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Community and Partner Education

Ongoing training and education is an essential part of a successful MDT. The vast majority of MDTs engage in multidisciplinary cross-training (76%) and training conducted by non-SART members (74.3%), though fewer than half engage in these trainings on a regular basis (38% and 22.8% respectively).107 There are many advantages to training together as team. First, it helps clarify each team member's role and responsibilities. Second, it helps to build better working relationships, making it easier to find solutions when problems arise. Education should occur if a change in one member's protocol would affect other team members. For example, if a crime lab decides that samples for DNA can be collected more than 5 days after the assault, everyone will need to be involved to make sure patients are offered the opportunity for evidence collection within the appropriate time period. Team training should be an expectation of all MDTs.

Table 3: SANE Program Benefits of Diverse MDT Membership

Stakeholder Group During Program Planning During Implementation During Ongoing Operation
Adult Protective Services  Determine a program’s mandatory reporting requirements Assist in developing mandatory reporting policies and procedures  
Children's Advocacy Centers

Assist with needs assessment

Provide demographic and statistical information

Preceptorship/clinical training for SANE-P

Assist in developing team protocols, confidentiality issues

Assist in ongoing training SANE-P

Provide process for case reviews

Neutral locations for team to meet

Child Protection/ Indian Child Welfare Services

Provide expertise on child maltreatment with emphasis on sexual victimization of minors 

Educate MDT partners on mandated reporting and maltreatment types that require a report

Assist in protocol development in cases that require or may benefit from child protection/welfare involvement

Promote cooperative co-investigations of child welfare/ protection and law enforcement

Refer victims to MDT partners and receive referrals from MDT partners

Participate in the case review process to promote the safety and well-being of victims

Participate in cross-training of MDT partners

Clergy/Faith Community  Assist with needs assessment of invisible communities

Education for faith community members

Input on cultural considerations important to their members

Referral source for clients

Possible supportive role for provision of items for victims (clothing, personal items)

Community-Based Rape Crisis Advocacy 

Assist with needs assessment

Provide demographic and statistical information

Site visit for SANE training

Train on the advocacy needs of victims

Develop a victim-centered approach and protocols

Referral sources for patients and families

Represent and advocate for the needs of victims during the team process and throughout the criminal justice process

Corrections Assist with needs assessment regarding correctional victims Train on special needs and circumstances of victims in corrections Responsible under the Prison Rape Elimination Act (PREA) for providing response to rape victims, including access to forensic examinations and victim advocacy
Crime Lab

Provide the service laboratory(ies) with the necessary information to forecast expected collection/submission metrics for the identification of testing resources

Design/procure/distribute appropriate sexual assault kits for evidence collection

Train SANEs on the collection and preservation of evidence

Clarify the potential and limitations of forensic testing services

Brief MDT partners on the submission and searching of forensic DNA profiles to CODIS

Develop best practices for the collection and testing of evidence

Provide data on the success of forensic testing

Provide training to SANEs to remain proficient

Culturally Specific, Community-Based Organizations Help MDT identify the best way to access specific populations in order for them to have access to services Make sure services and their locations are culturally appropriate Provide feedback about the acceptability of services to culturally specific groups and resources and support for service providers
Civil Attorneys  Assuring that a patient's civil legal rights are protected through the response process Forms and protocols meet privacy needs Provide consultation about victims' rights issues
Deaf Victim Services Agencies

Assist with needs assessment

Provide expertise on sexual violence against Deaf people

Train on Deaf culture and language access

Provide guidance on how to make services accessible

Assist in developing language access policy, including how to secure qualified interpreters

Referral source for patients
Disabilities Services Agencies 

Assist with needs assessment

Understand the specific needs of the populations they serve, including the need for adaptive equipment or modification of processes and protocols

Train on disabilities and accessibility

Provide information on how to make services accessible and applicable to the populations they serve

Assist in developing accommodation policies and procedures.

Referral source for patients and families.

Provide expertise for specific patient populations

Assess accessibility of the program on an ongoing basis

Domestic Violence Crime-Specific Agencies  Identify existing resources Assist in protocol development Provide expertise for their specific patient populations
Education System Identify existing resources for survivors within education systems in the community Make sure protocols do not conflict with Title IX Provide ongoing consultation
Judicial System    Provide input on protocols  
Law Enforcement 

Work to create a standardized communication network, identify response partners, and determine a logistical response to sexual assaults 

Assist in developing regional or statewide response practices.

Assist in defining roles and creating MOUs

Educate the team on law enforcement response to sexual assault

Provide information from the SART to other law enforcement agencies

Continue to identify gaps and needs

Facilitate case review and analysis

Update policy to reflect best response practices

Assist in delivering and receiving training in SANE, forensic evidence, victim response

Medical System

Assist in determining patient treatment sites and protocols for care

Assist in training SANEs (anogenital examination, which includes pelvic exam training and experience; identification of non-anogenital injuries)

Help develop treatment protocols

Sign off of standing orders

Medication/prophylaxis protocols

Assist in establishing followup care and HIV N-PEP followup care

Finalize treatment and prophylaxis protocols

Determine ED protocols around MD involvement in care and medical screening exam requirements

Educate medical staff and non-SANE nursing staff

Assist SANE team as requested by team leadership

Assist in developing QA review process

Protocol and operations review

Update medication/prophylaxis protocols

Review referral practices and protocols

Mitigate issues with referral physicians/practices

Perform QA review

Assist in program expansion and development

SANE education


Provide information specific to DoD policies, programs, and services available to military victims of sexual assault and points of contact at local installations

Develop protocol or memorandums of understanding with community-based victim service organizations to establish effective partnerships with local military installations to effectively respond to the needs of victims of sexual assault in the military

Develop memorandums of understanding between local installations and community hospitals if the local military treatment facility does not have the capability to conduct a SAFE by a trained SAMFE

Discuss recommended protocol for military victim advocates to work in partnership with local community-based victim advocates Assist with specific needs of sexual assault victims in the military, coordinate a collaborative response, and navigate potential jurisdictional issues
Social Services/Tribal Social Services  Help with protocol development to ensure that required notifications are included in protocols and procedures   Provide consultation for patients who are eligible for their services

Contribute to a discussion of which agencies should be members of the MDT and extend invitations to all identified prosecution and law enforcement agencies to join the MDT

Help write general goals for MDT meetings

Discuss and determine confidentiality issues applicable at MDT meetings

Discuss recommended guidelines for review of system issues and individual case studies at MDT meetings

Discuss the screening process generally at prosecution offices and how MDT members can work effectively with prosecutors

Have a prosecution representative at every MDT meeting

Contribute to case studies scheduled by MDTs

Provide basic training and ongoing updates on criminal law and procedure for the legal collection of evidence

Provide training and specific consultation for MDT members on being a witness in a criminal case

Research/ Evaluator  Conduct community needs assessment; make empirical argument for SANE and SART programs Provide ongoing feedback on what works and what needs to be revised Design and execute ongoing evaluation of the SANE and SART programs
Senior Services Program  Provide information about senior communities and facilities Make sure services are accessible for senior patients Provide feedback about the accessibility of services to seniors and resources and support for service providers
Sex Offender Treatment  Allow for communication to be established between sex offender treatment and the MDT Assist with protocol development that are consistent with victims' rights laws  
Victims/Survivors  Should provide an opportunity to share how their experience was impacted by the system response Assist in protocol development to make sure the victim's viewpoint is represented Provide ongoing consultation