Forensic Compliance Resources

Forensic Compliance Resources

This information is designed to:

  • communicate the requirements of the Violence Against Women Act (as reauthorized in 2005 and 2013), and
  • offer recommended practices for implementation.

The goal is to highlight examples of communities striving to achieve a higher standard of the “spirit of the law,” rather than simply meeting the “letter of the law” for VAWA forensic compliance.  It is critically important that readers consult state laws and regulations, as well as local policies and protocols, because they may have additional requirements beyond those included in VAWA 2005 and VAWA 2013.  For more information specific to your state or territory, contact the STOP Grant Administrator or coalition of advocacy organizations providing services for sexual assault victims.  A listing is available from the website for the Office on Violence Against Women, U.S. Department of Justice.

  • Topic

93 results.

Sexual Assault Kit Testing Initiative (SAKI) and RTI International developed this helpful guidance addressing victim notification protocols.

The 911 call center in Missoula, Montana offers a website for their program, “It’s Your Call.” Focused specifically on sexual assault, the website offers information about the services offered by the 911 call center and other resources in the community, including law enforcement agencies, health care facilities, and victim advocacy agencies. University resources are also provided, and links offer more information on topics such as risk reduction, bystander intervention, and the role of men in preventing sexual violence. With respect to forensic compliance, the website states: When you call 911, it does not obligate you to file a police report. It does, however, help you open doors to services available in the community. Such examples clearly point the way to achieving the true spirit of increase access for victims.

This training bulletin series explores the tension that is sometimes experienced between law enforcement and victim advocates in the community. It offers a detailed description of the advocate’s role during the criminal justice process, with particular focus on their involvement during forensic exams or interviews. Next, the bulletin addresses the fact that many law enforcement officers, forensic examiners, and other community professionals are reluctant to involve advocates in the process, so we address some of the common factors underlying this reluctance and offer strategies to resolve them.

The article was written by Dr. Kim Lonsway and Joanne Archambault of EVAW International; it is an excerpt from the training module on Effective Victim Advocacy within the Criminal Justice System that is available in the OnLine Training Institute (OLTI).

Community professionals in Duluth have implemented a fully functioning protocol for anonymous, third party reporting. Sexual assault victims can therefore obtain a medical forensic examination without filing a formal report to law enforcement. This allows DNA and other evidence to be stored indefinitely in the event a victim decides to report at a later time. The multidisciplinary team in Duluth, led by the staff of PAVSA (Program for Aid to Victims of Sexual Assault), has developed a variety of materials to implement this protocol that can be tailored for use in other communities:

Our VOICE (an advocacy program in Asheville, North Carolina) worked collaboratively with the Asheville Police Department and the Buncombe County Sheriff’s Office to offer blind reporting for sexual assault victims, using an online form provided on the Our VOICE website. Victims are advised that they may provide as much or as little information about their sexual assault as they choose. They are also free to provide contact information for themselves and/or for the suspect(s), but an investigation will not be started unless the survivor chooses that options. Our VOICE staff reviews all of the reports, and submits them to the appropriate law enforcement agency.

With the passage of a California law in 2011 to address forensic compliance issues (SB 534), the California Office of Emergency Services (formerly known as Cal EMA) promulgated an Informational Bulletin on sexual assault that was designed to address several Frequently Asked Questions.

The District Attorney of Cambria County, Pennsylvania sent out a letter to professionals encouraging them to attend a full-day training session to familiarize them with a new Sexual Assault Protocol, which included a new method for Anonymous Reporting of Sexual Assault. The letter offers a model for similar outreach efforts for multidisciplinary professionals involved in the criminal justice and community response system.

EVAWI’s template materials for non-investigative reporting include instructions and forms to document a victim’s choices among a variety of options for the response of health care providers and law enforcement officials. Language and documentation are therefore included to guide victims through the process of case conversion. Similar language is provided in the Minnesota Model Policies for Forensic Compliance.

Sample forms are also available for documenting a victim’s consent to release evidence from a medical forensic exam to law enforcement for use in a standard investigative process. Examples are provided from (1) the Texas Department of Public Safety, (2) Duluth, Minnesota, and (3) the Trauma Recovery Center at the University of California, San Francisco.

This article in Police Chief Magazine provides a detailed overview of the Start by Believing campaign, includes the history, community examples, and the potential impact of the campaign.

The Office for Victims of Crime (OVC) offers a SART Toolkit , providing resources for Sexual Assault Response Teams. In the section on Innovative Practices for Law Enforcement, information is provided on programs for Cold Case Investigations. Many of the issues related to cold case investigation pertain to forensic compliance, including questions of evidence storage, victim notification, and prosecuting cases after a long delay.

In April 2011, the Vera Institute of Justice published a valuable new resource, entitled: “ Forging New Collaborations: A Guide for Rape Crisis, Domestic Violence, and Disability Organizations .” This 23-page resource is based on their work with over 40 collaborative teams across the nation who have received grants from the Department of Justice, Office on Violence Against Women (OVW). All of these collaborative teams included both victim services and disability organizations, and the guide includes ten essential elements to building and sustaining these collaborations — as well as five common challenges they face. Any community implementing the spirit of forensic compliance will need to address issues of access for victims who have disabilities.

An outstanding report summarizes the results of a statewide assessment of forensic compliance in the state of Colorado. The report was produced collaboratively by the Colorado Coalition Against Sexual Assault (CCASA) and the Colorado Division of Criminal Justice. Released in September 2013, the findings are based on an analysis of 151 “medical reporting cases” (i.e., cases where a medical forensic exam was conducted without law enforcement involvement) and survey responses from 239 multidisciplinary professionals. With careful research and clear presentation, the report offers an example for other states seeking to determine how forensic compliance is being implemented statewide and identify areas for additional improvement.

