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Sexual Assault Forensic Examiners Program

The Gail Burns-Smith Sexual Assault Forensic Examiners (SAFE) Program is both a response program and a training program. As a response program, it provides specially trained sexual assault forensic examiners to participating hospitals for the purpose of providing care and the collection of evidence for patients, ages 13 and older, who report sexual assault.

What is a Sexual Assault Forensic Examiner?

  • A Sexual Assault Forensic Examiner (SAFE) is a health care provider who has completed specialized education and clinical preparation enabling them to conduct knowledgeable and skilled medical-forensic exams, ensure the integrity, preservation, and documentation of forensic evidence, and testify knowledgeably in court.
  • What is a medical-forensic exam?
    A medical-forensic exam is a comprehensive exam with several components:

    • A verbatim history of the assault from the patient: Intended to guide the physical exam, it is medical in nature, rather than investigative.
    • Physical Exam: There are two parts: a head-to-toe physical assessment and a genital assessment. Physical findings help to identify assault-related injury, if present, as well as location of evidence to be collected. The absence of physical findings does not mean that an assault did not take place.
    • Evidence Collection: There are two general types: Physical/Biological and Toxicology. The CT100 is used for the collection of physical and biological evidence and the CT400 is used for toxicology screening and evidence collection.
    • Sexually Transmitted Infection (STI) and Care: Based on current Centers for Disease Control Guidelines, prophylactic medications are offered to prevent a sexually transmitted infection from the assault. Testing at the time of the exam is of limited forensic value if the adult/adolescent patient is sexually active and could have acquired an STI prior to the assault.
    • Emergency Contraception: Along with prophylactic medications, emergency contraception is also offered to all patients with reproductive capability.
    • Discharge, Referrals and Follow-Up: Discharge and follow-up instructions are individualized to meet the specific needs of the patients.

    What are the qualifications to become a SAFE?

    • An unrestricted CT license as a Registered Nurse, Advanced Practice Registered Nurse, Certified Nurse Midwife, Physician’s Assistant, or Physician.
    • At least two years of current or recent clinical practice, preferably in acute care. Excellent patient assessment skills are essential to the role.

    What is the scope of practice for a SAFE?

    • The scope of practice is that of a Registered Nurse or higher.
      • SAFEs are clinically trained to conduct genital assessment and speculum exams.
    • Pelvic exams are not within the scope of practice for a SAFE at the RN level.
    • SAFE practice is not within the scope of practice for a paramedic or License Practical Nurse.

    What is the training to become a SAFE?

    • The SAFE training is comprised of didactic and clinical training components.
    • The didactic curriculum includes (but is not limited to):
      • Overview of Forensic Nursing and Sexual Violence
      • Victim Responses and Crisis Intervention
      • Collaborating with Community Partners – A Multidisciplinary Approach
      • Medical-Forensic History Taking
      • Medical-Forensic Examination and Findings
      • Evidence Collection
      • Medical-Forensic Photography
      • Sexually Transmitted Infection Testing and Prophylaxis
      • Pregnancy Testing and Prophylaxis
      • Medico-Legal Documentation
      • Discharge and Follow-up Planning
      • Regulatory issues regarding HIPAA, EMTALA and Other Regulatory Issues
      • Courtroom Testimony and Legal Considerations
    • The clinical curriculum includes (but is not limited to):
      • Consent
      • Language and cultural sensitivity skills
      • Specific structures of the female and male genital anatomy
      • Preparation and set-up for the ano-genital exam
      • Proper positioning and draping of the patient for the ano-genital exam
      • Ano-genital assessment, including differentiation of normal variations from abnormal findings
      • Ano-genital injury identification
      • Speculum assessment and visualization techniques. Learning takes place with both simulation models and live models
      • Evidence and Sexually Transmitted Infection specimen collection techniques
      • Documentation of findings

    Is the SAFE Training Program accredited?

  • The International Association of Forensic Nurse’s SANE Education Guidelines (current edition) sets national training guidelines. The IAFN SANE Educational Guidelines require a minimum of 40 hours in the didactic portion of the training.

  • The SAFE Training Program is approved for continuing nursing education by the International Association of Forensic Nurses, an accredited approver by the American Nurses Credentialing Center (ANCC) Commission on Accreditation. A certificate for CEUs is awarded at the completion of the didactic portion.

  • Both didactic and clinical components must be completed to practice as a SAFE.
  • What is the time commitment to take the SAFE Training Program?
    The didactic portion of the course is 6 days in length. Classes are held two days per week for three consecutive weeks. Content experts teach on the various required curriculum topics.

  • The clinical portion of the course is divided into three components:
    1. Clinical Training Evening: students develop taught genital assessment skills, speculum exam techniques, and correct evidence collection technique utilizing simulated pelvic trainers.
    2. Clinical Training Day: students develop competency in genital assessment, speculum exams and evidence collection utilizing medical models acting as patients who report sexual assault.
    3. Mock Exam: students combine didactic and clinical learning in a table-top case scenario during which students explain and demonstrate how to do a complete, beginning to end, medical-forensic exam. During the Mock Exam students can ask “what if” questions and resolve any technique issues.
  • Once training is completed, SAFEs that are joining the SAFE Response Program are required to precept at least one case with an experienced preceptor prior to becoming a fully trained SAFE are able to schedule on-call hours.
  • What are the dates of the next SAFE Training Program?

