Part 69-5. (1994) Tennessee Coalition to End Domes- Illinois Coalition Against Sexual tic and Sexual Violence (2009). Assault (2004). ICASA policy and North Carolina Council for Women/ Best practices for Tennessee sexual procedures manual. Springfield IL: Domestic Violence Commission, assault agencies. Nashville TN: author. a division of the North Carolina author. Department of Administration Iowa Coalition Against Sexual As- (2009). Sexual assault program Vermont Network Against Domestic sault (2005). Membership stan- guidelines. Raleigh NC: North and Sexual Violence (circa 2004). dards for sexual assault crisis Carolina Department of Adminis- Program standards. Montpelier centers. Des Moines IA: author. tration. VT: author. Kentucky Legislature. Standards for Office of Crime Victim Advocacy West Virginia Foundation for Rape Rape Crisis Centers. 920 KAR (1999). State of Washington sexual Information and Services (2003). 2:010 (2004). abuse/assault services standards. WVFRIS rape crisis center stan- Olympia WA: author. dards. Fairmont WV: author. Michigan Domestic Violence and Sexual Assault Prevention and Oregon Coalition Against Domestic Treatment Board (2011). Quality and Sexual Violence (2008). Self- assurance standards. Lansing MI: assessment tool: Oregon Domes- author. tic Violence and Sexual Assault Program Standards. Portland OR: Missouri Coalition Against Domes- author. tic and Sexual Violence (2009). Service standards and guidelines Pennsylvania Coalition Against Rape for sexual violence programs. Jef- (2008). PCAR standards. Enola ferson City MO: author. PA: author.