History of SARTs

In the 1990s

During the early part of the 1990s, the Joint Commission on the Accreditation of Health Care Organizations (JCAHO) required health care facilities to have protocols on rape as well as other violent trauma. The commission revised the initial standards in 1997 to require health care facilities to teach staff how to recognize and respond to violent trauma, including sexual assault.¹¹ During this time, the JCAHO standards were underscored when the American College of Emergency Physicians created Evaluation and Management of the Sexually Assaulted or Sexually Abused Patient to promote consistency and best practices in the care of patients who had been sexually assaulted or abused.

The1990s also brought about significant federal legislation that directly affected the response to sexual violence:

• The Student Right-to-Know and Campus Security Act of 1990 (H.R.1454 , Title 11) mandated that colleges and universities participating in federal student aid programs "prepare, publish, and distribute, to all current students and employees, and to any applicant for enrollment or employment, an annual security report" containing campus security policies and campus crime statistics for that institution.
• The Drug-Induced Rape Prevention and Punishment Act of 1996 (H.R. 4137) was enacted to address the use of sedatives by rapists to incapacitate their victims.
• The Crime Victims with Disabilities Act of 1998 (Public Law 105-301) was the first effort to systematically gather information on the extent of victimization of individuals with disabilities.
• The Violence Against Women Act (VAWA) of 1994 (H.R. 3355, Title IV) authorized more than $1 billion in program funds to combat violence against women.

SART Initiatives

• SARTs in the National Forefront
• SART Protocols and Guidelines
• Protocols for Rural Areas
• Statewide Coordination of SARTs and SANEs

SARTs in the National Forefront—Tulsa, Oklahoma (1994)
Tulsa's SANE program received a Ford Foundation Innovations in State and Local Government Award in 1994. The award recognized Tulsa's SANE/SART as an exemplary program that collaborated with law enforcement officers, advocates, forensic laboratory specialists, and prosecuting attorneys. The national media coverage of the award brought multidisciplinary response to sexual violence to the forefront for many communities that were previously unaware of the need for it. This, in turn, brought about training and replication efforts that led 22 states to establish or improve their own multidisciplinary forensic exam response.

Source: Communications with Kathy Bell, RN, Director of Tulsa SANE Program, January 2006.

SART Protocols and Guidelines—Montgomery, Alabama (1996)
In 1996, the Montgomery Sexual Assault Response Team, established by the Council Against Rape, developed a comprehensive, communitywide, multidisciplinary approach for responding to sexual assault. The team comprised the city police and sheriff's department, the district attorney's office, the Council Against Rape, the domestic violence program, the state forensic laboratory, the hospital, the victim's compensation board, and forensic nurses. A procedure manual outlined the responsibilities of all of these disciplines. The team met monthly to review cases (victims were assigned identifying case numbers to protect their privacy).

Protocols for Rural Areas—Fairbanks, Alaska (1997)
In 1997, Fairbanks developed communitywide SART guidelines with local and state law enforcement, the advocacy center, the district attorney's office, and the local hospital's administration. The guidelines were established to better meet the needs of a highly rural and very large area with only one community hospital and one military hospital.

The SART system in Alaska helps to ensure that supportive infrastructures are in place to promote victim safety and healing. To help maintain this victim-centered response, advocates are called to the hospital on every case and team interviews with nurse examiners and law enforcement are conducted when possible. (Sometimes, special circumstances make a team interview inappropriate.) To meet the needs of military personnel, Fairbanks Hospital has contracts with the local military bases to provide forensic exams when military personnel become victims of sexual assault.

Source: Communications with Angie Ellis, Forensic Nurses Association of Alaska, Fairbanks Memorial Hospital, December 2005.

Statewide Coordination of SARTs and SANEs—Augusta, Maine (1998)
In 1998, the Maine Coalition Against Sexual Assault hired a statewide SANE coordinator to ensure that efforts to create SARTs statewide were in line with the work already being done by SANEs. The coordinator reached out to hospitals, recruited nurses, organized the SANE training programs, and set up the first files on SANEs. In 2000, Maine became one of the first states to pass a statute providing victims with the option of anonymous reporting.

Source: Communications with Doreen Fournier Merrill, Public Policy and Member Services Coordinator, Maine Coalition Against Sexual Assault, Augusta, Maine.