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 |
| Military |
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 | |
| Prosecution |
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 |