Whether you are starting a SART, joining an existing SART, or have been a member of the same SART for a while, being thoughtful and informed about team membership is important. This section of the SART Toolkit will help you consider possible members to include in your SART and some of the skills and information they may bring with them.
Forming Your SART: Determining Membership
SARTs include agencies that are involved in the immediate response to reports of sexual assault as well as agencies that provide services to specific populations or that specialize in specific services. The majority of SARTs consist of core members that include advocates, law enforcement officers, prosecutors, and sexual assault forensic examiners. Many SARTs also include other members such as representatives from crime labs, child advocacy centers, local colleges and universities, family justice centers and victims. Research suggests that teams with broader active membership perceive themselves to be more effective with legal outcomes. 
Including all community agencies that respond to sexual assault in your SART can promote coordination and communication. Including too many members may decrease effectiveness or shift the focus of meetings. SARTs may go through phases of small or large membership, or have multiple meetings or committees with different stakeholders and focuses.
Some additional responsibilities of SART members include —
- training and educating other SART agencies on the member’s agency and services.
- identifying barriers victims face in seeking services.
- informing the team about the needs of victims from the members’ perspective and area of expertise.
- informing the SART about best practices in sexual assault response from the field the member represents.
- acting as liaison between the team and other organizations.
- assisting in development and review of policies and referral networks.
- contributing to relevant data collection and analysis.
As you think about membership on your SART, whether forming an initial team or expanding, consider the following questions:
- Why this particular agency?
- Will inclusion of this agency promote your mission to coordinate services effectively?
- What role could this agency play in the team?
- Does the current SART believe this agency has something to offer?
- Does the current SART recognize this agency’s expertise on a topic?
- Does the current SART recognize this agency’s leadership in the community at large or in a particular subgroup of the community?
- Is the SART’s intention to change the agency’s practice?
- Is the SART fulfilling grant requirements or a mandate by including this agency?
- Is there a path for this agency to move from collaborator to team member?
- Is the SART willing to share decision-making authority with this agency, now or in the future?
- How might the addition or exclusion of this agency impact the SART’s functioning?
- Is the agency interested in and able to participate actively in the SART?
- Is the agency willing or able to send a representative that has decision-making authority in their agency?
- Is the agency willing to develop and sign a MOU that represents the agency and SART’s needs?
SART membership may be required by state mandate, such as in New Jersey  and Oregon,  or by agreement. As of 2016, Georgia, New Jersey,  Oregon,  and Virginia have mandates for local SARTs that include guidance around membership. Indiana has a mandate for local SARTs, but it does not specify membership. Kentucky has a mandate that specifies membership for a statewide SART. Minnesota had a statute for judicial district teams that indicated membership, but it has expired. A California SART statute does not mandate a local SART, but does provide guidance on membership if a local jurisdiction has a SART. This information may change, and SARTs should always consult the most up-to-date laws in their jurisdictions. SARTs can also contact the states mentioned to further understand the impact of the legislation.
Most states that have mandated SARTs identify the required SART membership by statute, although those lists vary from state to state. In other cases, a funding agreement or MOU identifies who is on the team. In most cases these directives will specify minimum representation, allowing room for the SART to add other members to address identified needs.
If there is no MOU or mandate to guide your SART’s membership, or you are considering expanding your team, think about local agencies that could further the goals of strengthening or enhancing services to victims and holding offenders accountable. Depending on your team’s focus and needs, you may want to include all or some of these stakeholders.
You can also invite other agencies to participate in workgroups that undertake specific efforts that contribute to the SART’s work. Such efforts could include —
- a community needs assessment,
- development or revision of a SART protocol,
- community education,
- referral network,
- coordination of direct services to victims,
- coordination of supporting victims with collateral concerns,
- outreach to communities that are not being effectively served,
- development and promotion of prevention strategies,
- evaluation of the SART’s work,
- offender accountability, and
Your SART may also identify any of the efforts listed above as integral to the ongoing work of the SART and invite agencies that have expertise in these areas to join the team. Whenever agencies are added to a new or established SART, include orientation to the team, processes, roles, and procedures.
Potential Team Members
The following is a list of agencies and disciplines that SARTs may want to consider as members along with a brief description of the expertise each can bring to your team. This list is not meant to limit the possibilities of team members, but to provide suggestions. The New Orleans SART  and Placer County SART  provide two examples of membership lists.
Your SART should consider the needs of your community and resources for addressing those needs. This list is presented alphabetically, not in order of priority:
- Advocates are focused solely on the needs of victims, ensuring they receive support throughout the entire process of seeking care and reporting their assault if they choose that option. Advocates are valuable sources of information about trauma and victims’ reactions and can provide feedback regarding the consistency of services to victims and how victims perceive those services.  For more information about the types of advocates often involved in sexual assault response and their roles, see the section on Victim Advocates in the SART Toolkit.
- Anti-violence programs that focus on the needs of LGBTQ individuals, particularly supporting them in regard to HIV, homelessness, and discrimination, including sexual violence.
- Child advocacy centers/family advocacy centers often see adolescent and adult victims of sexual assault and abuse. They may provide sexual assault forensic exams and other services such as counseling, advocacy, assistance filing for restraining orders, and making reports to police. Representatives from these agencies can coordinate with other SART members to create protocols for interaction and communication between responding agencies for children and youth victims. Visit the National Child Advocacy Center to identify a local connection.
- Civil attorneys can help your SART be victim-centered by addressing victims’ legal needs that are outside the criminal justice system. Victims often face challenges in areas such as housing, employment, privacy, and schooling that can negatively impact their safety, recovery, and ultimately their ability to participate in the criminal justice process. As one expert noted, “it’s a problem that SARTs primarily focus on prosecution outcomes which really only affect 2.3 percent of victims. Civil lawyers can help, but they need to be at the SART table and part of the coordinated response.”  For more guidance on including civil attorneys in your SART, contact the Victim Rights Law Center.
- Culturally relevant organizations provide information on diverse communities, improving your SART’s ability to provide meaningful services to all victims. This may include agencies that work with distinct populations such as LGBTQ individuals, the Deaf and hard-of-hearing communities, the elderly, non-English speaking people, and immigrant and refugee communities.
- Crime lab personnel can provide guidance and feedback on the forensic collection, documentation, handling, storage, and testing for both victim and offender samples. Communication between the lab and other SART members can ensure that the policies and procedures for medical forensic exams are the most effective for the processing of evidence and the prosecution of cases. The Rapid DNA Service (RADS) system implemented in California is one example of potential partnerships.
- Disabilities organizations educate SART members on specific physical and attitudinal accessibility needs for victims with disabilities and can inform primary responders about appropriate services. For additional information on partnering with organizations focused on individuals with disabilities, see the Victims Who Have Disabilities section in the SART Toolkit.
- Domestic violence agencies/shelters can provide insight and coordination around the advocacy and response to victims of intimate partner violence. Often the legal response to domestic and sexual violence differs in significant ways, including strategies around offender accountability. Victims who experience sexual assault in the context of intimate partner violence will benefit from a coordination of these response systems, particularly in high lethality cases. Visit the National Network to End Domestic Violence for a list of cultural specific and state organizations.
- Educational institutions are important partners in coordinating response to young victims. Colleges and universities respond, investigate and adjudicate sexual assault, and victims are best served when there are protocols for how and when the college or university system and the criminal justice processes intersect. Your SART may also want to invite middle- and secondary-school representation to design a coordinated response for adolescent victims.
- Faith-based organizations are an integral part of the social service network in many communities. They can help your SART create referral networks and assist victims with their spiritual concerns. For example, faith-based communities that form partnerships with community-based advocates can offer onsite counseling as a collaborative effort between clergy and community-based advocacy. 
- Federal Bureau of Investigation (FBI) can be essential partners on a variety of crimes that fall under their jurisdiction as well as providing information, resources, and support to sexual crimes that do not fall under their jurisdiction.  The FBI will be important partners on SARTs that respond to sexual assault on reservations, cross-jurisdictional sex crimes, trafficking, and internet-related sex crimes, among others. FBI involvement during protocol development will enhance service provision for acute reports.
- Housing providers address the connection between housing insecurity and vulnerability, and can identify potential cross-training and referral networks. They can also coordinate support for victims of sexual assault who need immediate emergency housing, or long-term secure housing.
- Law enforcement conducts investigations to provide a factual history of the assaults. Law enforcement officers assist SARTs by explaining their processes and protocols and providing feedback to other agencies.  As you think about law enforcement representation on your SART, consider the jurisdictions in your area, including local, state, national, and tribal departments. Also consider the expertise of different members of the law enforcement community including sheriffs, local police departments, dispatching agencies, tribal police, Bureau of Indian Affairs, federal law enforcement agencies, college and university public safety officers, military police, postal inspectors, and park police.
- Sexual assault forensic examiners (SAFEs) conduct complete medical forensic examinations that provide medical care, evidence collection, and critical documentation of the assault for victims.
- Medical personnel may be able to help preserve evidence, connect victims with advocates, and help other team members understand the circumstances in which their patients typically disclose sexual assault. Some teams may include representatives from community clinics or paramedics/emergency medical services.  Some paramedics are specifically receiving training on response to sexual assault on college campuses. 
- Prosecutors provide for the safety of the community and victim by holding offenders accountable through the prosecution of criminal cases. On a SART they provide feedback to agencies on trials and judicial outcomes and how the work of other agencies can affect the prosecution of cases.  With regard to sexual assault response in American Indian country, tribal court prosecutors and federal prosecutors from the U.S. Attorney’s Office for the region may be important to add, based on the jurisdictions they serve.
- Judicial/court staff can address the privacy of victim information in court proceedings, the processing time for warrants and restraining orders, and securing crime victims’ rights, such as the right to a secure waiting area away from a defendant in preparing to testify.
- Probation, parole, juvenile justice, and correctional officers (e.g., officers involved with electronic monitoring, officers from city jails or state correctional facilities) assist SARTs with victim safety needs, communicating victim impact in reports to judges, responding to probation violations, notifying victims when an offender is released, and sex offender management issues.
- Refugee and resettlement organizations provide information to the SART on their communities, improving the SART’s ability to provide meaningful services to victims who are refugees.
- Researchers (e.g., volunteer consultants, employees of public and private institutions of higher education, professionals within medical and legal educational institutions) help the team monitor and evaluate initiatives, assess community needs, and analyze victim surveys. See the Evaluation and Systems Change sections of the SART Toolkit for additional information on potential collaboration with researchers.
- Sex offender treatment providers contribute important information about offending behavior and can provide insight into evaluation, testing, and treatment strategies. They can coordinate with other SART members around probation, parole, and sex-offender management issues. To learn more about these collaborations visit the SARTs and Offender Accountability section of the SART Toolkit.
- Mental health professionals involved with SARTs can consider whether cross-training SART colleagues on the neurobiology of trauma would help the SART serve sexual assault victims. They can also provide specific insight and guidance on cognitive disorders or forms of mental illness that may affect victims or offenders.
- Military officials may assist with specific needs of victims serving in the military and help coordinate the response inter-jurisdictionally.
- Government officials encourage sustainability, provide buy-in from government agencies, monitor success of government programs, and can assist with legislative and funding efforts.
- Public health officials practice the science and art of preventing disease and promoting health through an organized community effort. Their expertise includes ongoing assessment of the community's health care needs, injury prevention, emergency response planning, and control of communicable infections.
- Substance abuse programs address the significant connection between the aftermath of sexual assault and drug or alcohol abuse (38 to 45 percent of women in substance abuse treatment programs have experienced sexual assault). 