Modeled after the National Protocol for Sexual Assault Medical Forensic Examinations, the purpose of the Colorado state protocol is to assist providers with the consistent and complete collection of the sexual assault evidence collection kit, which is one part of a comprehensive medical forensic response to sexual assault patients. This protocol incorporates Colorado’s three options for reporting: Law Enforcement Report, Medical Report, and Anonymous Report, which do not apply to minors, or at-risk elders. The state protocol includes consent forms for victims to choose one of these three reporting options and document their consent to the medical forensic exam and/or testing evidence/release of results.

Perhaps the best place to start is the self-assessment tool we have developed, for communities to evaluate their current practices with respect to medical forensic examinations. Conducting this self-assessment will likely require the participation of professionals from a range of disciplines involved in the criminal justice and community response to sexual assault. This includes: law enforcement personnel, forensic examiners, victim advocates, prosecutors, crime lab personnel, victim-witness assistance professionals, and others providing health care and social services. Questions to be answered as part of the self-assessment process address:

  • Forensic examinations conducted without a report to law enforcement
  • Mandated reporting requirements
  • Information provided to victims regarding their reporting options
  • Procedures for documentation, records storage, and case tracking
  • Evidence processing, destruction, and victim notification
  • Anonymous reporting procedures

We have posted the self-assessment tool in Word format, so it can be filled in by community professionals. If you need the document in another format (e.g., PDF), please let us know.

Cambria County, Pennsylvania offers a comprehensive sexual assault protocol which includes a well-designed procedure for anonymous reporting (for victims age 18 and over). This protocol is thoughtfully designed and crafted with meticulous attention to detail. It is also beautifully written, making it an excellent model for other communities seeking to implement a similar protocol in their community. The final document is a consent form for victims who report anonymously, authorizing the collection, documentation, and release of evidence (to be stored by the municipal police department). The form offers a brief explanation of key issues for victims, including the fact that they will not be billed for the exam, that their medical records will remain private, and that their evidence will be stored for 2 years. Victims can choose whether or not they would like to be contacted 3 weeks before the evidence will be destroyed. If so, the form documents their preference and various methods of contacting them.

With respect to payment for sexual assault medical forensic exams (SAFEs), one example of a rather comprehensive law is Connecticut. While many specific aspects of forensic compliance are covered in the statute, it also specifically references Technical Guidelines that provide more detailed information to guide the process of implementation. These guidelines are referred to in the statute as the “Connecticut Technical Guidelines for Health Care Response to Victims of Sexual Assault, including the Interim Sexual Assault Toxicology Screen Protocol.” The law also explicitly states that these guidelines will be updated “from time to time” and that they “will be incorporated in regulations adopted in accordance with” the statute. This approach reflects an excellent balance between the general guidance provided in state statute – and the more detailed information in the technical guidelines that can be used to direct practical implementation.

These forms are used by crime lab personnel to evaluate the quality of evidence and documentation from a sexual assault medical forensic examination (i.e. a “rape kit”). They offer feedback to health care providers who conduct these exams and submit evidence (e.g., Sexual Assault Nurse Examiners, Sexual Assault Forensic Examiners, Emergency Department physicians). The samples provide two alternative formats — one from San Diego, California and one from Kansas City, Missouri.

Additional Quality Assurance Forms for crime lab personnel to use in evaluating the evidence submitted from a medical forensic examination can be found at the website for the SAFE-TA Project, which is funded by the Office on Violence Against Women and administered by the International Association of Forensic Nurses (IAFN). They can be found, along with many other resources, by clicking on the “Resources” tab and entering the “Form Library“.

The Sexual Assault Kit (SAK) Task Force was established in Cuyahoga County, Ohio, to investigate and potentially prosecute cases associated with approximately 5,000 previously unsubmitted SAKs. Research is now being conducted to understand more about these unsubmitted SAKs and explore how this can inform criminal justice responses across the country. Specifically, the Cuyahoga County Sexual Assault Kit (SAK) Pilot Research Project is being conducted by The Begun Center for Violence Prevention Research and Education at Case Western Reserve University. Their work has already produced several extremely valuable research briefs, summarizing the findings and exploring critical “lessons learned” for the field:

The Detroit Sexual Assault Kit (SAK) Action Research Project (ARP) was created after it was discovered that a large volume of untested sexual assault kits were held in storage in Detroit. The ARP was created to develop long-term strategies to decrease the volume of untested sexual assault kits in Detroit, Michigan. This multidisciplinary action research brought together researchers and practitioners from law enforcement, prosecution, forensic sciences, forensic nursing, and victim advocacy to address four primary goals. For more information on the findings, please see the full report entitled: Detroit Sexual Assault Kit (SAK) Action Research Project (ARP), Final Report.

For detailed guidance on how to develop a victim notification protocol, a number of tools are available. First, some basic recommendations provided by the National Institute of Justice (NIJ) in: Notifying Sexual Assault Victims After Testing Evidence.

Concrete suggestions can also be found in the Final Report on the Detroit Sexual Assault Kit (SAK) Project. Particularly relevant are the following sections:

  • The Step-By-Step Process of Creating the Detroit Victim Notification Protocol (Figure 5.1, 236-244)
  • Challenges & Solutions Encountered in the Implementation of the Detroit SAK ARP Victim Notification Protocol (Figure 5-3, p. 251-255).
  • Lessons Learned: Conducting Victim Notifications (p. 320-323)
  • Victim Notification Retreat Planning Guide (Appendix C1, p. 450-473)

The Oregon Recommendations for Survivor Notification provide detailed guidance on a variety of strategies for initial contact, including in-person contact, telephone, letter, email, and notification to the survivor’s designated third party. The recommendations also include sample letters for victim notification.

