Current through Register Vol. XLI, No. 38, September 20, 2024
3.1. Every hospital shall have available 24
hours a day seven days a week:
3.1.1.
Qualified medical personnel performing exams on adults/adolescents who have
completed a 40-hour sexual assault nurse examiner course and demonstrate
clinical competency as outlined and approved by the SAFE Commission;
3.1.1.a. Qualified medical personnel
performing exams on pediatric (under age 14)/adolescent victims (ages 14-18)
who have completed a 40-hour pediatric sexual assault nurse examiner course and
demonstrate clinical competency as outlined and approved by the SAFE
Commission;
3.1.2.
Physicians, physician assistants, or APRNs who have completed a modified
training course, or registered professional nurses who have completed a
40-hour, adult/adolescent sexual assault nurse examiner course and have access
to a teleSANE. All courses, modified courses, and teleSANE providers must be
approved by the SAFE Commission; or
3.1.3. In lieu of the requirements contained
in subdivisions 3.1.1. and 3.1.2., a signed written agreement with a hospital
that is in compliance with the requirements of subdivisions 3.1.1. and
3.1.2.
3.2. A health
care facility that provides sexual assault forensic exams shall provide the
following services:
3.2.1. Appropriate medical
forensic services without delay, in a private, age-appropriate, or
developmentally appropriate space, required to ensure the health, safety, and
welfare of a sexual assault victim and that may be used as evidence in a
criminal proceeding against a person accused of the sexual offense, in a
juvenile delinquency proceeding under W. Va. Code
49-4-701
et
seq.;
3.2.2. An offer to
complete the Sexual Assault Evidence Collection Kit for any sexual assault
victim who presents within 96 hours after the offense, or who has disclosed
past sexual assault by a specific individual and was in the care of that
individual within the last 96 hours;
3.2.2.a.
Appropriate oral and written information concerning evidence-based guidelines
for the collection of evidence, depending on the sexual development of the
sexual assault victim, the type of sexual offense, and the timing of the sexual
offense, shall be provided to the sexual assault victim. A qualified medical
provider shall educate and request consent to evidence collection of sexual
assault victims who present to a health care facility with a complaint of
sexual offense within 96 hours after the sexual offense;
3.2.2.b. The information required under this
subsection shall be provided in person by the qualified medical provider
providing medical forensic services directly to the sexual assault
victim;
3.2.2.c. Following the
discussion regarding the evidence-based guidelines for evidence collection in
accordance with paragraph 3.2.2.a., evidence collection shall be completed at
the sexual assault victim's consent.
3.2.3. Appropriate oral and written
information concerning the possibility of infection or sexually transmitted
infection in accordance with CDC guidelines.
3.2.4. Medically accurate written and oral
information about emergency contraception in accordance with CDC
guidelines;
3.2.5. Appropriate oral
and written information concerning accepted medical procedures, laboratory
tests, medication, and possible contraindications of that medication available
for the prevention or treatment of infection or disease resulting from sexual
offense;
3.2.6. After a medical
forensic or physical examination, access to a shower at no cost, unless
showering facilities are unavailable;
3.2.7. Photo documentation, with permission
of the sexual assault victim, of the victim's injuries, anatomy involved in the
offense, or other visible evidence on the sexual assault victim's body to
supplement the medical forensic history and written documentation of physical
findings and evidence. Photo documentation does not replace written
documentation of the injury;
3.2.8.
Referral by the health care facility personnel for appropriate counseling.
Initial referral should be to a community-based rape crisis center;
3.2.9. With the consent of the sexual assault
victim, a rape crisis center advocate shall remain in the exam room during the
medical forensic examination. (See W. Va. Code §61-11A-9 (Sexual Assault Victims'
Bill of Rights));
3.2.10. Written
information regarding services provided by a rape crisis center and children's
advocacy center, if applicable;
3.2.11. Information on drug- or
alcohol-facilitated sexual offense testing, including an explanation of the
comprehensive scope of a drug test or blood alcohol test, and the limited time
frame within which evidence can be collected; and
3.3. If a sexual assault victim is unable to
consent to medical forensic services, the services may be provided under the
West Virginia Health Care Decisions Act, the Health Care Surrogate Act, or
other applicable State and federal laws;
3.4. Procedures to ensure the welfare and
privacy of the victim shall be followed and shall include, but not be limited
to, the following:
3.4.1. A member of the
health care team shall respond immediately with the goal of placing a victim in
a private area within 30 minutes of arrival to ensure privacy. Upon arrival the
health care team shall initiate the facility's plan for sexual assault victims.
Health care personnel shall refer to victims by code to avoid
embarrassment.
3.4.2. If, for any
reason, the victim is incapable of receiving oral and written information
required in paragraph 3.2.2.a., the information shall be given to the
caregiver/guardian.
3.4.3. When a
victim is in custody, or has been arrested for or convicted of a violent crime
or forcible felony and continues to be in custody when the victim presents for
the medical forensic exam, then if the qualified medical provider and the
representative of the custodial agency, after consultation with the rape crisis
center advocate, agree that it is a necessary safety precaution, the
representative of the custodial agency may remain in the room. In these
situations, health care facility staff shall facilitate privacy for the victim
using curtains and positioning.
3.4.4. The health care facility shall call a
rape crisis center advocate and shall offer to call a friend or family member
to accompany the victim.
3.5. All health care facilities that provide
emergency medical services to sexual assault victims shall comply with the West
Virginia Crime Victims Compensation Act, West Virginia Health Care Decisions
Act, and any local ordinances, municipal codes, rules, or regulations that may
apply to the treatment of sexual assault victims.
3.6. Nothing in this rule creates a
physician-patient relationship that extends beyond discharge from the health
care facility.
3.7. The health care
facility shall take all reasonable steps to secure the patient's informed
written decision to consent to or decline examination and treatment.
3.8. Nothing in this rule prohibits a health
care facility from treating a sexual assault victim who presents more than 96
hours following the offense.