FRANKLIN, Ind. – ASSIST Indiana is renovating two of its counseling rooms, hiring up to a dozen sexual assault nurse examiners and getting ready to offer rape kits for the first time ever.

It will be the only location in Johnson County where pediatric and adult survivors can seek medical attention from a trained forensic nurse after an assault.

“We’ll have a freestanding exam chair that turns into a table that can accommodate all sizes of people,” Jenny Lee, the founder and director of ASSIST, pointed out.

ASSIST is set to receive a $325,000 reimbursable grant from the Indiana Department of Health. The money will at first help ASSIST get the necessary equipment to serve up to ten counties.

“It’s a big undertaking, but it’s needed,” she explained.

According to Lee, Leadership Johnson County is also donating up to $19,000 to install a large shower at the rape crisis center. As of April 12th, the group was about $4,000 away from its goal.

On April 30th, Leadership Johnson County will host its final fundraiser for the project. It will be at Bargersville Wellness Yoga Studio. People can donate to take a yoga Nidra class with Reiki. The class will begin at 8 a.m.

Funding comes two years after award-winning investigation by CBS4

In 2020, CBS4 revealed there was a sexual assault nurse examiner shortage statewide. Data showed that out of 115,000 registered nurses, only 45 were certified to work with adult and adolescent rape victims. Only 15 were trained and certified to work with children.

About 32 of Indiana’s 92 counties had a forensic nurse at all. It meant victims were being treated by uncertified examiners or having to drive across county lines to another provider.

“It’s frustrating. It’s time consuming,” Angie Morris, with Indiana’s SANE Training Project, said. “All the while, the clock is ticking. The clock is ticking, and it might not matter – maybe they don’t want evidence collection – but if they do, that time is degrading evidence.”

Knowing the COVID pandemic had led to a nursing shortage nationwide, CBS4 wanted to know how it affected SANE training, recruitment and retention.

“We have faced a lot of challenges,” Morris admitted. “Our project has been able to train a substantial number of nurses, however with the pandemic and how that has impacted all of the healthcare, we’re really challenged to retain the nurses were bringing into the profession.”

According to records obtained by CBS4 in 2022, SANE staffing has barely improved. Forty-one counties have someone trained to attend to a rape victim. Only 21 have a SANE available for pediatrics.

“It’s terrifying, but it’s the reality,” Morris said.

She attributed the slow improvement to the fact that SANEs are typically part-time positions, work on-call and don’t get paid a lot. Add in a pandemic and a lot of nurses, in general, are seeking better opportunities like travel nursing.

SANEs are not only trained to collect forensic evidence, but they are taught how to maintain the integrity of it and store evidence for trial. They are often called upon in court to testify. 

“Our criminal justice system is never going to be effective at successfully prosecuting offenders if we don’t have evidence,” Morris continued. “Juries want evidence. If there is nobody to get it, or we send the evidence literally walking out the door, it’s frustrating! Because you want to be like, it’s not this hard. It’s not this hard!”

Morris believes hospitals will eventually need to acknowledge a new standard of care. She hopes eventually, each will have a SANE on staff or available full-time.

“We have met with some facilities who are just like, ‘we don’t have that problem here.’ And I’m like, ‘you do. You just don’t want to admit you have that problem here because those patients are being cared for elsewhere,’” Morris said.

SANEs are difficult to locate

CBS4 found it is also difficult for assault victims to locate SANEs statewide.

While the SANE Training Project does offer a list of locations where there is a SANE on staff or on call, most Indiana facilities do not advertise whether they have a forensic nurse available. Assault victims would have to research where to go before heading out the door for an exam and in some cases, call ahead, to make sure the on-call nurse can attend.

Studies show cases addressed by a SANE have higher prosecution rate

After the city of Albuquerque, New Mexico established its SANE program in the 2000s, leaders examined the changes in reporting and prosecution rates.

The study showed when a SANE was present, 98 percent of victims agreed to forensic evidence collection, compared to 47 percent of victims prior to having a SANE available. About 67 percent of victims agreed to file a police report, compared to 46 percent. Conviction rates increased from 59 percent to 69 percent after the program was created.

Sexual assault survivors call for change

CBS4 spoke with a sexual assault survivor to ask whether she had sought medical attention afterward. The woman, who chose to remain anonymous, said she did not know at the time that sexual assault nurse examiners even existed.

“For me, anything I had ever envisioned was all the legal side. It was law enforcement, and it was court hearings,” she recalled. “I had never really seen or experienced how someone was actually treated if they did go and seek help, if they did have to be examined. I didn’t know that side of it.”

The woman said had she known then what she knows now, she would have located a SANE.

 I prayed that, in that instance, the physical pain was not going to force me to have to be seen. I prayed I would heal without needing to seek medical attention.

Sexual assault survivor

“If I knew then that there are people that can walk through this and they’re caring and they’re understanding and it’s not this cold sterile room you’re stuck in, I absolutely would have,” she said.

The survivor said she was assaulted both as a child and as an adult. She never pursued criminal justice afterward.

“One of the biggest things, for me, is victims have to prove what has happened to them. It’s almost like they have to prove they’re telling the truth while the person that does the assault gets to walk around until they’re proven guilty,” she said, frustrated. “People need to stop judging and start believing.”

When we explained what our story was about – and that there was an ongoing SANE shortage in Indiana – our interviewee reacted.

“It’s very sad,” she said. “Every victim has the right and should have the ability to get the help they need. They should know where to turn and there should be a gentle, caring person on the other side of the phone and on the other side of the door.”

Congress is taking notice, too

In February 2022, US Representative Deborah Ross (D), introduced the Supporting Access to Nurse Exams Act. The bill would provide $30 million in grant funding for SANEs to train through 2028. According to the text of the bill, the grants could also help pay for nurse salaries. In her press release, Ross acknowledged a 2016 study conducted by the Government Accountability Office, which showed a “critical shortage” of SANE-certified nurses across the country.

Texas Senator John Cornyn (R) introduced a companion bill known as Senate Bill 3648 or the SANE Act. It would amend the DNA Sexual Assault Justice Act of 2004 and the Violence Against Women Act Reauthorization Act of 2021. It would also help increase access to SANEs nationwide.