- Tribes and tribal agencies bring information about services available to tribal members and to victims of sexual assault in American Indian and Alaskan Native tribes. They provide leadership within tribal communities and can provide insight for the SART on jurisdictional issues, making mainstream services more accessible, and coordinating with tribal systems to best serve AI/AN victims.
- Victims provide feedback on policies, programs, and responses to sexual assault. Victims can also assist with or lead outreach, community education, and awareness efforts.
- Media (e.g., television and radio broadcasters, newspaper reporters) help the team promote public awareness of sexual assault intervention and prevention and keep the community informed of your SART’s activities. Media also educate the community when reporting on sexual assault.
SARTs can consider team membership related to function and structure. Some SARTs have advisory committees composed of individuals or agencies that are not direct responders to sexual assault, such as government officials, researchers, victims, and media experts. SART membership includes the agencies that will be governed by, and accountable to, the protocols they develop.
In some collaborative practices, such as multidisciplinary case review, it may be appropriate to limit participation to agencies involved in case management, or the team may specifically invite outside review by experts to deepen its understanding. How the team understands its primary focus will also influence your membership considerations.
Keep in mind, however, that even if your team believes its purpose is best served by maintaining a small core group, it still has the option to expand participation for certain kinds of projects (e.g. needs assessments, evaluation, advising on protocols), or add review committees, special advisors, or advisory groups to its structure.
After identifying agencies or groups needed to perform the work of the SART, it is important to consider selecting the individual from that agency who will be the most effective member. Ideally team members should be knowledgeable about their agency’s procedure, understand sexual assault, be able to regularly attend meetings and have the capacity to commit to the team’s work on behalf of their sponsoring agency. The individual should have the authority to make decisions regarding sexual assault response for their agency or be able to get needed approval easily.
SART Formation Resources
Considerations for Team Formation (PDF, 3 pages)
This handout from the Sexual Violence Justice Institute at Minnesota Coalition Against Sexual Assault provides considerations when establishing your team membership.
A national research study by the National SART Project, published in 2015, collected data to better understand SARTs. The primary goal of the research study was to obtain high-quality information on SARTs’ operations and effectiveness in the real world, to inform efforts to support SARTs, and promote their effectiveness, including membership.
Expert Interview - Benefits of Victim Advocates - Kim Lonsway by End Violence Against Women International, 2018. Retrieved from LINK. Provided with permission.
Sexual assault advocates are professionally trained to support victims and promote victims' rights. Advocates ensure that victims' emotional, physical, psychological, economic, and spiritual needs are met, referrals are made, and victims are offered and given access to all applicable services by all service providers. Advocates may offer victims information, resources, and present options available to them. Advocates support victims by empowering them with information and support to make their own decisions. 
Advocates work in systems such as the juvenile court system, or the military court system, prosecutor offices, or community-based rape crisis centers. An advocate’s level of confidentiality depends on their position, education, licensure, and the specific laws of each state.
Systems-based advocates work specifically for victims seeking help within a specific organization such as law enforcement or the civilian or military court system. Their primary goal is to support victims as witnesses to a crime in participating with law enforcement and moving through prosecution of a case.  Systems-based advocates may be called — 
- victim advocates,
- victim witness advocates,
- victim-witness assistance coordinators, or
- Sexual assault resource coordinators.
According to End Violence Against Women International, system-based advocates —
“…are employed by a public agency such as a law enforcement agency, office of the prosecuting attorney, or some other entity within the city, county, state, or federal government. Their roles and responsibilities will vary based on their host or governing agency as will the specific term they use to describe themselves.” 
Systems-Based Advocates’ Roles and Responsibilities
Systems-based advocates may — 
- provide information, resources, and practical support to victims.
- provide crisis intervention and supportive counseling.
- collaborate with community agencies to develop integrated systems of assistance.
- increase victims' opportunities to participate in the justice process by working to ensure their voices are heard.
- assist victims with safety concerns and safety planning.
- assist victims with referrals for emergency financial assistance.
- provide information about policies against victim and witness intimidation.
- orient victims to the criminal justice system.
- notify victims of court hearings and changes in court schedules.
- establish safe waiting rooms,
- inform victims about the detention status of defendants.
- consider the personal needs of victims (e.g., religious holidays, health requirements, family concerns, work-related challenges, ethnic and cultural issues, accessibility needs) in the context of their cases.
- provide court support by attending interviews, hearings, or trials with victims.
- help to ensure that victims' rights are maintained throughout the justice process.
- assist victims with the return of property.
- assist victims with victim compensation claims and restitution requests.
- provide childcare assistance during hearings and trials.
- assist victims with pre-sentence investigation reports and victim impact statements.
- inform victims about automated Victim Information Notification System (VINE) , if applicable.
Systems-Based Advocates, Privacy and Privilege
System-based advocates differ from community-based advocates not only in role, but also in how and whether the statements made by victims to system-based advocates are privileged or protected from disclosure in any way. In most states, a victim’s communications to a community-based advocate that are made during the course of the advocate’s service to the victim are privileged and cannot be disclosed without authorization from the victim. The privilege is usually statutory, and usually an absolute privilege that cannot be overcome even by court order.
In contrast, a victim’s communications to systems-based advocates are generally not protected by any privilege. Thus, what a victim tells a victim-witness coordinator employed by the prosecutor’s office is not privileged, and can be disclosed to others. In some circumstances, what the victim says must be disclosed to others, most notably to the defense if a criminal case is pending. For example, if a victim tells the victim-witness coordinator that she lied to the police during the investigation, the victim-witness coordinator is obligated to tell the prosecutor, who is in turn obligated to tell the defense.
The obligation to disclose is a matter of constitutional due process, and failure to disclose under the circumstances can lead to an appellate court finding that a defendant’s trial was not fair, overturning a conviction. The prosecutor is presumed to know what advocate knows, so if the systems-based advocate does not inform the prosecutor and it is discovered later that the victim told the systems-based advocate she lied, the prosecutor’s failure to disclose that to the defense can still be a constitutional violation. 
Resources on Systems-Based Advocates
Attorney General Guidelines for Victim and Witness Assistance (PDF, 66 pages)
This document by the U.S. Department of Justice provides guidelines for investigative, prosecutorial, and correctional agencies in their treatment of victims and witnesses to crime.
Community-based advocates "work in an independent, usually nonprofit, organization dedicated to assisting victims of sexual assault…"  These organizations, generally referred to as rape crisis centers, offer services that are usually free and confidential. Victims are generally referred to community-based advocates by rape crisis hotlines, hospitals, law enforcement agencies, prosecuting attorney's offices, educational institutions, faith-based organizations, social service agencies, or victims' friends, relatives, or colleagues. Victims work with community-based advocates by choice.
Community-Based Advocates’ Roles and Responsibilities
Community-based advocates champion the rights of victims. They provide a variety of services to victims: 
- Assist victims in accessing health services.
- Provide information, resources, and support to victims.
- Share culturally relevant resources.
- Provide crisis intervention that is usually available on a 24-hour, 7-days-a-week basis.
- Accompany victims to medical and legal appointments or interviews.
- Refer victims to other community agencies or services as needed.
- Provide information on anonymous reporting options and sexual assault forensic exams, including timelines for exams.
- Ensure victims understand and have access to information or explanations offered by other service providers at and beyond the point of service.
- Provide support to victims' friends and family.
- Ensure the victim receives follow-up care.
- Provide safety planning.
- Provide counseling and run support groups for victims.
- Assist victims in the criminal justice system.
- Consider the personal needs of victims when providing services.
- Assist with practical considerations and provide information and resources on issues such as lock replacement, transportation, and childcare resources.
- Hold systems accountable for offering all services to all victims.
Crisis intervention is the immediate support given to a victim after they disclose a recent sexual assault. Advocates are available 24 hours a day, 7 days a week through national, state, or local hotlines, or in communities. Advocates support victims as they seek physical safety and medical attention, consider completing a medical forensic examination, decide whether to report their assault, and manage the immediate follow-up from services.  A victim may disclose sexual assault days, months, or years later, and advocates are available to work with victims to identify their needs at the time of disclosure.
Advocates are trained to first make sure the victim is physically safe and receives any needed medical care. However, medical and safety needs may not always be immediately obvious. Victims who are in physical shock may be unaware of injuries they have sustained or the dangers they still face. 
Advocates pay attention to whether the victim feels safe. Even with law enforcement or security personnel present, a victim may not feel safe if —
- the victim sees or hears the assailant being interviewed by police.
- the victim is being interviewed at the scene of the attack.
- the victim is not given time to replace torn or lost clothing.
- the victim is hungry, cold, or uncomfortable.
- the assailant has not been apprehended and threatened to return, hurt the victim’s friends, family, pet, or threatened retaliation of any kind.
- the victim knows the perpetrator.
- the victim's family, friends, or witnesses are threatened.
Advocates may act on victims’ expressions of safety concerns and move to meet privately with a victim or interrupt an investigative interview, prosecution meeting, or other system response to ensure the victim is able to continue comfortably.
Advocates support victims during medical forensic exams or when victims seek follow-up medical care. Medical professionals should offer all victims the option of accompaniment by an advocate during medical exams.  It is the victim’s right to make the decision to allow the advocate to be present. If the victim does not wish for the advocate to be present during the exam, the advocate can remain on site to provide information, resources, and emotional support once the examination is complete. 
To ensure that medical advocacy works effectively, make sure your SART develops protocols that address how and when advocates will be notified, jurisdictional issues, Health Insurance Portability and Accountability Act of 1996 (HIPAA) provisions, multiple exam facilities, and timelines for first responders.
Once victims consent to having an advocate present for support during medical care, advocates can — 
- provide emotional support and answer any questions.
- ensure victims’ rights are protected and remind the victim of their rights throughout the process.
- explain the medical forensic examination process to victims, including the importance of collecting forensic evidence, how the costs of the exam will be covered, and general information about what will happen during the exam.
- ensure the victim has a change of clothes to wear after the medical forensic examination for clothing taken as evidence.
- explain the role of each professional (law enforcement, medical personnel, and advocate) and the limits of confidentiality of each.
- ensure the victim understands explanations by sexual assault forensic examiners and law enforcement by asking the victim if they would like the nurse or officer to explain something again.
- ensure victims understand their discharge instructions, including symptoms to watch for and any follow-up appointments.
- offer comfort items after the medical forensic examination is completed such as toiletry items, drinks, and snacks.
- assess victims’ safety at the time of medical discharge and help arrange safe housing if needed.
- provide victims and their support people with resources and referrals to other community-based resources.
Accompaniment During Law Enforcement Interviews
Advocates have an important role in helping victims manage any fears and anxieties associated with reporting to law enforcement or working with prosecutors. Victims may fear not being believed. They also may have had past experiences with the criminal justice system that make them distrustful. Victims may have been using recreational drugs or engaging in other forms of illegal or prohibited conduct prior to the assault.
Due to the way the human brain stores information during a traumatic event, victims may not remember everything that happened or the order in which it occurred.  Victims may have outstanding warrants and fear being arrested.  They also may fear going to the police station, sharing intimate details of a horrific experience with a stranger, reliving that horrific crime, or being blamed for any aspect of the assault.
Advocates do not tell victims what to do or what to say; their role is to remind victims of their rights during interviews and investigation and provide answers to any questions they have.
