The Intersection of Rape / Sexual Assault and Disabilities Presented by Project SAFE A local collaboration between VIBS Family Violence and Rape Crisis Center And United Cerebral Palsy Association of Greater Suffolk Inc.

OVERALL OBJECTIVES Staff will gain a better understanding of rape and sexual assault Staff will be able to differentiate between rape and sexual assault Acquire a vocabulary and comfort level incorporating sensitive and appropriate terminology Staff will gain an understanding of the intersection of rape / sexual assault and disabilities

OVERALL OBJECTIVES Staff will gain an understanding of the unique dynamics of rape / sexual assault against survivors with disabilities Staff will learn how to respond more effectively in working with a survivor with a disability Staff will learn what resources are essential in working effectively with a survivor with a disability

GROUND RULES Use respectful language and tone Be respectful of everyone’s different experiences Create a safe place to: Ask questions Make mistakes Learn from each other

RAPE AND SEXUAL ASSAULT “101”

STATISTICS ON RAPE / SEXUAL ASSAULT Every two minutes, another American is sexually assaulted. One estimate reports that 1 in 6 women in the United States has been the victim of an attempted or completed rape and 1 in 10 men has been the victim of sexual assault. 80% of rape survivors are under the age of 30, 54% are under the age of 17 Stats complied by RAINN from US Justice Department Studies, 1999 - 2000

STATISTICS ON RAPE / SEXUAL ASSAULT Over 62% of rape / sexual assault survivors know their attacker 10% of rape survivors are male 30% of rape / sexual assaults are reported Of every 20 rapes, only one will result in the rapist spending a day in prison Stats complied by RAINN from US Justice Department Studies, 1999 - 2000

MYTHS ABOUT RAPE / SEXUAL ASSAULT Myth: Only certain types of women get raped. Fact: Any woman can be raped. Age, social class, and/or ethnic group have no bearing on the person a rapist chooses to attack. Myth: Men rape women because they are sexually aroused or have been sexually deprived. Fact: Rape is about power and control and not about sexual gratification. Another myth associated to above: Women provoke rape by the way they dress or act. If victims don’t drink they won’t be sexually assaulted.

MYTHS ABOUT RAPE / SEXUAL ASSAULT Myth: Rapes are committed by strangers at night in dark alleys or parks. Fact: Most rapes are committed by someone known to the victim and at any time of the day or night. Myth: Men of certain races and backgrounds are more likely to sexually assault women. Fact: Men who commit sexual assault come from every economic, ethnic, racial, age and social group.

MYTHS ABOUT RAPE / SEXUAL ASSAULT Myth: Men can never be raped. Fact: Men can be raped. In 2003, 1 in every ten rape victims were male Myth: Sexual assault usually occurs between strangers. Fact: By some estimates, over 70% of rape victims know their attackers. The rapist may be a relative, friend, co-worker, date or other acquaintance.

DEFINITION OF RAPE Unwanted (without consent) or forced sexual intercourse to include some type of penetration, however slight. This would include vaginal penetration or anal penetration. Rape is considered a type of sexual assault but not all sexual assaults are rape.

DEFINITION OF SEXUAL ASSAULT Sexual assault is an umbrella term used to encompass a range of offensive behavior that may or may not be considered criminal under New York State Law. It includes sexual harassment, sodomy, incest, and sexual abuse.

TACTICS OF SEXUAL ABUSE General: Forcing sex or sexual acts Forced video taping of sex acts Not using contraceptives Knowingly transmitting STI’s Forcing the viewing of or participation in pornography, etc. Forcing survivor to perform sexual acts with other people or things(animals, objects, etc.); forcing masturbation; These sexual tactics of abuse are in addition to all other forms of sexual abuse faced by survivors. Threats and manipulations are also sexual tactics, does not have to be a physical act alone.

DEFINITIONS OF KEY TERMS Sexual Intercourse: is “any penetration however slight” Oral Sex: contact between the mouth and penis, anus, vulva, or vagina. Anal Sex: contact between the penis and anus. Sodomy: Sexual intercourse involving anal or oral copulation. Sexual Abuse: Subjecting another person to sexual contact without consent and / or by force.