    Spring 2024

    • Didactic Training: Office of Victim Services, all class days (attendance is required for all class days, which begin at 8:00 AM and end at approximately 5:00 PM)
      • Wednesday and Thursday, March 20th and 21st
      • Tuesday and Wednesday, March 26th and 27th
      • Wednesday and Thursday, April 3rd and 4th

    • Clinical Training:
      • Clinical Training Evening: Office of Victim Services (attendance is required on 1 day)
        • Tuesday, April 9th or Thursday, April 11th (3 hour evening class: 5:00 – 8:00 PM)
      • Clinical Training Day: Hartford area Clinic, (attendance is required on only 1 day)
        • Saturday, April 20th (8:00 AM – 4:30 PM) or Saturday, April 27th (8:00 AM – 4:30 PM)
      • Mock Exams: Office of Victim Services (attendance is required on 1 day)
        • Wednesday, May 1st, Thursday, May 2nd or Friday, May 3rd (9:00 AM – 3:00 PM)

    Fall 2024

    • Didactic Training: Office of Victim Services, all class days (attendance is required for all class days, which begin at 8:00 AM and end at approximately 5:00 PM)
      • Thursday and Friday, September 5th and 6th
      • Wednesday and Thursday, September 11th and 12th
      • Wednesday and Thursday, September 18th and 19th

    • Clinical Training:
      • Clinical Training Evening: Office of Victim Services (attendance is required on 1 day)
        • Tuesday, September 24th or Thursday, September 26th (3 hour evening class: 5:00 – 8:00 PM)
      • Clinical Training Day: Hartford area Clinic, both days (attendance is required on only 1 day)
        • Saturday, October 5th (8:00 AM – 4:30 PM) or Saturday, October 12th (8:00 AM– 4:30 PM)
      • Mock Exams: Office of Victim Services (attendance is required on 1 day)
        • Wednesday, October 16th, Thursday, October 17th or Friday, October 18th (9:00 AM – 3:00 PM)

    SAFE Program


    Public Act No. 09-3 authorized the Office of Victim Services (OVS), within the CT Judicial Branch, to establish a program to train and make available Sexual Assault Forensic Examiners (SAFEs) to adult and adolescent patients who report a sexual assault at participating healthcare facilities.

    The SAFE Program is available through an on-call system at the following acute care hospitals: Connecticut Children’s Medical Center, Hartford Hospital; Manchester Memorial Hospital, Middlesex Hospital; MidState Medical Center; Saint Francis Hospital; The Hospital of Central Connecticut, New Britain; and Windham Hospital. The SAFE Program is also available to students at the University of Connecticut, Storrs Campus.

    How do I apply to be in the SAFE Program?
    Please check back for information on the Fall 2024 class application.

    Please note: This position is not a Judicial Branch position, but a contracted position. It is part-time, not per diem, with a minimum requirement of 24 hours a month of on-call time. Any agreement that results from the contract, is a contract for services and not a contract for employment. As such, the Contractor/SAFE shall not be entitled to any employment benefits from the State of Connecticut, including, but not limited to vacation, sick leave, holiday pay, insurance, workers compensation, pension, or retirement benefits

    Will I be paid for my services as a SAFE?
    For state fiscal year 2023-2024, the following reimbursement rates have been established for new Program SAFEs:

  • On-Call
    • Weekday shift (Monday 7:00 am to Friday 7:00 pm) - $8 per hour.
    • Weekend shift (Friday 7:00 pm to Monday 7:00 am) - $9 per hour.
    • Holiday shift $16 per hour for both weekday and weekend responses.
    • Weekday phone coverage – Monday, Tuesday, Wednesday, Thursday at 5:00 pm through 8:00 am.
    • Weekend phone coverage - Friday at 5:00 pm through Monday 8:00 am.
    • Vacation phone coverage for any issues at $9 / hour.
  • Hospital Response
    • Standard response - $250 per response.
    • Standard response (CT100 is not opened) - $150 per response.
    • Night shift differential (response calls from 11:00 pm to 7:00 am) – an additional $125 per response.
    • Weekend shift differential (response calls from Friday 7:00 pm to 11:00 pm, Saturday and Sunday 7:00 am to 11:00 pm) – an additional $75 per response.
    • Holiday shift differential (case response and holiday differential) – an additional $200 per response.
    • Preceptor reponse - $350 per precepting response.
    • Preceptor reponse (CT100 is not opened) - $200 per precepting response.
  • Instructor Compensation
    • Instructor Services- $55 per hour and $17 for one hour of preparation time.
  • Trainer Compensation
    • Trainer Services- $55 per hour and $17 for one hour of preparation time.
  • Court Related Activities- $400 per case
  • Training Activities including, but not limited to, the following (all at $17/hour), number of hours vary per meeting:
    • Monthly case review/quality assurance meetings
    • Refresher training – mock exams, etc.
    • Individual supervision meetings
    • Annual staff training day
    • Preceptor meetings – usually one per quarter
    • Train the Trainer

  • A shift differential applies to the following holidays (the 24 hour time period begins at 12:00 am and ends at 11:59pm): July 4th, Labor Day, Thanksgiving, Christmas Eve, Christmas Day, New Year’s Eve, New Year’s Day, Easter, and Memorial Day.

  • Please note: as the SAFE program is operational 24 hours per day, the possibility of a SAFE being in dual payment status at the same time is quite likely. Examples include a SAFE being on-call and attending:
    • A monthly case review/quality assurance meeting or
    • An individual supervisory meeting.
  • Examples when dual payment status is not acceptable are:
    • A preceptor being on-call and having weekend phone coverage;
    • A preceptor being on-call and providing instructor services