Advocates can offset concerns about interacting with the criminal justice system by being proactive. For example, the Ramsey County Sexual Assault Response Protocol recommends that, unless there is a warrant against the victim for a serious offense (e.g., robbery, homicide), the warrant should be dealt with at a later time rather than at the time the victim seeks help after being sexually assaulted.  Similarly, the U.S. Department of Defense's Sexual Assault Prevention and Response Program Procedures state that commanding officers should consider delaying taking action against victims for misconduct before or during the assault (e.g., underage drinking) until after the investigation of the sexual assault is complete. 
Increasingly, states are passing legislation that allows for vacating or expunging trafficking victims’ records related to the crime of prostitution committed as a result of being trafficked.  These shifts in perspective allow victims and law enforcement to focus on one crime at a time and hold people who commit sex offenses accountable.
Generally, law enforcement conducts two trauma-informed interviews:
- Preliminary interview: The responding or reporting officer generally conducts the preliminary interview at the exam facility or the crime scene to gather information and establish elements of a crime. A suspect and witnesses may be identified. 
- In-depth or follow-up interview: A uniformed officer or detective conducts this more detailed interview to determine all the facts about the assault (e.g., confirm the elements of the crime, identify witnesses, gather additional information and evidence from the victim). More than one follow-up interview may be conducted to clarify issues or gather additional information. 
Jurisdictions differ as to whether advocates or support persons can be present with victims during preliminary or in-depth interviews. In California, a state statute gives victims the right to have an advocate or another support person at any interview by law enforcement authorities, district attorneys, or defense attorneys.  Law enforcement or the district attorney can exclude the support person, however, if they determine that their presence would be detrimental to the purpose of the interview. 
Depending on the community, if a victim contacts law enforcement first, advocates may not be notified or not allowed in the room when a victim is being interviewed by law enforcement.  Even if advocates are not allowed in the room during the interview, the advocate can still accompany the victim and provide support before and after the interview.  Some states such as Wisconsin have codified into law that advocates can accompany victims during interviews with law enforcement.  The Wisconsin Coalition Against Sexual Assault provides a Summary of Wisconsin’s Victim Accompaniment Law with link to statutory language.
How Should Advocates Respond if Law Enforcement Does Not Want to Allow Them in the Interview? By End Violence Against Women International, 2018. Retrieved from LINK. Provided with permission.
Your SART can apply best practices to what works in your jurisdiction and what roles advocates and law enforcement would play during interviews. Recording agreements in protocol helps maintain consistency among and between agencies and holds everyone accountable to the same standard. For more information on developing protocol see the section of the SART Toolkit on SART Protocol.
The role of the advocate during law enforcement interviews can include — 
- explaining the process of the police investigation and answering any questions a victim may have.
- providing victims with realistic expectations of what will happen during the investigation.
- explaining the advocate’s role throughout the process.
- ensuring victims have the information they need to make their own decisions, that they understand that information, and they feel comfortable asking follow-up questions.
- working with law enforcement on victim safety planning.
- working with law enforcement to identify when a victim may need a break during the interview.
- helping victims obtain a copy of a police report if they want one and it is available.
For more information on related issues, see the Critical Issues in Responding to Reports of Sexual Assault section of the SART Toolkit.
Legal advocacy assists and supports victims as they interact with criminal justice systems and participate in criminal prosecution. Victims typically work with a systems-based advocate during a criminal prosecution, but may also work with a community-based advocate during meetings with prosecutors and court proceedings. 
Advocates can — 
- provide victims with information about criminal and civil justice and victims' rights statutes.
- notify victims of the status of their case, meetings with the prosecutor, arraignment, hearings, and other court appearances.
- explain trial language, courtroom procedure, and courtroom etiquette in ways that victims can easily understand.
- accompany victims to interviews, meetings with the prosecutor, and court proceedings.
- arrange transportation for court-related appointments.
- work to ensure victims' voices are heard at various case decision points (e.g., offender release, charging, plea agreements, sentencing).
- help victims write impact statements and prepare them to speak at sentencing hearings.
- assist victims with filing orders of protection.
- partner with systems-based victim witness assistants to coordinate victim support.
- provide referral assistance for private attorneys.
- explain special conditions of the offender’s bail, parole, or probation.
- assist victims with victim compensation applications.
- assist victims with media requests. 
Differences Between Community-Based and Systems-Based Advocates
Expert Interview – Community vs. System-Based Advocates – Aurelia Sands Belle by End Violence Against Women International, 2018. Retrieved from LINK. Provided with permission.
Systems-based advocates are employed by agencies such as prosecutors, police departments, juvenile courts, and other public agencies within a city, county, state, or federal government. There are also community-based advocates employed typically by community-based rape crisis centers or other non-profits.  System-based and community-based advocates can be distinguished by where they are employed and sometimes the nature of their duties, though their duties may overlap. A victim may work with both types of advocates and in many cases the two types of advocates will work together to ensure victims receive the support they need. 
There are differences between systems- and community-based advocates:
- Community-based advocates typically — 
- provide services to all victims whether or not they report the crime.
- offer free services to victims and secondary victims (family and friends of the victim).
- provide 24-hour access to crisis intervention.
- offer support groups and education for victims and family members.
- offer confidential services to victims.
- are specially trained in working with victims of sexual assault.
- System-based advocates typically — 
- provide services to victims whose cases are being processed through the criminal justice system.
- provide services specific to the direct victim and not to secondary victims (family members and friends).
- provide advocacy specific to criminal court proceedings such as court dates and case status.
- provide services only through the length of the criminal justice process.
- are unable to offer the victim confidential services.
- work with all crime victims.
Best Practices for Community Based Advocates (PDF, 3 pages)
This resource from the Wisconsin Coalition Against Sexual Assault covers the recommended practices for community-based advocates.
End Violence Against Women International (EVAWI) developed this resource as a condensed version of a course designed for non-advocates who may encounter advocates so they can understand the role advocates play.
Effective Victim Advocacy Within the Criminal Justice System (PDF, 148 pages)
This training manual by EVAWI for victim advocates details the role of victim advocates including a detailed description of the differences between community-based and system-based advocates.
The Role of Victim Advocates (PDF, 14 pages)
This document by the National Center for Women & Policing discusses the role of victim advocates (or rape crisis advocates).
This online curriculum by the Center for Sex Offender Management (CSOM) provides detailed information about the different types of sexual assault advocates.
This page from CSOM discusses the categories of advocates and their differing roles.
Databases and Directories Resources
Military Onesource serves as a one-stop resource for members of all branches of the military and their spouses and families. Users can search for resources, including those dealing with sexual assault.
The National Sexual Violence Resource Center (NSVRC) lists state, territory, and tribal anti-sexual assault coalitions and national allied organizations.
The Office for Victims of Crime’s directory helps service providers and individuals locate non-emergency crime victim service agencies in the United States and abroad.
The Rape, Abuse & Incest National Network (RAINN) operates the National Sexual Assault Hotline to route callers to local rape crisis centers who are in their network. They also provide live online chat support.
Safety Planning Resources
This publication by the Pennsylvania Coalition Against Domestic Violence and the Pennsylvania Coalition Against Rape is for advocates in their safety planning work around technology.
Danger Assessment is a company that assesses the severity and frequency of intimate partner violence and provides online training materials, domestic violence resources, conference information, references, and more.
The SANE Program Development and Operation Guide provides information to Medical Forensic Providers on addressing safety planning at discharge, especially in cases of high lethality.
This interactive safety planning tool by Loveisrespect is geared toward youth but can be used by anyone experiencing abuse or in an unhealthy relationship. They also offer specific resources and guides for college students and high school students.
This guide for advocates and attorneys by the Victim Rights Law Center (VRLC) is to help victims of non-intimate partner sexual assault identify potential safety threats and create a safety plan.
Sexual Assault Safety Plan Worksheet (Microsoft Word, 2 pages)
This document developed by the Sexual Assault Prevention and Response Office of the Department of Defense is specific to the needs of military victims.
This online toolkit by the National Network to End Domestic Violence provides many resources, safety tips, information, and privacy strategies for survivors.
This document by the Victim Rights Law Center and the Mississippi Coalition Against Sexual Assault addresses the unique needs of campus sexual assault victims.
Service Provider Resources
Advocates and Law Enforcement: Oil and Water? (PDF, 19 pages)
This article published by the Civic Research Institute describes the role of advocates in the criminal justice system and explains the similarities and differences between community-based and systems-based advocacy.
Attorney General Guidelines for Victim and Witness Assistance (PDF, 66 pages)
This resource by the U.S. Department of Justice establishes guidelines for government-based (systems-based) advocates located in investigative, prosecutorial, and correctional agencies.
Effective Victim Advocacy Within the Criminal Justice System (PDF, 148 pages)
This training manual for victim advocates by EVAWI details the role of victim advocates including a detailed description of the differences between community-based and system-based advocates. A similar manual for other professionals is also available: Breaking Barriers: The Role of Community-Based and System-Based Victim Advocates.
Excellence in Advocacy: A Victim-Centered Approach (PDF, 83 pages)
This document by the Ohio Family Violence Prevention Center is for victim advocates, specifically victim advocates who are new and have been in the field five years or fewer. It defines advocacy, legal remedies, and safety planning.
The It Happened to Alexa Foundation assists rape victims' families with travel expenses during the litigation process.
This online curriculum by Office for Victims of Crime — Training and Technical Assistance Center has materials for trainers to teach advocates about advocacy and counseling, the realities and impact of sexual assault, procedures to follow in common situations, techniques to support recovery, and compassion fatigue and self-care.
Sexual Assault Advocate Training Manual (PDF, 320 pages)
This manual by the Texas Association Against Sexual Assault offers a detailed introduction to sexual assault and reviews advocate responses to it.
Sexual Assault Demonstration Initiative Final Report (PDF, 104 pages)
The Sexual Assault Demonstration Initiative (SADI) was created to enhance sexual assault outreach, services, and community partnerships in dual or multiservice programs. The Final Report provides concrete lessons learned and recommendations for funders, technical assistance providers, and dual or multiservice programs.
VINE allows victims to inquire about the status of an offender and to register to be notified immediately in the event of an offender's release, escape, transfer, or court appearance.
VictimLaw provides a national snapshot of victims' rights created by the Office for Victims of Crime Training and Technical Assistance Center.
Law enforcement officers are in a unique and visible position in addressing sexual assault. A primary role is responding to victims as well as conducting a professional, thorough investigation to piece together a factual history of the assault.  By participating on a SART, law enforcement officers can work with other service providers to enhance services to victims and improve the handling of cases with the goal of making communities safer.
In response to reports of sexual assault, law enforcement is responsible for — 
- providing for the immediate medical, emotional, and physical safety needs of the victim.
- providing a trauma-informed response, including a trauma-informed interview process.
- ensuring victims are treated with dignity and respect.
- providing appropriate referrals to victims.
- processing the crime scene for physical evidence, which may include gathering personal property of the victim and the subject.
- collecting evidence.
- taking a report of the sexual assault or starting an investigation, depending on the wishes of the victim. 
- identifying suspects, as appropriate.
- arresting suspects, as appropriate.
- referring charges on the suspect, as appropriate.
- arranging for forensic examination of the suspect when necessary.
- including victim advocates and other helping professionals in the law enforcement response and investigation.
- documenting the case appropriately in a written report.
- participating in court proceedings.
- completing all other duties normally associated with investigative and law enforcement functions.
Throughout these activities, law enforcement should use trauma-informed principles to develop a factual history of the victim’s experience.
Because law enforcement is involved with both victims and offenders in the interest of community safety, they are essential team members for SARTs. Law enforcement response and subsequent investigative success can benefit from healthy relationships between members of a SART. Law enforcement officers bring important information and perspective to the team, and can gain a great deal of knowledge, understanding, and insight into the effectiveness and results of their work through the feedback of other team members.