DEFINITIONS OF KEY TERMS Sexual Contact: touching of the sexual or other intimate parts of a person for the purpose of sexual gratification whether directly or through clothing. Incest: Sexual activity between close relatives that is illegal in the jurisdiction where it takes place and / or is socially taboo. Often used to define sexual abuse of a child by an adult family member. People commonly refer incest as one person not giving consent in a sexual activity, but it can be two consenting adults that are related by blood or marriage.

DEFINITIONS OF KEY TERMS Sexual harassment: unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature when: Such conduct is made a term of employment or schooling Response to the conduct is used as a basis for employment or school decisions Conduct interferes with work or school performance or creates an intimidating, hostile or offensive work or school environment. Harassment means having power over another. In other situations outside of employment and schooling it would be considered another sexual act but not sexual harassment.

SENSITIVITY IN TALKING WITH SURVIVORS Service providers should feel comfortable in using non- slang terminology, but - Let the survivor guide you in what feels most comfortable for them in communicating and understanding Straightforward terminology may be re-traumatizing for the survivor Don’t blame the survivor Be non-judgmental Provide legal information, but don’t impose an agenda Instead of using slang terms to describe sexual parts, use Penis, Vagina, Anus, etc. Instead of using slang terms to describe sexual intercourse use the appropriate terms, such as sexual intercourse, oral sex, anal sex, etc. Define re-traumatizing Avoid using phrases that may be disrespectful, offensive, re-traumatizing Respects the survivors choice regarding legal options.

RAPE AND SEXUAL ASSAULT CAN OCCUR BETWEEN PEOPLE WHO ARE: Married Divorced Have a child in common Cohabiting Dating or formerly dating Family member Primary caregiver and an individual with a disability Stranger / Acquaintance Friends and or neighbors Rape and Sexual Assault can occur between any two people regardless of relation.

COMMON EMOTIONAL REACTIONS AFTER A RAPE OF SEXUAL ASSAULT Visibly upset Fear Crying / Sobbing Humiliation Mood swings Embarrassment Restlessness Self-blame Tenseness Revenge Anger Retaliation Anxiety Irritation Masked feelings Depression Flat affect Numbness Each person going through a crisis of any kind, progresses through stages of emotional adjustment. Shock, denial, anger, bargaining, depression, acceptance, and assimilation. A victims may spend a great deal of time in one stage and only touch lightly another. It is also common to pass through a number of stages over and over again, each time experiencing them with a different intensity. Anyone close to the victim may also experience these stages as well.

COMMON PHYSICAL REACTIONS AFTER A RAPE OR SEXUAL ASSAULT Physical Trauma. Tension headaches, fatigue, sleep pattern disturbances. Stomach pain, eating pattern changes. Vaginal discharge, chronic vaginal infections STI’s, pregnancy.

OTHER COMMON REACTIONS TO A RAPE OR SEXUAL ASSAULT Guilt and Shame Negative Beliefs about Self, Others and the World Relationship Difficulties May experience chronic nightmares and flashbacks. I shouldn’t have…..If only…… The world is dangerous…I’m stupid…Life has no meaning…I’ll never trust another man…

POSSIBLE LONG TERM EFFECTS FOR SURVIVORS Physical lifestyle: Can endure additional / long term health problems Psychological lifestyle: nightmares, intrusive imagery and flashbacks, phobic behaviors, loss of self-esteem. Social lifestyle: changing phone number, moving residences, upset of normal routine, either turn to for support or avoid family.

COMMON BARRIERS TO DISCLOSING RAPE / SEXUAL ASSAULT According to the National Coalition on Domestic and Sexual Violence: 80% Embarrassed about what happened 61% Felt partly responsible 54% Did not realize they had been raped 46% Did not feel the police would be able to make an arrest

COMMON BARRIERS TO DISCLOSING RAPE / SEXUAL ASSAULT 45% Too upset 43% Afraid the attacker would get angry and rape them again 43% Afraid the police would not believe them 40% Afraid they would have to testify in court 36% Were too young at the time Children are also afraid sometimes to report to parents; parents may choose not to report; parent may be the perpetrator.

