hile SANE programs may operate differently depending on factors such as community-specific coordinated response protocols and SANE program location, their primary function is to provide objective forensic evaluation of victims of sexual assault. SANEs have embraced the challenge to be technically skilled evidence collectors who display compassion and acknowledge the patient's dignity during every step of the
Most SANE programs use a pool of SANEs who are on call 24 hours a day. The on-call SANE is paged whenever a sexual assault victim enters the community's response system9 and usually responds within 30 to 60 minutes.10 The SANE or other medical personnel (e.g., emergency department physicians or nurses) first assess the victim's need for emergency medical care and ensure that serious injuries are treated. After the victim's medical condition is stabilized or it is determined that immediate medical care is not required, the SANE can begin the evidentiary examination. During the course of exams, SANEs
In many jurisdictions, community-based sexual assault victim advocates are involved in the initial medical-legal response to sexual assault victims. SANEs often collaborate with these advocates during examinations to ensure victims receive crisis intervention, help with safety planning prior to discharge, and referrals for other types of assistance and ongoing support.
SANEs should interact with victims and their families in an objective and neutral manner that promotes informed decisions regarding evidence collection and available treatment options.12 To facilitate decisionmaking, SANEs provide information regarding evidence collection procedures and reporting options. An exam is never done against the victim's will, no matter what age.13 SANEs release evidence to law enforcement agencies only with the victim's consent in cases where the victim has agreed to report or has already reported the crime. SANEs are mandated, however, to report to the proper authorities in cases of sexual assault of vulnerable adults (e.g., an older person dependent on a caregiver); sexual assault of minors by family members, caretakers, or persons in positions of authority over them; or sexual assaults of minors that were the result of parental neglect.14 Depending on state statutes and local enforcement policies, SANEs may or may not be mandated to report cases of statutory rape if adult perpetrators were not caretakers or were not in positions of authority over minors.15
In cases where victims are uncertain whether they want to report, the evidence can be collected and held in a locked refrigerator for a specified time, as mandated by state statutes. Victims should be informed of the time period in which they must decide how the evidence will be disposed if they choose not to report. If victims choose not to report and do not have evidence collected, the SANE ensures that they receive appropriate medical treatment and community referrals and are informed about advocacy services.
SANEs also conduct evidentiary examinations of suspects in sexual assault cases. These exams are usually conducted at local law enforcement agencies or jails. Meticulously collected evidence in suspect exams can be invaluable in case investigation and prosecution because the evidence can corroborate the victim's account of the assault.
If the case goes to trial, SANEs may be asked to provide testimony about forensic evidence they collected during victim and suspect exams. They view testifying as an integral part of their job and will readily adjust their schedules to be in court as needed. Prior to testifying, they often communicate with prosecutors so that they are informed about the issues involved in the case.