More Hospitals to Collect Sexual Assault Evidence

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Victims of sexual assault will no longer have to travel to potentially far-off hospitals to have forensic evidence collected, following the implementation of a new law this fall.

Starting Sept. 1, all Texas hospitals with emergency rooms will be required to have staff trained in at least basic collection of forensic evidence from sexual assault victims.

Currently, communities in Texas are required to have one facility designated as the primary care center for victims of sexual assault. If the victims go to a hospital that lacks the designation, they are stabilized but would have to go to the primary center for evidence to be collected. Now, all emergency room hospitals will have to offer to collect such evidence. 

The primary care center designation stems from a 2005 law that required communities in the state to devise plans for law enforcement, health care providers and sexual assault victims' advocates to respond to sexual assault cases.

Under Senate Bill 1191, any hospital with an emergency room must have physicians and nurses trained in a basic level of forensic evidence collection — a standard still less rigorous than that required for the Sexual Assault Nurse Examiners that most primary care centers have. The hospitals will also be required to give patients the option of a transfer to the primary care center after they have been medically stabilized. 

Requiring all hospitals to have a SANE program — which are found mostly in primary care centers — would be impractically expensive, said Jennifer Banda, the Texas Hospital Association’s vice president of advocacy, public policy and HOSPAC, the political action committee the association operates. SANE certification is costly, and currently, there are not enough certified personnel in the state for every hospital to have a SANE program, she said.

Currently, 312 sexual assault nurse examiners are certified in the state, according to the Texas attorney general’s office, which runs that program and certifies the nurse examiners.

Although primary care centers will remain the best option for survivors, they are often not a viable one, said Torie Camp, deputy director at the Texas Association Against Sexual Assault. Camp cited distance, family and professional obligations, and travel costs as reasons victims might not go to a second hospital after being stabilized.

“At least they’re going to have their evidence collected with someone with some level of training” under SB 1191, she said, adding that it “may not be the best standard of care, but it’s going to get the job done.”

SB 1191 was primarily authored by state Sen. Wendy Davis, D-Fort Worth, who said it was inspired by stories of women who had to go to multiple hospitals for treatment and evidence collection after being sexually assaulted.

“My fear is that some women won’t continue to do that,” Davis said. “They won’t go forward and prosecute their case.” 

Kelly Davenport, an Austin Police Department sergeant who deals with sex crimes, said that she does not believe SB 1191 will change the number of crimes prosecuted in Austin but that it could have a major impact in rural areas.

In those regions, survivors who find out they may need to drive several hours to have evidence collected, “may think twice before going through it,” she said. 

“It might be a vast improvement where people know they can get the services they need and the response they want locally,” she said. 

Banda, who worked with Davis’ office in drafting SB 1191, said having all hospitals provide professionals trained in basic evidence collection would present them with a standard that “wouldn’t be impossible to comply with.” The training for forensic evidence collection could in theory be added to training that emergency room doctors and nurses already undergo, she said.

Until licensing boards determine how to certify nurses and doctors in basic evidence collection, it’s hard to determine the costs for hospitals to meet SB 1191’s standards, said Sherry Brown, who chairs a policy and procedure committee for Seton Medical Center. 

The center operates multiple hospitals in Texas, many of which do not have SANE programs.

Depending on the hours of training deemed necessary, the cost “could be substantial,” Brown said.

“It’s going to be a very large undertaking” for hospitals that don’t have SANE programs, she said.

In addition to hospital regulations, SB 1191 stipulates that the Department of State Health Services publish an online list of hospitals designated as primary care facilities for sexual assault survivors. DSHS is “still determining how we’ll collect that information,” spokesman Chris Van Deusen said in an email.

Sexual assault is historically underreported, with only 18 percent of victims reporting the incident, Camp said. Victims might not report the crime for a variety of reasons, and they can have evidence collected without speaking to law enforcement, she said, leaving it unclear whether SB 1191 will increase sexual assault reporting rates.

“But I can hope that if a sexual assault survivor is engaged positively by the system — even if it’s the medical system — then perhaps they’ll be encouraged to pick up the phone and call law enforcement,” she said. 

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.    

Sexual Assault Nurse Examiners' (SANEs) Presence in Texas

Though Senate Bill 1191 will require all hospitals to have medical personnel trained in basic forensic evidence collection, many facilities will still not have any certified sexual assault nurse examiners, who are generally considered the most qualified in collecting forensic evidence from sexual assault victims.

Editor's note: This story previously included a map of SANE nurses by county. It was removed for technical reasons.