NT OF ME J T US U.S. Department of Justice R T A I P C E E D B O J C S F A V Office of Justice Programs F M O I N A C I J S R E BJ G O OJJ DP O F PR Office for Victims of Crime JUSTICE Sexual Assault Nurse Examiner SANE Development & Operation Guide Sexual Assault Resource Service Minneapolis, Minnesota Office for Victims of Crime NCJ 170609 Advocating for the Fair Treatment of Crime Victims U.S. Department of Justice Office of Justice Programs 810 Seventh Street NW. Washington, DC 20531 Janet Reno Attorney General Raymond C. Fisher Associate Attorney General Laurie Robinson Assistant Attorney General Noël Brennan Deputy Assistant Attorney General Kathryn M. Turman Acting Director, Office for Victims of Crime Office of Justice Programs World Wide Web Homepage http://www.ojp.usdoj.gov/ Office for Victims of Crime World Wide Web Homepage: http://www.ojp.usdoj.gov/ovc/ For grant and funding information contact U.S. Department of Justice Response Center 1–800–421–6770 This document was prepared by the Sexual Assault Resource Service, under grant number 96–VF–GX–K012, awarded by the Office for Victims of Crime, Office of Justice Programs, U. S. Department of Justice. The opinions, findings, and conclusion or recommendations expressed in this document are those of the authors and do not necessarily represent the official position or policies of the U. S. Department of Justice. The Office for Victims of Crime is a component of the Office of Justice Programs, which also includes the Bureau of Justice Assistance, the Bureau of Justice Statistics, the National Institute of Justice, and the Office of Juvenile Justice and Delinquency Prevention. NT OF ME J T US U.S. Department of Justice R T A I P C E E D B O J C S F A V Office of Justice Programs F M O I N A C I J S R E BJ G O OJJ DP O F PR Office for Victims of Crime JUSTICE Sexual Assault Nurse Examiner SANE Development & Operation Guide Linda E. Ledray, PhD, RN, FAAN Sexual Assault Resource Service Minneapolis, Minnesota Office for Victims of Crime Advocating for the Fair Treatment of Crime Victims SANE Development and Operation Guide CONTENTS Chapter 1: Introduction..................................................................................................1 ■ Project Goals and Objectives ................................................................................................................................ 1 ■ Scientific Basis of This Guide ............................................................................................................................... 2 ■ Terminology......................................................................................................................................................... 2 • She or He .......................................................................................................................................................... 2 • Rape, Sexual Assault, or Abuse? ......................................................................................................................... 2 • Victim or Survivor? ........................................................................................................................................... 2 ■ SANE Guide Evaluation ...................................................................................................................................... 2 Chapter 2: History and Development of SANE Programs .........................................3 ■ Rape in the United States ..................................................................................................................................... 3 ■ Demonstrating the Need for SANE Programs ...................................................................................................... 5 ■ History of SANE Program Development ............................................................................................................. 5 Chapter 3: SANE Program Model .................................................................................7 ■ What Is a SANE? SANC? SAFE? FNE? ............................................................................................................... 7 ■ SANE Program Values, Mission, and Goals.......................................................................................................... 7 • Values Statement ............................................................................................................................................... 8 • Mission Statement ............................................................................................................................................ 8 • Program Goals .................................................................................................................................................. 8 ■ SANE Scope of Practice ....................................................................................................................................... 9 • Medical Care ..................................................................................................................................................... 9 • Reporting and Victim Support .......................................................................................................................... 9 ■ Education, Training, Research, and Program Evaluation ...................................................................................... 9 ■ SANE Standards of Practice ................................................................................................................................. 9 ■ How a Model SANE Program Operates ............................................................................................................. 10 • Hospital-Based SANE Programs ..................................................................................................................... 10 • Community-Based SANE Programs................................................................................................................ 10 • Community Response and Responsibilities ..................................................................................................... 11 • SANE Responsibilities .................................................................................................................................... 11 ■ Community Impact and Benefit ........................................................................................................................ 12 iii Contents Chapter 4: SART: A Community Approach ...............................................................13 ■ Who Is on a SART? ........................................................................................................................................... 13 ■ The Sexual Assault RESPONSE Team Model .................................................................................................... 13 • How a Sexual Assault RESPONSE Team Operates ......................................................................................... 13 • Sexual Assault RESPONSE Team Model Limitations ...................................................................................... 14 ■ The Sexual Assault RESOURCE Team Model ................................................................................................... 14 ■ Summary ........................................................................................................................................................... 15 Chapter 5: Assessing the Feasibility of a SANE Program ......................................17 ■ Needs Assessment .............................................................................................................................................. 17 • Identifying Allies ............................................................................................................................................. 17 • Determining the Extent of the Community Problem of Rape ......................................................................... 17 ■ Assessing Community Services and Developing Community Support................................................................ 18 • Law Enforcement ............................................................................................................................................ 18 • Rape Crisis Center .......................................................................................................................................... 18 • Medical Facility ............................................................................................................................................... 18 • Prosecuting Attorney ....................................................................................................................................... 19 • Other Agencies................................................................................................................................................ 19 ■ Identifying and Overcoming Obstacles: ............................................................................................................. 19 • Concerns About Costs..................................................................................................................................... 19 • Fear of Interference ......................................................................................................................................... 20 • Concern the SANE Will Not Do the Exam as