Forensic Compliance in Colorado: An Examination of System Response to Sexual Assault Colorado s Approach, What We Learned, and How We are Addressing Our Issues; Plus, Tools for Examining Your System and National Best Practices
Your Presenters! Terri Livermore Karen Moldovan Colorado Coalition Against Sexual Assault, Director of Advocacy & Policy Division of Criminal Justice, Sexual Assault Response Director
Sounds like the most boring topic on earth
The reality is. Yes, it is Critically Important to our Work! According to the US Department of Justice, in 2011 only 27% of rapes were reported. http://www.bjs.gov/content/pub/pdf/cv11.pdf
Understanding Forensic Compliance The term forensic compliance commonly refers to victims ability to access free medical forensic exams without the victims participation with a law enforcement investigation. The Forensic Compliance Evaluation Project (FCEP) sought to identify effective approaches and challenges encountered with the implementation of forensic compliance laws-- mandated through the federal Violence Against Women Act (VAWA) 2005 and related Colorado statutory changes in 2008.
Why is Forensic Compliance Necessary? What we know about victims What we know about sexual assault What we know about trauma What we know about perceived fears of the criminal justice system
What are Forensic Compliance Goals? 1) Victims can get time sensitive medical care 2) Victims can ensure time sensitive evidence collection 3) Victims can explore their options and make informed choices 4) Improve reporting rates, increase the number of investigations, improve prosecution rates of sexual assault crimes Rape is the most underreported crime in America. Dean G. Kilpatrick, Ph.D., National Violence Against Women Prevention Research Center
Colorado s law (enacted 2008) C.R.S 18-3-407.5(3) No government official can require a sexual assault victim to participate in or cooperate with the criminal justice system as a condition of receiving a medical forensic exam (summarized) Local law enforcement with jurisdiction over the assault picks up and stores the kit for at least two years The evidence collection portion of medical forensic exams for victims not participating in the criminal justice system is paid by the Division of Criminal Justice
Forensic Compliance in Colorado CO = Medical Mandated Reporting Significant pushback from law enforcement no anonymous reporting system developed Medical Reporting Victims Victims who seek medical services following a sexual assault but elect not to participate in the criminal justice system at the time of receiving medical services. Law Enforcement Reporting Victims Victims who report the assault to law enforcement prior to, at the time of, or independent of a medical forensic exam.
Forensic Compliance in Colorado Victim s should have sole discretion over ability to obtain an exam want one, get one [C.R.S. 24-33.5-113(1)(b)(I)] Medical forensic exam programs call law enforcement; law enforcement picks up kits and stores for minimum of 2 years [C.R.S. 18-3- 407.5(3)(c)] Interaction between LE and victim inconsistent across jurisdictions Little follow-up support for medical reporting victims
Forensic Compliance in Colorado Evidence collection paid by: Law Enforcement LE reporting victims Division of Criminal Justice medical reporting victims Associated medical costs paid by: Victim Compensation Law Enforcement reporting victims Sexual Assault Victim Emergency (SAVE)Payment Program medical reporting victims (created in 2013, as a result of Forensic Compliance work)
What s Going on In Your State! Knowing your approach
Florida Framework What are Your Forensic Compliance Laws? State Laws/ Community Specific Laws/Practices? Identify Your Stakeholders Statewide or community approach? Initial Questions Are victims getting exams without participating in criminal justice system? Is the number of victims accessing this option increasing or decreasing? Is any tracking/data collection currently done? What s working? Gaps and barriers?
Scenario Victim presents at a hospital without a SANE program and tells doctor he was raped. He doesn t want anyone to know, has no insurance, but wants medical care. He was drinking but thinks he may have also been drugged. Two days after exam, victim wants to report assault to law enforcement. Questions How is victim informed of options? Can he remain anonymous? Does that change the advocate response? What is the advocate response? Where is exam performed? Who decides if DFSA testing is warranted? Who pays? Who pays for the evidence collection? Who pays the associated medical costs, if any? What happens to kit? Who stores it and for how long? How does he report? Is it likely the case will be investigated? Prosecuted?
Forensic Compliance Evaluation Project 3 years of forensic compliance; needed a comprehensive assessment Obstacles No funding side project Data collection not very centralized New to assessment (not researchers) Victim input?
Forensic Compliance Evaluation Project Volunteers! Time Commitment Expertise Interest in topic Created a Statewide Multi- Disciplinary Team Identified Goals Multi-year project Two part study concept 1) Case Analysis 2) Survey How We Did It!
Two Part Study 1) Case Analysis: Reviewed cases to determine the current reporting status, and if applicable, the length of time between the exam and law enforcement report, as well as case outcomes. 2) Professional Responder Survey: Used SurveyMonkey to collect responses from sexual assault responders regarding forensic compliance and related issues.