An editorial in the Houston Chronicle provided valuable information for the public on the topic of forensic compliance. Written by Mica Mosbacher and Annette Burrhus-Clay, the article was titled “Two New Laws Empower Victims of Sexual Assault.” It appeared on April 14, 2011 and provides an excellent example of media outreach conducted to educate the public about their right to a medical forensic exam regardless of whether or not they ultimately decide to participate in the criminal justice process.

Many states have passed legislation to address forensic compliance, including laws outlining the payment mechanism for Sexual Assault Forensic Exams (SAFEs). A few examples are cited below, which highlight some key elements of comprehensive laws:

1) Comprehensive laws address a broad range of critical issues, including who pays for exams and what treatment, medications, and other services (i.e. follow up medical or psychological care) are covered. Ideally, laws can also provide guidance on other critical issues such as:

  • State and national protocols for medical forensic examinations
  • State specific guidelines for investigation and collection of evidence
  • Evidence storage location
  • Timelines for destruction

2) It is especially helpful when such laws are written to be clear and concise, so they are easy for practitioners to implement.

3) It is also helpful for such laws to include a clear, affirmative statement that victims are not required to report and/or cooperate with law enforcement in order to have the exam costs covered.

Note: Thanks to Charlene Whitman for her assistance compiling this information. She serves as an Associate Attorney Advisor at AEquitas: The Prosecutors’ Resource on Violence Against Women

The Trauma Recovery Center (TRC) at the University of California, San Francisco has long been providing medical forensic examinations for sexual assault victims who have not yet decided to participate in the criminal justice process. Evidence collected during these exams is stored by the TRC, and if the victim decides to participate, it is transferred to law enforcement. To facilitate this process, the TRC has developed an Evidence Storage Log and a Consent Form to Hold / Release Evidence to Law Enforcement.

The Sexual Assault Kit Initiative (SAKI) offers an Evidence Tracking Toolkit, which includes documents, webinars, and other resources on a three key topics: (1) Conducting a Sexual Assault Kit Inventory, (2) Selecting and Implementing and Evidence Tracking System, and (3) Sample Evidence Tracking Systems.

The International Association of Forensic Nurses (IAFN) offers a Sexual Assault Forensic Examination Technical Assistance (SAFEta) project, which provides many valuable resources on a range of topics associated with medical forensic exams and exam payment. One section of their website allows you to click on each state or territory, to find a detailed summary of the exam payment process in that state or territory, along with helpful information on Crime Victim Compensation (CVC) and other pertinent information.

This spreadsheet was compiled by the Florida Council on Sexual Violence, to document the number of forensic examinations conducted in the state without a report to law enforcement. Information is also recorded on the county where the exams took place, the size of the population served, and the number of forcible rapes reported to the FBI in the Uniform Crime Reporting program – for comparison purposes. The number of exams that convert to a standard report is also recorded, along with the specific agency conducting the exams, and their evidence procedures. This is an excellent place for communities to start in developing a data collection system. It allows community professionals to immediately identify which communities are conducting more of these exams, and which are seeing more victims convert to a standard report. This could help to identify best practices in those communities that are encouraging victim participation in the investigation, even if they were initially unsure or unwilling to do so. Additional information that could be included in data collection would be the reasons given by victims for being unable to report at the time of the forensic exam and factors that helped them to re-engage with the process by converting to a standard report. Specific quotes from victims would also be important to document, to enliven the documentation of factors affecting their decision making.

This Powerpoint Presentation was given at the 2012 EVAWI conference in San Diego, California. It was presented by Joanne Archambault and Kim Lonsway of EVAWI, in conjunction with Kim Day, SAFE Technical Assistance Coordinator at the International Association of Forensic Nurses (IAFN). It was adapted from an earlier version presented as a series of webinars (which are archived here), and it presents the results of a survey of multidisciplinary professionals regarding the practices they have implemented to achieve compliance with the forensic compliance provisions of VAWA 2005. Topics address exams and evidence, payment mechanisms, victim information and options, documentation and case tracking, data collection, and victim notification.

This EVAWI training bulletin addresses the critically important (but all too often overlooked) source of evidence in a sexual assault investigation, the suspect examination. In our experience, we have found that most law enforcement agencies have failed to establish appropriate policies and procedures for obtaining comprehensive forensic examinations for sexual assault suspects which is unfortunate, given the potential for recovering probative evidence from the body as well as the clothing of suspects.

When victims are given options for alternative reporting methods, it will be necessary to develop a form for them to use. One recommendation is to adapt the Supplemental Reporting Form developed by the International Association of Chiefs of Police (IACP).

This form and the corresponding guidelines for investigative strategies designed to supplement the IACP Model Policy on Sexual Assault Investigations and the corresponding Concepts and Issues Paper (October, 2017).  The IACP also created the Sexual Assault Response Policy and Training Content Guidelines (2015), which provide law enforcement with issues, procedures, and recommendations to consider when developing a policy related to sexual assault as well as accompanying training content.

These tools are based upon national best practices regarding sexual assault investigations and were developed in collaboration with local, state, and federal law enforcement, prosecutors, advocates, medical, and forensic professionals. The goal is to support officers and departments in preparing sexual assault cases for successful prosecution through detailed case documentation and thorough investigations. These tools can also be used for anonymous reporting when victims are willing to provide information to law enforcement without identifying themselves or making an immediate decision about whether or not to participate in the investigation and prosecution of their sexual assault. (Note: These guidelines are not intended for use when the victim is a minor.)

Yet another example of a rather comprehensive law is seen in Illinois. The statute provides detailed information regarding a wide range of issues, yet is clear and concise. For example, the procedure for payment is outlined in a straightforward way to make it easier for practitioners to follow.

In this Training Bulletin, we review the research literature on sexual assault disclosures and the responses survivors receive from both informal and formal support providers. We also examine public awareness campaigns designed to prevent sexual assault and improve responses to survivors. This includes outlining the rationale for our Start by Believing campaign and describing preliminary evidence for its positive impact. The ultimate goal is to improve responses to sexual assault victims around the world.