COMMON COPING STRATEGIES AFTER A RAPE OR SEXUAL ASSAULT Attempts to block memories or forget Refuses to talk about the incident Uses defense mechanism of denial May self-medicate (Drugs, alcohol) May self-injure

INTERSECTION OF RAPE / SEXUAL ASSAULT AND DISABILITIES

STATISTICS ON RAPE / SEXUAL ASSAULT ON INDIVIDUALS WITH DISABILITIES The risk of being physically or sexually assaulted for adults with developmental disabilities is likely 4 to 10 times as high as it is for other adults (Accessing Safety Initiative Website, Sobsey 1994) In one study, the rate of sexual abuse among people with developmental disabilities was found to be at more than 70% (Accessing Safety Initiative Website, Sobsey and Doe 1994?)

STATISTICS ON RAPE / SEXUAL ASSAULT ON INDIVIDUALS WITH DISABILITIES 97% to 99% of abusers are known and trusted by survivors who have an intellectual disability 32% were family members or acquaintances. 44% had a relationship with the survivor specifically related to the person’s disability (i.e. residential care staff, transportation provider, personal care attendant) (Accessing Safety Initiative Website: Baladerian, N. Sexual Abuse of People with Developmental Disabilities, Sexuality and Disability 1991)

STATISTICS ON RAPE / SEXUAL ASSAULT ON INDIVIDUALS WITH DISABILITIES Over 50% of abuse is generally perpetrated by someone who is known to the victim – a family member, spouse or caregiver. Accordingly, 49% of sexual abuse perpetrators access their victims through their work in a disability service (Sobsey, 1994). Persons with disabilities who are survivors of rape and sexual assault knew their attacker in 90% of these assaults (Valenti-Hein and Schwartz 1995as reported in A Call to Action: Ending Crimes of Violence Against Children and Adults with Disabilities. A report to the nation 2003.)

MYTHS ABOUT THE INTERSECTION OF RAPE/SEXUAL ASSAULT AND DISABILITIES Myth: People with disabilities are asexual, do not have sexual feelings, do not have sexual relationships and are not capable of understanding (or determining) their own sexuality. Fact: People with disabilities are sexual beings with the same needs, desires, and dreams as anyone living with out a disability. (Stop the Violence, Break the Silence: A training guide, By: Disability Services ASAP (A Safety Awareness Program) of SafePlace, Austin, Texas) It is important for people with disabilities to be seen as sexual beings, the same as any person without a disability. It is important that they be educated on appropriate relationships, their rights, and what to do in an uncomfortable situation.

MYTHS ABOUT THE INTERSECTION OF RAPE/SEXUAL ASSAULT AND DISABILITIES Myth: People with disabilities are oversexed or promiscuous and need to be punished for acting on sexual needs or urges. Fact: People with disabilities are no more promiscuous than people without disabilities.

MYTHS ABOUT THE INTERSECTION OF RAPE/SEXUAL ASSAULT AND DISABILITIES Myth: Most of the abuse and violence perpetrated against people with disabilities is done by strangers. Fact: Of all reported sexual assaults, 91% of the perpetrators are known to the victim (Sobsey, 1988) (Stop the Violence, Break the Silence: A training guide, By: Disability Services ASAP (A Safety Awareness Program) of SafePlace, Austin, Texas) At its core, sexual assault is about power and control, not physical attraction. This makes ANYONE regardless of race, gender, disability, socio-economic status, etc… at risk of rape

MYTHS ABOUT THE INTERSECTION OF RAPE/SEXUAL ASSAULT AND DISABILITIES Myth: People with cognitive disabilities are not affected by sexual abuse. Fact: ANYONE subjected to a rape / sexual assault is affected regardless of disability or not.

