Cultivating SART Efficacy: Insights on the Impact of the Oregon Sexual Assault Response Team Mandate

Transcription

1 Cultivating SART Efficacy: Insights on the Impact of the Oregon Sexual Assault Response Team Mandate Sexual Violence Justice Minnesota Coalition Against Sexual Assault Prepared by Laura Williams, consultant, for the Sexual Violence Justice Institute November 2016 i

2 Acknowledgements This project and report were made possible by the partnership between the Sexual Violence Justice Institute (SVJI) at the Minnesota Coalition Against Sexual Assault (MNCASA) and the Oregon Attorney General s Sexual Assault Task Force (Task Force), with Violence Against Women Act funding from the Office on Violence Against Women. Emily Tofte Nestaval, former SVJI Program Manager, and Leah Lutz, current SVJI Program Manager, provided administrative oversight, and Jessica Jerney coordinated project support and management. Michele Roland-Schwartz, Executive Director of the Oregon Attorney General s Sexual Assault Task Force, offered her insight, coordination and resources to support the project, including time from her staff Kirstin Heydel and Suzanne Gray. All three participated in numerous phone calls to coordinate around the project s goals and activities. In particular, Suzanne Gray, Criminal Justice Coordinator, served as the main point of contact for from the Task Force and provided invaluable coordination and feedback. Special appreciation goes to the Oregon professionals who shared their time and thoughts in the form of interviews and reviewing drafts of documents. Their names and agency affiliations are listed in Appendix B. If the project results are useful in advancing SART work in Oregon, it is because they took time for participation in this project. Their involvement reflected their commitment to advancing the cause of compassion and justice for all Oregon survivors of sexual assault. Finally, the financial support and technical guidance from the Office on Violence Against Women (OVW) provides a backbone to our collective efforts to ensure every community, in every state or territory, can expertly support a survivor who dares to disclose and seek justice for their experience of trauma. Twenty years after the initial passage of the Violence Against Women Act, OVW leadership continues to be crucial to what we do. This project is supported by Grant Number 2012-TA-AX-K014 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication are those of the author and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women. ii

3 Table of Contents Acknowledgements... ii Background... 4 Project Description... 4 Limitations... 5 Context of the Oregon SART Mandate... 5 The Mandate s Goal... 5 Passing the Mandate... 6 Pre-Mandate Landscape for Oregon SARTs... 7 Findings... 8 What was the impact of the Oregon mandate on the growth of SARTs?... 8 What was the impact of the Oregon mandate on SARTs efficacy?... 9 What were some of the challenges of mandate implementation? What other notable events occurred as a result of mandating SARTs in Oregon? Discussion Conclusion References Appendices Appendix A: Key Events Timeline Appendix B: Interview Participants

4 Background In 2011, the Oregon Statutes were amended to mandate local sexual assault response teams (SARTs). As part of a national initiative to explore the impact of such mandates on the formation, performance and efficacy of SARTs, the Sexual Violence Justice Institute (SVJI) at the Minnesota Coalition Against Sexual Assault partnered with the Oregon Attorney General s Sexual Assault Task Force (Task Force) to gather input and document as many examples of the legislation s impact as possible. SARTs work to increase the coordination and collaboration of the community systems that respond to sexual assault particularly the medical, criminal justice, and mental health/advocacy systems (Greeson and Campbell, 2012). Originally developed in the 1970 s through grassroots efforts (Zajac, 2006), most SARTs are community-level interventions that vary somewhat in their structure, organization, and activities 1. In most cases, interested stakeholders start SARTs voluntarily. Starting in the 2000s, however, a few states began mandating local SARTs. State mandates bring SARTs to the full variety of community contexts across a state, and to responders who may not have chosen to organize their local response through a SART. SVJI became interested in exploring the impact of state mandates on the growth, formation, and development of these varied SARTS as part of its larger effort to gather insight into the ecosystem 2 all SARTs need to become strong and effective. This report summarizes insights gathered from SVJI s exploration of the impact of the Oregon SART mandate. Laura Williams was the Project Consultant for the Sexual Violence Justice Institute, and Suzanne Gray, the Task Force s Criminal Justice Coordinator, was the lead project contact for the Task Force. Executive Director, Michele Roland-Schwartz, and Sexual Assault Training Initiative Coordinator, Kirstin Heydel, also provided invaluable information, direction, and support. Project Description In 2016, SVJI worked with the Task Force to identify a core group of people that were familiar with the background and history of the mandate. People with historical knowledge of the mandate and regional or statewide experience within advocacy, prosecution, law enforcement, and forensic nursing were identified as potential interview participants by Task Force staff. Seven professionals were interviewed in late May and June The interviews were designed to gather background and contextual information to prepare for a meeting with a wider group of SART members and other professionals from across the state scheduled for July 20, The purpose of the meeting was to educe and document what happened as a direct result of the 2011 amendment to the Oregon Statutes (ORS O). Four background documents were created based on the interviews. One document summarized what was learned about the Oregon SART landscape before, during, and after the mandate s passage. Another document detailed a timeline of relevant events, and the other two identified some of the first ripple effects of the mandate and context for the July meeting s central question 3. The interview participants and Task Force contacts were asked to review the Oregon SART Landscape document for errors or omissions. Task Force staff reviewed the remaining documents. 1 Researchers have noted significant variation in SART implementation (Greeson & Campbell, 2014, p.15). 2 We define a SART ecosystem as the interplay between local SARTs and the climate, organizations, and resources that affect their growth, development, and efficacy in a specific region. For more on this concept, see Understanding SART Mandates: Insights from an exploration of the impact of state mandates on SART growth and development published by the Sexual Violence Justice Institute. 3 The July 2016 meeting was designed around exploring the question What happened as a direct result of requiring the district attorney in each Oregon county to organize a sexual assault response team per ORS that went into effect on July 1, 2011? using a highly-facilitated process called the Implications Wheel. 4

