When someone in the Grand Forks area reports a sexual assault, a process is initiated that brings professionals from multiple sectors to support and assist them.
"We call it 'activating the SART,' " said Rachael Fuller, an emergency room nurse at Altru Health System who is also a trained sexual assault nurse examiner.
In 2014, Grand Forks victim's advocates from the Community Violence Intervention Center, law enforcement and emergency room personnel joined together to form the Sexual Assault Response Team, or SART. The team was fully implemented in March 2015.
Awareness of the program has spread through word of mouth and a concerted effort by the CVIC, Fuller said. In 2015, 47 people came to the hospital to report a sexual assault. So far this year, 79 people have come to report a sexual assault. During an interview with the Herald in November, another victim arrived at the hospital.
Fuller, an Air Force veteran who moved to Grand Forks from Colorado, is a certified forensic nurse with training specific to examining, interviewing and assisting victims of sexual assault. She said the increase in the number of victims coming to report is not necessarily due to a dramatic rise in sexual assaults, but rather a knowledge that there is a program in place to make survivors feel comfortable, and perhaps more importantly, believed.
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When victims come in, they are placed in a position of power, and are allowed to decide who they want to talk with and if they want to submit a sexual assault evidence kit. Fuller said nurses always collect evidence kits unless the reported incident happened more than five days ago, in which case physical evidence will likely be gone.
Under the Health Insurance Portability and Accountability Act, medical facilities are required to obtain two forms of consent from victims of sexual assault. One is the consent to collect evidence; the other is to allow the medical facility to release this information to law enforcement.
Victims always have the option to decline testing.
"If the victim wants to report, we call law enforcement, but we have 100 percent of cases reported to the CVIC," Fuller said.
It wasn't that way at first, but the SART team holds regular meetings with a victim's advisory board to track what works, what doesn't and what improvements need to be made. They found making an advocate available was always a good idea.
"Our process was to call if the victim wanted to," said CVIC victim's advocate Allison Smaaladen. "Now we're seeing more victims reach out to advocates."
"We always want to ask the victim if they want us there," she added.
If the person wants the advocate to stay around, their experience can vary. Sometimes, Smaaladen said, they're close confidents, other times they might be grabbing a cup of coffee.
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"We're really just there to support them," she said. "There's no real protocol for options because every situation is unique."
The CVIC has a full-time campus advocate at UND who assists victims there and helps spread word about SART to students.
Detective Robert Starr with the Grand Forks Police Department said he believes it is now about a 50-50 split between victims who report to law enforcement and those who go straight to the hospital. No matter where a victim reports, a victim's advocate from the CVIC such as Smaaladen will be there within 20 minutes. Law enforcement is also immediately contacted.
"We don't want to make them wait," Starr said.
Smaaladen said a small number of survivors will report the encounter directly to CVIC.
In a basic sense, the purpose of SART is to make what is a traumatic time in someone's life as simple as possible. A major reason for coordination among medical personnel, law enforcement and advocates is to minimize the times survivors must relive their ordeal.
"We want to get everyone together first so we don't have the victim or victims repeat their story," Starr said.
The CVIC has 16 full-time advocates, and one of them is always available to answer the phone or respond to the hospital or police station if an assault is reported.
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Improving the process
Over the past 30 years, North Dakota has taken steps make the process of reporting and prosecuting sexual assault easier.
In 1987, North Dakota formed a task force to address unmet needs of sexual assault victims by law enforcement, health care experts, crisis organizations and state departments.
This task force created the North Dakota Sexual Assault Evidence Collection Protocol and the Sexual Assault Evidence Collection Kit.
In 1994, under then-Attorney General Heidi Heitkamp, the protocol was changed to make prosecution of offenders easier. The protocol sought to immediately set up victims with medical and law enforcement resources.
In 2001, a team formed by North Dakota Council on Abused Women's Services joined the taskforce.
North Dakota's first SART program was established in Bismarck in 2003. The Red River SART team was formed in Fargo in 2008. Albert said members of the Red River SART team helped the Grand Forks team get organized.
Erica Davidson, CAWS North Dakota Sexual Assault Program Coordinator, said SART programs exist in every major town across the state and in some form in rural areas. The state's biggest challenge will be expanding those services.
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Prosecution remains rare
Few sexual assault reports result in a full criminal investigation, and even fewer ultimately lead to a conviction.
"Sexual assaults are really hard to prosecute," said Jennifer Albert, coordinated community response program coordinator with the CVIC.
Starr said law enforcement does not try to pressure victims to press charges or not press charges, but rather to lay out options and let them decide.
"The victim one day could say 'I want to cooperate,' sleep on it and say 'I just want to forget about it,'" Starr said.
He said all victims are given the number of a detective to call if they do eventually want to pursue a criminal investigation.
The Grand Forks Police Department, UND Police Department and the Grand Forks County Sheriff's Office all say they do not currently have any untested rape kits. Law enforcement officials say. Rape kits are only tested if the victim decides to press charges.
UND had four reported sexual assaults in 2015, one rape and three fondling incidents. UND Police Sgt. Danny Weigel said no criminal charges were filed in any of the incidents, nor have their been charges filed from a UND reported sexual assault in several years. The University Police had one reported rape in 2014 and three in 2013.
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The Grand Forks Police Department had 40 reported rapes in 2015, a 38 percent increase from 2014. Over the past decade, Grand Forks Police have had between 21 and 41 rapes reported.
Whether or not charges are filed is ultimately the decision of the State's Attorney's office, Starr said. That decision often depends on how much evidence is available.