MYTHS ABOUT THE INTERSECTION OF RAPE / SEXUAL ASSAULT AND DISABILITIES Myth: People with disabilities are not credible witnesses and can not be believed without some extra burden of evidence or excessive questions and testing of competence (disability equals non-credibility). Fact: People with disabilities can be very credible witnesses with the same support any other victim of a crime receives. Just because a person requires additional or alternate accommodations, it does not mean that he or she is less-credible or that the validity of their claims is decreased. There are no more false reports of sexual assault than of any other crime (2-3%)

VULNERABILITY FACTORS OF PEOPLE WITH DISABILITIES TO SEXUAL VIOLENCE Inaccurate societal views of people with disabilities. Insufficient education about safety and domestic / sexual violence, personal rights, appropriate sexual relationships and proper responses to victimization. Dependence on service providers, primary caretaker, family member or intimate partner for a range of living skills and personal assistance. What makes an individual with a disability more vulnerable to experience DV / SA? It is not the disability but society’s views!! Inaccurate societal views: Can’t be assertive, can’t say no. Being “people pleasers”. Needing behavior modification programs to increase cooperation. (Second point above): Individuals with disabilities are not given the same opportunities for education on these issues.

VULNERABILITY FACTORS OF PEOPLE WITH DISABILITIES TO SEXUAL VIOLENCE Lack of education about perpetrator motives. Lack of credibility in the eyes of the criminal justice system. They are viewed as easy targets. Society’s perception that because they have a disability, the individual can not be a credible witness. Individuals with disabilities are taken advantage of due to societal perceptions that they are limited in understanding, communication, self-defense, etc.

ADDITIONAL TACTICS OF SEXUAL ABUSE Against survivors with disabilities: Threatening to leave or deny care if she doesn’t consent to sexual activity Abusing intimate body parts; grabbing genitals while providing care Taking advantage of lack of understanding about sex Forcing sterilization These sexual tactics of abuse are in addition to all other forms of sexual abuse faced by survivors. Threats and manipulations are also sexual tactics, does not have to be a physical act alone.

EFFECTS OF SEXUAL VIOLENCE SPECIFIC TO A SURVIVOR WITH DISABILITIES Difficulties with systems collaboration Separation from support network / loved ones Adjustment to living with disability in cases where no disability was present prior to assault New health challenges, exacerbation of existing medical issues As a results of a rape or sexual assault a client could acquire HIV which is a disability. Any form of violence could result in TBI.

BARRIERS FOR SURVIVORS WITH DISABILITIES TO DISCLOSING RAPE / SEXUAL ASSAULT Fear of losing housing, primary caregiver, and family. People with developmental disabilities have additional concern that multiple entities become informed as part of mandated report process – they don’t just tell one person. People who are totally dependent on caregivers may not be able to communicate about the assault, or may not realize what it is.

SCREENING FOR RAPE AND SEXUAL ASSAULT

POSSIBLE PHYSICAL SIGNS OF SEXUAL ABUSE Torn, stained clothing / bedding Redness Irritation Difficulty walking or sitting Unusual bathroom habits Weight gain / weight loss Pregnancy Change in hygiene habits STI’s Cuts, bruises, scratches Vaginal / Penile Discharge Bite marks, burns Infection Vaginal bleeding Anal bleeding

POSSIBLE BEHAVIORAL INDICATORS OF SEXUAL ABUSE Extreme, irrational changes in behavior Fear of being alone Frequent bathing and/or washing Infantile behavior Sexual promiscuity Change in attitude about body or sexuality Lavish and abundant gifts given for no reason Unexplained fears of a particular person

POSSIBLE BEHAVIORAL INDICATORS OF SEXUAL ABUSE Uncomfortable with disrobing Wearing layers of clothes Appearing unkempt and neglecting personal hygiene Aggressive and/or disruptive behavior Shy, withdrawn, and depressive state Suicide attempts

POSSIBLE BEHAVIORAL INDICATORS OF SEXUAL ABUSE Self – mutilation Excessive masturbation Sleep disturbances Continual daydreaming or vacant stares Pulls away with slightest touch Complaints about frequent, recurring physical problems

WHY SCREEN FOR RAPE / SEXUAL ASSAULT? Rape / Sexual Assault is a public health concern with an American being sexually assaulted every two minutes Rape / Sexual Assault has devastating effects on the survivor which may impede and interfere with her services. Identifying Rape /Sexual Assault helps service providers and organizations to deliver services more appropriately and safely.