5 As the project unfolded it became clear that July 20 th session design depended heavily upon participants knowledge of the mandate s early ripple effects knowledge that many of those registered simply did not have. The Project Consultant and lead Task Force staff jointly decided to cancel the meeting. Unfortunately, there was insufficient time to develop an alternate approach for gathering the desired information. Thus, this report is based on information collected through the background interviews, and a review of selected documents provided by the Task Force. Limitations The findings presented in this report should be considered in light of four key limitations. First, the persons identified for interviews represent a convenience sample. Task Force staff identified potential interview participants at the request of the Project Consultant. Given the purpose of the interviews, experience with the mandate and discipline variety was emphasized over representation from specific SARTs. While this was necessitated by project constraints, it does limit the scope and breadth of our understanding in important ways. Second, interviews were not originally intended to be the sole way information would be gathered from Oregon professionals. Because of this, participant criteria did not extend more broadly and some questions were simply not asked. Unless otherwise stated, the team examples provided should be considered as evidence toward a theme, but not necessarily conclusive about the experience of all Oregon SARTs. The third limitation arises in relation to asking people to recall past events. Since most Oregon communities had SARTs by the time the mandate passed, few interview participants recall the mandate s passage as triggering significant reaction locally or statewide. While some notable ripple effects and implementation challenges were identified, the more nuanced or incremental changes most teams likely experienced emerged less often. Finally, the fourth limitation arises in relation to the project focus itself. By focusing on teams affected by the mandate, we did not explore the growth of other voluntary or specialized teams such as tribal, campus, or military SARTs. The growth, development, and challenges of these teams in Oregon are missing. Despite these limitations, the interviews did elicit valuable insights for SVJI s larger initiative and hopefully for those interested in building on Oregon s investment in SART development and sustainability. Context of the Oregon SART Mandate The Mandate s Goal The Oregon Attorney General s Sexual Assault Task Force (Task Force) was the main proponent of the SART legislation. Christine Herrman, Executive Director of the Task Force, was approached by a staff member in Oregon Senator Chris Edwards Office about the possibility of legislating a community-based response to violence against women. Ms. Herrman endorsed SARTs as community-based interventions that were working in Oregon, but noted that they lacked the force of law. She reviewed the idea with the Task Force s Legislative and Public Policy Committee and through these conversations and other groundwork, Oregon s proposed SART mandate emerged. Proponents of the legislation believed SARTs represented a best practice for creating victim-centered responses to sexual assault (Hoyt, 2011). They wanted to bring a coordinated, criminal justice response for sexual assault to every county in Oregon, one that would be both standardized and communitycrafted (Herrman, 2011). While a great number of Oregon communities had SARTs by 2010 (the year before the mandate), eleven of Oregon s thirty-six counties did not (SATF, 2010). Further, the SARTs that did exist were at different stages of development (Hoyt, 2011), meaning community response varied as well. Thus, in much the same way that every county was required by law to have a multidisciplinary team (MDT) to address child abuse, the Task Force and other proponents wanted every Oregon county to have a SART. Supporters specifically noted that the availability of medical-forensic services for survivors depended upon where in Oregon a survivor sought treatment or help. Citing complaints received by the Task 5

6 Force that some hospitals were turning victims away, interview participants noted that one clear goal of the legislation was to improve victim access to medical-forensic care across the state. In addition to expanding SART response and addressing access to exams, professionals interviewed in this project identified three additional goals they saw for the legislation: 1) to provide visibility to sexual assault as a distinct issue to address (separate from domestic violence and not to be conflated with other coordinated response efforts such as child abuse multidisciplinary teams or domestic violence fatality review teams), 2) to strengthen Oregon s twenty-five existing SARTs, and 3) to solidify a statewide network of knowledge and skill for all sexual assault responders. Passing the Mandate The new law (Oregon Revised Statutes and ) was signed on June 23, 2011 and took effect on July 1, The law directs district attorneys to convene quarterly SART meetings in their county at times distinctly different from when the local multidisciplinary child abuse team (MDT) meets, and to develop and adopt protocols for adolescent and adult sexual assault response. An early proposal for the bill also included reporting requirements: each team was to make an annual report on the victim services provided in the county by January 31st of each year, and the Sexual Assault Task Force was to compile these reports into a report to the legislature. Both of the reporting provisions were removed before the bill passed. SART membership was another area of discussion in the developing legislation. Over some initial outside objections, the Task Force s Legislative and Public Policy Committee backed the inclusion of representatives of local, non-profit, sexual assault victim services programs as required members. There was also discussion on the Task Force s Legislative and Public Policy Committee about identifying civil attorneys as required SART members in order to generate SART awareness and coordination around non-criminal justice issues faced by survivors. Ultimately, civil attorneys were not identified as required members of every Oregon SART 4, but a catch-all provision allows them to be included at the discretion of the district attorney or by a team s recommendation. Oregon is the only state in our study of state SART mandates that seems to have explored, even temporarily, adding this representation to required SART membership. The membership required by the mandate is representation from the following local agencies: the district attorney s office, the prosecution-based victim assistance unit, the county sheriff s office or local law enforcement agencies (or both), sexual assault medical forensic examiner, and the program that serves victims of sexual assault (the law addresses which ones qualify). Additionally, a catch-all provision allows for other persons the district attorney considers necessary or others recommended by the team to be included. Since most of Oregon s counties already had SARTs, the medical-forensic provisions attracted much of the discussion and focus in the bills passing. Three requirements were added to the bill to help secure and expand good medical forensic services for sexual assault victims. These provisions required select medical facilities to 1) employ or contract with at least one sexual assault forensic examiner 5, 2) follow the medical guidelines developed and published by the Task Force s Medical Forensic Committee and, 3) adopt protocols for the transfer or treatment of sexual assault victims (Hoyt, 2011). The enrolled bill was later amended to clarify that hospitals that only did exams on minors were excluded from the requirement to employ a sexual assault forensic examiner. Many hospitals already had physicians or 4 According to those interviewed, this was largely due to concerns that Legal Aid, the organization most likely to be tapped to provide civil attorney representatives on SARTs, would have difficulty staffing SART meetings. With no additional funding being offered, Legal Aid felt that their attorneys would not be able to attend multiple SART meetings in the regions they served. 5 To fulfill this element of the statute, the sexual assault forensic examiner needs to have completed didactic training consistent with that required for certification by the Oregon SAE/SANE Certification commission established by the Attorney General (ORS , Subd. 2b). 6