Two states have developed materials to provide instructions for mailing evidence to the state crime laboratory when a forensic examination is conducted without a report to law enforcement. They may be helpful for other jurisdictions implementing a similar procedure for transferring evidence. The instructions developed for the state of Virginia even include detailed pictures to illustrate the process, as well as a consent form for sexual assault victims to sign documenting their understanding of the process. While many community professionals are not aware of it, these procedures for mailing evidence are a standard practice for many law enforcement agencies; what is new in this context is the fact that the evidence is being mailed by forensic examiners rather than law enforcement investigators.

Sexual assault victims have long faced unwarranted skepticism from friends and family members, as well as responding professionals. In this Training Bulletin, we document examples of this historical bias and examine a few measures that have been taken to help ameliorate it. In particular, we focus on the Start by Believing philosophy and examine its relevance for victim and suspect interviews. Our goal is to inform criminal justice professionals and others about what this philosophy does – and does not – say about how to approach sexual assault cases, including interviews with victims, suspects, and witnesses. Ultimately, we emphasize that Start by Believing is an approach to conducting thorough, professional, and unbiased investigations.

Also available is a report by the Joyful Heart Foundation, entitled Navigating Notification: A Guide to Re-Engaging Sexual Assault Survivors Affected by the Untested Rape Kit Backlog. This report summarizes findings from interviews with 19 sexual assault survivors and 79 professionals from a variety of involved disciplines.

A training module in the OnLine Training Institute (OLTI) explores the complex role of DNA and other biological evidence in a sexual assault investigation. A number of resources and tools are provided, along with a series of complex and interactive case examples.

Many tools are available for notifying victims when the evidence in a cold sexual assault case will be tested or picked up for renewed investigation. This includes a free webinar series offered by the University of Texas School of Social Work. The webinars present information based on “lessons learned” from the Houston Sexual Assault Kit (SAK) Project.

A number of states have addressed the issue of forensic compliance legislatively. One rather comprehensive example is Maine’s law, which enacts the recommendations of a commission specifically tasked with designing a process for sexual assault medical forensic exams. Key provisions outline the payment process and protections for victim privacy, as well as evidence collection and storage procedures when the victim has and has not yet decided to participate in the criminal justice process.

A statewide assessment of Sexual Assault Forensic Examiner (SAFE) programs was conducted in 2011 by the Maryland Coalition Against Sexual Assault (MCASA). Some findings pertain to exams conducted without the patient providing identifying information to law enforcement. This includes the number of exams conducted with such “Jane/John Doe” clients (p. 7), questions of evidence storage location and length (p. 8-9), victim notification regarding evidence destruction (p. 9), and access to records (p. 9).

A statewide work group was convened by the Governor’s Office of Crime Control and Prevention (COCCP) in close partnership with the Maryland Coalition Against Sexual Assault (MCASA), to develop the Maryland Forensic Compliance Guidelines. Also corresponding to the Maryland guidelines is a Memorandum of Law prepared by the Sexual Assault Legal Institute within MCASA, to address Frequently Asked Questions regarding forensic compliance.

Some states require medical personnel to report to law enforcement when a patient discloses that she/he has been sexually assaulted. Attached is a sample form with instructions for the state of California. In California, most forensic exams are conducted with a report to law enforcement, so the mandated reporting requirement is met when the forensic examiner submits the standard form (known as the “OES-923 Form” for documenting evidence from an adult victim of sexual assault). However, when a forensic exam is conducted without a report to law enforcement, medical personnel must still meet their requirement of mandated reporting. Some forensic examiners have therefore used this alternative form and instructions provided below to report the sexual assault to law enforcement without the victim’s participation.

Through a two year STOP-funded project, the Sexual Violence Justice Institute (SVJI) at the Minnesota Coalition Against Sexual Assault (MNCASA) developed a number of materials to assist professionals in their state to achieve both the spirit and letter of the law with regard to forensic compliance. After providing basic contact information, visitors can access their document: Minnesota Model Policies for Forensic Compliance (updated November 2011) which specifically identifies ten decision points to guide local policy development. They also created an assessment survey to identify practice around the state, a Forensic Compliance Quiz for professionals, and a special forensic compliance website with information designed to address Frequently Asked Questions pertaining to how this issue is addressed in Minnesota. For more information, please contact MNCASA staff directly by emailing svji@mncasa.org or calling 800.964.8847.

Community professionals in Duluth, Minnesota have implemented a fully functioning protocol they describe as anonymous, third party reporting. Their multidisciplinary team, led by the Program for Aid to Victims of Sexual Assault (PAVSA) developed the following materials to implement the protocol, so they can be used as a starting point to adapt for use in other communities:

EVAWI created model policy materials on Evidence Retention and Disposition and/or Removal to provide law enforcement agencies guidance in this area. The materials include sample language to use when developing an agency policy, as well as instructional commentary and template materials. It can therefore be used as an educational tool as well as a resource to assist in the development of policies, protocols, and training materials.

EVAWI has developed a set of templates to help communities implement a multidisciplinary protocol for victims to anonymously report their sexual assault to law enforcement. There are also 2 different versions, depending on whether or not your state has medical mandated reporting.

The intent of the Nebraska Medical Sexual Assault Protocol is to assist medical providers statewide with best practice standards around the medical forensic examinations. In addition to full law enforcement reporting, the protocol outlines procedures for a Partial Report with Evidence Collection (where evidence from the medical forensic exam is submitted to the laboratory for DNA testing, and any foreign DNA profiles potentially uploaded into CODIS) and Anonymous Reporting (where evidence is stored by law enforcement for 20 years, and no testing/investigation conducted unless the victim converts to full participating by contacting the agency).