TIPS TO KEEP IN MIND WHEN SCREENING FOR RAPE / SEXUAL ASSAULT Always interview survivor individually, in private, away from partners, family members, caregivers or personal care attendants. If the third party is present to accommodate the needs of the survivor, service provider should, at the soonest possible time, get the survivor alone. Advise survivor about program’s confidentiality policies and mandatory reporting obligations before requesting disclosures.

TIPS TO KEEP IN MIND WHEN SCREENING FOR RAPE / SEXUAL ASSAULT Use the language the survivor with whom you work uses when referring to his/her experiences. Be cautious when using words like “rape” in initial conversations. Maintain eye contact and eye level Maintain a nurturing / supportive tone Respect boundaries Do not ask “why” questions, as they can feel blaming.

TIPS TO KEEP IN MIND WHEN SCREENING FOR RAPE / SEXUAL ASSAULT Identify and use appropriate language that recognizes personal caregivers, or other specialized support personnel as potential abusers/ perpetrators/ stalkers. Ask questions designed to elicit broad responses and give you a full picture of her/ his experiences and relationships Be flexible – survivor may disclose after trust and relationship built, when its safe to talk, or after an incident

TYPES OF DISCLOSURES Testing the waters Tentative approach The “Inappropriate” Question A disguised disclosure Vaguely Using exact words Testing the waters: Survivor may offer some details of incident to see what reaction will be. Tentative approach: Survivor may need to know that you will take the time to take privately, at a time and place where others can not hear. The “Inappropriate” Question: Survivor may ask you directly if certain sexual acts are performed within your relationship. The person may decide that if you know about sex you may be able to help with this kind of problem. A disguised disclosure: A survivor may say negative things about the abuser and say things such as “He’s not so nice to me”. Many disclosures begin with a vague criticism of the abuser. These phases may be the start of yelling you about a more serious problem. Vaguely: A survivor may offer a very mild description of a sexual assault by saying “He keeps me awake at night or he touched me the other day” Using exact words: A survivor may say directly what she is experiencing or has experienced.

HANDLING DISCLOSURES Talk to the survivor in a private place Explain your professional role and confidentiality procedures Report disclosure as required Assess the immediate safety needs of the survivor

HANDLING DISCLOSURES Immediately reduce any blame, guilt, or shame survivor may feel Listen intently – story may get confusing. Support survivor’s feelings Offer safety planning as appropriate

CONSENT AND RAPE / SEXUAL ASSAULT

THE THREE C’S Basic Definitions: Competence: The scope of a person’s abilities Capacity: The mental ability to understand the nature and consequences of a decision Consent: Willful permission to have something happen or to do something

COMPETENCE Is a judicial decision Incompetence must be demonstrated by a lack of the needed functional abilities of the individual in certain areas Having a developmental or acquired disability does not mean that the person is incompetent or incapacitated to make decisions Includes critical thinking, analyzing, comparing, understanding consequences of choices. In NYS, people are considered competent until proven otherwise in court.

COMPETENCE Being “presumed competent” however, does not mean that the person is competent Law generally does not presume that incompetence in one area renders an individual incompetent in other areas

CAPACITY TO CONSENT The mental ability to understand the nature and consequences of a decision Incapacity occurs when there is a mismatch between the functional abilities of the person and the demands of the specific situation requiring a decision Capacity to make a decision can be assessed by clinicians or, in some cases, by treatment teams Since clinicians can determine capacity, this is not necessarily a judicial decision. Clinicians refers to trained specialists who use standardized tests and skilled interview techniques to make this determination.

INFORMED CONSENT Permission for something to happen or to do something, given with full knowledge of the risks involved, probable consequences, and the alternatives. For people with cognitive disabilities, all facets of an issue requiring a decision must be explored in a manner they can understand. Understanding must be verified.

