Developed by the SA/DV Industry Training Advisory Group

Wisconsin Department of Health and Family Services

August 2003

1. ENSURE VICTIM’S PHYSICAL AND EMOTIONAL SAFETY
2. Develop systems that avoid victim re-traumatization.
3. Ensure that facility staff responding to a reported sexual assault incident are trained to sensitively and appropriately handle any report.
4. Ensure throughout the entire process the thorough and accurate documentation of information, observations and facility decisions.
5. Ensure that records and any physical evidence are collected, preserved and protected.
6. Provide assistance and support to all victims and hold abusers accountable by conducting adequate and complete investigations.

STEP

PROCEDURES

NOTES

STEP 1: Facility designates a resident contact person to respond to victim needs.

• The facility administrator must designate a resident contact person.

• The contact person must have specialized training in responding to disclosures of sexual assault and in assessing the primary emotional and physical safety needs of a victim.

• If the designated contact person is not a facility employee, a Memorandum of Understanding (MOU) must be developed with the individual or outside agency that agrees to serve as the first point of contact for a resident victim.
• Possible appropriate contact persons include: Facility Administrator, Director of Nursing (DON), Elder Abuse Coordinator, Social Worker, Sexual Assault Service Provider (SASP), or Community Advocate.

STEP 2: Facility becomes aware of a suspected sexual assault that involves a resident.

• A sexual assault incident including physical or emotional harm or exploitation may be disclosed by a victim, observed by staff or another, or may be suspected.
  
• Determine whether sexual assault is current (that is, within past 28 days).

• Reasons to suspect assaultive behavior include a change in the victim’s demeanor or condition, evidence of physical trauma that is consistent with sexual assault, the existence of other medical or physical evidence that may suggest sexual assault, or there are injuries of unknown origin, and an assessed possible cause includes sexual assault.

• If current, Sexual Assault Nurse Examiner (SANE) examination may be able to collect forensic evidence; or other physical evidence may be collected, preserved and protected.

• If not current, the facility’s actions in the following steps may be modified, as appropriate, considering the date the reported assault occurred.

STEP 3: Victim is contacted.

• Regardless of the source of information, when there is a report of an assault or when there is reason to suspect sexual assault has occurred, the person designated by the facility should contact the victim as soon as possible but within 24 hours to assess the immediate emotional and physical safety needs of the victim.

• Victim safety needs must take into consideration whether the assault is current and if a medical assessment is needed and wanted by the victim.

• Further assessment should include what, if any, steps are necessary to protect the victim from further trauma or harm.

STEP 4: Available internal and external resources are contacted and made available to the victim and facility, as appropriate.

• Facility social workers, mental health support persons, community advocates (domestic violence or sexual assault), sexual assault nurse examiners (SANE), law enforcement, adult protective services (APS) and lead elder abuse agency workers, regional ombudsmen and staff from the Bureau of Quality Assurance (BQA) may serve as resources or otherwise provide services or consultation to the facility and the victim.

• If the victim is competent or is capable of self-determination:

1. Does the victim desire support services such as advocacy, counseling about options or specialized therapy? Does the victim wish the facility to contact providers of those services?
2. Does the victim wish the facility to contact law enforcement?
3. Does the victim desire to have a medical examination?
4. Does the victim want any other persons notified, such as persons within the family or close friends?

• If the victim has a guardian or is not capable of self-determination:

1. Has the guardian been notified, if not the suspected perpetrator?
2. If appropriate, have all possible services, including reporting to law enforcement, been discussed and offered to the guardian on behalf of the victim? (See above for possible resources and services.)
3. What services does the guardian consent to? Follow up in securing any services consented to by the guardian.
4. If the person does not appear able to self-determine next steps, does not have a guardian and the situation is not life threatening, determine whether the person is competent or in need of a guardian. You may wish to consult with your county APS agency for advice on determining competency. Proceed accordingly.
5. If the person is not capable of self-determination, does not have a guardian and the situation is life threatening, obtain emergency medical care. If the individual is determined incompetent by a physician, seek appropriate legal authority (e.g., temporary guardianship or a court order) in order to provide necessary services. The county APS agency can assist in determining legal issues and ways to obtain needed protections. Then proceed as follows.

• Assess the risk of continuing harm to the victim or to others.

1. If the victim is competent or capable of self-determination AND there is no risk of further harm to the victim or others, then the facility should follow the victim’s wishes and desires.
2. If the victim or other clients or residents are at risk of physical, emotional or financial harm (including death) by the suspected perpetrator(s), then the facility should report the alleged incident to law enforcement.

• It is recommended as a best practice, that facilities provide notice of their reporting policies to all residents upon admission.

STEP 5: The investigation continues.

• An investigation may be by law enforcement, the facility, APS or any others responsible for such an investigation.

STEP 6: Aftercare or follow up.

• The facility should assess the after-care needs or wishes for support services of the victim and the victim’s family.
  
• The facility should evaluate their own internal intervention processes of the case and determine whether gaps occurred or where the process worked efficiently and make revisions as necessary.

• This may include providing information and referral, medical, psychological or emotional care or other care.

• Consideration should be given to prevention strategies as well.

Date

Note/Comment

Initials or Name