Law enforcement representatives’ roles on a SART include —
- providing case status information, though it is important to note that law enforcement officers may not be able to discuss certain cases.
- training team members on law enforcement protocol for responding to sexual assault.
- acting as the liaison between the SART and their law enforcement agency.
- educating the team on how to improve coordination with law enforcement agencies.
- updating the team on emerging criminal justice issues.
- providing background information for team case reviews.
- completing after-action reports and analyses to identify areas of success or concern post-investigation.
- updating the team on local ordinances that affect sexual assault cases.
- implementing initiatives aimed at teaching the community how to prevent and address sexual assault.
- aiding SART agencies on policy development and guidance.
- assisting with reviewing SART protocol.
SARTs provide an excellent venue for law enforcement and community agencies to provide cross-training on roles and responsibilities. This allows law enforcement and other community members to understand and articulate each other’s part in responding to sexual assault, including goals, expertise, and limitations.
There are numerous beneficial outcomes for law enforcement agencies from the collaboration within a SART:
- Increased number of reports taken. 
- Increased number of reports investigated. 
- Increased number of reports referred to prosecution. 
- Increased successful prosecutions and offender accountability. 
- Decreased incidence of future sexual assaults. 
- Increased referrals to advocates and medical and forensic professionals. 
- Decreased instances of secondary victimization. 
- Increased arrests of suspects. 
- Shorter delays in reporting. 
An increase or decrease in numbers of reports to law enforcement may be due to several factors. An increase in reports could mean that victims feel more comfortable reporting, victims have increased faith in the system, victims know where to report, and victims are treated with respect when they do report. Similarly, an increase in prosecution rates can be viewed positively in a community and often indicates more reports, thorough investigations, and comprehensive support to victims.
Law Enforcement Jurisdictions
Many U.S. jurisdictions have more than one law enforcement authority. Any single jurisdiction may have —
- city or county police,
- sheriff's offices,
- highway patrol,
- state, tribal, campus, and military police,
- federal agencies, such as the FBI, and
- State Park Rangers and U.S. Park Police.
For example, the Stillaguamish Tribe of Indians in Washington State patrols tribal parks and wilderness areas and has full police authority throughout the reservation. Some rangers, particularly those employed by public agencies such as the U.S. National Park Service, have police powers and enforce laws in parks and surrounding areas.
Your SART should be aware of which law enforcement agencies have jurisdiction over sexual assaults in your community, especially in cases where overlapping jurisdictions may be more difficult to understand. See the Jurisdictional Considerations section of the SART Toolkit for more information. See Best Practices for Law Enforcement Agencies and Prosecutor’s Offices Working With Immigrant Sexual Assault Survivors for information on working with immigrant sexual assault survivors.
Law Enforcement Buy-In
In some communities, law enforcement agencies lead SARTs, including sharing space and proactively analyzing their policies and procedures to meet and exceed national standards and emerging promising practices.
In other locations, establishing buy-in among law enforcement agencies or individuals within a particular agency may be challenging for several reasons:
- Historic distrust or previously failed relationships between law enforcement and community service provider agencies.
- Belief that the SART will be critical of their work rather than constructive.
- Lack of sufficient previous training on the benefits of a SART for the agency.
- The law enforcement agency’s belief that other operational areas are a higher priority.
- A community’s belief that the agency’s other operational areas are a higher priority.
- Limited or no funding or resources to commit to SART participation.
- Concern about the agency’s capacity to effectively respond to a potential increase in their caseload, especially if they are already overextended.
- Limited capacity or poor process for selecting the right officers and developing them into well-trained, experienced sex crimes investigators.
- The SART representative lacks sufficient internal authority within the agency to effectively implement agency-level change based on SART feedback or identified opportunities for improvement.
To improve buy-in, it is important to focus on mutual goals for all SART agencies, and the benefits to law enforcement in particular. Mutual goals include —
- public safety,
- offender accountability,
- community involvement and collaboration,
- serving vulnerable and underserved populations,
- increasing positive public relations, and
- improving multidisciplinary procedures, policies, and trust among responding agencies.
Specific benefits to law enforcement include the aforementioned mutual goals, as well as —
- assisting law enforcement in training their personnel on community organizations and available resources.
- sharing responsibility for victim care.
- promoting collaboration and subject matter expertise with other professionals outside law enforcement.
- developing leadership skills of officers assigned to the SART.
- sharing decision-making responsibilities, especially in complex cases.
- identifying culturally relevant resources (translators, schemas, and norms) for specific demographic and traditionally underserved populations within the community.
Members of any SART may experience conflict with one another around the provision of trauma-informed services, agency buy-in, goal alignment, perceived credibility of individual SART members, authority within the SART, and other topics. While a SART may not be able to resolve these areas of conflict immediately, the process of coming together on a regular basis and in an open-minded format will increase agencies’ abilities to communicate, collaborate, and improve systems responses to support victims and hold offenders accountable.
In all communities, it is essential for stakeholders to discuss the barriers to joining a SART. Progress will be hindered if your SART meetings become blame sessions, regardless of what agencies are blamed for failures to respond effectively to sexual assault. When open discussions occur at the outset of your SART — so each agency understands the others’ roles — and continue regularly, your team will function more effectively.
SARTs looking to engage with law enforcement are most likely to receive positive participation by being clear about their sincere desire to build collaborative relationships that will benefit the agency as it benefits the community. SART members should clearly communicate how they hope to collaborate with law enforcement and work with agencies to identify potential obstacles to participation and possible resolutions. Discussions with law enforcement agencies to better understand their policies and procedures is an essential step in making all members, including law enforcement representatives, feel welcome.
One SART member suggests asking, “How can we help you with your difficult job?” as a way to start conversations and engage in relationship building. The following questions were suggested on the NSVRC SART Email Group  as a way to engage law enforcement on a SART:
- What is the process a case follows from initial report to prosecution? (This question usually needs collaboration between law enforcement and the county attorney’s office.)
- What kind of information is gathered during an initial report?
- What is the most difficult part of an investigation for law enforcement?
- What information about investigations do you wish victims knew or understood better?
- How do you see advocates and law enforcement working together best?
- What problems or difficulties have you run into with sexual assault cases in the past?
- What resources would law enforcement like or need to have on hand to enable a more informed and better response?
No single approach determines the best makeup of a SART, including which law enforcement agencies will be best to have as members. It is best practice to include on your SART everyone who has authority over providing services to victims. Agencies, including law enforcement, have more buy-in when they are included in decision-making processes, particularly those that affect them.
Possible SART composition options include selecting a representative from the law enforcement agency that investigates the largest number of sexual assaults or asking each of the law enforcement agencies that operate in the SART jurisdiction to select a representative. Even when all agencies are not able to commit to SART meetings, SARTs should be careful to include them in their teamwork, decisions, and outcomes in a routine manner, maintaining an open invitation to participate.
A few examples of possible law enforcement representatives include —
- dispatchers and communications staff,
- responding officers,
- investigating officers,
- U.S. Border Patrol officers,
- FBI agents, and
- U.S. Park rangers.
Casting the net broadly to include professionals in areas of law enforcement who may have little training in sexual assault but may encounter individuals who need help can be essential to building comprehensive victim service.
The 911 operator determines whether the victim needs emergency medical attention and is in a safe environment, collects pertinent case information, and relays this information to the responding officer in a timely manner.
By participating in a SART, dispatchers and communications staff can gain an enhanced understanding about trauma-informed approaches to sexual assaults that can be applied during initial calls.
All initial responding officers to reports of sexual assault must assess the victim’s medical needs and safety concerns prior to taking a statement. This brief statement is one element in determining whether the criminal elements of a sexual assault occurred.
Depending on the circumstances of a report, responding offers may also identify the crime scene, take appropriate steps to secure the crime scene, and identify and document potential evidence for collection. See the Receiving a Report of Sexual Assault section of the SART Toolkit for additional information.
The continuing investigation of sexual assault begins after the immediate emergency needs of the victim are met and preliminary information has been gathered to identify the offense and possibly the offender.  The thoroughness with which investigations are preformed has a drastic effect on victim and case outcomes. One study found with each additional investigative step completed on a case, the case was more likely to have an arrest, slightly more likely to result in a referral to prosecution, and twice as likely to have both an arrest and a referral. 
In some jurisdictions, responding officers are also responsible for follow-up investigations. In other jurisdictions, reports are assigned to a detective unit for follow-up.
Ongoing investigations normally include scheduling trauma-informed victim interviews, conducting suspect interviews, apprehending suspects, and exploring strategies for corroborating victims' statements, such as those that support victims' recollections of sounds, smells, and surroundings. 
SARTs can receive cross-training on the role of various law enforcement personnel, particularly as the tasks associated with each role vary by jurisdiction.
U.S. Border Patrol Officers
SARTs that border Mexico or Canada have unique issues to consider to meet victims' medical and emotional needs and to address international legal issues. For example, the State of Arizona Recommended Guidelines for a Coordinated Community Response to Sexual Assault proactively addresses border patrol responses:
“When Border Patrol agents, in the course of their duties, become aware that a sexual assault has occurred, they should determine who has primary jurisdiction and refer the case to the appropriate law enforcement agency. When Border Patrol agents come upon the scene of a sexual assault in progress, they should respond and then refer the case to the appropriate local law enforcement agency.” 
These guidelines provide a good example of how issues involving border patrol should be addressed by a SART.
Federal Bureau of Investigation
The FBI becomes involved in cases that occur in international waters, national parks, on American Indian reservations, and military installations. The FBI also has jurisdiction regarding sexual assault cases across state lines and in those cases involving prostituted adolescent victims or victims of human trafficking.
Having federal law enforcement agencies participate on SARTs can promote interagency understanding of complex interjurisdictional responses and proactively address issues that may otherwise go unnoticed. For example, the FBI victim specialist on the Cuyahoga County SART educates advocates, local law enforcement, and medical forensic examiners on ways to screen sexual assault victims who may be prostituted teenagers or human trafficking victims.
Individuals who are sexually assaulted in the almost 400 national parks in the U.S. National Park Service often include tourists who are in unfamiliar and often remote areas, as well as employees who live and work in isolated places. 
Park rangers carry out law enforcement duties in national parks. The U.S. Park Police perform concurrent duties with rangers in some urban park sites such as the National Mall (Washington, D.C.), Statue of Liberty (New York), and Golden Gate (San Francisco).  The FBI also has jurisdiction regarding sexual assault cases in national parks.
By including park rangers on SARTs, teams can offer needed education and training about sexual assault to park rangers, increase victim safety, enhance investigations, and facilitate referrals among other law enforcement jurisdictions and community-based service providers. In some instances, inviting park officials to participate on the SART links park rangers with more resources to promote public safety and assist rangers in referring victims to services they need.
Examples such as these may serve as incentives to prompt collaboration and enable new partnerships to respond to reports of sexual assault in a consistent way that supports victims at the time of the report.  In the future, specific protocols may develop for park rangers who receive a report, including first response to a victim, referral to a SART, or transportation for the victim to seek appropriate care.
Law Enforcement Technical Assistance Providers
EVAWI is a professional training organization that offers a broad portfolio of resources to improve criminal justice and community responses to gender-based violence.
IACP's Police Response to Violence Against Women Project, with funding from the Department of Justice's Office on Violence Against Women (OVW), focuses on the development of tools and policies to assist law enforcement in responding effectively to human trafficking, sexual assault, domestic violence by police officers, and domestic violence and all other crimes against women.
