Official Informal Briefing Minutes Tuesday, June 21, 2016-10:30 AM Present: Charlotte J. Nash, Jace Brooks, Lynette Howard, John Heard Absent: Tommy Hunter 1. County Administration Gwinnett Sexual Assault Center and Children s Advocacy Center Overview Ann Burdges, CEO and Executive Director of the Gwinnett Sexual Assault Center and Children s Advocacy Center, provided an overview of the organization and services provided. No Official Action Taken.
Ann Burdges CEO/ Executive Director 770-497-9122 ext.22 aburdges@gsac-cac.org www.gsac-cac.org
GSAC-CAC Overview Sole-source provider defined by the needs of victims and families: Community resource to the criminal justice system response to SA victimization. Independent, objective, expertise Victim Centered/ Offender Focused: identify & hold sexual assault/abuse offenders accountable. Accessibility & Readiness
GSAC-CAC Overview (continued) Cases reported to LE and cases not-reported to LE Informed consents Non-reporting SA evidence management and storage Accreditations, Certifications, & Continuous Education (State and Federal) Agency: SAC & CAC Agency: Clinical National SAMFE Protocols Staff: SANE Staff: Child Forensic Interviewers Sustainability
State of Georgia: SA & CAC Resources 159 counties/ 49-judicial districts 21-SA Centers/ 47-CAC programs Varied scope of services
GSAC-CAC : Advanced Specialty Services 1) 24-Hour Crisis & TA Access line 2) Medical-Forensic evidentiary exams on-site Follow-up Suspect Search Warrants Special assistance: ME s Office Coordinate PREA services 3) Victim & Family Advocacy 4) Legal Advocacy; Legal Assistance 5) Mental Health: licensed Counseling referrals
GSAC-CAC: Advanced & Specialty Services (continued) 6) Certified Child Forensic Interviews (non-medical) < 18-yoa: Child FI s: physical/sexual abuse; CSEC; witness to family violence: homicide/suicide 7) Community Awareness, Education & Outreach Campus Response to SA (Clery Act & Title IX requirements) Mandated Reporting of Suspected Child Abuse Allied partner agency trainings 8) Georgia SANE-SAFE Training & TA
Staff: 24/7 Services Full-Time (F/T) Staff: 4.7/8 Part-Time (P/T) Staff: 5/8 SANE: 4/9 Volunteer Advocates: 17
Training Room Medical-Forensic Waiting Area
Children s Waiting Room
Adolescent/ Adult Interview Rooms Child Forensic Interview Room
Medical Supplies Quiet Room Medical Forensic Exam Room
GSAC-CAC Founded 1986: 30-years Scope of services and expertise has evolved with research-based best practices. Standards of response and care National protocols State and federal statutory requirements Public policy rules
GA Legislation: Sexual Assault O.C.G.A. 15-24-2 SA Response Protocols (2005) (e) The purpose of the protocol shall be to ensure coordination and cooperation between all agencies involved in sexual assault cases so as to increase the efficiency of all agencies handling such cases and to minimize the stress created for the alleged sexual assault victim by the legal and investigatory process O.C.G.A. 17-5-71 Storage of Evidence (2008) O.C.G.A. 17-7-72 Free Forensic-Medical Exam (2008)
Georgia Statutes O.C.G.A. 17-5-70 Criminal Procedure/ Definitions Section 17-5-70 "Forensic Medical Examination, (1) "Forensic medical examination" means... Such examination shall include a physical examination, documentation of biological and physical findings, and collection of physical evidence from the victim. (3) "Sexual assault" means rape, sodomy, aggravated sodomy, statutory rape, child molestation, aggravated child molestation, sexual assault against a person in custody, sexual assault against a person detained in a hospital or other institution, sexual assault by a practitioner of psychotherapy against a patient, incest, bestiality, sexual battery, and aggravated sexual battery as those terms and offenses are set forth and defined in Chapter 6 of Title 16. HISTORY: Code 1981, Sec. 17-5-70, enacted by Ga. L. 2008, p. 486, Sec. 3/HB 1297.
Payment of Medical-Forensic Exams O.C.G.A. 16-6-1 Rape (2011 HB 503/amended) (c) When evidence relating to an allegation of rape is collected in the course of a medical examination of the person who is the victim of the alleged crime, the Georgia Crime Victims Emergency Fund, as provided for in Chapter 15 of Title 17, shall be responsible for the cost of the medical examination to the extent that expense is incurred for the limited purpose of collecting evidence.
