According to the Rape, Abuse & Incest National Network, the largest anti-sexual violence organization in the nation, there is a sexual assault in the United States every 68 seconds. Despite the alarming frequency, only 25 out of 1,000 perpetrators end up in prison, emphasizing the persistent challenges that sexual violence poses in the country. Unfortunately, horrific crimes like this happen in communities just like ours. In response, a collective effort involving politicians, law enforcement and health organizations is underway across the state to devise effective solutions.
In the aftermath of a sexual assault, a health care organization plays a crucial role in addressing immediate injuries suffered by the victims. However, an important part of the examination is the meticulous collection of forensic evidence within the five-day window following the assault. Ensuring proper protocol and expertise is paramount for this to take place, requiring a specialized sexual assault examiner. It takes a unique set of skills to navigate the sensitive process and provide support to victims who choose to undergo examination.
At Logan Health Medical Center (LHMC) in Kalispell, a team of sexual assault nurse examiners — or SANE— are trained to examine and treat victims of sexual assault who arrive at their emergency department. The program is made up of seven Logan Health nurses who take on-call shift responsibilities to ensure that service can be provided 24-hours a day, seven days a week with a response time within an hour. These nurses range in specialties from emergency nurses to obstetrics and surgical nurses. However, when they are on-call, they all have the same role: providing careful and compassionate care to sexual assault patients.
While this community service is very necessary, it’s not as common as it should be. Only a handful of hospitals in Montana offer 24-hour service for sexual assault examinations. Rural communities are especially underserved, as the closest location to any sort of examination could be hours away.
As a result, Logan Health’s SANE program serves a vast region, collaborating with health and law enforcement agencies all over northwest Montana. “The closest 24-hour SANE programs outside of Kalispell are in Missoula and Helena,” says Anna Wilson, RN, the SANE program coordinator. “That means that we will see cases from as far away as Polson, Libby, Eureka and all along the Hi-Line region and even as far as Great Falls. We’ve even seen some cases from outside of Montana. We collaborate with the agencies where the victims are from to ensure that they have the forensic evidence they need.”
The work of the SANE is difficult, but certainly necessary. “We see people on the worst day of their life,” Wilson continues. “It’s a challenging role, but it’s so important to the community. We serve as an initial contact for many of the victims and then work with them to ensure they have what they need, both in terms of immediate medical attention and for forensic evidence.”
The SANE are specifically trained in providing trauma-informed care and forensic evidence collection. They collect evidence for cases within the five-day window. If a patient arrives outside of that window, the SANE will offer guidance for medical care. They also partner with the Abby Shelter, who provides resources to patients after they are discharged.
Over the years, Logan Health has been an industry leader with their program, pushing to have the highest standard of resources available at their facility. Thanks to grants they received in 2022, they were able to able to purchase a CortexFlo, a machine designed specifically for sexual assault examinations. The technology, which is considered the most advanced in the world of forensic evidence collection, allows nurses to take high quality photographs and videos that will best aid them in the collection process.
Logan Health is committed to providing care to victims of sexual assault and their goal is to provide this service at no cost to the patient. They will work with many different resources to exhaust all options of payment so the patient doesn’t receive a bill for their sexual assault exam.
The team works closely with local law enforcement agencies on many of their cases. In cases involving children, they work with Child Protective Services and the Flathead County Children’s Advocacy Center. Adult victims have the right to seek medical attention for sexual assault without filing a report with law enforcement if they’re not yet ready to do that. Recognizing the sensitivity of the matter, the state recently took action to allow victims all the time they need to make decisions.
During their last legislative session, Montana lawmakers passed a series of bills to support sexual assault victims. HB 79, which created a sexual assault response network program for the state, was signed by Governor Greg Gianforte in April 2023. The bill also established a state position tasked with standardizing care across the state for examinations. HB 640 was signed into law during the same month, revising the preservation laws of sexual assault evidence. Previously the victim had one year to report their sexual assault to law enforcement and their evidence would have been held for them – now they have 75 years. Both laws were passed unanimously by the state house and senate.
With a statewide network, Logan Health’s SANE program will have guidance on things like standardization of care and will be able to collaborate with other SANE programs within Montana. “We are looking forward to working collaboratively with the state on this,” says Wilson. “One of our big initiatives is to one day have a tele-SANE program, which would allow us to virtually reach hospitals in rural locations and help walk nurses there through a SANE kit. That would save the patient from having to drive a long distance to get this service. With the state’s coordination, we can hopefully make things go quicker with some of this.”
SANE like Wilson are optimistic about the future of sexual assault examination in Montana. In the meantime, they will continue to serve their community to the fullest because they represent hope for sexual assault victims across western Montana.