Developing a Contractual Agreement With Hospitals
FRIS’s contract with the project administrator was strictly for the administrative component of the job. The host hospital also employed this individual as a SANE—any time she provided on-call services or did an examination, she was paid by the hospital like any other SANE in the project.
The hospitals agreed to participate in the project, in part, because FRIS was willing to hire the project administrator for the first year. FRIS’s involvement in startup and day-to-day program operation provided a stable base to sustain the project in later years. It also helped keep the project focused on its mission of providing enhanced care and forensic evidence collection to patients presenting as sexual assault victims, rather than getting sidetracked by the interests of particular hospitals or responders.
In another region, a local hospital participating in the program might choose to hire a project administrator, as the West Virginia project did in its second year. Keep in mind that one approach to project administration is not necessarily better than another; the main consideration is whether the chosen course can facilitate project success.
Roles and Responsibilities of the Hospitals
After most of the initial issues among hospitals were ironed out, one of the hospitals needed to assume the role of host for the Regional Mobile SANE Project. The largest hospital, United Hospital Center, agreed to take on this responsibility.
After much negotiation, the four participating hospitals and FRIS signed an “Agreement for the Provision of Regional SANE Service.” Each hospital agreed to—
- Identify three nurses from the county where it was located who would participate in the project. Nurses did not necessarily have to be employed by the hospital. To function effectively, the program needed at least 12 SANEs.15
- Pay $1,000 per quarter to the host hospital for services related to the project (with the host hospital also contributing this amount to the project).
- Bill the state Forensic Medical Examination Fund for examinations conducted at each hospital and submit these reimbursements, for services rendered, to the project. This state fund reimburses hospitals $350 for each approved examination.
- Designate an appropriate, secure, and private space in the facility where SANEs can conduct forensic medical examinations of sexual assault victims, as well as a separate waiting area for victims and their support persons.
- Provide common examination supplies as needed to facilitate the examination.
- Contact the on-call SANE when a patient presents as a sexual assault victim at its facility.
- Designate a locked and secure area for storing the sex crime kits until they are released or picked up by law enforcement (hospitals typically hold kits for up to a month in cases in which victims are undecided about whether they will report the assault to law enforcement).
- Collect data on sexual assault patients as requested by FRIS.
In exchange, each hospital would receive 24/7 SANE service and advocate coverage; adult and pediatric SANE training for nurses participating in the project; and a medical storage cart stocked with the necessary supplies for the forensic exam, a Macro 5 Camera, a map, a copy of the protocol, and an identification badge for each location.
In addition, the host hospital agreed to—
- Hire/employ nurses on a temporary part-time basis to be trained as SANEs and provide SANE services on a regional basis.
- Compensate SANEs at a rate of $3 per hour on call and $200 per examination.
- Compensate nurses for their participation in required trainings.
- Bill other hospitals at a rate of $1,000 per quarter and $350 per examination conducted.
The host hospital also provided liability insurance for the project.