From left, Lawrence Police Chief Tarik Khatib, and Detective Capt. Mike Pattrick, along with Lawrence Memorial Sexual Assault Nurse Examiner Julie Jacobson watch Sarah Martin, also a SANE nurse, demonstrate a new imaging system used to collect evidence in sexual assault cases. LMH had a private open house Thursday, Sept. 9, 2010, for its SANE program. by Richard Gwin

District Attorney Charles Branson lauded Lawrence Memorial Hospital for improving its services to sexual assault victims during the past couple of years.

“There has been tremendous improvement,” Branson said. “The training and emphasis LMH has put on these cases is wonderful.”

LMH has a new examination room, new state-of-the-art equipment, and more nurses trained to be a Sexual Assault Nurse Examiner (SANE). The hospital went from two nurses to 10, and there are three nurses who are in the process of completing their training. There is one nurse on call at any given time. Last year, LMH paid $118,245 for SANE nurses to be on call.

“They now have 24/7 coverage for sexual assault exams,” Branson said.

These improvements began in September 2009 when Branson publicly raised concerns about the number of rape victims being transferred from LMH to hospitals in Topeka and Kansas City.

At the time, he said delays in an examination could destroy evidence needed to hold an attacker accountable. He also feared that victims would abandon the reporting process instead of going to another hospital.

Since then, there have been no transfers of adult patients. There were 40 cases in 2010, and 45 last year. In 2009, three of the 64 cases were transferred. In 2008, five of the 34 cases were transferred.

Pediatric cases

Branson and LMH leaders agree that it’s still best to send pediatric cases — children 14 and younger — to Children’s Mercy Hospital in Kansas City, Mo., because it is better equipped and trained to handle such cases.

Jessie Fazel, SANE coordinator at LMH, said it takes 40 hours of training to become a SANE nurse and an additional 40 hours for pediatrics. At LMH, the nurses also go through an orientation process where they observe a couple of sexual assault cases, assist a couple of cases and then they are observed taking care of two cases. After they become a SANE nurse, Fazel said they need to perform cases to stay proficient and competent.

She said there are not enough pediatric cases in Lawrence to do that. There were three children transferred last year, one in 2010, and five in 2009.

“Children’s Mercy has a dedicated facility that only deals with child abuse and sexual assault cases,” Fazel said. “It would kind of do them an injustice to keep them here.”

If someone is concerned that a child has been sexually assaulted, Fazel said they can go to LMH where the hospital will facilitate law enforcement involvement and transportation to Children’s Mercy.

“We are here as a resource and we know how to facilitate all of that,” she said. “We strive to be the best in everything we do and we want to provide the best care that we can to our community.”

Fazel is president-elect of the Kansas chapter of the International Association of Forensic Nurses. The state chapter formed in January 2011 and the meetings rotate quarterly among eight Kansas hospitals, including LMH. She said topics have included the court process, documentation and missing and exploited children.

In addition, Fazel said LMH will be hosting a two-day advanced training session in May for SANE nurses and anyone involved in a sexual assault response. The sessions will feature nationally known speakers in the field of forensic collection.

Sarah Jane Russell, executive director of GaDuGi SafeCenter, praised LMH for its response to a community need.

“They responded with great integrity and they got it done,” she said.

Russell said the new examination room has made a huge difference for victims. It is located away from the Emergency Department and is designed to give victims more privacy and a sense of security and hope. There also is a shower.

“For a victim to be able to receive treatment in a private room that is welcoming and soothing that means everything,” she said. “We have had comments from victims that the experience at the hospital was not as upsetting as they thought it might be.”

LMH began using a new $25,000 system for collecting evidence called a Secure Digital Forensic Imaging System in June 2010. The camera It provides high-resolution and detail-oriented evidence. There is a yearly fee of $900 for the electronic encryption and storage capabilities.

“It’s very safe for transferring the information online,” Fazel said.

The startup costs for the new services cost about $150,000, and it was provided through the Douglas County Community Foundation, Douglas County District Attorney’s Office, LMH Endowment Association and LMH employee Audrey Bishop.

Jessie Fazel, coordinator of Lawrence Memorial Hospital's Sexual Assault Nurse Examiner program, is holding a high-resolution digital camera that is used to collect evidence. The hospital began using the camera in June 2010. The camera is just one of several improvements that the hospital has made during the past couple of years in its services to sexual assault victims. by Kevin Anderson

Community efforts

There has been a renewed effort for sexual assault response among Douglas County agencies as well.

Branson said communication has improved among members of the Sexual Assault Response Team, which has been around for years. Members include the district attorney’s office, LMH, Lawrence Police Department, Douglas County Sheriff’s Department, Kansas University’s Watkins Health Center and GaDuGi SafeCenter. This fall, the group created a new protocol that defined their roles.

Russell said that was a big step for the group.

“I think there is a greater recognition of the importance of a coordinated community response,” she said.

There is no charge to a patient for a SANE exam, and by law the hospital is required to provide this community service. It costs approximately $2,000 per case. The Douglas County District Attorney’s office pays $500 per case and the balance is written off by LMH. Last year, the district attorney’s office paid $250 per case. The payment will increase to $750 next year.

BY THE NUMBERS

Lawrence Memorial Hospital has improved its services to sexual assault victims. Here’s a review of the Sexual Assault Nurse Examiner program in 2011:

• 48 — sexual assault cases.

• 0 — adult transfers.

• 3 — transfers of children ages 14 and younger to Children’s Mercy Hospital.

• 4 — instances where two or three victims were in the ER at the same time.

• 28 — patients elected to report to law enforcement.

• 8 — patients elected to not report to law enforcement, but sent evidence to KBI to be kept up to five years. Victim can file a report and pursue charges within this timeframe.

• 9 — patients declined or were out of the 72-hour window for forensic evidence collection.

• 10 — nurses trained to handle SANE cases.

• 3 — nurses are in process of completing orientation.

• $118,245 — wages paid to have one nurse on-call.

• $2,000 — approximate cost per SANE exam for LMH. There is no charge for patients.

• $250 — district attorney’s office paid LMH per case.