Public Safety, Finance, and
Strategic Support Committee
SEXUAL ASSAULT FORENSIC EXAM
COORDINATION REPORT
Date: May 19, 2022
Item: (d) 2
Agenda
• Background
• Understanding the SAFE Exam
• Non-Investigative Reporting (NIR) Audit Findings
• Recommendations
• Mandatory Reporting Laws
• Notification & Access for Children Aged 12-17
• Kit Labeling of NIR & Survivor Name
• Surrender of SAFE Kit to PD
• Cal OES Reimbursement
• Coordination with Santa Clara County
2 BACKGROUND
3 Timeline
JUN 2016
• Santa Clara County Sexual Assault Protocol was developed OCT 2020
• NIR Sub-committee was formed and met bi-weekly
OCT 2020 –
MAR 2021
• SAIU conducted an audit of NIRs
(Dating back to January 1, 2016)
APR 2021
• SAIU presented an analysis of the NIR SAFE Kit audit
NOV 2021
• Provided an update on the California Governor’s Office of Emergency Services (Cal OES) process for reimbursing SAFE exams JAN 2022
• Conclusion of NIR Sub-committee
4 SART vs. SAFE
5 • Sexual Assault Response Team (SART)
– Community-based team established by the County in 2016 that coordinates the response to survivors of sexual assault.
– Comprised of Sexual Assault Nurse Examiners (SANE's), hospital personnel, sexual assault victim advocates, law enforcement, prosecutors, judges, and any other professionals with a specific interest in assisting victims of sexual assault. • Sexual Assault Forensic Exam (SAFE)
– A SAFE can provide medical care as well as collect evidence that may be helpful to the prosecution of a case.
– A sexual assault survivor has the option to have a SAFE Exam without filing a police report (VAWA and California SB 534). This is referred to as a Non-Investigative Report (NIR) exam in Santa Clara County.
County Protocol
• The SART Committee developed the County Protocol “to
establish a common understanding and framework for the
provision of services to survivors of sexual violence, enable greater coordination and collaboration between community partners, and respond to issues and trends with respect to sexual assault in the county” (Santa Clara County Sexual Assault Protocol, p. 3).
6 SAFE EXAM
MEDICAL ONLY
For the purpose of
medical treatment
(Does NOT collect
forensic evidence)
For individuals 12+
Minimum Required
Form(s)
2-920
(Mandated Suspicious Injury Report)
Billed to Victim or
Victim’s Insurance
FORENSIC &
MEDICAL
(Includes NIR)
For the purpose of
evidence collection
Required Form(s):
2-920
(Mandated Suspicious Injury Report)
2-923
(Acute Adult/Adolescent Forensic
Medical Report)
2-924
(Acute Adult/Adolescent VAWA)
2-925
(Non-Acute Child/Adolescent Forensic
Medical Report)
2-930
(Acute Child/Adolescent Forensic
Medical Report)
LE is billed. Cannot
be billed to victim or
victim’s insurance
UNDERSTANDING
THE SAFE EXAM
FOR
NIRs
7 ANALYSIS
8 Non-Investigative Reporting (NIR) Audit
Summary of Findings
1. The SAFE office did not always provide the mandatory report (920 form) or the Survivor’s name when the officer collected the SAFE kit. In some cases, the mandatory report or related reports were not timely received by the Department.
2. For children aged 12-17, the Department was not immediately notified and afforded access to all children who received NIRs.
3. The NIR SAFE kits were inconsistent with NIR labeling and the identification of the Survivor’s name. Some kits were labeled unknown or anonymous for the Survivor’s name.
4. Some of the NIR SAFE kits were not provided to the Department in a timely manner. Several kits were not collected for weeks or months after the exam had taken place.
9 Mandatory Reporting Laws
Summary of requirements & associated Cal OES
Reporting Forms
• Mandated Suspicious Injury Report (920 Form): Penal Code Section 11160 requires that if any health practitioner, within the scope of their employment, provides medical services for a wound or physical injury inflicted as a result of assaultive or abusive conduct, or by means of a firearm, shall make a telephone report immediately or as soon as possible.
• Acute Adult/Adolescent Sexual Assault Exam Report (923 and 924 Forms): Penal Code Section 13823.5(c) requires that every health care practitioner who conducts a medical
examination of a sexual assault or a child sexual abuse victim for evidence of sexual assault or sexual abuse use a standard form to record findings.
– The CAL OES 2-923 form is used for this purpose. In the case of NIRs, the consent page from the CAL OES 2-924 form is also used.
