Pioneering teamwork between college and Porter Hospital supports sexual assault victims

MIDDLEBURY — A groundbreaking partnership between Middlebury College and Porter Medical Center should make it easier for victims of sexual assault to get immediate, local care from medical professionals who are specially trained to work with trauma survivors and collect forensic evidence.
The college on Friday announced that it will partner with Porter Medical Center to share certified Sexual Assault Nurse Examiners, known as SANEs, so that individuals seeking treatment at Porter could meet with SANEs staff from the college’s Parton Center for Health and Wellness or that Middlebury College students could see SANEs at Porter.
The collaboration is the first of its kind in Vermont and provides a model for communities across the country, according to Sarah Kunz-Robinson, statewide SANE coordinator for the Vermont Network Against Domestic and Sexual Violence in Montpelier.
“We believe this is significant and groundbreaking, both regionally and nationally,” said Kunz-Robinson. “We are not aware of any other collaboration like this nationwide.”
In Middlebury, WomenSafe Executive Director Kerri Duquette-Hoffman said that her organization had advocated for such a collaboration over a number of years, but that logistical hurdles had gotten in the way of previous attempts to move ahead with the partnership.
WomenSafe is thrilled at this new announcement, she said.
“In the past there’s been roadblocks just in terms of how do you share privileges, how do you share insurance, kind of all those big logistical things. So we’re really excited that they have made this happen,” Duquette-Hoffman said.
Duquette-Hoffman commended both Porter and Middlebury College for their work on the collaboration and especially commended the leadership of Parton Medical Director Mark Peluso.
“Mark has really put some fire and momentum behind this. It is really great, and we’re very thankful,” she said.
Deputy State’s Attorney Dennis Wygmans, who prosecutes the county’s sexual assault cases, said the partnership will be a “huge benefit” to victims of sexual assault.
“I expect that’s where the largest impact is going to be felt,” Wygmans said. “We may not see much change in the number of cases, but I think that we might see higher quality cases because they’re getting to the cases quicker, survivors will be more open to talking, that sort of thing. It really is an area where there is such a huge stigma attached, a lot of self-blame goes on and people want to keep it private for obvious reasons. So any barrier to something being reported is a barrier to prosecution. And this will at least alleviate one step.”
According to Kunz-Robinson, previously there was often just one certified SANE in the Middlebury area, Barbara Wagner, a Porter nurse for over 40 years. Indeed, earlier this year WomenSafe bestowed on Wagner its Kimberly Krans Women Who Change the World Award, in part because of her long service to the community as, often, its only Sexual Assault Nurse Examiner.
“There’s only one of her. I’d love to have seven of her,” Wygmans said.
In addition to the recently announced partnership, this year both Porter Hospital and the college’s Parton health center increased their SANE staffing, said Kunz-Robinson. In April, three Parton nurses and one Porter nurse completed the rigorous SANE course and will receive their official certification next month. Additionally, Porter hired another SANE-trained nurse earlier this year. The college announced that it will be adding a fourth SANE.
“The women who have been involved with the SANE efforts for many years and the women that are new to the program are some of the most amazing people I have ever met,” said Amanda Young, Porter emergency department medical director. “I feel lucky to have been part of the process, but the real praise should be reserved for them.”
Low SANEs staffing is typical of Vermont’s rural communities, said Kunz-Robinson.
“It’s very common for small rural hospitals like Porter to have very few SANEs,” she said. “Because it’s only one or two people, they’re not able to be staffed 24/7. Really the only hospital that’s able to achieve that level of staffing is UVM Medical Center.”
Kunz-Robinson also commended Middlebury College for taking an exceptional step. It is now the only institution of higher education in Vermont to have SANEs on staff.
“There is no other college campus in the state of Vermont that has any certified SANEs working in college health centers, so that’s why this is really so groundbreaking for us,” Kunz-Robinson said. “Not only are they going to be able to provide services for students on the Middlebury campus, which is very significant, but this partnership between a local college or university and their local hospital where the local college is actually contributing to the overall sustainability and strength of the hospital’s SANE program is really exceptional. So Middlebury in addition to serving their own students is really serving their entire community.”
Both Duquette-Hoffman and Kunz-Robinson emphasized that while physicians can provide excellent care to sexual assault victims, it’s important for communities to have the specially trained SANEs and to have them on call locally.
There’s the training, for one thing. SANEs must take a 40-hour course to become certified, said Kunz-Robinson, and must then keep up with training and coursework to re-certify every two years.
“They’ve had this really focused multi-day training about how to collect the evidence and respond to survivors,” said Duquette-Hoffman. “We have many amazing physicians in the county but they might not have that specific information as ready at hand. It’s everything from current terminology to sensitivity.”
Also important is that SANE exams provide not just medical care but forensic evidence. (Duquette-Hoffman emphasized, however, that proceeding with legal or law enforcement action is up to the survivor.) And that forensic evidence must be handled a particular way to be valid.
“There’s a chain of custody that a kit has to follow,” Duquette-Hoffman said. “It has to be in the nurse’s possession, literally, until it’s handed to the police. And it’s tricky for physicians to do that in a busy ER.”
Duquette-Hoffman also explained that getting a SANE exam can take from one to five hours, so having more SANEs on hand will make it easier for those who’ve been assaulted to seek and get treatment right away.
More SANEs will also mean that more sexual assault victims will get help. In the past, when no SANE was available through Porter, some survivors opted out of the trek from Porter to Rutland or Burlington.
“There’s so many barriers. It’s not the same community. You may not have transportation. This could happen at any hour, day or night so when you’re released you may be worried about how to get home. You might not have a support system. There’s just a whole host of reasons why transferring to a different hospital wasn’t ideal,” Duquette-Hoffman said. “And there was always the chance that there wouldn’t be a SANE available at that hospital and then the person was back in the same place.”
Sexual assaults happen all over, and sexual assaults on college campuses have come under renewed scrutiny in the past few years.
“Sexual violence occurs in every community in Vermont,” Kunz-Robinson said. “And it’s most often perpetrated by people the victims know.”
While certain populations are more vulnerable — adults who are homeless or couch-surfing, runaway or homeless youths, those with substance abuse issues — Kunz-Robinson emphasized that “this kind of violence exists in our communities in all different ways, both expected and unexpected.”
She continued, “We collect aggregate data on individuals who seek medical care after they’ve experienced sexual violence and what that tells us is that we are seeing victims who are really of all adult ages. We have victims every year who are elderly adults, as well as middle-aged individuals, college-age individuals. So we really see the full range in terms of age. And I think the other piece is that people’s life experiences really vary. In the same way that there are all types of people who experience domestic violence, all types of people in our communities experience sexual violence.”
Statewide, Kunz-Robinson reports, forensic evidence is collected from around 250 sexual assault victims a year.
Many more, she said, go to a hospital for medical care but do not have forensic evidence taken. Even more than that never even seek medical care.
“There are many barriers in terms of time and transportation for individuals to receive medical care. So we know that even the folks who are coming to the hospital for care is a very small percentage of the total number of individuals that have experienced sexual violence.”
Reporter Gaen Murphree is at [email protected].
Listen to Gaen Murphree talk about the partnership between Middlebury College and Porter Hospital by clicking here.

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