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Implementing SANE Programs in Rural Communities: The West Virginia Regional Mobile SANE Project
Publication Date:  June 2008
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Office of Justice Programs Seal   Office for Victims of Crime, Putting Victims First

Sustaining the Project

Build In Sustainability

FRIS believed that the project had to plan for sustainability right from the start. Its rationale was that there was no point in building something that in the end would fall apart.

Creating a sustainable project was emphasized throughout the planning and implementation process. FRIS knew that grant funds supporting the project would run out at the end of September 2005. At that time, it would need to abstain from direct involvement. If the project was to survive, it was imperative that regional stakeholders be able to maintain it on their own. Much of the planning process was geared toward producing a programmatically and fiscally sound project. Elements that contributed to project sustainability include the following factors:

  • FRIS and the participating counties were committed to making the project work, despite challenges.

  • Preliminary research was instrumental in designing a project that fit the region’s needs.

  • Careful groundwork helped to identify a region in the state that had the capacity to support the project.

  • Rape crisis centers and SARTs worked energetically to garner local support for the project.

  • Community stakeholders were involved in planning and implementing it.

  • The hospitals were willing to collaborate on this project, and FRIS was willing to help them work through any concerns.

  • An advocacy component was included in the project.

  • SANEs were involved in making decisions related to SANE program administration.

  • A detailed 1-year implementation plan was developed.

  • Positions essential for project operation were created.

  • The project developed materials that would require only minor updating in subsequent years (e.g., MOUs with the hospitals and rape crisis centers, agreements with SANEs and advocates, job descriptions and applications, protocols and procedures, forms, and resource manuals).

  • Forensic examination equipment was procured for all participating hospitals.

  • Each hospital signed a formal agreement stating that it would provide nurses from its area to participate as SANEs.

  • A balanced budget was developed.

The West Virginia Mobile SANE Project is now in its third year, thanks to the dedication of its partner hospitals, rape crisis centers, SARTs, project administrators, advocacy coordinators, and of course, SANEs and volunteer advocates. Ongoing technical assistance from FRIS has also been critical in helping Mobile SANE deal with regional problems as they arise.

Several noteworthy changes have occurred since the grant expired. The host hospital, rather than FRIS, now hires and employs the project administrator. To cover this expense, each hospital increased its contribution to $2,000 per quarter, for a total of $8,000 per year. The rape crisis centers have continued their volunteer sexual assault advocacy programs in conjunction with the project. One center absorbed the cost of the advocate coordinator position; the other decided to have its staff share the responsibilities of this position.

The Challenge of 24/7

Maintaining an adequate number of SANEs for the 24/7 on-call program is an ongoing challenge. Not only does the project need to retain the high caliber of nurses already involved, it has to continuously recruit nurses. The project also has to be watchful that its structure, policies, and protocols support SANEs in being effective in their role. For example, the service area should not be so large or difficult to travel across that it leads to SANEs taking too long to respond to calls.

The project also has increased the number of counties it serves. In its second year, one county dropped out and two new counties were added. The new counties, located at the farthest ends of the region, have had difficulty arranging for nurses from their areas to participate as SANEs. Consequently, the SANE program must cover a larger region with the same number of nurses, and it takes SANEs longer to travel to and from hospitals in the new counties. As a result, Mobile SANE has had increased turnover among its nurses during the past year and has had to spend more time recruiting and training new SANE candidates than expected. To maintain a sufficient number of SANEs to fill the on-call schedule and reduce SANE response time, the project is considering dividing the SANE team into two teams that would each serve a smaller area.

No doubt other changes will occur in the future that could affect the project’s sustainability. These changes further illustrate that the project must be adaptable enough to weather these changes while remaining true to its goal of providing quality services for victims of sexual assault in this region of the state.