Part 1: Case Analysis Able to compile data because all medical reporting cases paid through DCJ 33 months of data 33 total LE jurisdictions 151 total Medical Report Cases Study data on 127 cases from 22 LE jurisdictions Data points Confirm case exists Reporting status Length of time between exam and LE report Case outcome
Case Conversions
Case Analysis Results Snapshot What Works! Single source payment makes statewide data collection/analysis possible Statewide mandate on evidence retention provides consistency for victims wishing to report sometime after the exam Some hospitals/law enforcement agencies have developed good response processes and wrote them into protocols What still needs to be studied/improved Not many cases less than we would suspect. Why? Marketing Inconsistent approaches Victim support lacking Victim reporting options limited Limited investigations; ~even less (or no) prosecutions
Lessons Learned How We ll Handle the Case Analysis Next Time Define study objectives/information needs more clearly Information from LE agencies was inconsistent and case study was primarily dependent on that information Have one person, with forensic compliance knowledge, working with law enforcement offices and district attorneys offices Keep better records on the front end when initially working with law enforcement during the payment process Extend study objectives to include information gathering from District Attorneys Offices Why cases were or were not accepted for prosecution? What was the outcome of cases accepted for prosecution?
Part 2 Professional Responder Surveys: The Specifics Multi-disciplinary group identified issues Anonymous Reporting Medical Mandated Reporting Sexual Assault Response Protocols Both law enforcement reporting and medical reporting Sexual Assault Response Advocates Both law enforcement reporting and medical reporting Intimate Partner Sexual Violence Response Multi-disciplinary group developed survey questions Questions were tailored to 4 primary response professions Short 10-12 questions per profession Primarily check box with opportunities to comment
Part 2 - Professional Responder Surveys
Issue 1: Anonymous Reporting (not currently an option in Colorado)
Issue 2: ADULT Medical Mandated Reporting C) = complex and poorly written medical mandated reporting law (C.R.S 12-36-135) Various types of wounds a physician believes to have been intentionally inflicted must be reported; plus, dog bites any other injury that the licensee has reason to believe involves a criminal act, including injuries resulting from domestic violence Sexual assault Injury is undefined Licensee believes
Adult Medical Mandated Reporting Support
What We re Doing About MMR and Anonymous Reporting Developed and disseminating a statewide Reporting Options brochure Clarify MMR statute around sexual assault Clarify who has duty to report Create an anonymous reporting option
Issue 3: Sexual Assault Response Protocols
Issue 4: Advocate Response
Issue 5: Intimate Partner Sexual Violence
What We re Doing about Response Protocols, Advocate Response and IPSV Forensic Compliance Team will develop Colorado Model Multidisciplinary Protocol Victim-Centered Approach Education and clarification on (hopefully new) medical mandated reporting statute Best practices in advocate response Guidelines for working with converted cases Guidelines to IPSV response Interaction with the (hopefully new) anonymous reporting option
Lessons Learned What Worked in Conducting the Surveys Statewide approach - consistency Involved research partner for analysis Utilized multi-disciplinary group to develop study Asked the questions of all responders sought info and formed conclusions rather than let conclusions inform process Anonymous survey (with some changes) Graphic Designer
Lessons Learned How We d Approach the Survey Differently Involve research partner in survey (and case analysis) development Vet questions; be prepared to adjust Know what you want answered; and what you don t Grant personal anonymity but at least obtain agency (or at least regional demographic) info One large PD may have skewed some results More case data, especially around prosecution Funding would be nice
building on what works in Colorado and addressing gaps through the incorporation of national best practices
It Doesn t Stop with the Study FCEP Team and Subcommittees Policy and Protocols Outreach and Education Research Prioritizing Issues Policy Changing the Law MMR & Anonymous Reporting Model Protocols Integrating Survivor voices!! Education and Outreach Reporting Options Brochure Integrating Survivor voices!! Research Informs all change
National Best Practices Forensic Compliance http://www.evawintl.org// Forensic-Compliance What We re Looking At Incorporating Anonymous reporting Advocate response to medical reporting victims Law Enforcement using trauma-informed interview techniques Training LE and Prosecutors on converted cases
Making A Difference! New Programs/Statutes/Language In Progress SAVE Program Reporting Options/MFE Payment info brochure for victims (statewide, adaptable to include local resources) Statutory language clarifying that victims are the sole decision makers about obtaining an exam All SA kits tested (2 exceptions) MMR Fix Anonymous Reporting Additional Research Case studies/in-depth examination to identify issues with investigations and prosecutions of converted cases New consent forms with more control for victims Switch from non-reporting to medical reporting
Model Response Protocol Survivor focus groups Laws around minors Update and expand LE training (POST and roll call videos) DNA storage laws current conflict
Resources Reading To snuggle up with our report: www.ccasa.org, click on Resources National Best Practices = www.evawintl.org Tools Survey Format Outline Sample Questions Reporting Options Brochure Payment Information Sheet Laws Governing Medical Forensic Exams Handout
Any Questions?
Connect with Us! Terri Livermore Colorado Division of Criminal Justice, Office for Victims Programs Sexual Assault Response Project Director 303-239-4546 terri.livermore@state.co.us Karen Moldovan Colorado Coalition Against Sexual Assault Director of Advocacy & Policy 303-625-9565 (direct line) advocacy@ccasa.org