7 other staff trained in child abuse exams, so the amendment allowed them to continue responding as they had been to these pediatric patients 6. The legislation did not address, nor secure, funding for local SARTs, hospitals, the Task Force or any other state level entity that would provide training, support, or oversight to the mandate s implementation. Pre-Mandate Landscape for Oregon SARTs In 1999, a group of Oregon s victim advocates who believed that response to adolescent and adult sexual assault could and should be better, organized a Statewide Sexual Assault Summit (SART Handbook, p. v). 7. Around 130 people attended the meeting to discuss the current state of Oregon s sexual assault response and how it could be improved. Interview participants describe this time as one in which sexual assault response was often siloed by discipline and agency, with barriers to coordination and consultation between responders. Overall, sexual assault issues were not being addressed as visibly as domestic violence issues were, and very few stand-alone sexual assault programs existed to call attention to the gap. Each discipline worked in a vacuum...i remember being told, don t call an advocate, don t call police until you absolutely have to because they ll just get in the way. That was also in the day, here in Oregon, that police had to be called to question the patient and then it was decided if there was a crime [and] enough evidence to go forward to have a kit collected. According to the Oregon SART Handbook (2009), the top needs identified at the May 1999 Summit were: training for responders that is adequate, specific, and of quality; more financial resources to improve local response; useful data that is adequate, specific and consistent; and closer and more cooperative local collaboration in sexual assault response (SART Handbook, p. v). Before the end of the year, the Oregon Attorney General s Task Force was created to address the issues and strategies identified by Summit attendees. The Task Force brought distinct attention to sexual assault and prioritized support for the development of community-based teams like SARTs. Within the first two years, Attorney General Hardy Myers personally visited every county and every district attorney in the state to encourage them to start a SART. This seemed to be the period of greatest change for SART development in Oregon. As some professionals interviewed for this project recalled: During that original time we all learned to work together; there was a whole culture change, we came to appreciate each other, we taught each other what our roles were, so that that ground work was already done. [Attorney General] Hardy [Myers] was saying you need to do this because it s right. To me, he was the champion of providing services for victims of person crimes, much more than the law that was passed. In 2005 and again in 2010, the Task Force sponsored statewide SART surveys that also shed light on the landscape for SARTs prior to the mandate. The 2005 survey report provides a summary by county of each SART s issues and successes and applies 5 status categories of SART development no SART, just getting started, building momentum, well-established, and fizzled out to each Oregon county. Eight counties were identified as having no SART, four as just getting started, ten as building momentum, and three as fizzled out. The 2010 survey report notes that 25 of 36 Oregon counties had a SART in 2010 (the same number as the 2005 report if no SART and fizzled out are combined), but 6 It was also a practical issue of sufficient staffing. In Oregon, there are only 5 sexual assault nurse examiners trained in pediatric forensic medical exams and only two that see pre-pubescent children (PK, personal interview, June 2, 2016). 7 See the Oregon SART Handbook Version II, 2009, for more information on the beginning of the Task Force. 7

8 does not repeat the same SART status rating. Thus, it s unclear whether any counties shifted their status between 2005 and The 2010 report does include a comparison of themes raised from both surveys. It notes the key themes in the earlier survey included lack of funding and limited resources, limited law enforcement participation, an insufficient number of certified SANEs, and community denial and minimization about the extent, frequency, and impact of sexual assault (Oregon Attorney General s Sexual Assault Task Force, 2010). The report also cites these overall themes: Most SARTs are strong but have experienced periods of downturn since the 2006 Survey. 8 Most SARTs identified as building momentum or well-established. There is a need for consistent and qualified leadership. Many SARTs experience inconsistencies with their membership. Many SARTs are working on effective protocols, including those for case review. Most SARTs are asking for further assistance (training, peer-to-peer, technical assistance, etc.). Some of the same stated themes as The report further notes, we found in the process of revising the Handbook and developing the survey, that SARTs in the state needed more technical assistance and support around SART sustainability with the stresses of the economy and staff turnovers, barriers to SART sustainability have been exacerbated and the support of the SATF is needed ever more (Oregon Attorney General s Sexual Assault Task Force, 2010). The mandate was passed the following year. Findings This project focused on identifying the impact of the mandate on SART growth and functioning. Findings are presented in light of four related questions: What was the impact of the mandate on the growth of Oregon SARTs? What was the impact of the Oregon mandate on SART efficacy? What were some of the challenges of mandate implementation? What other notable events occurred as a result of mandating SARTs in Oregon? What was the impact of the Oregon mandate on the growth of SARTs? Based on project interviews, it seems that additional SARTs were started as a result of the mandate, although no surveys have been conducted since the mandate that offer data on these teams. If every county that did not have a SART in early 2011 has complied with the mandate, eleven new SARTs were started or re-started as a result of the mandate. Rural, frontier or economically challenged areas have faced the most difficulty complying with the mandate according to those interviewed. Small budgets mean fewer personnel to focus or specialize on the sexual assault response and attend SART meetings. This challenge is magnified in frontier counties where it may take three to four hours to travel to a meeting. The rural and frontier areas are, I think, trying for the most part, but the challenges that they face are much greater and much different than an urban area. I don t think some of them are there 8 There is a discrepancy about the dates of the earlier survey that I was unable to resolve. The 2010 report references the 2006 SART survey and findings in its discussion, but the earlier report is titled the 2005 Sexual Assault Response Team Survey. Perhaps there were multiple surveys or perhaps there is an error in the 2010 report. It is unclear. 8

