Danielle Recchia, a registered nurse and sexual assault nurse examiner

Danielle Recchia, a registered nurse and sexual assault nurse examiner, looks through a microscope at the Dolphin House Child Advocacy Center Aug. 22. The center and area hospitals are teaming up to allow Recchia to offer the exams to adults, too.

 

The Dolphin House Child Advocacy Center’s mission, in part, is to assist child victims of sexual assault in a centralized, kid-friendly location so as to reduce the risks of re-traumatizing them.

The center, which also serves the child victims of physical abuse and domestic violence in the 7th Judicial District, recently added an important position: a sexual assault nurse examiner, or SANE, who can perform forensic exams not only on child victims, but for adult sex assault victims, through pending agreements with area hospitals.

The addition of Danielle Recchia, the SANE, means adult victims will no longer have to travel to Grand Junction for forensic examinations. Recchia also serves as the sexual assault response team coordinator.

“It’s better patient-centered care,” she said, of her new position, which is grant-funded at 30 hours. Montrose Memorial Hospital and Delta County Memorial Hospital also are helping fund the position.

Sending victims out of town for a detailed, lengthy forensic sexual assault exam “adds more trauma on top of trauma,” Recchia said.

“The Dolphin House has taken it upon ourselves to try to fill the void in the community,” the center’s executive director Jacob Conklin said.

“We’ve really tried to make a point to bring as many people as possible to the table. We just received amazing support.”

The center is working through memoranda of understanding with the two hospitals, to allow SANE exams (sometimes also called SAFE, or sexual assault forensic exams) to be done at those facilities.

The Dolphin House also will continue performing such exams for children, adolescents and developmentally disabled adults in-house, with Recchia and local pediatricians.

“The Dolphin House serves the pediatric and adolescent population and also the adult mental disabilities population,” Recchia said. “I will also be working with both Montrose Memorial Hospital and Delta County Memorial Hospital and we’ll be doing adult SANE exams there. I do the whole spectrum — pediatric, adolescent and adult exams.”

Recchia said her position provides SANE services throughout the 7th Judicial District, where before, only Gunnison and San Miguel counties had such services.

“If there is a victim and they go into the emergency department and say ‘I was sexually assaulted,’ then the hospital will follow protocol. I’ll be notified and come in and be able to do the exam. It will work the same way at Delta, as well,” she said.

Prior to the creation of Recchia’s position, sexual assault examinations for adults were treated in a bit of a “piecemeal” fashion in Montrose and Delta, said Chief Deputy District Attorney Seth Ryan, who is the 7th Judicial District’s main sex crimes prosecutor.

“We had a pool of nurses who were willing to do that. They got trained on it, then wouldn’t do exams for a while, or move on to different employment, or retired. No one was keeping track of that,” Ryan said.

He said Rhonda Follman, the previous Dolphin House executive director, reached out to Grand Junction providers to see how SANE services were handled there and, in speaking with a SANE nurse coordinator there, determined it would be most efficient to have a person certified to perform the exams and also coordinate others with training.

Ryan said Recchia is lining up nurses at both area hospitals who are willing to be trained in SANE procedures as the MOUs are finalized.

He said the new strategy will help emergency departments when people on shift are not sure of what procedures to follow when a sexual assault victim comes in.

“This idea was to fix all that. It took a while to get up and running. There was a time when sexual assault victims were having to go to Grand Junction while we were getting back up to speed,” Ryan said.

“The issue is just making sure she has permission to do that kind of work at both hospitals and the hospitals have protocols in place so when she needs to use the facilities, she can use the facilities.

“It really is a huge benefit. It, I think, will create one place where law enforcement can go if they need an exam scheduled; they know who to reach out to and now we have someone keeping track of all the training.”

Both MMH and DCMH referred questions to the appropriate directors of nursing, who because of their schedules, could not be reached for comment.

Recchia previously worked as a nurse in correctional settings. “There were a few times we had an individual who needed the (forensic) exam. After I found out what a SANE nurse was and what they did, I became more interested,” she said.

In order to be able to perform forensic sexual assault exams on adults and children, Recchia underwent additional training through a 64-hour course offered by UC Health/Memorial Hospital in Colorado Springs.