10 The 2-920 form requires medical personnel provide
the following information:
1. Name of Patient (Last, First, Middle)
2. Birth Date
3. Gender (male or female)
4. SAFE Telephone Number
5. Patient Address (Number and Street/Apt – No
P.O. Box)
6. Patient Speaks English (yes or no)
7. Date and Time of injury
8. Location/Address Where Injury Occurred, if
Available.
9. Patient Description of the Incident. Include any
identifying information about the person the
patient alleges caused the injury and the names
of any persons who may know about the
incident.
10. Name of Suspect, if identified by the Patient
11. Relationship to Patient
12. Suspicious Injury Description. Include a brief
description of the physical findings, lab tests
completed or pending, and other pertinent
information.
11 9 PAGES
12 Count of Reports Received with Each NIR Kit
• 920 reports were not received in 22 of 59
cases (As of March 31, 2021).
• Incomplete forms
• Two (2) were not Sexual Assault related
• Three (3) were not appropriate jurisdiction
• Twenty-Four (24) were missing location
information, therefore jurisdiction could
not be determined
• One (1) marked location as “Home” and
no information for the residence was
provided
*As of March 31, 2021
13 Notification & Access for Children Aged 12-17
• Section 11166(a) of the California Penal Code
provides that when a mandated reporter knows
or reasonably suspects that a child has been
the victim of child abuse or neglect, they shall
make an initial report by telephone to the
specified law enforcement agency
immediately or as soon as practicably
possible.
• 8 NIR kits were collected from juvenile
survivors. The Department was not provided
immediate access to the juvenile survivors, as
required by the Penal Code.
**Note: 10 of the NIRs in the Department’s
possession have not been identified as juveniles
or adults.
14 Kit Labeling of NIR and Survivor Name
• Inaccurate labeling of SAFE kits has created confusion during submission to the crime lab for analysis.
• Potential chain of custody issue in court if a survivor wishes to convert their NIR into a standard report, which ultimately gets investigated and potentially prosecuted. 15 Surrendering SAFE Kit to PD
• Many of the NIR SAFE kits were
received several days and even
months after the SAFE kits were
collected; four kits were received 100
days after the report was made. The
Department is under the impression
that there are no refrigerators/freezers
at Valley Medical Center or most sites
where SAFEs are collected.
• PC 680 does not explicitly specify the
amount of time the medical team had
to get the SAFEs to law enforcement,
but the spirit of the law and local
policy is that SAFEs should be
provided to law enforcement
immediately.
16 Cal OES Reimbursement
• Pursuant to Penal Code § 13823.95, law enforcement may seek reimbursement from Cal OES to offset the cost of conducting medical evidentiary examinations for victims of sexual assault. • Effective February 2022, Cal OES modified its reimbursement process to allow law enforcement agencies to submit for reimbursement within one year of the medical evidentiary examination. This should allow sufficient time for the County to invoice the Department and for the Department seek
reimbursement from Cal OES. The Department is continuing to work with the County to ensure invoicing occurs in a timely manner.
17 Coordination with the County of Santa Clara
• SAIU personnel met with the SAFE Nurse Manager to close gaps related to NIRs issues. Although progress was made, not all gaps have been closed.
• The following efforts have been undertaken by SAIU to resolve NIR issues:
1. SAIU met with the SART Committee and discussed issues.
2. SAIU conducted an internal audit of NIR cases.
3. SAIU asked the SART Committee to create an NIR sub-committee.
4. SAIU met and briefed VMC SAFE Nurse Manager.
5. SAIU consulted with Santa Clara County District Attorney’s Office for clarification on laws related to sexual assault and received guidance.
6. SAIU provided all relevant data to VMC SAFE Nurse Manager.
7. Engaged the chain of command within the Police Department • June/July 2022 – City Manager’s Office and Police Department are meeting with County and District Attorney’s Office to close all gaps. 18 RECOMMENDATIONS
19 Recommendations
1. The required report or the survivor’s name should be provided to the officer collecting the SAFE kit to ensure timely delivery of reports and that all information in all Cal OES forms be correctly filled out with no missing data, and historical data missing from prior forms should be provided (inclusive of Name, Date of Birth, Crime, etc.)
2. In the case of children aged 12-17, law enforcement should be notified immediately, before the commencement of an evidentiary examination, to facilitate the collection of evidence and witness statements, and the identification of crime scenes.
3. SAFE kits should be marked with “NIR.” With consent, the survivor’s name should be written on the SAFE kit to maintain the integrity of the chain of evidence. If a survivor does not consent, steps should be taken by the SAFE team to ensure the case number on the SAFE kit and the case number recorded by the police department are consistent.
4. NIR SAFE kits should be provided to the Department the same day the SAFE was provided.
20 Questions?