Police and the Sexual Assault Examination.

Suppose you are a detective assigned to investigate a sexual assault complaint. You know that any physical evidence available in the case will play a vital role in determining what happened and whether or not an arrest will occur and later will affect the ability of the prosecutor to file charges and obtain a conviction against the perpetrator. You will work closely with a sexual assault examiner who is a member of a sexual assault response team, rather than a member of your department's forensic evidence team. If this were a case of homicide, robbery, or any other major felony, you would rely on your department's crime scene investigators, medical examiner, and other forensic analysts to provide you with facts needed to make decisions about the case. But this is a sexual assault case. Why are the medical professionals who examine sexual assault victims not members of a law enforcement agency forensic team?

THE SEXUAL ASSAULT RESPONSE TEAM MODEL

Most law enforcement agencies throughout the United States rely on a variation of the sexual assault response team model. Developed in California, this model involves a coordinated response among various professionals to meet the needs of the assault victim and to collect physical evidence associated with the complaint. Typical members of the team include a victim advocate, a police officer, and a sexual assault examiner. Team members work together to ensure a sensitive, thorough investigation. The advocate provides support to the victim and sets the stage for continued services. The police officer investigates the facts of the case and takes appropriate action. The examiner assesses, documents, and collects forensic evidence and reports obvious pathology or suspicious findings to the victim with a suggestion for follow-up care and referral. Evaluation and diagnosis of pathology extends beyond the scope of the forensic examination. (1)

Currently, two prevalent team models exist. In the hospital-based program, a community hospital maintains responsibility for the administration of the program, including the selection, training, and scheduling of medical personnel involved. In the second model, the community-based program, a nonprofit agency assumes administrative responsibility for the program. Dedicated professionals with unquestionable commitment to the proper treatment and investigation of sexual assault cases support both team models. The primary purpose of the sexual assault examination, however, is forensic in nature. The examination is not intended to provide medical care, which is performed by the emergency department or the victim's physician, nor to substitute for the services provided by a counselor or therapist. The unique purpose of the examination is evidentiary-based, which assumes that law enforcement later may introduce findings of the examination as evidence against a defendant.

All team members play an important role. But, professionals who approach the sexual assault examination with priorities other than the standards required of forensic evidence collection designed to stand up in the court system render a disservice to the victims of sexual assault. This particularly holds true of the sexual assault examiner.

THE HISTORY OF SEXUAL ASSAULT EXAMINER PROGRAMS

The role of forensic evidence collection and examination traditionally has been assigned to the police. Police departments employ and train personnel in such forensic areas as evidence collection and analysis, fingerprint analysis, and blood-spatter evidence. In cases requiring advanced professional credentials, such as forensic medical pathology, dentistry, or anthropology, the police have employed, or contracted with, professionals for those services. In the area of sexual assault examination, however, the police have not assumed an active role. The reasons for the lack of police involvement in sexual assault examination programs may be found in the history of the development of the programs.

Nurses and other medical professionals, counselors, and advocates working with rape victims in hospitals, clinics, and other settings established the first Sexual Assault Nurse Examiner programs in Memphis, Tennessee, in 1976, and Minneapolis, Minnesota, in 1977. (2) These professionals recognized the inadequacy of services to sexual assault victims. Women's advocacy groups asserted that law enforcement did not approach these cases in a sensitive manner and, too often, dismissed a woman's claim of rape based on cultural misconceptions, bias, or lack of understanding. Additionally, the prosecution of cases suffered due to scarce research or specialization in the body of knowledge concerning sexual assault.

To address many of those concerns, teams throughout the United States formed. The 1994 Violence Against Women Act provided funding for training and program development. Nurses who have received specialized training in the field, have completed a proctorship, and are available on a rotating on-call basis usually staff sexual assault response teams. However, in the existing model, examiners do not get enough regular exposure to cases nor enough time to conduct the follow-up, research, or court preparation time to truly develop solid expertise in the field. Examiners who staff the programs remain genuinely devoted to them, but must direct the majority of their time to their full-time careers.

Unfortunately, law enforcement did not play a pivotal role in the administration of the newly formed programs, despite their critical role in the investigation and prosecution of sexual assault cases. While law enforcement may have been slow to recognize and respond to the needs of sexual assault victims in the past, tremendous changes in attitude have taken place within police organizations. Many agencies have formed specialized units to investigate sexual assault and have trained theft officers to prioritize their response to sexual assault cases and to treat victims with sensitivity while thoroughly investigating cases. Departments have forged new partnerships with community-based organizations, including women's advocacy groups, and have raised the credibility level of the police by addressing mutual needs.