She also shadowed local pediatricians, which she said was helpful.

‘Head-to-toe’ approach

A sexual assault forensic exam is not like going into the doctor for a basic physical.

“We do a thorough head-to-toe assessment. We’re not just going to specifically focus on the assault. We want to make sure there’s nothing else going on medically,” Recchia said.

“ … It’s a very thorough assessment. Generally, a SANE takes at least four hours. It’s not a quick, ‘Hi, how are you.’ It’s an extensive process.”

A forensic exam is undertaken to collect evidence that can be used in court. Such evidence might include hair, fibers, saliva or other biological material. Multiple factors affect whether there is evidence to collect — such as the passage of time, or whether the victim showered, or changed clothing.

Whatever evidence is gathered is packaged and sent to the Colorado Bureau of Investigation for processing, if the victim has opted to seek prosecution.

“There’s different factors that can come into play, but we do our best to collect what we can. Certain patients might not let us collect items, either. They have that option,” Recchia said.

She tells her patients they are in control.

“If they don’t want me to look in their ears, I won’t. If they don’t want me to proceed with the exam anymore, they don’t have to,” she said.

In Colorado, adult sexual assaults can be reported through law enforcement agencies, which then would investigate. But they can also be reported medically, when victims come into a hospital on their own and have evidence collected. The patients are not required to make a report to law enforcement just because they have medically reported.

There is also an anonymous reporting method. Victims can obtain the medical exam and have evidence collected, but instead of it being sent to the crime lab for processing, it is stored as evidence until the victim opts to proceed.

In this method, a case number is attached to the evidence and, in the patient’s private file, a medical case number is also assigned. If the victim decides to proceed with an investigation, he or she will sign a release that allows authorities to match the case number on the evidence with the medical case number and proceed.

SANE work is not for everybody.

“There are different areas in nursing that aren’t for everybody. … Corrections is an extremely hard place to work in. As far as mentally, I think I’m doing a better service to the patients and to the community, which to me is more rewarding,” Recchia said.

Community service, community need

Conklin hopes the be able to sustain the SANE position, which for now is grant-dependent. Money comes through a Rocky Mountain Health grant and a grant award under the Victims of Crime Act (VOCA).

“It really needs to be a full-fledged, full-time program that should be established for years to come,” Conklin said.

In addition to Recchia, the Dolphin House has therapists and victim advocates on staff, one of whom is bilingual. With two forensic interviewers (who interview child victims about what happened to them) and mobile equipment, the Dolphin House is able to serve more of the 7th Judicial District’s far flung areas.

“We offer all these services and they can always come to us, but now we have the ability to offer everything there,” Conklin said, in explaining how the advocacy center is adapting to serve the sprawling judicial district — Montrose, Delta, Hinsdale, Gunnison, Ouray and San Miguel counties.

As testament to the need — and the growing awareness of the Dolphin House’s services — the center is receiving more reports, he said. (A Dolphin House case of sexual of physical child abuse does not always mean an arrest is made.)

Those case numbers fluctuate, but in just one week this month, 17 forensic interviews took place at the Dolphin House, compared to another month when only 14 total took place.

There is no pattern to the monthly numbers, Conklin said; they ebb and flow — and, unfortunately, abuse is not always reported.

“It’s a double-edged sword,” Conklin said. Having more reports of crimes against children is not good, but that more people seem to be aware of how the Dolphin House can help is, he said.

“We have seen a general uptick in some of our utilizations,” Conklin said.

Offering adult SANE exams is “more of a community service, which unfortunately is needed in this community,” Recchia said.

“It is in every community.”

Ryan reiterated having SANE capabilities here is an asset, especially for victims.

“Asking someone to travel 1.5 hours, wait for someone to be available to do the exam and then do one that lasts two to four hours and then to have to travel back — it’s just a huge burden to ask someone who’s been sexually assaulted to do that,” Ryan said.

Recchia thanked everyone who is helping get the SANE program going, including the two hospitals and law enforcement agencies.

“It’s a team effort. I just really appreciate the support and how welcoming everyone has been,” she said.

Katharhynn Heidelberg is the Montrose Daily Press assistant editor and senior writer.

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