9 some of the rural areas do a really great job and some are still struggling a little bit. But, I think for the most part everyone is making an effort to do what the mandate set out to do. What was the impact of the Oregon mandate on SARTs efficacy? Research on SART efficacy is limited. One of the most significant studies to date was conducted by Campbell, Greeson, Bybee, and Neal (2013). By studying the relationship between SART structure and effectiveness, 9 they sought to understand if some ways of operating SARTs were more effective than others (Greeson, 2015, p. 8). 10 Their findings suggest that formalization, regular collaborative processes, and broad active membership from diverse stakeholder groups are components of successful SARTs (Campbell, Greeson, Bybee, & Neal, p. ix) and link a team s perception of their own efficacy, in part, to how they organize themselves. The current project did find evidence suggesting the mandate improved the effectiveness of some Oregon SARTs, but our understanding of how many improved, and in what ways, is limited. The examples that did surface are organized below by the research-identified components to which they relate. Please note, however, that the absence of detailed information about any component of SART efficacy does not indicate its absence among Oregon SARTs. It simply reflects that the information did not come up in project interviews. Hopefully, future surveys or inquiry about Oregon SARTs may build or expand on these findings. Membership Breadth Since SARTs exist to coordinate response across numerous systems and collaborate to improve outcomes for survivors and cases, active participation from local agencies that respond to sexual assault is crucial to team success. Oregon s mandate standardized basic SART membership by specifying who minimally should be involved on the SART. These identified members the local prosecutor, law enforcement, a sexual assault forensic examiner, and representatives of both prosecution and community based victim advocacy services reflect the most common active members on SARTs nationally (Greeson & Campbell, 2014, p. 9). While most Oregon SARTs already included these professionals 11, project interviews suggest the mandate may have elevated and secured the role of some especially victim advocates from community-based, non-profit service programs. As one interview participant said: I think for most agencies and [district attorney s] offices the receptiveness of advocates as part of the process was increased because the SARTs really push for the agencies [involvement]--that having advocates respond is best practice. So I think that improved over the last few years with the push of SARTs. Expanding membership beyond this core group is another component studied by researchers with regard to SART efficacy. Campbell, Greeson, Bybee, and Neal (2013, p ) suggest that SARTs need to develop a high degree of collaborative relationships across a diverse group of sexual assault stakeholder groups, from both the criminal and non-criminal justice sectors [and] focus on 9 SART interventions often look quite different across communities meaning their structure and function vary considerably (Campbell, Greeson, Bybee, & Neal, 2013,p. vii) For a brief and accessible summary about the research findings on SART effectiveness prior to Campbell, Greeson, Bybee & Neal (2013), see Greeson (2015) pages Campbell, Greeson, Bybee, and Neal (2013, p. ix) characterized SART effectiveness as improvements in one or more of four domains 1) improvements related to victims help-seeking experiences, 2) police processing and 3) prosecution of sexual assault cases, and 4) victims participation in the criminal justice system-- and measured how the SARTs perceived themselves in each. These perceptions were cross-referenced to what SARTs had reported about how they had organized themselves based on looking at: 1) membership breadth, and 2) implementation as characterized by the use of formal structures and resources and the use of identified collaborative processes. 11 The Task Force s 2005 SART Survey indicates most teams included these professionals as part of their core membership. 9

10 building the inter-organizational relationships that are going to be the most beneficial to achieving their effective goals. The value of investing in these collaborative relationships was echoed by an interview participant who said: You know the critical part is getting folks in the room together on a regular basis so they build those relationships because when that big case hits, or the bad case, or the headline case that s not the time to try to figure out what resources you have available to you. The 2005 SART survey report identifies ten additional groups that are missing from many Oregon SARTs. While the Oregon SART mandate did not specify any of those groups among required membership, the mandate does allow for teams to add additional members as they see fit. As mentioned above, this catch-all provision is a way that some teams are adding civil attorneys into their membership a stakeholder group that was considered for required membership during the crafting of the mandate. See the findings around the mandate s notable events on pages for further information on this point. Unfortunately, the current project was unable to locate or gather data on the current breadth and activity level of membership on Oregon SARTs. Use of Formal Structures and Resources The Campbell, Greeson, Bybee, and Neal study (2013) identified items such as formal funding, meeting agendas, recorded and distributed meeting minutes, subcommittees and bylaws among the formal structures and resources (Greeson, 2015, p. 29) they studied. While this project s design did not lead us to inquire directly about Oregon SARTs use of these structures, some of those interviewed did mention them. For example, it appears that teams commonly use meeting agendas and meeting minutes. Alternatively, the lack of funding was mentioned in interviews and has been consistently identified by SART members as a resource need in the Task Force s SART surveys in 2005 and No formal funding for SARTs was provided along with the mandate. By prescribing meeting frequency and certain required tasks, state mandates function to formalize SARTs to some degree. Oregon s mandate specifies the minimum frequency of meetings (quarterly) and prohibits the combining of SART and MDT meetings a signal that proponents believed there is sufficient work to be done on adult and adolescent sexual assault response to merit distinct meetings. Use of Identified Collaborative Processes Project interviews elicited examples of three types of the research-identified collaborative processes impacted by the mandate 12 : policy/protocol adoption, multidisciplinary cross-trainings, and increased conversation among responders. Policy/Protocol Adoption SARTs largely complied with the requirement to develop and adopt protocols for adolescent and adult response to sexual assault. All but two SARTs submitted protocols to the Task Force by December One interview participant believed the protocols have increased consistency in the front-line response: Counties having protocols also helped to get a more consistent response from all law enforcement agencies. There is still a lot of room for improvement. But, I think most know what to expect you ll talk to a patrol officer, from there you ll do a medical exam (if that s appropriate), and then from there a detective will follow up with you and those kinds of things. And, then an advocate will be called to the hospital or wherever you are and offer services, and usually a detective will offer times 12 The Campbell, Greeson, Bybee, and Neal study (2013) measured the use of the following collaborative processes: policy/protocol development and adoption, multidisciplinary case review, multidisciplinary cross-trainings, other trainings for sexual assault responders, memoranda of understanding, and formal program evaluation (see also Greeson, 2015, p. 31). Project evidence of increased conversation among responders was added to this section because of its strong relationship to effective collaboration. 10

