HOUSTON -- For the last two months, sexual assault victims in Fort Bend County have been told to drive all the way to the Texas Medical Center in Houston for treatment from specially trained nurses, a trip that emergency responders say has dissuaded a number of rape victims from submitting to important examinations.

The problem arose after the Memorial Hermann hospital system, lauded by police and rape crisis workers, eliminated an on-call program that made those nurses available at all times to its hospitals outside Houston. Memorial Hermann was the only hospital system offering treatment by what were called mobile SANE nurses.

There are some very specialized nurses who are called sexual assault nurse examiners, explained Vita Goodell, executive director of the Fort Bend Women s Center. We call them SANEs for short. And they are very well trained in how to collect evidence that will stand up in court.

Hospital officials instead are now offering treatment by emergency room personnel trained to offer basic forensic examinations, as required by a law the Texas Legislature passed last year. That will cut the sometimes long delays rape victims faced while waiting for on-call nurses driving from distant locations, but the nurses conducting the examinations won t be specialists dedicated exclusively to sexual assault treatment.

They re emergency department nurses that are trained to do the evaluation and examination of a sexual assault, so it s different from a SANE nurse, explained Tom Flanagan, chief operating officer of Memorial Hermann Texas Medical Center.

But some police officials said they would still recommend that victims seek examinations from SANE nurses, despite the drive into Houston. SANE nurses, they say, are specifically trained to work not only with victims but also law enforcement authorities and prosecutors building cases against rapists.

SANE nurses are very specific to sexual assaults, which you need, said Tracie Dunn, Rosenberg s assistant chief of police. I mean, the victims are very traumatized. They may not want to speak. They have to make them comfortable. The examinations are intrusive, they re not comfortable. So that nurse has extra training on how to make the victim comfortable, to talk and to get through the process.

SANE nurses also testify in court, sometimes years after the assaults happen, one of the reasons Dunn said the examinations are extremely important to their cases.

Emergency responders are especially disturbed that a number of victims, facing the prospect of traveling all the way to Houston for treatment, have simply rejected the idea of undergoing examination by a SANE nurse.

We ve had two so far, unfortunately, that were not able to secure a SANE exam, Dunn said. One was all for going, and then once they found out where they had to go -- and we even offered to take them -- they flat out refused.

Fort Bend County isn t the only county facing a gap in SANE nurse coverage. Indeed, it s a statewide phenomenon.

In Brazoria County, we have not had a SANE program in about four years now, said David Moore, executive director of the Women s Center of Brazoria County. We had two hospitals and two nurses that were spread out in the county. And those hospitals have lost the ability to do it. It s a widespread problem across the state as far as smaller hospitals in smaller to mid-size counties being able to keep a SANE program going.

Indeed, research conducted by The Texas Tribune last year indicated most counties in Texas had no access to SANE nurses.

We re very concerned, Dunn said. And I hope we don t have a huge impact of a lot of victims saying, No, I m not going to go.

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