A NEW LEADERSHIP ROLE

Law enforcement agencies once again may play a critical role in the collection of forensic evidence of sexual assault cases. If existing teams work well and the forensic standards supply the evidence needed to make decisions and prosecute cases of sexual assault, then no changes may be necessary. It however, teams are not focused clearly on their primary roles, experience role conflict, or waste valuable energy in political conflict, law enforcement should assume a leadership role. Clearly, the examination remains critical to the successful investigation and resolution of a sexual assault case.

Large agencies may employ full-time forensic examiners to conduct examinations. Smaller agencies may devise a funding scheme to share the costs of funding for an examiner position. To obtain professional, reliable evidence collection, departments should employ or contract a full-time forensic examiner to conduct examinations at the highest standards.

ONE AGENCY'S EXPERIENCE

Santa Cruz was one of the first counties in California to adopt the sexual assault response team model. (3) The team operated in a manner commonly found throughout California: a full-time administrative coordinator scheduled several registered nurses who had completed examiner training. The administrator of the program was the local Criminal Justice Council, a nonoperational agency. Examiners struggled to find the time needed to devote to the program and felt unable to develop true expertise in the field. Because the examiners worked on an infrequent, on-call basis, they often were unfamiliar with procedures and equipment and had to relearn essential job functions during actual examinations. They could not find enough time to keep up with the reading, research, and developments in the field, which would prepare them to conduct the most thorough examination and later testify in court concerning their findings.

Team Transition

Due to concerns over the quality of the examinations, reliability of findings, and stability of service, the Criminal Justice Council asked the Santa Cruz County Sheriffs Office to submit a proposal concerning how it may assume administration of the team. The sheriffs office recommended the elimination of the coordinator model with the existing funding, which previously had supplied the coordinator's salary, on-call pay, and compensation for examinations, to fund full-time forensic examiners. The sheriffs office assembled a multidisciplinary panel, including representatives from the advocacy, medical, and prosecutorial communities, and chose candidates based on their professional experience. The selected nurses became full-time examiners, rather than nurses who were available but had careers elsewhere. The sheriffs office also saw the importance of forming partnerships with all of the various team members and program users to ensure the best possible program. The office established regular meetings between t he team members and users so that interested parties could discuss what worked well and what needed further attention to improve the quality and service level of the program.

Benefits of Increased Law Enforcement Involvement

The current examiners now have the time necessary to prioritize and attend professional training, stay abreast of current research and developments, and thoroughly network among other entities in the criminal justice system. All team members have benefitted from the transition. The examiners have formed instructive relationships with the local branch of the state crime laboratory, agency crime scene investigators, and prosecutors. Law enforcement agencies have benefitted from receiving reliable, consistent examinations, which yield more accurate and relevant information than previously available. Prosecutors have been able to train and develop the examiners to be the best possible expert witnesses. Further, the examiners are available to conduct case-specific research in preparation for court.

The local women's advocacy group has formed a close association with the examiners and meet regularly to ensure a seamless delivery of services to sexual assault victims. The local hospitals have discovered benefits from the examiners whose interaction with the emergency room staff now are consistent and reliable. Finally, and most important, sexual assault victims have benefitted. Examiners, fully committed to their profession, can conduct sensitive and thorough examinations, which provide the tools for law enforcement agencies to investigate and arrest perpetrators. Better investigated and prepared cases enhance the likelihood of a disposition prior to trial. A strong, well-prepared case constitutes the best way to obtain a conviction, and a dedicated, well-trained examiner program represents a key component in obtaining reliable and relevant forensic evidence in a sexual assault complaint.

CONCLUSION

The concept of designing a sexual assault examiner program with authority and direction associated with law enforcement and staffed by full-time, dedicated examiners with a clearly defined mission is the next logical step in the development of the field of sexual assault forensic examination. To accomplish this goal, law enforcement agencies must establish credibility within the community by assuming responsibility for the sensitive and thorough investigation of all sexual assault complaints and providing leadership concerning this area of criminal forensics.

Endnotes

(1.) U.S. Department of Justice, Office of Justice Programs, Sexual Assault Nurse Examiner Development and Operation Guide, (Minneapolis, MN, 1999), 9.

(2.) Ibid., 5.

(3.) The first Sexual Assault Response Team (SART) Program in Santa Cruz, California, began in June 1986 and was registered nurse-based. This multidisciplinary approach was based on the SART program in San Luis Obispo County, California, which was physician-based. See, S. Arndt and S. Goldstein, The SART/SANE Orientation Guide, 1997 (Santa Cruz, CA: Forensic Nursing Services) and Sherry Arndt, interview by author, July 2001.