11 when an advocate can be there. So, I think that has improved and given a little more consistency in response across the counties. Multidisciplinary Cross-Trainings The Task Force established the Sexual Assault Training Institute in late 2001 to offer both disciplinespecific and multidisciplinary training to those involved in responding to sexual assault, including SARTs. (Oregon Attorney General s Task Force, 2009, p. v). In 2002, the Task Force created a statewide SART conference to bring together SARTs from across the state to learn from each other and from speakers on issues specific to SART work. According to interview participants, these conferences were popular and well received. They were also a key way the Task Force identified communities that needed or wanted technical assistance or training. Unfortunately, the Task Force could no longer sponsor the biennial conference after 2012 due to funding shifts. Ironically, this important venue for cross-sart coordination and training was ending just as the mandate s impact to further formalize and establish the work of SARTs was taking hold. Shortly after the mandate s passage, the Task Force did receive funding that enabled them to provide a single, two and one-half day training for four SARTs, and other funding to create a tribal SART training. Yet without dedicated SART funding, the Task Force had to limit their SART training to those instances when it was requested, or when grant-specific funding would allow. Fortunately, grant funding has been available to support important SART work. Most notably, the Task Force was awarded OVW funding to do significant projects with the Northwest Portland-Area Indian Health Board and with a group of four rural and frontier counties in Oregon. With these funds, the Task Force developed and delivered Sexual Assault Response and Resource Circle training, which is the tribal equivalent of a SART. These projects enable the Task Force to continue their multidisciplinary training for SARTs in targeted ways. Today, the Task Force continues to provide SART training by request, and through grant-funded projects that typically target a specific issue or region. Increased Conversation One of the most significant outcomes of the mandate, according to those interviewed, was that it got people talking. Getting people to start talking...about starting a SART, even if it wasn t crazy successful that they were starting SART, at least they were talking about the issues and the barriers to starting a SART. I think the different disciplines do a better job of working well together, of owning our weaknesses and seeking out help in dealing with our weaknesses, because we all have them. In addition to compelling conversations in communities that needed to start a SART, this may indicate that the mandate triggered new and different conversations on existing SARTs. Such communication is an important pre-requisite to the cross system coordination that researchers recommend SARTs implement more consistently (Greeson and Campbell, 2014, p. 15). Putting It Together Ultimately, SART efficacy depends on the dynamic interaction of the components explored above-- collaborative processes, formal structures and resources, and membership working together in a cohesive whole. One indication of this on Oregon SARTs comes from a team active since the mandate, but characterized in the 2005 SART survey as fizzled out. A team member recounts their first impression upon joining the team (sometime in ): Well, [my impression was] extremely positive. There was a set agenda. It brought together some of the most well intended community partners, basically anyone that had a role in ensuring that a victim or survivor had a positive experience from start to finish. From experiencing a sexual assault, 11

12 which is never a positive thing, [our] county does their best to make sure it s the best. So in our county its DA led, we have an extremely passionate and knowledgeable district attorney who leads the team. We have both victims assistance and our community-based advocacy, [agency name], who play an active role and attend every single time. And then we have some amazing law enforcement officers who are on it. Detective sergeants attend from each of our [four] agencies and then two smaller law enforcement agencies attend when they can, but they are absolutely included. We have a signed MOU between all the agencies around the SART mandate that have participation in the SART, and its really an open place for our community to problem solve what s working and what s not working when it comes to sexual assault. What were some of the challenges of mandate implementation? Since most Oregon counties had SARTs prior to the mandate, most interviewed did not recall a significant shift after the mandate passed. However, implementation challenges that were identified by interview participants included: the perceived role of the prosecutor; resource constraints; privacy and information-sharing issues for nurses; and keeping SART members engaged after protocols are complete. The Role of the Prosecutor While there were already SARTs in most Oregon counties, the statutory language that the district attorney in each county shall organize a sexual assault response team led to the interpretation by some prosecutors that they were now in charge of the team. I remember bringing the law to our SART and they were surprised. The DA of one of the counties read that he had to physically run the SART program and our SART went from functioning really, really well to very low attendance because it became a teaching moment from him for an hour. And, people stopped coming. Prior to that we would provide statistics, what worked well, what did not, what happened when cases closed out, real information on what was happening in the county and that stopped completely...somehow he got word that he did not have to run it and so it s back functioning well now. The Task Force responded. After learning of such instances and fielding questions directly from a few prosecutors wondering about their role, they issued a statement. Former Task Force SATI training coordinator, Jenna Harper recalls, One of the things we did do in response was that we issued a clarification to all SARTs that just because the legislation is written that the DA shall, it does not mean that the DA has to be the organizer, the facilitator, or the coordinator and that it does not mean that they have any more power than anyone else to make decisions. Resource Constraints Another reaction Ms. Harper encountered soon after the legislation passed was frustration that it was an unfunded mandate. She recalled, I think there were a lot of people upset there was a unfunded mandate to do something.people called it the unfunded mandate when I would go around to do training. The concern about adequate resources to do the work had shown up in SART survey results in the years prior to the mandate as members of existing SARTs expressed their challenges. This concern was elevated when the mandate required teams in counties that had not previously had them, and protocols from all SARTs, without a concurrent pathway to additional funding. Economically depressed areas and frontier communities felt the biggest challenge in implementing the mandate without additional resources. There are communities in Oregon that have lost funding for law enforcement. And when people call for help, they may have to wait two, four, six hours, or days to get a response. Domestic violence patients are told, lock the door and don t let anyone in, because they have no officers to send. 12

