Effective sexual assault response can be a challenge for rural communities.
In Merced County, for example, when a person is sexually assaulted, she or he has to be transported outside the county for proper examination and collection of forensic evidence. Such services are not available here.
For the past six years, rape victims have been taken to Forensic Nurse Specialists of Central California in Clovis, about a one-hour drive from the city of Merced.
Some have criticized the process, but according to the Sexual Assault Response Team, or SART, in Merced County, this is the best available option.
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The SART advisory committee, made up of public health officials, law enforcement, hospital staff and victim advocates, is working to find a way of conducting rape examinations more efficiently. They understand that having to transfer victims outside the county can have a negative impact on the delivery of care and on the criminal investigation.
In late February, the committee put out a request for proposal, which sought bidders to administrate forensic exams in Merced and Mariposa counties. The application period closed at the end of March, but the committee did not receive any proposals.
The committee plans to meet again next month to discuss solutions that might work better for the county and victims.
Kathleen Grassi, director of Merced County’s Public Health Department, said she can understand why no groups stepped up. Providing forensic examinations is an expensive and demanding service, she said.
For example, according to the request for proposal documents, the bidder would have to have an on-call team available 24/7 to handle cases. The bidder also would need to ensure that staff members have a response time of one hour or less to the exam site, among many other functions.
Grassi explained that the nurses that perform these sexual assault examinations receive specialized training that allows them to provide expert witness testimony in court.
Meghan Kehoe, the director of the Valley Crisis Centers in Merced and Mariposa, said she was disappointed the request for proposal did not attract any bidders.
Kehoe, who deals firsthand with sexual assault victims, said having these services closer to home is imperative. Valley Crisis Center advocates are called by law enforcement when requested by a victim. Advocates are responsible for providing emotional support, and provide transportation to and from Clovis when needed.
Kehoe explained that a rape kit exam is a long and invasive procedure. This process becomes harder when victims are taken away from their communities and families.
The exam may include collection of blood, urine and other samples. Victims are asked to stay in the clothes they had on during the assault to preserve evidence. They are asked not to drink, eat or use the bathroom. The examination can last two to four hours.
“Having to stay in their clothes when all they (the victims) want to do is shower – it’s traumatizing,” Kehoe said. “And then if you add having to be transported an hour away, that makes it even harder on them.”
During the exam, victims may be given strong medications to prevent infections, and many get sick on the drive home. Kehoe said she believes the long distance may discourage victims from choosing to go through the forensic exam, which becomes a problem when trying to collect evidence for prosecution.
“We (advocates) are there for them; we are trained to provide support. But at the end of the day, we are still strangers to them,” Kehoe said. “The best practice would be to serve them in their own community.”
Kari Mansager, program director at UC Merced’s CARE office, formerly known as the Violence Prevention Program, is also part of the committee. She explained that for the forensic exams to take place in Merced, the committee would need to reach three goals: find a location, allocate funding and contract with someone who could administer the SART program.
The need for a location has been covered by Mercy Medical Center in Merced. The hospital has provided an examination room free of charge and donated basic equipment. Meanwhile, law enforcement agencies have committed to covering the additional costs that come with bringing forensic examinations to the area.
“Law enforcement is truly for this, and they’re willing to pay more to make this happen,” Mansager said. “The next step is to find someone who can take over the program.”
Mansager said there are fewer requests for forensic exams for sexual assault in Merced than in other counties, pushing away potential bidders who could provide the service because they can’t justify investing the time and resources in this area.
But this isn’t a problem unique to Merced County.
According to a 2009 California SART Report, in large rural areas with small populations, SART programs that would provide services such as forensic exams often are nonexistent. In rural areas with larger populations, programs typically operate in larger, nearby cities.
Mansager said this is also a well-known problem in rural areas of Santa Barbara County, where she previously worked, and Riverside County in Southern California, as well as in several areas in the Central Valley.
The request for proposal documents show that the services sought were specifically for adults. Forensic medical exams for minors are provided at no cost to the county at Valley Children’s Hospital in Madera.
Committee members appreciate that services for Merced County victims are available in Clovis and Madera, but being able to provide these exams at the local hospital, committee members said, would be ideal.
Sun-Star staff writer Ana B. Ibarra can be reached at (209) 385-2486 or firstname.lastname@example.org. Follow her on Twitter @ab_ibarra
By the numbers
Forensic medical exams recorded by agency from 2010 to 2014:
Merced police: 76
Atwater police: 41
Merced County sheriff: 35
Los Banos police: 30
Livingston police: 15
Gustine police: 6
UC Merced police: 0
Dos Palos police: 0
Mariposa County sheriff: 5