Payment for Forensic-Medical Services Forensic-Medical Services Provided NOT Eligible for CVCP Payment: Suspect Exams (Search Warrant); blood/buccal swabs *CSA: Family exclusionary lab tests (CSA) PREA: Coordinated w/ GMC-L Children in DFCS Custody (FI; MFE; Wellness)
Georgia Legislation 2016 Effective July 1, 2016: SB 304 Pursuing Justice for Rape Victims Act Protocol for rape kit collection, transfer, processing & analysis HB 705 Child Abuse Records Protection Act Child Abuse and deprivation records; greater confidentiality of child abuse records; change provisions for persons and agencies permitted access to child abuse records; content of protective orders; immunity of CAC s under certain circumstances
Sexual Assault Nurse Examiner (SANE) Education, Training & Sustainability RN Nursing Specialty Education, Training & Clinical Competence Adolescent & Adult: 40-hours didactic training Pediatric: 40-hours didactic training Clinical competencies (3-months to 1-year) National Certifications: SANE-A/ SANE-P IAFN Certification; renew every 2-years Hospital Practice Privileges GMC-L/D; Emory Eastside; CHOA
Georgia Hospital SA Services Remarkable physical injury/ trauma GSAC-CAC responds to GMC-L/D Hospital staff are not trained in SA medical-forensic exam protocols Not equipped for FME (evidentiary) exams (i.e., digital imaging, documentation, ALS, Toluidine Blue, ALS, etc.) Not certified MFE clinically competent Liability & Risk Management Documentation & future access to exam records Confusion w/medical insurance & patient billing Lack of advocacy, legal assistance & access to follow-up services Drying of biologic evidence; packaging; chain of custody Storage of evidence as needed; future retrieval of evidence A/DFSA investigations lab services
The Evolving Role of the SANE Originated from the grassroots volunteer efforts Expertise, duties, skills, & certification have evolved Expanded science: DNA, ALS; advanced skills, expanded training requirements Trauma informed response Documentation of injury Access to documentation; fact/expert testimony Expanding state & federal legislation Nat l. SAFE Protocols CE requirements/ credentialing/certifications Increased demand for services and court testimony
SANE Compensation: History PRN Contractors Paid by exam fee flat amount (included future court testimony) Expanded to include: nominal, intermittent on-call or stipend Exam Fee Reimbursement by CVCP (2011) Capped line item fee schedule: paid by reimbursement State processing of invoices (administratively burdensome) Manual paper/mail processing Subject to adjusting down Delays : weather, sequestration, limited staff, volume of invoices
Sustainability Today s Challenges for Sustainability: Need to be competitive with higher compensated [nursing] overtime opportunities. CVCP fee schedule do not cover full MFE costs Accessibility & Readiness factor (similar to firefighters/ paramedics). Gov t. Accountability Report (GAO) March 2016 http://www.gao.gov/assets/680/676230.pdf and the summary http://www.gao.gov/assets/680/675878.pdf DOL/ FLSA: SANEs = Employees Eligible for overtime pay and benefits Eligible for court prep & testimony compensation 40-hour work week must adjust for court preparation & testimony Incentivize: professional memberships, CE s, Incorporate overlap/back-up SANE for scheduling controls DOL/FLSA: All staff positions Limitations of Volunteers
Next Steps The Good News: The importance & effective outcomes from high-quality SA services is research based & evidence supported. Accessibility to High-Quality MFE/Advocacy serves: Health, well-being & stability of victim and families And directly supports: Public health; local hospital systems; criminal investigations; successful prosecution of offenders; reduction in sexual assaults/abuse; increased reporting; education and health awareness Increased federal VOCA grant funds Advocacy; Victim Assistance Attorneys; SART Coordinators
Next Steps: Re-define SANE job descriptions with non-clinical duties expanding eligibility for alternate funding. Identify alternate funding for SANE compensation. Identify cash-flow solutions: eliminate SANE payments as subject to reimbursement. Recruitment/implement SANE schedule overlaps to assure Time management Back-up SANE staff as needed
DOL (Dept. of Labor)/FLSA (Fair Labor Standards Act) Impact of FLSA Contractors meeting definition of employees Administrative burden of time management Texts, calls, emails, training travel, court time, court prep Eligibility for overtime SART Coordinators previously on-call now meeting hourly minimum wage (text, call, emails, etc.) Exempt staff minimum salary requirement Index increases every 3-years Volunteers cannot provide services otherwise provided by paid personnel
Contact Information **24/7 Crisis Line & TA Access Line** (770) 497-9122 Office (770) 497-9122 Ann Burdges Executive Director (770) 497-9122 ext. 22 Aburdges@gsac-cac.org