13 The communities that were not doing it, were not doing it for a reason a big part of that is the lack of resources whether its manpower, finances, infrastructure or whatever. So, many of the times when we have laws like this, it s a great law, but it s painful growth. The requirement that the SART meet independently of the county s child abuse multidisciplinary team (MDT) led to concern about the impact of adding another meeting in many of these same communities. One interview participant noted this challenge was resolved with a decision by the Attorney General s office: I think what they worked out with the Attorney General s office is that they could have their meeting on the same day as the MDT meeting. They could even have the same people on them, but they had to be separated in time. They could have the MDT in the morning, break for lunch, and then have the SART meeting in the afternoon. The AG said: you can t hold them together because they are two separate meetings. Resource constraints also impacted medical and care facilities subject to the new requirements about who could perform the exams and the policies they needed to have for treatment and referral of patients. The new laws sought to improve patient access to exams in areas where they were subjected to waiting long hours for care. Yet, it was often precisely these areas that struggled to comply: Suddenly counties, hospitals were being held accountable for having access for medical exams, which also became somewhat a crisis in the medical world and there was also in some communities a crisis with having to have these SARTs covered. While many hospitals actively supported their nurses efforts to achieve SANE certification, some struggled to find the resources for employing sufficiently trained sexual assault forensic examiners. The challenge grew when a few years after ORS went into effect, the Oregon Board of Nursing determined that conducting sexual assault exams was outside of the scope-of-practice for registered nurses without specified training (e.g. the 40 hour SANE training). In practice it s almost impossible for some communities to do hospitals have to make a choice in where to put their monies. Do you put it in heart attacks (which you are most likely to have), as opposed to sexual assault exams, which in their eyes are not life threatening in the moment and are few and far between? And the Emergency Nursing Association says that nurses can do this. So, it put communities, they were now having to divert money from heart attack, strokes, trauma services to taking care of sexual assault patients or telling them "no we don t provide that here, head on up the road." Privacy and Information Sharing Another challenge faced by medical professionals was navigating privacy and information-sharing constraints posed by some SARTs activities. Patti Kenyon, the Task Force s former statewide SANE Coordinator, recalled receiving calls from nurses to clarify what they could and could not say at team meetings, particularly when a specific SART seemed to take on a case management approach. I had a lot of calls from nurses saying, what can we say? what s our role on the SART team? can we even say anything if it s an investigative committee? And, of course with adults (18 and above), [I d tell them] no you cannot say anything about what you were told during the exam. You cannot be part of the investigation. So, then, nurses started saying, well then why should we even be a part of this?" Noticing a difference among SARTs, she noted that a specific type of SART seemed to raise this question of the nurses role. So, if you were in a community where they saw it as an investigatory tool the nurses had a harder time, advocates had a harder time. The law enforcement and prosecution saw it as a great way to figure out whether they were going to take a case forward or not. Communities that saw [the SART] 13

14 as a community resource training of the community, training of different partners, developing policies around how kits are handed off to law enforcement, what has gone well in an investigation, what did not go well, as opposed to specifics of the case, and after they were adjudicated using them as an education tool, those communities had no problems seeing the value of a SART. Keeping SART Members Engaged Finally, confusion around the team s work and focus after they have protocols completed was cited as a key challenge. And then from my experience the biggest challenge with these meetings is what you talk about. Most of them come together and they write a county protocol on how to respond to these cases. They may have a case now and then to review, but once you have your protocol in place and you have these meetings, what do you have to talk about? That s always the challenge for these teams is to keep people interested, keep them attending, make the meetings interesting so that they come and attend. So, that it s just not, hey you have to be here because there is this requirement that you have a team." What other notable events occurred as a result of mandating SARTs in Oregon? Interviews with project participants provided some notable results of the SART mandate. These included a discussion around the inclusion of civil attorneys in SART membership, loss of funding for the Task Force to do significant SART-specific work, increasing standardization of the law enforcement response, enhanced credibility of community-based advocacy partners, and ideas around monitoring for SART quality and compliance with the mandate. Civil Attorneys as SART Members During the drafting of the mandate, the Task Force s Legislative and Public Policy Committee considered which agencies and representatives to require district attorney s to invite to join their SART. Civil attorneys were included in this discussion for consideration. This raised a larger question for SARTs in Oregon and elsewhere to consider: Do SARTs sufficiently consider the challenges and barriers that survivors face in areas such as immigration, education, employment, housing, privacy and public benefits that impact both a survivor s safety and ability to fully participate in the criminal justice process? While civil attorneys were not ultimately put into the mandate as a required entity for SART membership, a few Oregon SARTs have begun inviting a civil attorney to join their teams to promote communication and insight between those working with survivors on civil matters and those working on criminal matters. Many SARTs highlight a victim-centered focus as part of their mission and research suggests that being victim-centered is not incompatible with improving legal outcomes for SARTs (Campbell, Greeson, Bybee, and Neal, 2013, p. 142). As SARTs nationwide strengthen and deepen their commitment to a victim-centered response, they may want to consider Oregon s on-going conversation about broadening attention to the civil legal challenges survivors face. While these challenges and barriers exist outside the criminal justice system, survivors may experience them as inherently connected to meaningful participation within it. As one interview participant noted: Individual survivors and the community as a whole are so much better off when we do everything we can to help sexual assault survivors stabilize their lives, and meet their most urgent needs. Whether it s housing or safety or privacy; helping survivors stay in school or keep their jobs... or promote their financial stability, survivors are better able to participate effectively in the criminal justice system if we can help them meet their most basic needs. If you don t have a place to live, for example, going to court and testifying is probably not your top priority. If you have no way to pay the rent, to pay for health insurance, to put food on the table, then showing for court or for meetings with the prosecutor isn t going to be the number one concern on your list. If you re get fired from your job or drop out of school it may lead you to move to live with family or friends or someone who will put a roof over your head in which case you may not be around to testify. Civil 14

