MEDCOM Fort Sam Houston

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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
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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

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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
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MEDCOM Roles and Responsibilities
Garrison Theater
Sexual Assault Program is governed by MEDCOM Reg 40-36 MEDCOM Regulation serves as a directive to all Medical Treatment Facilities (CONUS and OCONUS) Provide a comprehensive and consistent standard of care from the start of care until care is completed Maintain a level of dignity and respect in taking care of the victim MEDCOM Regulation 40-36 serves as sexual assault management guide for Theater medical care Sexual Assault care is provided at Division level (Combat Support Hospital (CSH)) where the CSHs are staffed with required expertise to best care for the patient Each CSH responds to managing the victims care in accordance with their specific Standing Operating Procedure (SOP)
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Key MTF Medical Staff

• Sexual Assault Clinical Provider (SACP)
• Manage each sexual assault patients 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/treatmen
  ts are
• Clinically appropriate for each individual
  patient
• Consistent with his/her clinical diagnosis and
  policy

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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

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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

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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

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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

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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

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Resources