New Hampshire offers this statewide protocol on the care of patients who have experienced sexual assault. This protocol is a statutory mandate for all hospitals and physicians in the state of New Hampshire providing medical forensic exams to victims of sexual assault. The Protocol is continually being revised in an effort to improve evidence collection outcomes for patients who have experienced sexual assault, to maximize the continuity of care for patients who have experienced sexual assault.

The Office of Violence Against Women has compiled a list of Frequently Asked Questions on STOP Formula Grants, and forensic compliance issues which are primarily summarized on pages 1-25 (in points #3-14). The document was updated in February 2014, so it includes provisions of VAWA 2013.

This protocol was developed based on recommendations from Ohio experts and the National Protocol for Sexual Assault and Medical Forensic Examinations. It is intended for use by health care providers to ensure comprehensive care of sexual assault patients. The protocol includes a contingency plan for the handling of anonymous kits. Adult patients are informed of their right to decide whether or not to speak to law enforcement, and if they choose not to report the sexual assault, the hospital/facility may provide the date and general assault location to the law enforcement agency with jurisdiction, without giving the patient’s name, address, or other identifying information.

Also available is the General Consent Form and the Consent Form for Anonymous Evidence Collection, and a Model for Developing a Sexual Assault Community Protocol.

EVAWI has developed templates to provide victims with information about their options for the medical forensic examination and to document their preferences.

First is a document providing victims with information about their options for: medical testing and treatment, forensic evidence collection, reporting to law enforcement, and follow-up contact.

Second is a form (entitled “Choosing Your Options”) that can be used to document the victim’s preferences, and it is designed to correspond to the informational document. The form can also be used to document information such as the medical record number or patient number, contact information for the exam facility and law enforcement agency, and the law enforcement case number (if there is one).

There are 2 different versions of the templates, depending on whether they will be tailored for use in a state with or without medical mandated reporting for sexual assault. You will need to address the questions in yellow and make changes to the wording to reflect your multidisciplinary protocol. You will also need to fill in the name of the specific facility conducting medical forensic examinations. The documents refer to the “SAFE program” but you will need to replace it with the name of the facility providing medical forensic exams in your community.

States with Medical Mandated Reporting for Sexual Assault:

States without Medical Mandated Reporting for Sexual Assault:

In 2003, the Oregon legislature created the Sexual Assault Victims Emergency Medical Response (SAVE) Fund, which covers the costs of a medical forensic exam, medications to prevent STD’s, emergency contraception and a pregnancy test for up to 7 days, and up to 5 counseling sessions for victims of sexual assault, regardless of whether they report the assault to law enforcement or otherwise participate in the criminal justice process. It is funded with a combination of punitive damages and restitution levied against convicted offenders, as well as donations and federal matching funds.

In January 2017, the U.S. Department of Justice, Office on Violence Against Women (OVW) published a critical position paper, offering guidance on the storage and testing of evidence in a non-investigative case. Entitled Sexual Assault Kit Testing Initiatives and Non-Investigative Kits, the paper outlines three reasons for not submitting evidence in a non-investigative case to the laboratory for analysis. The paper also offers additional background, guidance, and context for this complex and challenging issue.

A great deal of confusion surrounds the payment for medical forensic exams across state lines. Who should pay for these exams? How should payment be handled? The Sexual Violence Justice Institute (SVJI) at the Minnesota Coalition Against Sexual Assault (MNCASA) developed an informative yet simple fact sheet to offer helpful information about the policies for exam payment in Minnesota and a number of neighboring states. This tool can serve as a model for other organizations that want to create a similar resource.

Insurance billing can still be used for medical forensic exams, though it will be administratively complicated because victims cannot be charged for any co-pays, deductibles or any out of pocket costs. Insurance billing can also present complications for victims, including a loss of confidentiality. For more information on this topic, the Office of Violence Against Women has compiled a list of Frequently Asked Questions on STOP Formula Grants, and forensic compliance issues which are summarized on pages 21-22 (in points #3-4). The document was updated in February 2014, so it includes provisions of VAWA 2013.

Two communities have developed excellent public service announcements (PSAs) to address the issues related to sexual assault, forensic exams, and reporting to law enforcement. One was developed by the Sexual Assault Response and Resource Team (SARRT) in Austin, Texas. This PSA was developed for television, and it was designed to increase reporting of sexual assault to law enforcement, by communicating the message that victims are welcome and every effort will be made to treat them with competence and compassion. The Sex Crimes Unit of the Austin Police Department was also featured in an article in a local Spanish-language newspaper, ensuring that outreach was directed at this underserved community as well.

If a release wavier is going to be used for the purpose of documenting the victim’s wishes, a sample form is the Victim Preference Statement developed by the Naval Criminal Investigative Service (NCIS). This form can be adapted by other agencies, particularly because it meets several purposes beyond simply documenting victim preferences. By asking victims to read and sign the statement, a number of purposes are actually met:

  • Explaining the various reporting options for victims
  • Explaining the limitations of alternative reporting methods
  • Memorializing the victim’s decision regarding reporting and participation
  • Documenting the involvement of an advocate or other advisor in the process

The Victim Reporting Preference Statement is also available in the SAPR Toolkit, to provide information for victims about their options and document their reporting selection.

The June 2011 issue of the Journal of Forensic Nursing (JFN) features an article by Kim Lonsway and Joanne Archambault, addressing the issues of VAWA forensic compliance. This article was written in response to a previous one in the same journal by author Bonnie Price. In it, Price described how complex and challenging the issues of forensic compliance are for communities and emphasized the critical role that forensic nurses and multidisciplinary collaboration play in achieving this goal. Given the significance of this topic, we sought to clarify a few issues in our reply. We also explored additional implications for the criminal justice and community response system, and highlighted the TA resources that are available, including those offered by EVAWI.