15 lawyers can represent survivors in all these areas. We need them at the SART table. There are so many ways in which taking a holistic approach allows us to better respond to survivors needs so that they, in turn, are more able to participate effectively in a criminal prosecution. Loss of SART-Specific Funding Another notable event around the mandate s implementation was the loss of funding for the Task Force to do SART specific work. This was coincidental timing with the passing of the mandate, not an outcome of it. However, after more than a decade of developing a strong focus on SARTs through training, technical assistance, a biennial SART conference and at least two SART surveys, it is notable that the Task Force lost its funding for this dedicated work soon after the mandate took effect. It s unclear that any other group has been funded to do this work with SARTs in Oregon or that any have taken it up with the focus the Task Force had. Further study might provide insight into the impact this loss of funding and services has made on the growth of individual SARTs and the overall SART ecosystem in Oregon. Enhanced Credibility of Community-based Advocacy Partners; Increasing Standardization of the Law Enforcement Response The enhanced visibility and acceptance of community-based advocates and the increased consistency and standardization around the basic law enforcement response are ripple effects of the mandate that are addressed above on pages 9 and 10, respectively. Both are notable in that they directly relate to a core SART goal improved coordination and consistency among responders to provide a victimcentered approach to intervention. Monitoring for SART Quality and Compliance Finally, it should be noted that the mandate includes no penalty for non-compliance. One interview participant acknowledged this, yet offered that the mandate none-the-less elevated the priority for addressing sexual assault cases. So, these things tend to die out if you don t have the mandate. And again, we have the mandate but there are no teeth to it. The police aren t going to arrest your team because you are not meeting. But, people pay attention to that so the reason for the mandate was to emphasize the importance of handling these cases. We want you to make these cases a priority, so I think that was part of why [the mandate was passed]. However, another interview participant suggested that SARTs might benefit from an audit process similar to the one in which child abuse multidisciplinary teams (MDTs) participate to maintain good standing: The child abuse MDT has an audit process, it s kind of an insurance--what cases are being reviewed, who's at the table, what information is being discussed, just to ensure that it s happening properly and that the tracking and all of the mechanisms that the law intended are in place. I am unaware of that being established for a SART. And while by no means do I appreciate audits in any aspect of my life, it seems silly that you would implement a law and then have no way to ensure that it s being followed in the way that it s intended. So, I think the MDT ones are extremely useful. I appreciate that someone cares enough about the MDTs to make sure that we are following up correctly to ensure that we are doing it in the way that the law intended that it be done. So seeing something that is so important and so critical as a sexual assault response team is in place, I think that that mechanism [could work]. 15

16 Discussion This project sought insight into the Oregon SART mandate s impact on Oregon SARTs to inform the larger goal of identifying elements of the ecosystem 13 all SARTs need to become strong and effective. The project findings suggest a mixed story that some Oregon SARTs are doing well and that others are struggling to maintain compliance. Campbell, Greeson, Bybee, and Neal write that collaboration is a shifting dynamic process: members join and leave the team, goals shift, ideas for what constitutes best practice evolve, resources change, and so on (2013, p. 139). Their research on SART implementation suggests that SARTs need enough structure 14 to organize their work amidst these changes, and that the use of formal structures provides a backbone that keeps the team focused on its collaborative work (2013, p 139). States also face shifting dynamics that impact the growth and development of multiple SARTs. Williams (2016) proposes that states and territories cultivate a healthy SART ecosystem that sets conditions for SART growth, efficacy and sustainability. Just as SARTs benefit from formal organization and leadership to organize their work, the state as a whole can benefit from creating the structures, networks, and resources that help local SARTs to be successful (Williams, 2016). Based on information gathered in Oregon and other states with mandates, Williams identifies at least seven elements of a SART ecosystem (2016, p 2-4). They are: Skilled and well-trained professionals to staff teams Guidance and support on how to create and sustain effective SARTs A commitment to SARTs as a chosen approach to improving response to adult sexual assault Cross-system coordination at multiple levels Formal structures that provide support within and among SARTs Dedication to learning within and across teams, and Sufficient resources to support the work Based on findings in this project, Oregon has had most, if not all, of these elements in place to grow the work of SARTs since Good data on Oregon SART composition, functioning, and challenges faced is available for the period prior to the mandate s passage. Unfortunately, similar surveys that could give trend or growth data for comparison have not been conducted since the mandate. While the most noticeable growth in the Oregon SART landscape came prior to the mandate, teams may still face ongoing challenges to remain successful. Interviews from the current project suggest that new SARTs were started as a result of the mandate, but that SARTs in economically depressed areas and frontier communities struggle the most with compliance. While further research is needed on the ecosystem that fosters SART efficacy, Oregon and other states can use the identified elements to consider the conditions they set for SARTs. Cultivating a SART ecosystem can amplify local SART efforts; it need not undermine them. When local efforts are fed by a system of connections, resources, and guidance that both informs them, and is informed by them, the entire environment for effective SART work can expand. 13 We define a SART ecosystem as the interplay between local SARTs and the climate, organizations, and resources that affect their growth, development, and efficacy in a specific region. For more on this concept, see Understanding SART Mandates: Insights from an exploration of the impact of state mandates on SART growth and development,. Published by SVJI. 14 Formal structures mentioned in the research include: a formal leader, written agendas, meeting minutes, mission statements, sign in sheets, operating rules, and formal funding sources. The researcher s scale rated teams use of 13 formal organizational structures and resources (Greeson & Campbell, 2014, p.11). 16