The National Institute of Corrections provides assistance at the federal, state, and local levels.
This nonprofit helps sheriffs, deputies, and others in criminal justice system improve their services and level of professionalism.
OVA is responsible for ensuring that victims of crimes investigated by the FBI are afforded the opportunity to receive the services and notification as required by federal law and the Attorney General Guidelines on Victim and Witness Assistance. This website includes links to local FBI offices and information on the rights of federal crime victims and national resources.
Sexual Assault Training & Investigations provides multidisciplinary, victim-centered training for law enforcement.
Law Enforcement Resources
This guide by the International Association of Chiefs of Police provides law enforcement agencies with an understanding of sexual misconduct by officers as well as prevention efforts.
Best Practices for Law Enforcement (PDF, 3 pages)
This resource from the Wisconsin Coalition Against Sexual Assault explains the recommended practices for law enforcement officers responding to sexual assault.
Improving Response to Sexual Assault and Sexual Abuse Crimes in Illinois: Comprehensive Guidelines for Law Enforcement Policies on Responding to and Investigating Sexual Assault and Sexual Abuse (PDF, 21 pages)
This resource developed by the Office of the Illinois Attorney General provides an evidence-based and trauma-informed approach to responding to sexual assault.
Sexual Assault Incident Reports: Investigative Strategies (PDF, 8 pages)
This resource, developed by IACP includes guidelines and strategies for carrying out sexual assault incident investigations.
Sexual Assault Pocket Tip Card (PDF, 2 pages)
This printable pocket card, developed by IACP, includes tips for officers writing a report, interviewing victims and suspects, and investigating the incident. There is also a section available for contact information of local resources.
IACP developed this resource to aid law enforcement in creating training content and policies related to sexual assault.
Sexual Assault Supplemental Report Form (PDF, 8 pages)
The Sexual Assault Supplemental Report Form developed by IACP is recommended for use in reporting, recording, and investigating sexual assault incidents.
This Training Key developed by IACP discusses procedures for investigating sexual assaults as well as working with victims.
This resource developed by IACP discusses victim-centered care in relation to the forensic examination.
This resource developed by IACP defines different “types” of sexual assault and covers defenses that may be raised as well as strategies to overcome defenses.
This resource developed by IACP explains the use of the “pretext” phone call in sexual assault investigations.
Sexual Assault Forensic Examiners
Sexual assault forensic examiners (SAFEs) are health care providers who receive specialized training in conducting sexual assault medical forensic examinations including physical assessment, documentation, evidence collection, and clinical care.  Various terms such as SAFE, sexual assault nurse examiner (SANE), sexual assault examiner (SAE), sexual assault medical forensic examiner (SAMFE), and forensic nurse examiner (FNE) are used to describe a health care provider who has been trained and is qualified to complete these exams.
In the acute phase following an assault, a SAFE’s primary role is to perform a medical examination of a victim to address their health care needs, assess for injuries, collect evidence, objectively document findings and collaborate with other members of the health care team to address the personal health, safety and emotional well-being of the victim. Additionally, sexual assault examiners are responsible for testifying as fact or expert witnesses, if subpoenaed by the prosecution or defense. 
On a SART, SAFEs —
- serve as liaisons with the medical community.
- provide current information from medical literature pertinent to sexual assault and best practice standards.
- collaborate with hospitals to maintain protocols for best practice for the care of sexual assault patients.
- assist in case reviews.
- help implement initiatives aimed at teaching the community how to prevent sexual assault.
- provide support and education to their SART specific to —
- recommendations for medical care following an assault (including sexually transmitted infections prevention, HIV prophylaxis, and emergency contraception).
- local health care resources available for victims of sexual assault.
- roles and responsibilities of medical forensic examiners.
Health Care Providers
Health care providers may be the first professionals victims encounter following a sexual assault. Not all providers (emergency room physicians, nurses, primary care physicians, obstetricians, gynecologists and midwives, American Indian healers, campus health center clinicians, public health professionals, dentists, mental health counselors, and military medical personnel) are trained in the acute care of a sexual assault patient, nor are they always aware of the local resources available for patients reporting a recent sexual assault. Your SART can provide education and information regarding local resources to community providers.
SARTs often include a medical forensic examiner on their team, most commonly a SAFE. That provider may be the person most ideally suited to serve as the liaison to the health care services in the SART’s jurisdiction. However, given the number of health care facilities in the community and size of the jurisdiction, this could prove to be an unreasonable expectation for one provider; this responsibility may fit best within overall SART responsibilities.
The objective for SARTs collaborating with health care providers is to consistently meet the needs of victims by ensuring —
- victims have access to comprehensive post-assault services in their community and resources to access those services,
- health care providers are aware of options for referral services regardless of a patient’s plan to proceed with evidence collection or report to law enforcement, and
- all community providers receive education on reporting options, so victims can make informed decisions.
To ensure quality health care for patients, your SART must be well informed of the available community resources that support recent victims of assault, facilities providing acute care, medical services, evidence collection, follow-up health care services, advocacy support, legal aid and local emergency shelters and the gaps in services that exist in your community.
Building relationships with the community’s health care providers is essential for your SART.
You can begin this work by inviting health care providers to your meetings, hosting trainings on the SART, and opening conversation with providers by inquiring about their experience caring for victims of sexual assault. SARTs have the unique opportunity to develop relationships with health care providers in the community, provide support and instruction on protocol development to support best practice standards, and assist with the development of guidelines for payment options for forensic examinations that are aligned with the Violence Against Women Act. 
To build collaborative relationships with health care providers in the community, your SART can develop a referral process. SARTs can conduct a health care-specific needs assessment to determine how health care providers manage treatment and referrals for patients seeking care for a sexual assault. Begin by determining which health care facilities have existing protocols and referral networks in place. Determine which providers at each location can be identified as a resource or liaison to your SART. Determine if there are individual providers or clinics in each facility available to see patients for follow-up and to meet their medical or mental health needs.
SARTs are encouraged to work collaboratively with health care facilities to develop protocols and seek their assistance with initial drafts and revisions. Before entering agreements with local providers and health care facilities your SART should identify —
- jurisdictional (state, tribal, or local) requirements for becoming a medical forensic examiner that impact training for health care providers,
- whether and where trained forensic examiners are available 24 hours a day, 7 days a week, and
- gaps in the existing medical response that need attention.
The National Protocol for Sexual Assault Medical Forensic Examinations  provides a foundation for the development of protocols for acute care and follow up of sexual assault victims. SARTs and health care providers, working together, can develop protocols for their own community or jurisdiction. With the establishment of standardized guidelines, your SART can help ensure providers are prepared to care for victims and refer them for medical and support services following an assault. Protocol should include payment mechanisms for evidence collection exams and referral information for victim compensation funds and other services and supports victims may need to access after the assault.
Establishing outcome measures for health care services can help SARTs and their health care partners evaluate their effectiveness. Understanding how victims access and perceive available services can provide beneficial information to foster open communication between providers and your SART for the continued improvement of victim services in your community. For more information see Evaluation in the SART Toolkit.
SARTs that include health care providers in their meetings and routinely engage with their community partners can build stronger relationships and foundations for success. It is beneficial for your SART to talk to health care providers on the following topics:
- Trained medical professionals providing post-assault care.
- Availability of providers.
- The current medical response to sexual assault in the community, including gaps in services.
- Obstacles to providing post-assault care for the community include — 
- lack of trained examiners,
- lack of support for on-call services,
- lack of administrative support from health care facilities, and
- limited number of patients resulting in lack of experience by trained examiners.
- Roles of the medical professionals in your SART (SAFEs, registered nurses, physicians, physician assistants, emergency medical technicians, (forensic) nurse practitioners, and mental health providers).
- Protocols and community resources needed for victims with substance abuse problems.
- Population specific providers or supports locally available to offer additional support to victims (ex. indigenous or culturally responsive healers).
- Law enforcement and crime lab collaboration to understand how forensic evidence from sexual assault evidence collection kits fits into the larger evidence collection context.
Victims' Practical Needs
Hospital-based SAFE programs must consider victims' practical needs, such as safety, food, clothing, and transportation. To help maintain the privacy of victims and their families who are in public emergency or waiting rooms, some hospitals have developed codes for personnel to use when referring to sexual assault cases. Medical professionals involved with SARTs can work with hospitals in their jurisdiction to create similar policies. 25
According to A National Protocol for Sexual Assault Medical Forensic Examinations, hospital personnel should make sure that patients are aware of available follow-up care and should arrange for such care before discharging them from the hospital. For example, personnel should — 
- provide referrals to other professionals,
- provide discharge instructions with a schedule of medications and a list of those received,
- arrange follow-up appointments,
- coordinate with advocates and law enforcement to discuss a range of other issues with victims prior to discharge, including safety planning, well-being, physical comfort, information needs, the investigative process, and advocacy and counseling options.
- provide referrals for mental health counseling, and
- ensure the patient is being discharged to a safe location.
Campus-Based Sexual Assault Care Settings
Students who are sexually assaulted may come forward at various entry points, with differing emotional states and at varying lengths of time following the assault. The victim may first contact a staff assistant, resident assistant, nurse, counselor, clinician, faculty member, administrator, volunteer advocate, or campus law enforcement. The American College Healthcare Association recommends that a seamless response to sexual assault includes service coordination between campuses and communities.
Students should be provided medical forensic examination access, options on reporting, law enforcement investigative response, access to judicial or disciplinary board proceedings, academic and housing accommodations if needed, and follow-up services including counseling, support, and advocacy. 27
Military Sexual Assault Care Settings
Victims who are serving in the military and reserves may also receive sexual assault forensic exams, which are provided by health care professionals who, ideally, have specialized education and clinical experience in performing a medical forensic exam and treating sexual assault victims. For more information, see the Sexual Assault in the Military section of the SART Toolkit.
The military's minimum standards of health care intervention correspond to clinical standards set in the U.S. Department of Justice's National Protocol for Sexual Assault Medical Forensic Examinations. However, clinical guidance is not solely limited to this resource. The U.S. Department of Defense's Sexual Assault Prevention and Response Office oversees policy directives, victim care, research and analysis, outreach, and operations. While national guidance exists through the Department of Defense, each branch and local installation has discretion over some aspects of implementation.
SARTs often struggle to maintain a full team, and a lack of administration support from hospitals is one reason for high turnover among medical forensic providers. To help ensure consistent staffing of medical forensic personnel, read the SAFE/SANE Sustainability section of the SART Toolkit and should consult the Building a Sustainable SANE Program section of the OVC SANE Program Development and Operations Guide.
Your SART can work to develop relationships with hospital administrators. This can help build understanding of the need and support for having medical forensic examiners on staff. Medical forensic examiners who do not receive administrative support with things like initial and continuing education and appropriate compensation for their expanded role are likely to leave their positions and subsequently cause increased stress on remaining examiners and hospital staff.
Ensuring hospital-wide protocols are in place that standardize care for sexual assault patients should place the responsibility on all hospital staff to identify victims, contact advocacy, and provide victims with an exam room.
Hospital administration can be instrumental in supporting SAFE programs and the work of your SART by furnishing equipment, exam room space, providing facilities for meetings, making connections with area resources, providing access to medical consultants, and other benefits in terms of resources and support.
Hospitals that are actively involved in providing services for sexual assault patients may receive positive publicity, obtain additional referrals from community partners for other victims of crime, add to their resources for providing care to unserved populations, enrich their relationships with their community, and attract highly skilled medical forensic providers to their organization.