If you do not personally subscribe to JFN, you can get a copy of the article from a library or colleague who does. Otherwise, you can
purchase a copy of the article for $35, by visiting the website: http://onlinelibrary.wiley.com/doi/10.1111/jfn.2011.7.issue-2/issuetoc. You will need to register with the publisher’s online store (John Wiley & Sons), before ordering a copy of the article.

This module is designed to provide detailed information on the background, philosophy, and implementation of alternative reporting options for victims of sexual assault, such as anonymous reporting, non-investigative reporting, and third-party reporting. It provides a thorough overview of the key concepts and components necessary to implement such alternative reporting options, as well as recommendations for best practice.

Many professionals have questions about the laws in their own state or territory, pertaining to forensic compliance and payment for sexual assault medical forensic exams. Answers can be found in the document entitled, Summary of Laws and Guidelines with Charts: Payment of Sexual Assault Medical Forensic Examinations. This document was created by AEquitas: The Prosecutors’ Resource on Violence Against Women, in collaboration with EVAWI. You can download the whole 228-page document, which includes the laws and guidelines for each U.S. state and territory, as well as a number of charts summarizing the provisions. For an overview, you can also download the 13-page Summary of Laws and Guidelines.

We have developed a sample press release, to announce the availability of medical forensic exams for sexual assault victims without first talking with law enforcement. As with many of our other resources, we offer two versions: one for states with medical mandating reporting for sexual assault of competent adults – and one for states without such a mandated reporting requirement. You are welcome to use these as a starting place for your own community, but you will need to fill in the highlighted areas with local information, including the names of specific agencies and people, the term your community has selected to refer to these exams, and the details regarding your mandated reporting requirements. We also provide an article in a small local newspaper based on an earlier version of the press release used in San Luis Obispo, California.

We have also compiled several template MOU and/or SANE service agreements for hospitals that do not have their own SANE program but are interested in contracting with SANE nurses. These templates are drawn from a broad range of programs, offering a sense of the diversity that can be seen in free-standing facilities, as well as community-based and hospital-based forensic examiner programs. They are provided in Word format, so you can easily adapt them for use in your own community. Please note that they have been redacted to protect the identity of the individuals and organizations that provided them. Additional resources include the following:

New Hampshire offers this statewide protocol on the care of patients who have experienced sexual assault. This protocol is a statutory mandate for all hospitals and physicians in the state of New Hampshire providing medical forensic exams to victims of sexual assault. The Protocol is continually being revised in an effort to improve evidence collection outcomes for patients who have experienced sexual assault, to maximize the continuity of care for patients who have experienced sexual assault.

This Training Bulletin addresses the question of whether or not evidence collected in association with a non-investigative report (often referred to as an anonymous report) should be submitted to the laboratory for analysis. In short, the answer is no.

In an effort to identify both strengths and opportunities within their multidisciplinary response to sexual assault, practitioners in South Carolina developed this survey for health care providers across the state. Future surveys are now being developed for victim advocates, law enforcement officers, and other collaborative partners. The resulting report will be used to enhance the coordination of care, evidence collection, law enforcement investigations, judiciary outcomes, and victim assistance in South Carolina.

In this training bulletin, prosecution expert Herb Tanner delves into questions that have been raised with the philosophy of Start by Believing, and other victim-centered and trauma-informed approaches. In particular, he addresses one specific manner of attack: Defense cross-examination aimed at exposing the law enforcement investigation of a sexual assault as biased.

This training bulletin addresses the question of whether participation of criminal justice professionals compromises the ability of police and prosecutors to remain objective, potentially opening them up to attacks by defense counsel and/or losing cases at trial.

Many professionals have questions about the laws in their state pertaining to medical mandated reporting for sexual assault. Answers can be found in the compilation of laws prepared in 2010 by the National District Attorneys Association. This 66-page document is entitled, “Mandatory Reporting of Domestic Violence and Sexual Assault Statutes,” and it includes any relevant laws for all U.S. states and territories.

A similar compilation was also completed in 2010 by AEquitas: The Prosecutors Resource on Violence Against Women. While it pertains exclusively to domestic violence, this will of course cover sexual assault that is perpetrated within the context of intimate partner violence. The document is entitled, “Reporting Requirements for Competent Adult Victims of Domestic Violence.

Several state protocols for medical forensic examinations incorporate alternative reporting methods, including New Hampshire, Ohio, and Colorado. For more information, see the State Protocols tab.

The Texas Association Against Sexual Assault (TAASA) has developed an excellent program to educate the public about “Non-Report Sexual Assault Examinations,” including Frequently Asked Questions and a brief Public Service Announcement.

The Texas Department of Public Safety stores evidence collected during medical forensic exams with victims who have not yet decided to participate in the criminal justice process. The evidence is stored for a period of two years, and then destroyed. Among other sample documents, their website provides:

  • Instructions for packaging and mailing the evidence
  • Instructions for the release of sexual assault evidence
  • A form to submit evidence to the crime laboratory for a non-reported sexual assault (it is not analyzed)
  • A form listing the services provided during the exam (along with associated costs)
  • A consent form to release sexual assault exam evidence

As of June 19, 2009 sexual assault survivors in Texas have a statutory right to a sexual assault forensic exam without first making a law enforcement report. The Non-Report Sexual Assault Forensic Evidence (NRSAFE) Program was created by HB 2626 and became law in June, 2009. The NRSAFE program is described on the website for the Texas Department of Public Safety, which stores the evidence for victims who have not yet decided to participate in the criminal justice process. The evidence is stored for a period of two years, and then destroyed. The website also provides a number of instructional documents and forms, which are provided on the Non-Reported Sexual Assault Evidence Program page of the agency’s website. A more recent addition to the Texas law (HB 2966) enhances confidentiality protections for victims.