17 Conclusion In passing the SART mandate, Oregon sought to bring a standardized, but community-crafted response 15 to sexual assault across the state. By standardizing a core group of SART members, some interview participants report that community advocates were added to teams that had not previously included them and elevated their role on others. Others reported that this move to standardization prompted these responders to talk more with each other and with colleagues across the state about sexual assault response. By requiring SARTs to adopt protocols for response to adult and adolescent sexual assault, at least one interview participant noted that the core law enforcement response had become more consistent statewide. The current project found these gains and others regarding SART growth and efficacy despite project limitations. And, while the success or failure of the mandate was not the focus of the current project, several interview participants said they believed that the mandate generally accomplished its initial goals of increasing the visibility of sexual assault issues and getting people talking to each other: I think that it has certainly accomplished many of the things that it hoped for, bringing communities together, to force people to do, what I think is the right thing for victims, survivors, patients. As with anything it s painful, as usual it comes without financial backing which makes it very difficult for communities. In some of the urban areas, agencies did not understand the dynamics of sexual assault and the role of the advocates and SANEs and as a result, many cases were not fully investigated. So, I think for the most part, and in most of the state, [the mandate] accomplished what it meant to do. As a component of SVJI s national initiative, the current project did focus on eliciting elements of an ecosystem that could support the growth and development of SARTs. Since the Task Force was created in 2000, Oregon has had many, if not all, of the identified elements, which could explain the intense growth in SARTs from 2000 to According to data from previous SART surveys, team members from across the state have identified strengths and challenges, but current data is lacking to know how many and which teams are having similar experiences today. While the Task Force continues its work with SARTs by responding to requests for assistance and embedding SART training and support in specific projects, it does not have the funding to be doing all it would like. The current project did note that the loss of the Task Force s dedicated SART funding could have been a set back for the Oregon SART ecosystem just as the impact of the mandate was starting to be felt most. As evidenced by the mandate and all the work that preceded it, Oregonians have shown a commitment to SARTs as a key way local communities can organize their response to sexual assault. Oregon also possesses professionals with significant knowledge, skill and expertise in both the best response to sexual assault and SART development. Yet, with the shifting dynamics of collaboration continuously at play, and the scope of sexual assault crimes broadening, the further cultivation of their SART ecosystem can ensure that Oregon s sexual assault response continues to be among the best in the nation. 15 Herrman, 2011, p. 2 17

18 References Campbell, R., Greeson, M.R., Bybee, D., Neal, J.W. (2013, September). Sexual assault response team (SART) implementation and collaborative process: What works best for the criminal justice system? Unpublished. Made available electronically through the National Criminal Justice Reference Service. Greeson, M. R., Campbell, R. (2013). Sexual assault response teams (SARTs): An empirical review of their effectiveness and challenges to successful implementation. Trauma, Violence, and Abuse, 14 (2): Greeson, M.R. (2015). Sexual assault response team (SART) functioning and effectiveness: Findings from the national SART project. Available from Greeson, M.R., & Campbell, R. (2014). Coordinated community efforts to respond to sexual assault: A national study of sexual assault response team implementation. Journal of Interpersonal Violence, published online 13 October Online version can be found at: Hoyt, S. (January 25, 2011). SB 557 Sexual Assault Response Teams. [Legislative Issue Brief]. Salem, OR; Office of Senator Chris Edwards. Herrman, C. (2011). Oregon Attorney General s Sexual Assault Task Force Memo of May 25, 2011 to the Oregon State Legislature, Oregon State House of Representatives, House Judiciary Committee, Rep. Jeff Barker and Rep. Wayne Krieger, Co-Chairs regarding Senate Bill 557. Keizer, OR: Oregon s Sexual Assault Task Force. Or. Rev. Stat (2011). Or. Rev. Stat (2011). Oregon Attorney General s Sexual Assault Task Force (2010). Status of SARTs in Oregon-2010 Sexual assault response team survey report. OR: Author. Victor, D. E. (2005) Sexual assault response team survey. OR: Oregon Attorney General s Sexual Assault Task Force. Oregon Attorney General s Sexual Assault Task Force (2009). SART handbook version III. Salem, OR: Author. Williams, L. (September 2016). Understanding SART Mandates: Insights from an exploration of the impact of state mandates on SART growth and development. [Submitted report]. St. Paul, MN: Sexual Violence Justice Institute at the Minnesota Coalition Against Sexual Assault. Zajac, J.J. (2006). Report on the national needs assessment of sexual assault response teams. Enola, PA: National Sexual Violence Resource Center. 18

19 Appendices Appendix A: Key Events Timeline OR SART Mandate Appendix B: List of Interview Participants 19

20 Appendix A: Key Events Timeline 20

21 21