Health Care Provider Resources
Best Practice for SANE (PDF, 4 pages)
This resource from the Wisconsin Coalition Against Sexual Assault covers best practices for sexual assault nurse examiners (SANEs).
This website includes links to hospitals in Cuyahoga County with 24-hour SAFE units.
This page provides a list of medical forensic exam programs.
This Office for Victims of Crime site provides a plan for communities to start a SAFE program and highlights innovative programs.
This website explains the history and benefits of the hospital’s SAFE program.
According to A National Protocol for Sexual Assault Medical Forensic Examinations, service providers should be able to explain to patients, in language patients understand, how confidentiality and privileged communications affect their medical records and forensic evidence collection.  Providers are obligated to inform patients when a mandatory report is required and which information will be shared. Even when the health care provider must disclose a patient’s name, the patient remains under no obligation to report or talk to law enforcement.
Medical professionals are bound by ethical responsibility and legal requirements, including the Health Insurance Portability and Accountability Act of 1996, to ensure patient’s privacy. Mandatory reporting laws require certain health care professionals to report suspected or known abuse (physical, emotional, or sexual) or neglect of children or elders. When providing care for a recent victim of sexual assault, it is not unexpected for providers to encounter situations where mandated reporting is required. If the victim is a child, elderly, mentally incapacitated, or depending on the type or severity of the injury (near death, death), filing a report may be necessary.
In cases where there is a statutory mandate to report the crime to law enforcement, (e.g. reporting required for all sexual assaults of patients less than 16 years of age), it is the health care provider’s responsibility to make a report, even if the patient was a willing participant in the sexual activity. In these situations, it is essential that the provider first inform the patient of their legal obligation to report and the possible outcomes of that report.
Victims have the right to share information about the assault with whomever they choose. It is critical victims be educated about their options. If victims choose to report their assault to law enforcement officers, justice system-based advocates, or share information with adult or child protective services workers, the information is typically available to investigators, prosecutors, and defense attorneys. Sharing information with a patient about reporting, privacy, and mandatory reporting empowers patients to be active participants in their care.
Consent for Care by Medical Providers
It is the responsibility of the medical provider to seek informed consent prior to any medical treatment or procedure. This includes providing information that helps the patient understand the benefits and risks that may be associated with the treatment. The information should be given in a language that the patient can understand and that is developmentally appropriate. 
During the forensic medical examination and consent process, medical providers should be sensitive to verbal and nonverbal cues from patients and adjust their methods of seeking consent to meet patients' specific needs, including encouraging patients to ask questions. Medical providers must provide this information without judgment or prejudice to ensure the decision is truly that of the patient. Consent is a process that continues throughout the medical forensic examination. 
The patient should be made aware that the provider will continue to seek consent as the exam continues and at any point the patient may withdraw their consent or decline any or all of the examination or procedures associated with the examination.
To give informed consent for medical care, patients must understand the full nature of their consent to each procedure, including what the procedure entails, possible side effects, limits of confidentiality, and potential impacts in order to make informed decisions regarding the nature and consequences of the medical intervention, the proposed treatment, and alternatives to treatment.  Written and verbal consent must be gathered for medical and evidentiary procedures throughout the exam process.
A National Protocol for Sexual Assault Medical Forensic Examinations provides an in-depth explanation of informed consent and when it should be gathered throughout the exam process. 
Consent is typically needed for — 
- general medical care,
- evidence collection,
- obtaining photographic evidence,
- pregnancy testing and reproductive health care,
- testing and prophylaxis for sexually transmitted infections and Hepatitis B,
- HIV prophylaxis,
- permission to contact the patient for medical purposes, and
- release of medical information.
Health care providers need to have policies in place to address consent when patients are minors, have cognitive disabilities, are vulnerable adult patients, are temporarily impaired (due to drugs, alcohol or other), or are unconscious. All policies should respect the autonomy of the individual and be consistent with jurisdictional interpretations of emergency exceptions to informed consent. These policies are best developed in conjunction with advocacy organizations, law enforcement agencies, district attorney's offices, forensic examiner programs, and hospital administrators, when applicable. Hospital ethics committees should ideally approve policies. 15
SAFEs should develop policies and procedures for providing sexual assault care to an unconscious patient that outline what care should be provided and under what circumstances hospital personnel will be involved in making these decisions. A Guide to Assessing Decision-Making Capacity  offers additional points to consider when setting up policies.
The following forms provide examples for informed consent:
Colorado Sexual Assault Consent and Information Form (PDF, 1 page)
This example form from the state of Colorado allows the patient to consent to a medical exam, make a report, or not make a report, as well as consent for law enforcement to release or collect and store evidence.
This example form allows Colorado patients to provide consent for a medical exam, make an anonymous report, or not make a report.
This example form from Immanuel St. Joseph’s-May Health System empowers the patient to provide consent for or decline a medical exam, authorize the hospital to release the evidence, or decide not to report.
Authorization for Release of Drug Facilitated Sexual Assault Screening (Microsoft Word, 1 page)
This document allows the patient to provide consent for evidence collection to identify the presence of drugs during a sexual assault exam.
Consent for a Forensic Evaluation (Microsoft Word, 3 pages)
This form, from Sexual Assault Forensic Examiner Technical Assistance (SAFEta), allows a patient to provide consent for a forensic exam as well as for photography.
Informed Consent for Sexual Assault Evidence Collection (PDF, 1 page)
This form from SAFEta allows the patient to request evidence collection and decline an interview with law enforcement.
Acute sexual assault should be triaged as an urgent medical event even in the absence of noticeable physical injuries. During intake, hospital personnel should provide a private setting to ensure confidentiality and prevent a recent victim from waiting in a public area. The intake process should include calling victim advocates. This can be done without releasing any personal information about the victim. Crisis intervention is most effective when it is offered as quickly as possible.
Emergency department personnel must manage victim intakes and any patient transfers in accordance with state and federal laws. For example, according to the Ohio Protocol for Sexual Assault Medical and Forensic Examination —
- the patient should be seen by a provider within 15 minutes of arrival, or as soon as possible.
- the patient should be given priority for room assignment in a private area.
- regardless of whether the patient chooses to proceed with prosecution or talk with law enforcement, swift and immediate medical care must be provided.
- medical personnel must inform patients of their rights in choosing whether to speak to law enforcement personnel.
- rape crisis advocates are to be contacted at the same time physicians or medical forensic examiners are called and should be present when advocate support is offered to patients.
- to ensure that the patient feels safe saying who they would like present during procedures, medical personnel should ask everyone accompanying the patient to leave the room and then should ask the patient to name the people they would like present, if any.
- speaking to law enforcement can never be a precondition to the collection of evidence.
Exams can be performed in clinics, hospitals, community-based advocacy or sexual assault programs, campus health centers, traditional health settings, and others. Most SAFE programs are based in hospitals (75 percent) and are located in the emergency department; others are located in community settings, such as rape crisis centers or health clinics. 21 State and local laws and protocols may dictate where exams can take place.
Regardless of the setting, consider whether the current or proposed location includes timely, compassionate, victim-centered care that meets the health care needs of victims, including the ability to provide sexually transmitted infection prophylaxis, contraception, and evidence collection as needed. A National Protocol for Sexual Assault Medical Forensic Examinations contains a section on facilities. 
When designating a sexual assault exam site for your SART, consider whether — 
- forensic medical examiners are available to victims within a reasonable timeframe:
- In many regions, the acceptable response time is 60 minutes.
- It is essential that there be rapid availability to ensure that the patient’s health care needs are met, including the emergent evaluation of injury and risk for HIV.
- a program coordinator is needed to exercise administrative and clinical oversight.
- quality medical care provided to victims includes screening, evaluation, and treatment.
- services are compliant with Emergency Medical Treatment and Active Labor Act (EMTALA) requirements for patients presenting for emergency care. For more information see the EMTALA section of the SART Toolkit.
- protocols include quality assurance mechanisms for the collection and storage of evidence. For more information see the Chain of Custody for the Sexual Assault Kit section of the SART Toolkit.
- victim advocates are available to respond to victims.
- the exam facility is appropriately equipped, including facilities that are fully accessible for individuals with disabilities.
- protocols include procedures for safe discharge, medical transfers, follow-up care, consultation and referrals, replacement clothing, and transportation.
- protocols include prophylaxis for sexually transmitted diseases, hepatitis B, and HIV.
- protocols provide specific information to meet victims' reproductive health concerns.
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires that emergency and ambulatory care facilities put policies in place that will help identify and assess potential victims of sexual assault.  JCAHO also requires staff to be trained on these policies and that facilities clearly define their responsibilities for collecting and preserving evidence.  Sexual assault examiner programs are helping many health care facilities to meet these requirements. 
SARTs often struggle with turnover among key staff, including the medical/forensic examiner, which on many SARTs is a SAFE.
The 2016 U.S. Government Accountability Office report Sexual Assault: Information on Training, Funding, and the Availability of Forensic Examiners summarizes sustainability challenges for forensic examiners and SAFEs and describes strategies to address these challenges. Web-based training courses, clinical practice labs, mentorship programs, and multidisciplinary teams that respond to sexual assault can all help keep key staff such as SAFEs on board with SARTs.
The Government Accountability Office report also describes promising practices, such as telemedicine, that connects local medical providers with specialists in sexual assault medical forensic exams. The National TeleNursing Center in Massachusetts is one location exploring the benefits of telemedicine.
The Office on Violence against Women funded the SANE Sustainability Project to address the challenges faced by SAFE programs. The project provided targeted on-site technical assistance to 10 SAFE programs and their community partners who identified themselves as in danger of closing. 
The project identified common problems for SAFE programs struggling to survive:
- Recruiting staff.
- Retaining staff.
- Providing 24-hours-a-day, 7-days-a-week coverage.
- Addressing conflict within the staff.
- Evaluation (program and policy).
- Funding (billing, budgeting, marketing, fundraising).
- Collaboration within the facility.
- Collaboration with the community.
- Expanding services beyond sexual assault care.
- Formal training for administrators.
SART Support for SAFE Programs
SARTs can be critical to assuring that SAFE programs are developed and sustained locally by engaging administrators and health care providers at local hospitals or other health care facilities. Hospital administration may consider sexual assault a criminal justice issue, rather than an essential health care service. Providing information on the health care costs of sexual assault can be helpful to gain support. The community members of your SART can encourage hospital administration to establish and sustain SAFE services, as well as advocate for space and personnel.
A single hospital or health care facility may not be willing to provide all the resources necessary to create a SAFE program, but may be willing to pool or share resources. Your SART can also apply for external funding to support a SAFE program, which may make it possible for health care partners.
SARTs Without SAFEs
Many SARTs exist for a period of time without a SAFE or other medical or forensic providers on the team. Depending on the location, available resources, or other factors, SARTs may exist for years with a struggling or inconsistently staffed SAFE Program. A SART’s responsibility is to ensure victims receive the best care available and to build systems that improve the standard level of care to meet national best practices for all victims.
In the absence of a SAFE locally, your SART should identify where the most appropriate SAFE program is located and develop temporary protocols to ensure that providers and victims are able to access those services. Factors such as distance, availability of transportation, jurisdictional concerns, available SAFEs, hospital administration support, and the availability of non-hospital-based SAFE-trained providers (tribes, campuses, military) should be considered when determining how best to meet victims’ needs.
Protocols should be developed with temporary providers to ensure victims’ needs are met throughout the process and all routine evidence collection, transportation, reporting, referral to advocacy, and applicable confidentiality laws are followed.
