LOUISVILLE, Ky. – If an individual is sexually assaulted the collection of forensic evidence from the body is key. A Sexual Assault Nurse Examiner (SANE) receives specialized, hands-on training to collect that evidence.

RN Clinical Coordinator, Amanda Corzine, oversees SANE nurses at the University of Louisville Hospital. She is also a SANE nurse and said most sexual assault patients seeking an exam come from around Jefferson County, but some further away.

“A lot of times they are brought in by detectives from other areas who know about our program and want to seek out our care, and so they'll drive them from great distances, just to make sure that they get them to us,” Corzine said.

University of Louisville Hospital also has a SANE nurse on-call 24-hours-a-day, seven days a week. However, Corzine said that’s hard to come by. 

“We have had it for two years, but before that we struggled with it, too,  because of the shortage of [SANE] nurses statewide,” Corzine told Spectrum News 1.

Having at least one SANE nurse that is on call 24/7 is not the norm in Kentucky.

In a September 2019 report, the Kentucky Center for Investigative Reporting found that only one-third of Kentucky’s 120 counties have hospitals with at least one SANE nurse. With the lack of SANE nurses, the report also found that some Kentucky hospitals turned sexual assault victims away illegally.

Under Kentucky law, every hospital that offers emergency services is required to provide a qualified medical professional “available on call 24 hours each day for the examinations of persons seeking treatment as victims of sexual offenses.”

The Kentucky Association of Sexual Assault Programs (KASAP) provides SANE training but also helped create a video to train medical professionals on how to do a sexual assault forensic exam.

“There is always a doctor in the E.R., but a lot of times that doctor says I don’t know how to do this. We don’t have a SANE nurse; you have to go somewhere else. That’s not appropriate,” said KASAP’s Executive Director, Eileen Recktenwald.

While the video is meant to provide training to medical professionals so no sexual assault victim is turned away, Recktenwald said it’s not ideal because a SANE nurse are the ones with the hands-on training to collect forensic evidence.

The University of Louisville Hospital has 18 SANE nurses on staff.

“SANE nurses provide one-on-one care for victims from the time they walk in the door until their exam is complete, and that's very difficult for other providers to really set aside and be able to do,” Corzine explained. “We also have 100 extra hours of training beyond our nursing license to give us expertise in this exam and how to perform it in a trauma-informed way.”

Recktenwald said the shortage of SANE nurses in Kentucky is complicated. Time away from the job for nurses to receive the training, a hospital’s willingness to spend the money, and the hospital’s size are all factors. It’s also a challenge to have SANE nurses on call 24/7. However, Recktenwald said turning away a victim is not only illegal but also presents another issue.

“Everywhere you go, you lose evidence. It's what's on your body. You get in and out the car, you lose evidence,” Recktenwald explained.

Under the Sexual Assault Forensic Evidence (“SAFE”) Act of 2016, an individual who has been sexually assaulted has a right to a forensic exam whether or not they choose to report it. The exam is also performed at no charge.

“The choice in reporting sexual assault is both in federal and state law,” said Laela Kashan, KASAP’s Staff Attorney. “The purpose for that is so that victims are empowered, right. Those individuals can then make the choice on what's best for them going forward.”

Under the SAFE Act, all evidence collected is also stored for at least one year in case the individual decides to report.

The solution to the SANE shortage is complicated.

“How do you get a hospital to respond appropriately to sexual assault victims? I mean, there is a law saying you have to, but there's no fine or anything,” Recktenwald said. “It's basically something that they [hospitals] need to provide because it's appropriate for their community.”

Corzine is currently working on a program in partnership with The Center for Women and Families, a rape crisis and domestic violence center. The University of Louisville Hospital would send a SANE nurse to any hospital where a sexual assault victim goes, in the Kentuckiana geographic area that The Center for Women and Families serves, if a SANE nurse at that hospital is not available.

“We think that that's important because victims currently have to do a lot of research and guessing as to where they might be able to find a SANE nurse, and that's burdensome to them,” Corzine explained. “We want to make it a more victim-centered process and bring the SANE nurse to them. When really our current model is that the patients to come to us.”

Corzine said that program should be available by the end of the first quarter in 2020.

For information on services offered at sexual assault programs in Kentucky, visit KASAP’s website or call 1-800-656-HOPE (4673) to be connected to a local sexual assault program.