The Non-Reported Sexual Assault Evidence Program was created by the Texas Legislature in 2009. Evidence collected during a medical forensic examination of a victim who has not yet decided to participate in the criminal justice system is stored by the Texas Department of Public Safety. Sample documents that might be useful for other jurisdictions include instructions for packaging and mailing the evidence, and releasing it to law enforcement. Forms are also provided to submit evidence to the crime laboratory for storage (not analysis), bill the state agency for specific services, and release evidence to law enforcement. These documents can easily be adapted for use in other communities.

An extremely helpful report summarizes the results of a statewide assessment of forensic compliance in the state of Texas. Researchers in the School of Social Work at the University of Texas (Austin) conducted hundreds of in-depth interviews and web-based surveys with: Sexual Assault Nurse Examiners (SANEs), medical personnel, rape crisis center advocates, law enforcement officers, prosecutors, and state agency personnel. Results suggest that the “non-report program” has been successful, yet challenges remain. Interview quotes enliven key findings. Lead authors are Dr. Noël Bridget Busch-Armendariz and Laurie Cook Heffron.

An extremely helpful report summarizes the results of a statewide assessment of forensic compliance in the state of Texas. Researchers in the School of Social Work at the University of Texas (Austin) conducted hundreds of in-depth interviews and web-based surveys with: Sexual Assault Nurse Examiners (SANEs), medical personnel, rape crisis center advocates, law enforcement officers, prosecutors, and state agency personnel. Results suggest that the “non-report program” has been successful, yet challenges remain. Interview quotes enliven key findings. Lead authors are Dr. Noël Bridget Busch-Armendariz and Laurie Cook Heffron.

EVAWI has developed a training module in the OnLine Training institute (OLTI) dedicated to forensic compliance, entitled The Earthquake in Sexual Assault Response: Implementing VAWA Forensic Compliance. This training module is designed to increase understanding of the forensic compliance provisions in the federal Violence Against Women Act (VAWA), which require that sexual assault victims be provided a medical forensic examination free of charge and regardless of whether they personally report to law enforcement or participation in the criminal justice process. This module also provides extensive resources and tools to assist local communities in their implementation efforts.

The September 2010 issue of Police Chief magazine features an article by Kim Lonsway and Joanne Archambault, addressing the issues of VAWA 2005 forensic compliance. In this article, we explain the provisions of VAWA 2005 that pertain to medical forensic exams for sexual assault victims, and outline some of the challenges seeking to implement compliant protocols. By depicting the realities that face sexual assault victims, we seek to help law enforcement executives understand why so many victims decide they are unable to report the crime and participate in the police investigation. Yet we also highlight the consequences of non-reporting, which often denies victims access to community services and gives perpetrators a free pass to continue offending with impunity.

In this Training Bulletin, Prosecution Expert Herb Tanner begins with the basics of direct examination, examining the function of the basic direct in a sexual assault trial. Following that, he goes beyond the basic direct to explore how the investigating officer’s trauma-informed investigation lends weight to the victim’s testimony. Building on the first two parts, he the discusses the strategy of offering the investigating officer’s testimony as an expert witness. Finally, he explore the possibility of how robust an investigation can be when it is free, root and branch, from gender bias.

Many community protocols specify a certain timeline for how many hours after a sexual assault incident a medical forensic examination will be conducted. The timeline is commonly in the range of 72, 96, or 120 hours. While the longest of these (120 hours) can be used as a general guideline, best practice is for each sexual assault to be evaluated on a case by case basis. The question of whether or not to conduct an exam should be based on the facts of the case, the victim’s history, the likelihood of recovering evidence, and the types of evidence that will be needed for successful prosecution. This issue is discussed in detail in a Promising Practices article from the e-newsletter for Sexual Assault Training & Investigations (SATI), Inc. The article was also published in Sexual Assault Report, Volume 10, Number 3, January/February 2007, p 33-47.

The issue of timelines for evidence collection is also discussed in the A National Protocol for Sexual Assault Medical Forensic Examinations (2013) (adults/adolescents), published by the U.S. Department of Justice, Office on Violence Against Women.

Exam timelines are also discussed in an article in the New England Journal of Medicine, entitled Care of the Adult Patient after Sexual Assault. It was written by Judith A. Linden and appeared in the September 2011 edition, Volume 365, Number 9, p. 834-841.

This training module is designed to help communities address the complex challenges of untested evidence in sexual assault cases. While the material is largely written with reference to cold cases, much of the guidance applies equally to current sexual assault cases and investigations that have been recently inactivated or suspended. Specific guidance is offered for notifying victims that their investigation has been re-opened, keeping victims informed of the status of their case, and providing ongoing victim support throughout the criminal justice process.

The Urban Institute published a research brief on evidence retention issues entitled VAWA 2005 and Sexual Assault Medical Forensic Exams: Kit Storage Issues in 2014. This brief is part of a full report, entitled Sexual Assault Medical Forensic Exams and VAWA 2005: Payment Practices, Successes, and Directions for the Future, which examines how states are meeting the goals of VAWA provisions regarding medical forensic examinations.

The Urban Institute published a study in 2014, entitled Sexual Assault Medical Forensic Exams and VAWA 2005: Payment Practices, Successes, and Directions for the Future. This research was funded by the National Institute of Justice (NIJ) and conducted by the Urban Institute in partnership with George Mason University, and the National Sexual Violence Resource Center (NSVRC). The purpose was to examine how states are meeting the goals of VAWA provisions regarding medical forensic examinations.

The full report is posted along with four research briefs:

This article summarizes the primary provisions of VAWA 2005 regarding forensic examinations — those addressing access and payment, especially for victims who do not participate in a law enforcement investigation. It also clarifies how the issues interact with questions of medical mandated reporting and law enforcement authorization of forensic examinations. However, readers must keep in mind that the article was originally written in 2006, and does not include VAWA 2013 provisions. It was written by Dr. Kim Lonsway and Joanne Archambault of EVAW International, and the description of VAWA 2005 provisions was reviewed by Marnie Shiels, Attorney Advisor for the Office on Violence Against Women, U.S. Department of Justice. The article was published in Sexual Assault Report, 2007, Volume 10, Number 5, pp. 65, 74-77 by the Civic Research Institute.