SARTs should continue to work in their local communities to develop consistent access to SAFEs or other trained medical forensic examiners. The OVC SANE Program Development and Operation Guide describes how supportive stakeholders can be the primary motivators for SAFE program development. 
Your SART can create a SAFE program development team to explore financial and political support and other goods and resources that could help get a SAFE program established. This team can also provide guidance for determining the best SAFE program model for your community. Assuring that the best possible medical/forensic care is delivered in a timely manner should be at the heart of the process.
SAFE Sustainability Resources
Numerous resources have been developed to address SAFE program development and sustainability and medical forensic care of sexual assault victims.
This blog seeks to enhance clinical excellence by promoting scientific literature, peer-reviewed technical guidance, and free and low-cost continuing education.
IAFN is a membership organization that supports and provides information for forensic nurses.
This organization provides technical assistance for pediatric sexual assault forensic examinations.
This email group, hosted by NSVRC, is a way to learn about events, connect with other SARTs, and connect with national technical assistance providers and seek support on local concerns.
This online OVC developed resource helps programs that are developing or looking to sustain SAFE Programs.
SAFEta.org provides technical assistance for those using the National Protocol for Sexual Assault Medical Forensic Examinations.
This app, developed by The International Association of Forensic Nurses (IAFN) and National Sexual Violence Resource Center (NSVRC), provides up-to-date resources and tools for program management, geared toward existing programs. It is an essential resource for SAFE program leaders, whether or not they have formal management training or managerial positions in their health care facilities.
SANE Sustainability- Making the Argument (multimedia, 13:09)
This podcast is from a portion of the SANE Sustainability six-week online course that was offered by IAFN and NSVRC. This course highlights ways in which to cultivate leadership and build a successful, sustainable SAFE program.
A prosecutor is a trial lawyer who investigates and tries criminal cases on behalf of the government. Prosecutors are often known as district attorneys, state's attorneys, or United States attorneys.
On a SART, prosecutors perform the following functions —
- keep the team informed about the legal status of cases, including decisions about which cases will or will not be prosecuted.
- assist in developing and implementing strategies to enhance prosecution of sexual assault.
- assist with case reviews.
- educate the team about prosecutorial policies and practices that have an impact on cases involving sexual assault.
- help implement initiatives educating the community about prevention of sexual assault and what is being done to improve the experience for victims who report an assault.
- provide explanations of legal terms and principles as they relate to prosecution.
- provide training on pertinent legal issues that affect how other members of the team approach their roles and responsibilities.
- serve as liaison with other offices or agencies.
Overview of Prosecution
The prosecutor’s duties are to seek truth and justice, to fight for victim safety and offender accountability, and to ensure that all parties involved in the prosecution of a criminal case receive fair treatment, with their legal rights diligently protected.  These duties, and the position of prosecutors in the criminal justice system, make prosecutors ideally situated to take a leadership role in the effort to improve the criminal justice system’s response to sexual assault.
In sexual assault cases, prosecutors should collaborate with law enforcement, health care providers, victim advocates, and other professionals to coordinate efforts and address challenges in the criminal justice system. Prosecutors can leverage specialized resources and training opportunities, and implement promising new practices while refining established processes to improve systemic responses to sexual assault.
Prosecutor Responsibility to Victims
Prosecutors have special responsibilities to victims of sexual assault in view of the uniquely traumatic impact of these crimes. Prosecutors have a duty to treat victims with fairness, respect and dignity; to inform victims about all critical stages of the criminal proceedings; to use all means at their disposal to keep victims safe from intimidation, harassment and abuse; to ensure that victims have the opportunity to be heard at certain key proceedings; and to meet personally with victims to discuss the crime, as well as to discuss and explain decisions to charge and prosecute, decisions to decline prosecution, and any proposed dispositions.
Many states have victims’ rights laws; prosecutors and SART members should look to their jurisdiction’s specific laws for more guidance.  Prosecutors may also work with victims who have different immigration statuses; see Best Practices for Law Enforcement Agencies and Prosecutors’ Offices Working With Immigrant Sexual Assault Survivors.
Victim safety is of paramount concern in sexual assault cases as in all crimes of violence against women. Victim safety goes beyond appropriate provisions for physical safety to include concerns for the victim’s emotional well-being. Prosecutors should inquire regularly about the victims’ needs, informing them of available resources. Prosecutors will also prepare victims for the rigors of trial by explaining what the victim can expect by way of direct, cross, and redirect examinations and orienting them to courtroom logistics and procedures. Prosecutors should recognize and respect the importance of community-based advocacy and the confidentiality it provides to victims. Prosecutors should work diligently to protect victim privacy in the context of demands for discovery or media requests.
Prosecution Role and Responsibilities in a SART
Prosecutors are foundational members of a SART, along with police, advocates, and medical forensic examiners. Prosecutors provide the team with unique insight to the trial aspects of every case. They also educate the team about the members’ legal obligations, suggest helpful strategies, and advise on relevant constitutional and statutory rights and requirements that may affect defendants, victims, team members, and the operation of the SART.
Prosecutors may provide comprehensive support and regularly participate in SART meetings. Prosecutorial participation in your SART improves trust and enhances communication between prosecution and other team members, not only at the meetings but in the daily responsibilities of SART members. Prosecutors can describe what circumstances of sexual assault rise to the legal level of a crime in a particular jurisdiction and support team members’ understanding of charging decisions. Ideally, the chief prosecutor in a jurisdiction lends political support to the SART and its efforts, contributing to the legitimacy and value of the SART and demonstrating a commitment to victims of sexual assault.
During case review, a prosecutor’s presence ensures a multidisciplinary, complete review of both open and closed cases within the SART. Prosecutors provide a unique vantage point in case review and can assist your SART in identifying areas of opportunity for improvement. They also assist in reviewing standardized operational procedures in the field, reviewing practices, and updating procedures that impact various aspects of case investigation and prosecution.
Prosecutors may also be able to access and network with other governmental or private entities in the community, whose cooperation is necessary for the success of team efforts. Prosecutorial involvement in your SART is institutionalized via a MOU incorporated into your policies and procedures.
A valuable attribute of a SART is its ability to define and explain the role of each member. Your SART refines a collective understanding of each member’s duties and obligations, permitting members to educate each other about their unique knowledge and perspective of sexual assault cases. Prosecutors share their knowledge of the criminal justice system, trial experience, and charging viewpoints about sexual assault cases and in turn gain insight and knowledge from other team members.
Prosecutors should inform team members about discovery obligations, evidence admissibility requirements, and the statutory elements of various sexual assault offenses. They should discuss with the team the final disposition of each case including declination of prosecution, plea agreement, trial outcome, sentencing decision, appellate results and any revocation of probation or parole. Prosecutors contribute an important perspective in SART discussions of continuous improvement in systemic responses to sexual assault.
Engaging Prosecutors in the SART
It is not unusual for SARTs to experience challenges in having regular participation on the team by prosecutors, primarily due to caseloads and court schedules that prevent them from attending meetings. Your SART leadership can outline the benefits of SART participation, and can also leverage support from community leaders to encourage prosecutors to participate. The participation of systems-based victim and witness advocates, housed in the prosecutor’s office, can also bring a prosecution perspective to your SART, and help advocate for active participation by prosecutors.
A jurisdiction’s chief prosecutor can articulate the need for the SART to additional community and governmental stakeholders, and provide the top-down leadership and support. An active systems-based victim and witness advocate can be a helpful liaison to community-based organizations and provide useful feedback about the impact of criminal justice practices on victim safety and security. For more information, see the Systems-Based Advocates section of the SART Toolkit.
SARTs work best when they bring together all the professionals who work with victims on sexual assault cases, enabling them to pool their education, experience, and judgment to continually re-examine and refine their practices. The collaborative qualities of a well-run SART make the team much more powerful than the sum of its parts, promoting the overarching goal of achieving justice in every individual case.
SART Benefits for Prosecutors
The benefits of active and meaningful prosecutor participation in SARTs are well documented.  SARTs improve prosecutors’ understanding of the dynamics, characteristics, and personal impact of sexual assault, which leads to better preparation, strategy and trial execution of cases. SARTs improve the victims’ experience with the system by promoting comprehensive, trauma-informed investigations, which increases their willingness to participate in investigations and prosecutions. SARTs also help prosecutors develop strategies to identify significant trial issues and overcome common barriers to successful resolution of cases at trial.
Participation in a SART benefits all members, prosecutors included.  Following are the three primary advantages of participation for prosecutors:
- Education : Perhaps the greatest benefit is the opportunity for education and cross-training. This is an opportunity to share with other SART members the policies and practices of their office, their approach to cases, and their statutory and ethical duties to provide discovery and exculpatory information to the defense.
SARTs provide an opportunity to learn more about the dynamics of sexual assault and its impact on victims. Advocates, who work daily with victims of sexual assault, can assist prosecutors in understanding the evidence in these cases and can help improve their interactions with victims. They can also help prosecutors identify evidence of trauma, making trials more compelling. Team members can help prosecutors to put issues into context at trial, such as victim behavior, absence of physical injury, or voluntary intoxication. Prosecutors also benefit by learning how collateral systems in police work, health care, and advocacy operate in their jurisdiction.
- Teamwork : Working in a team setting improves communication, information sharing, and the overall system response to the needs of the victim. Prosecutors and police are not in the position to perform certain tasks essential to effective response. First and foremost, victims who have suffered the trauma of sexual assault have immediate and ongoing needs for safety and support that must be met. Victim safety requires assessments and planning, and advocates provide these crucial services for the victim, which in turn benefit police and prosecutors during the investigation and trial, as well as for any post-trial issues.
A strong, supported victim is a stronger witness. Medical personnel ensure that victims are treated for their injuries, including the risk of disease or pregnancy, and collect crucial evidence for analysis. Advocates and medical professionals who are informed about the criminal justice system better serve their clients and can even vouch for investigators and prosecutors as known and trusted professionals. The many perspectives represented in the team will lead to overall improvement to the response. Team members provide crucial support to prosecutors as they navigate the difficult course of a trial and as they review prior practices and explore new strategies.
- Coordination : SARTs also improve coordination of effort in the system’s response to sexual assault. Whatever the point at which victims enter the system, they will receive the same accurate information about how the system works and what to expect. Coordination helps eliminate duplication of effort, highlights any gaps in the system, and permits issues to be addressed in a comprehensive fashion. Additionally, outreach efforts to engage and educate community partners and the community at large can be coordinated for maximum impact.
Securing Prosecutor Participation
The benefits of SART participation should be persuasive arguments for prosecutor participation in the SART. While all team members have demanding workloads, prosecutors are often required to be in court much of the time, and thus may have less flexibility to be available for team meetings. Some SARTs organize around the prosecutor’s schedule by selecting a day and time when prosecutors are less likely to be needed in court (e.g., the last Friday afternoon of the month or after court has adjourned for the day) or by holding meetings at the prosecutor’s office.
Every prosecutor’s office will want to demonstrate to their community that they recognize the seriousness of sexual assault and are committing their available resources and partnerships to maximize the effectiveness of their response. SART participation offers prosecutors an opportunity to engage the community in a positive way. It encourages victims to report these crimes and to remain engaged with the criminal justice process, with assurances that the case will be treated seriously and appropriately by all involved.
Finally, just as there are benefits to prosecutor participation in a SART, there are risks involved when the prosecutor does not participate. Failure to coordinate the elements of the response can lead to inadequate police investigations, missed opportunities to engage the victim, failure to provide adequate safety and support, and less-than-compelling evidence at trial. The costs of opting out of the SART, which include not only a failure to achieve justice but also a loss of community confidence, far outweigh the cost of participation.
