Sexual Assault Nurse Examiner (SANE) Program: Frequently Asked Questions

What is the Sexual Assault Prevention & Crisis Services Program doing to assist medical professionals who work with survivors of sexual assault?
The Program offers training for registered nurses (RNs) to conduct a comprehensive sexual assault medical forensic examination and to testify in court on that exam if called. Certification is also available for registered nurses who have completed the SANE Training Program.

What is a SANE?
A Sexual Assault Nurse Examiner is an RN who has been specifically trained to:

  1. Provide comprehensive care to sexual assault patients;
  2. Demonstrate competency in conducting a medical forensic exam to include evaluation for evidence collection;
  3. Have the expertise to provide effective courtroom testimony; and
  4. Show compassion and sensitivity to survivors of sexual assault.

What is a sexual assault medical forensic exam?
A sexual assault medical forensic examination is performed by specially trained medical professionals for the purpose of evaluation and treatment of trauma, treatment of possible exposure to infection, referral to counseling and follow-up medical care, and for the collection of evidence following a report of sexual assault by a victim. The medical well-being of the patient is the primary objective of the SANE at all times during the examination.

Who may request a sexual assault medical forensic exam?
If the victim reports the crime, local law enforcement may authorize the exam or the victim may request a sexual assault exam without first reporting to law enforcement as a ‘non-reported sexual assault.’

What is a ‘non-reported sexual assault?’
The Non-Reported Sexual Assault Evidence Program was created in HB 2626 by the 81st Legislature and went into effect June 21, 2009. The program allows survivors of a sexual assault to obtain a medical forensic exam and have evidence collected, without cost to the victims, even if they do not wish to involve law enforcement at the time of evidence collection. This allows the evidence to be secured while giving the survivor time to consider whether they want to report the assault. A patient who has requested and obtained a non-reported sexual assault medical forensic examination has up to two years to decide to report the crime. Information related to the program can be found in Chapter 56.065 Code of Criminal Procedure. .

Will the sexual assault medical forensic exam “prove” I have been sexually assaulted?
The presence or absence of physical evidence does not prove whether a person has been sexually assaulted. Rather, the examination may provide supportive evidence to be used during legal proceedings. A SANE examination is one piece of information in a community effort by healthcare, advocates, local law enforcement and prosecutors to investigate and prosecute a reported case of sexual assault.

Are sexual assault medical forensic exams performed on adults and children?
Yes. Many of the evidence collection issues apply equally to adult and child survivors of sexual assault/abuse. However, there are particular issues regarding the interviewing and medical examination needs of children that differ from those of adults.

What happens during a sexual assault medical forensic exam?
Once consent is obtained from the patient, a medical history is taken by the SANE to determine injuries and appropriate medical treatment for the patient. The next step is a head-to-toe examination, including the genital area, in order for the SANE to document trauma to any part of the body. Last, a collection of forensic evidence is done, and a sexual assault evidence collection kit is sometimes used.

What is an evidence collection kit?
In addition to the sexual assault examination, a kit is used to collect physical evidence. Kits can be made from materials readily available at most medical facilities or purchased commercially. Kits are packaged in a crush-proof box to protect the contents during transportation to a forensic lab.

When would a sexual assault evidence collection kit not be used?
If it is determined that the assault took place more than 96 hours prior to the examination, the use of an evidence collection kit may not be necessary. It is unlikely that evidence would still be present on the survivor. However, evidence may still be gathered by documenting any findings obtained during the medical examination (such as bruises or lacerations), photographs and bite mark impressions (if appropriate), and securing statements made by the survivor about the assault.

Will a SANE know when to use a kit and when not to?
Yes.

Does a SANE treat injuries such as broken bones, internal bleeding, cuts requiring stitches, etc.?
No. A SANE will refer the sexual assault victim/survivor to an emergency room.

What does an RN need to do to become an OAG Certified SANE?
An RN must complete both classroom and clinical components before applying for certification.

How can an RN become OAG certified or re-certified as a SANE?
Certification and re-certification packets and instructions are available here.

Does the classroom training include information on all kinds of survivors?
Yes. Regardless of the client population (male, female, adult, adolescent, child or adult) a SANE program chooses to care for, the training must include information on all age groups and genders.

What information is included in the classroom training?
Information is provided on Adult, Pediatric and Courtroom components and covers the following:

  • Advocacy
  • Survivor Symptomology
  • Documentation
  • History-taking Skills
  • Collection of Forensic Evidence
  • Use of a Sexual Assault Evidence Collection Kit
  • Courtroom Testimony

Who pays for the exam?
State law requires the law enforcement agency requesting the exam to pay all expenses related to the gathering of forensic evidence from the victim. The victim's cooperation in pressing charges is not a factor; if the law enforcement agency requests that the exam be conducted, the law enforcement agency is responsible for paying the costs.

For victims who report to law enforcement, other medical care for the victim such as treatment of physical injuries, testing for AIDS/HIV and sexually transmitted diseases, or counseling may be paid for by the Crime Victims' Compensation Program, if eligible. Applications for Crime Victims' Compensation and assistance completing the form are available from the hospital, sexual assault program or law enforcement agency.

How does a SANE program benefit a sexual assault survivor?
It is vital to a victim's recovery to be treated properly while the evidence is collected. It is also vital to the survivor's recovery and the prosecution of the offender that forensic evidence be properly collected.

It has been noted that survivors heal faster when treated properly by someone who is trained to be a sexual assault examiner. In addition, victims are more likely to follow through with the prosecution of criminal cases when they have received compassionate treatment from the same caregivers throughout the exam.

How does a SANE Program benefit a community?
With accurate evidence collection and more prosecutions, more sexual assault felons will be incarcerated rather than offending more victims, thus making for a healthier community. The message that a survivor receives when a SANE program is developed is: Sexual assault is a problem for the entire community, not just victims and local sexual assault programs.

The mental health and physical well being of sexual assault victims are important to the community. Support for professionals to receive special training to learn how to properly collect forensic evidence is important to community leaders to ensure a higher conviction rate of sex offenders. In addition, support is provided to ensure a SANE Program continues.

Does every community in Texas have a SANE Program?
No. However, many communities are aware of the benefits and are actively pursuing the development of a program.

How can I find out whether my community has a SANE Program?
You can contact your local sexual assault program, medical facility or district attorney's office.

If my community does not have a SANE Program, is there anything I can do to start one?
You can call your local sexual assault program and inquire whether steps have been taken to establish a program. If nothing has been done to start a program and you'd like more information on how to begin the process, contact:

    Sexual Assault Prevention & Crisis Services Program
    Crime Victim Services Division, MC-011-1
    Office of the Attorney General
    PO Box 12548
    Austin, TX 78711-2548
    (512) 936-2880
    (512) 936-1650 FAX
Revised: March 31 2011
CVS Update CVS Update - the Crime Victim Services Division E-newsletter CVS Materials Order Form
Contact Information:
Crime Victims' Compensation
P.O. Box 12198
Austin, Texas 78711-2198
1-800-983-9933 (state-wide) 1-512-936-1200 (in Austin)
1-512-936-1800 (FAX)
crimevictims@texasattorneygeneral.gov Address Confidentiality Program, MC-069
P O Box 12199
Austin, Tx 78711-2199
512-936-1750
888-832-2322 TexasAttorneyGeneral.gov