VAWA 2013 is the most recent authorization of the Violence Against Women Act.

This EVAWI training bulletin reviews forensic compliance issues within the Violence Against Women Act (VAWA) addressing a sexual assault victim’s access to a medical forensic exam, with specific emphasis on the new most recent VAWA reauthorization in 2013. States and territories have until March 2016 to certify that they are in compliance with VAWA 2013 provisions.

For more information, please visit our Forensic Compliance Background Page.

Although not a law, the state of Virginia has an Executive Order (92) directing the state crime laboratory to accept and store physical evidence that is collected from health care providers in cases of sexual assault, for victims who have not yet decided to participate in the criminal justice system. The state crime laboratory has also developed instructions and consent form for evidence storage in these cases.

This outstanding document provides detailed guidelines and tools to guide the integrated, multidisciplinary response to sexual assault. It is entitled: “Virginia’s Healthcare Response to Sexual Assault: Guidelines for the Acute Care of Adult and Post-Pubertal Adolescent Sexual Assault Patients” and archived by the Virginia Partnership for an Effective Response to Sexual and Domestic Violence.

The Virginia Department of Criminal Justice Services also provides answers to Frequently Asked Questions regarding Physical Evidence Recovery Kit (PERK) authorization and payment.

This EVAWI webinar with presenters Kim Day, Joanne Archambault, and Dr. Kim Lonsway examines forensic compliance issues and discusses the considerable challenges in designing protocols in areas such as: the initial response to a sexual assault disclosure, payment for the medical forensic examination, mandatory reporting to law enforcement, storage and transportation of evidence, case tracking and retrieval, processing of evidence, and the potential for evidence-based prosecution (i.e., without the victim’s cooperation). For many states and territories, the changes that are required in public policy and daily practice have been described as “monumental.”

An archived webinar is available on the EVAWI website, entitled Investigating and Prosecuting Converted Cases. It addresses a range of issues such as: “What should we call these cases?” “How are they viewed?” “How should they be investigated?” “How do we overcome challenges for prosecution?”

This EVAWI webinar, moderated by Sgt. Joanne Archambault (Ret.) and Dr. Kim Lonsway of EVAW International, with expert presenters include Kim Day, and Teresa Scalzo, is designed to clarify the complex issues surrounding medical mandated reporting and explore questions regarding compliance with VAWA 2005 provisions and forensic exams.

In the webinar, Opening Doors: Alternative Reporting Options for Law Enforcement and VAWA Forensic Compliance, we explore a number of community models that have been implemented to improve victims’ access to the criminal justice and community response systems. Best practices are reviewed from across the country, and existing tools and resources are evaluated. With a focus on local implementation, the goal is for participants to leave prepared to make recommendations for positive changes in their own communities.

Starting in 2013, the Cuyahoga County (Cleveland, Ohio) Sexual Assault Kit Task Force began investigating and prosecuting cases from approximately 5,000 previously unsubmitted SAKs from 1993 to 2009. In the Fall of 2014, a research team was given access to the SAK case files, and they coded a random sample of 243 sexual assaults case files with completed investigations that either resulted in prosecution or were not pursued due to insufficient evidence. The webinar, Unsubmitted Sexual Assault Kits: Changing What We Know About Rape, details key findings from this research study and discuss how these findings are being used to inform and reform how sexual assaults are investigated and prosecuted.

During this EVAWI webinar, presenters Diana Faugno, Rachell Ekroos, and Debra Holbrook discuss alternate light source (ALS) technology, negative invert filter software, and digital photo documentation as each relates to patients/victims who have been strangled or physically abused. These technologies can be used by medical professionals at the time of an exam or by law enforcement professionals with assaulted persons who do and do not seek medical treatment. In addition to physical injury visualization, ALS technology may be used to identify dried fluids (e.g. semen, blood, urine) and other evidence (e.g. fingerprints) that can be collected for forensic analysis. Without these technological tools many of the samples might otherwise go undetected under standard lighting.

The San Francisco Police Department offers an excellent example of public outreach designed to educate victims of their right to a medical forensic examination regardless of their decision about participating in the criminal justice process. On their website, they provide answers to a number of Frequently Asked Questions about Sexual Assault. One question asks how victims of sexual assault can get help when they are not sure whether or not they want to make a police report. The answer provided on the SFPD website clearly emphasizes that victims should seek medical care regardless of whether or not they want to participate in the criminal justice system:

Go to San Francisco General Hospital Emergency and be seen by their competent and caring medical staff who will provide you with help and support whether or not you want to report the incident to the police.

This EVAWI training bulletin addresses the difficult question of when to conduct the interview of a sexual assault victim. In it, we argue that communities can go a long way toward improving our response to sexual assault by operating from the premise that we want victims to be involved in our response systems, so we should do whatever we reasonably can to help them do so. Sometimes we get so focused on our own policies and procedures that we forget to make accommodations that would encourage victims to participate, even if they entail some compromises that are less than ideal.

The You Have Options program (YHOP) provides victims with the option of reporting their sexual assault in a variety of ways, including “Information Only,” “Partial Investigation,” and “Complete Investigation.” In order to become certified as a YHOP agency, law enforcement agencies must commit to the 20 Elements of a Victim-Centered and Offender-Focused Response. However, agencies can also adopt individual elements of the YHOP program. By addressing the barriers victims face when reporting sexual assault, and increasing the number of sexual assault reports, the goal of YHOP is to provide investigators with information they would otherwise never have.