PROVIDER RESPONSIBILITY Providers are expected to: Respect the decisions and choices made by a person with the ability to do so (even when they disagree with those decisions or choices) Ensure that protection is afforded those persons that do not have the ability to make those decisions Conflicting responsibilities: Provide care, habilitation and support services to enable persons in their care to lead as normal lives as possible AND Protect these same persons from harm, particularly when there is some question as to their ability to make choices/ decisions

CAPACITY TO CONSENT TO SEXUAL CONTACT Exists when: The person is an adult generally defined as 18 years or older He/she is capable of making a decision to engage in the type of sexual contact under consideration, He/she has full knowledge and understanding of the activity He/she has an ability to convey this decision. “The principle which underlies all law is that an adult citizen is presumptively entitled to all his or her rights and privileges and immunities unless limited by a court of law ( judicial competency) or by a professional judgment made under standards authorized by or otherwise unacceptable under the laws (clinical or functional competency”). (Quality of Care newsletter, Counselor’s Corner, NYS Commission on Quality of care, issue 50, November –Dec 1991, p 3.)

CAPACITY TO CONSENT TO SEXUAL CONTACT The evaluation of a person’s ability to consent should include consideration of the following: The person’s awareness of having the choice to engage in or to abstain from the type of sexual contact under consideration The person’s ability to make a choice as to whether or not to engage in the type of sexual contact under consideration Special considerations in terms of people with cognitive disabilities as there are concerns about level and depth of comprehension.

CAPACITY TO CONSENT TO SEXUAL CONTACT The person’s awareness of the nature of the sexual activity and its risk and consequences. The person’s understanding of what constitutes sexual expression, and the possible need for restrictions as to time, place or behavior. This “ awareness” relates to the type of sexual contact involved. A person’s awareness may be different for different types of sexual contact. For example, a person may have an awareness of the nature of touching but not of intercourse.

CAPACITY TO CONSENT TO SEXUAL CONTACT The person’s understanding of how to prevent pregnancy and diseases which are sexually transmitted The person’s understanding that sexually assaultive behavior is prohibited and a crime, and sexually exploitative behavior is inappropriate. The person’s understanding that certain sexual behaviors may be regarded as unacceptable or immoral by others in the community in which he or she resides, and that if a person chooses to engage in such behaviors certain social consequences may occur. A person with the ability to consent to sexual contact may be unable to verbalize this. In this situation, a determination needs to be made as to whether the person can so through other means of communication.

RESTRICTIONS ON ABILITY TO CONSENT TO SEXUAL CONTACT A parent or legal guardian of an adult with a disability cannot limit that adult’s sexual activity except where the Court has given the parent/ guardian the authority to make such decisions The expression of sexuality can also be reasonably limited or restricted , including the time and location, in accordance with a plan necessary for the health and well being of the individual or for effective facility management. (14 NYCRR Section 633.4)

PRIVACY RIGHTS All persons have the right to privacy All persons should also have the opportunity to discuss their sexuality on a formal, informal and private basis with anyone of their choice, provided others are willing to participate. Sexual expression and choices of partners are private and subject to the same rules of confidentiality as other matters In NYS facilities serving people with developmental disabilities, this is subject to the requirement to report incidents, alleged abuse and possible crimes in accordance with applicable laws and regulations.

ASSESSING CAPACITY TO CONSENT TO MEDICAL TREATMENT & COUNSELING Consider four functional abilities: Ability to express a choice Ability to understand information relevant to the decision in question Ability to appreciate the significance of that information for one’s own situation, and the probable consequences of treatment options Ability to reason with relevant information so as to engage in a logical process of weighing treatment options (Grisso & Appelbaum ( 1998) Assessing competence to consent for treatment: A guide for physicians and other health professionals.)

LEGAL CONSENT IN NYS Forcible compulsion Incapacity to consent less than 17 mentally disabled (cognitively incapable) mentally incapacitated (intoxicated drugs /alcohol) physically helpless in the custody of the state department of correctional services, office of children and family services, or a health care setting A clear expression of no

MANDATORY REPORTING REQUIREMENTS VIBS mandates: *Only mandate is to report suspected or known child abuse to Child Protective Services *No mandates covering persons with developmental disabilities *Professional discretion utilized regarding Adult Protective Services for people with developmental disabilities VIBS and UCP-Suffolk have two different legal mandatory reporting requirements in respect to survivors with disabilities.