Challenges for Prosecutors: Brady Rule
One perceived challenge for prosecutors is the sharing of case-specific information that may reveal exculpatory and discoverable information that they are required to share with the defense. The duty to disclose exculpatory evidence is largely defined by the Brady rule, which requires prosecutors to disclose to the defense any material exculpatory evidence in the government’s possession. 
“Brady material,” evidence the prosecutor is required to disclose under this rule, includes evidence that tends to negate a defendant’s guilt, reduce a defendant’s potential sentence, or affect the credibility of a witness. While prosecutors have a duty to disclose such information in advance of trial, the timing of such disclosures may be coordinated to allow for safety planning. Prosecutors can seek a protective order, delaying or denying disclosure in the interest of victim or witness safety and privacy.
In reality, when preparing for trial, prosecutors will need to know all of the information and appropriately disclose that information when obligations require them to do so. Obtaining this information as early in the pretrial period as possible allows the prosecutor to strategize and prepare to meet any safety or privacy challenges potentially posed by release of the information. Your SART should be prepared to work with prosecutors to develop policies that minimize any negative impacts that could be caused by the Brady rule.
When SARTs seek to develop a relationship with prosecutors, it is important to understand and share all legal responsibilities regarding victim information for each participant. Your SART should always be clear when victim-specific information will be shared. Many SARTs do not discuss victim-specific information at every meeting and have specific processes in place prior to meetings where victim information will be shared to ensure that confidentiality is respected and legal responsibilities are upheld. For more information see the Confidentiality section of the SART Toolkit.
Prosecutors have many available resources to assist them in realizing maximum benefit from their participation in SARTs. These include dedicated training to promote the effective prosecution of sexual assault cases, sample MOU defining roles and obligations, SART Toolkits, and coordination with existing SARTs in nearby jurisdictions to observe meetings and ask questions to learn how other successful teams operate.
The AEquitas library includes resources on the investigation and prosecution of sexual assault, intimate partner violence, stalking, human trafficking, and other violent crimes.
Best Practices for Prosecution (PDF, 11 pages)
This resource from the Wisconsin Coalition Against Sexual Assault covers best practices for prosecutors working on cases of sexual assault.
This webinar recorded by AEquitas discusses how and when expert testimony may be admissible in cases of sexual violence to explain victim behavior.
Model Response to Sexual Violence for Prosecutors (PDF, 235 pages)
The Model Response to Sexual Violence for Prosecutors, developed by the Urban Institute, The Justice Management Institute, and AEquitas, outlines the model response covering all aspects of sexual violence prosecution.
This organization supports prosecutors and other professionals in helping survivors of gender-based violence find justice and holding offenders accountable.
Developed by AEquitas, this guide walks prosecutors through understanding the medical evidence, working with the SAFE before and during trial, terms related to the medical forensic exam, and sample direct questions for the SAFE.
Wisconsin Prosecutor’s Domestic Abuse Reference Book, second edition (PDF, 582 pages)
Although this 2012 resource is specific to Wisconsin, it provides in-depth information on domestic abuse, including sexual assault. There are several resources and case references that may be useful to prosecutors in any jurisdiction.
Technical Assistance Providers for Prosecutors
AEquitas is dedicated to improving the quality of justice in sexual assault, intimate partner violence, stalking, and human trafficking cases by developing, evaluating, and refining prosecution practices that increase victim safety and offender accountability. AEquitas provides 24-hour, 7-days-a-week technical assistance and case consultation, training, and a library with publications, statutory compilations, abstracts, etc.
Legal Momentum is a national nonprofit organization that leads action for the legal rights of women. Its targeted litigation, education, policy advocacy, and research help to shape the laws and policies that affect gender equality and ensure that they are properly implemented and enforced.
NCPCA hosts national, regional and local training on state-of-the-art basic and advanced training using evidence-based and victim-centered practices; provides immediate, comprehensive technical assistance; develops and distributes publications on a range of child maltreatment topics; and contributes to coordination efforts to improve resource delivery.
NCPVAW is a program of the National District Attorneys Association (NDAA) and exists to serve prosecutors, members of the prosecution team, and other allied professionals as they strive to deliver justice to all victims of domestic violence, dating violence, sexual assault, and stalking and to hold criminals accountable. NDAA maintains a Yahoo group listserv, open to prosecutors and law enforcement personnel.
Emergency medical services (EMS) personnel — paramedics, emergency medical technicians, and medical first responders — are responsible for providing early, pre-hospital treatment to those in need of urgent medical care and rapid transportation to an emergency department.
“EMS providers work well at addressing the patient’s medical needs, but often fail to comprehend or meet a patient’s emotional needs, causing a withdrawal of cooperation from within the judicial process. EMS education also leaves large gaps in knowledge needed to help preserve biological evidence and maintain the chain of custody of evidence taken into our possession. EMS providers are often one of the first people to contact a victim,  and their actions play an important role, whether or not an immediate life threat is present.” 
On a SART, EMS personnel provide the SART with medical information related to emergency procedures in response to sexual assaults. They can —
- give detailed explanations of EMS procedures and protocols,
- assist the team in developing crime scene preservation practices,
- act as a liaison between the team and the EMS community,
- help implement initiatives aimed at teaching the community how to prevent and respond to sexual assault, and
- participate in the SART response to sexual assault by providing care for victims, documenting care, and providing testimony in court.
Emergency Medical Services
EMS may be provided by fire departments, private ambulance services, city, county, or other municipality, hospitals, or a combination of these. Emergency medical technicians (EMTs), paramedics, and first responders may be paid or could be volunteers. Although a small percentage of sexual assault victims enter the medical system through EMS (e.g., by ambulance), including EMTs and paramedics as core SART members can be a critical component of a coordinated response that meets the needs of all victims.
Whether or not EMS is a member of your SART, the team can train EMS providers on how to properly assess and treat victims of sexual assault and on the importance of transporting victims to a designated sexual assault medical forensic exam site. SARTs can also —
- contact schools, offering initial first responder, EMT, and paramedic training to set up workshops on victim-centered responses to sexual assault,
- inform EMS of designated exam facilities, 
- define procedures for transferring patients to designated exam facilities,
- discuss reimbursement benefits available when victims are transported or transferred by ambulance such as victim compensation,
- inform EMS about evidence collection, and
- provide information about the aftermath of sexual assault on victims.
Whether or not EMS is a member of your SART, EMS can —
- provide feedback,
- inform the development of protocols,
- share concerns or feedback from the field, and
- seek support and training on situations concerning victims.
The National EMS Education Standards and National EMS Core Content provide limited insight into the handling of sexual assault victims aside from stating EMS are responsible for review of emotional support techniques, controlling vaginal bleeding, and evidence preservation related to medical and legal ethics.  With limited national guidance, local collaboration is essential to ensure EMS personal are a strong link in supporting victims of sexual assault.
SARTs may provide the opportunity for EMS to develop consistent policies and protocols for providing care to victims of sexual assault. EMS should be aware that a request for assistance following sexual assault does not automatically imply consent for treatment. If injuries do not appear serious, EMS providers should still emphasize the need for further medical evaluation to address related health concerns.
The amount of information victims want or need at this time varies and could be offset by other issues such as concerns about safety, family reactions, or language barriers. EMS personnel can benefit from connection with a SART to ensure their responses to victims are trauma-informed.
Sample EMS Protocol
- Build consensus among involved agencies regarding procedures for coordinated initial response when a recent sexual assault is disclosed or reported. Educate responders to follow procedures. 
- Recognize essential elements of initial response. 
- Have an updated list of medical forensic providers or locations for SAFE/SART exams in the state or service area.
- Receive training on: transport decision-making, trauma-informed care, law enforcement and mandated reporting requirements, victims’ rights and options for reporting and evidence collection, evidence preservation, confidentiality and privacy considerations, and emergency medical record documentation requirements. 
- Ask victims if they would like family members or friends to be contacted.
- Explain victims' rights for advocacy, even if victims choose not to receive medical care or have the medical forensic exam.
- Explain reporting options to victims, keeping in mind that the amount of information desired will vary with each individual.
- Take measures to preserve crime scene evidence, including evidence on victims.
History and Documentation
- Document victims' demeanor and statements related to the assault (e.g., time, date, place of attacks).
- Obtain medical history, including the possibility of pregnancy.
- Document physical areas violated in the attack if victims volunteer the information. Include all marks or evidence of trauma, including marks indicating strangulation, and other significant physical findings.
- Record information about whether victims have bathed since the attack.
- Document all treatment given.
Physical Exam (unless a life-threatening condition that needs immediate treatment occurs)
- Keep in mind that physical exams need to be limited in scope without causing further emotional distress to victims.
- Explain to victims the importance of preserving bodily evidence until it can be collected (e.g., do not wash, change clothes, urinate, defecate, smoke, drink, eat, brush hair or teeth, rinse mouth).
- If drug-facilitated sexual assault is suspected and victims cannot wait to urinate until arriving at the exam site, collect urine samples.
- Establish consent for all treatment.
- Obtain vital signs.
- Stabilize injuries that need immediate attention (e.g., fractures, bleeding).
- Advise victims of their right to have an advocate meet them at the exam facility.
- If victims are wearing clothing worn during the assault, determine if it is possible for them to bring replacement clothing to the hospital, as victims' clothing is often taken into evidence.
- If victim changed clothes after the attack, make sure that they bring the clothing they were wearing while assaulted. Use paper rather than plastic bags as plastic bags trap moisture and promote mildew, which destroys vital evidence. Follow law enforcement procedures for retrieving clothing or other items from a crime scene so that evidence is not inadvertently destroyed or contaminated.
- Transport victims to designated facilities where medical forensic exams are performed, unless medical conditions or local protocol dictate otherwise.
- Victims with disabilities may have equipment (e.g., wheelchairs) or service animals that also need to be transported.
- Notify receiving facilities of estimated time of arrival according to jurisdictional policies. 
- Document when and why transport does not take place.
- Provide information if the victim does not wish to be transported to the hospital, including where to go if they change their mind and who they can contact for advocacy or to report to law enforcement. Any other resources available in the community should also be described.
Emergency Medical Services Protocol for Sexual Assault (PDF, 6 pages)
The EMS Protocol for Sexual Assault offers guidance to medical professionals offering medical treatment and performing forensic evidence collection for victims of sexual assault. The protocol instructs medical professionals on how to provide sensitive and impartial emergency responses to sexual assault victims in scene response, patient evaluation, medical treatment, transport of victims to medical facilities, documentation, and evidence handling.
This page from the International Association of Forensic Nurses provides recommendations for facilitating initial contact with victims.
In Your Own Backyard: Survivor Inspired Change (PDF, 2 pages)
These tools for EMS responding to a sexual assault were developed by the Texas Association Against Sexual Assault. This sheet offers advice to emergency medical service professionals for responding effectively to sexual assault victims, and provides guidance on respectful treatment of victims, medical and forensic evidence collection options to victims, and thorough documentation and evidence preservation.
Report to the Governor, the Senate Finance Committee, and the House Health and Government Operations Committee Regarding Improved Access to Sexual Assault Medical Forensic Examinations in Maryland (PDF, 133 pages)
This report presents the findings of the Maryland Planning Committee to Implement Improved Access to Sexual Assault Medical Forensic Examinations in Maryland regarding sexual assault victim access to medical care and forensic evidence collection.
The SAFEta organization offers recommendations to medical professionals for carrying out effective first response to sexual assault victims.