MEDCOM Fort Sam Houston

1. MEDCOMFort Sam Houston Defense Task Force on Sexual Assault in the Military Services Ms. Kandice Ray, RN, SANE-A Sexual Assault Prevention and Response Program Case Manager

2. BRIEFING OUTLINE PURPOSE: To provide relevant information on the Health Care Role in supporting victims of sexual assault • History • Roles/Responsibilities • Key MTF Medical Staff • Policy • Training • Initiatives 7. Resources

3. Army Sexual Assault Policy-History FY04: DoD & DA Task Force Reports MEDCOM Regulation 40-36 December 23, 2004 Medical Facility Management of Sexual Assault - Create a policy and training. - Establish SAPR program - Establish a system for documentation, program assessment, reporting, and program improvement

4. MEDCOM –Roles and Responsibilities

5. Key MTF Medical Staff • Sexual Assault Clinical Provider (SACP) • Manage each sexual assault patient’s primary medical treatment • As directly related to the sexual assault incident • From initial presentation to completion of all follow-up visits • Forensic Examiner • Trained in performing forensic examination and evidence collection • A member of the MTF medical staff or • Available outside the MTF • IAW an established memorandum of understanding (MOUs)/memorandum of agreement (MOAs) • Sexual Assault Care Coordinators (SACCs) • Assist SACPs with the delivery of a uniformed standard care • Ensure initial and follow-up evaluations/treatments are • Clinically appropriate for each individual patient • Consistent with his/her clinical diagnosis and policy

6. Key MTF Medical Staff • The majority of the MTFs continue to utilize Obstetrics/Gynecology physicians and social workers as the traditional healthcare providers for sexual assault. • The SACC continues to be the primary medical representative participating on the Garrison Sexual Assault Review Board • IG finding affirm Sexual Assault healthcare staffs are passionate and caring although often performing additional duties and retention challenges

7. Policy • Revision of MEDCOM Regulation 40-36; Medical Facility Management of Sexual Assault • Confidentiality and Reporting Options • Notification and role of SARC and/or VA responders • Case management • Appendixes • Support Multi National Coaliation-I Surgeon with revision of Sexual Assault Policy • Forms – incorporated DD2911 • Training- web based/DVD • ICD-9 Coding • Level II facility to provide medical & forensic examinations of sexual assault patients if approved thru Combat Support Hospital

8. First Responder Training • First Responder Training for Healthcare Providers • TRI-Service web-based Training Support Package • March 08 Army Learning Management System (ALMS) Operational • March 08 Fielding on MEDCOM SAPARP AKO webpage • First Responder Training for Healthcare Providers who perform Sexual Assault Forensic Examination • Virtual Practicum operational March 1, 2008 on the Sexual Assault Forensic Examiner Technical Assistance website (www.safeta.org) • Based on the National Protocol for Sexual Assault Medical Forensic Examinations • Supports DoDI 6495.02, “Sexual Assault Prevention and Response Program Procedures”

9. Training • Annual Sexual Assault Medical Management Conference • 17-21 Aug 08 • Annual platform to Train SACPs & SACCs • 24 CME credits approved, Nursing CEs being processed • Explore strategies to increase the availability of the Sexual Assault • Forensic Examination (SAFE) at the local MTF Annual Conference • Present Prevention Campaign • Review Annual Program Assessment

10. Initiatives • First Responder Training for Healthcare Providers who perform Sexual Assault Forensic Examination • Explore documentation of the Virtual Training for Sexual Assault Forensic Examiners • TRI-Service Forensic Training DVD • E-learning project to support documentation of the SAFE • FY09 Staff Assistance Visits

11. Resources