MANDATORY REPORTING REQUIREMENTS UCP Mandates: *NYS Office for People with Developmental Disabilities highly regulates agency responsibilities in allegations of abuse and other incidents of harm. *People with developmental disabilities certified by OPWDD who attend programs and services certified by OPWDD which accept OPWDD funds – ALL allegations of abuse must be reported and investigated according to stringent regulations, subject to audit.

RESPONDING TO RAPE / SEXUAL ASSAULT

THINGS TO SAY TO A SURVIVOR OF RAPE / SEXUAL ASSAULT You do not deserve to be abused You have the right to be in a non-violent environment You are not responsible for the perpetrator’s behavior Refer her to VIBS or gain additional guidance from Project SAFE Victims of domestic violence are often referred to as victims or survivors. Follow what they choose as the most comfortable way to be addressed – victim for some may seem too harsh. Never ask a survivor why she stays, rather ask her what are the challenges or factors that prevent her from leaving. This takes the onus off her and eliminates blame. It puts the responsibility where it should lie – with the abuser or system.

INFORMATION FOR A SERVICE PROVIDER TO TELL A SURVIVOR AFTER A RAPE / SEXUAL ASSAULT Encourage survivor not to shower, clean up the area, or put anything mouth (no food, water, mouthwash, etc.) Encourage survivor to obtain medical attention (SANE Center)

INFORMATION FOR A SERVICE PROVIDER TO TELL A SURVIVOR AFTER A RAPE / SEXUAL ASSAULT Provide survivor with VIBS hotline number Provide support and tell survivor the rape / sexual assault was not her fault

WHERE TO GO AFTER A RAPE OR SEXUAL ASSAULT? SANE (Sexual Assault Nurse Examiner) Centers are private, undisclosed locations set up outside the hospital emergency room have specially trained nurses who are sensitive to rape and sexual assault issues

WHERE TO GO AFTER A RAPE OR SEXUAL ASSAULT? SANE (Sexual Assault Nurse Examiner) Centers have special amenities to help make the procedure as comfortable as possible for the survivor can request that an ERC (emergency room companion) is present

FAQ’S ABOUT SANE Anyone who has been raped or sexually assaulted can use a SANE Center It is required that the survivor seeks medical attention within 96 hours from the time that the rape / assault occurred The three SANE centers in Suffolk are at: *Peconic Bay Medical Center *Good Samaritan Hospital *Stony Brook University Medical Center

WHO TO CONTACT FOR ASSISTANCE VIBS Hotline is 24 Hours 360 – 3606 Project SAFE collaboration representatives can be contacted for further assistance on the intersection of domestic violence and disability *Kathleen Cammarata (VIBS) *Ruth Reynolds (VIBS) *Clarice Murphy (VIBS) *Pat Caso (UCP) *Dana Waite-Esposito (UCP)

PROJECT SAFE’S MISSION VIBS Family Violence and Rape Crisis Center and UCP-Suffolk will work together to promote a safe, accessible and responsive service environment for women in Suffolk County who are survivors of domestic and sexual violence with a physical and/or developmental disability. We will accomplish this by creating sustainable changes in our organizational cultures through:

PROJECT SAFE’S MISSION Fostering collaboration Sharing resources and knowledge Enhancing the existing service delivery system Implementing policies and procedures that reflect best practices of professional ethics, trust, open communication, and true understanding of the challenges and needs of survivors with disabilities

CREDITS  Project SAFE collaboration team and Organizational Workgroup utilized the following organizations training materials in creating this power point. Accessing Safety Initiative: Funded by the Office on Violence Against Women. The website address is: http://www.accessingsafety.org Building Bridges Project: This project was a collaboration between Empire Justice Center, New York State Coalition Against Domestic Violence, and Center for Disability Rights, Inc. New York State Coalition Against Sexual Assault: As an umbrella advocacy organization for rape crisis agencies throughout New York State. Pennsylvania Coalition Against Rape: “Professional Guide for Identifying Sexual Assault in Individuals with Developmental Disabilities” Safe Place, Austin, Texas: “Stop the Violence, Break the Silence: A training guide”

REFERENCES RAINN: Rape, Abuse and Incest National Network. The website address is: www.rainn.org National Coalition on Domestic and Sexual Violence