By Gigi Weislogel, Education Intern, August 12, 2024
What is a SAFE exam?
After an assault, many survivors may choose to seek medical attention. A SAFE exam is an opportunity for a survivor to receive health care and have the option to have evidence collected by a health care provider who has been trained to provide support and care after a sexual assault.
The Sexual Assault Forensic Exam (SAFE) Program is a program funded and established by the New York State Department of Health. This program was created to provide comprehensive medical, emotional, and legal care for survivors of sexual assault, sexual abuse, and rape.
The first priority of a SAFE provider is to provide survivors with care to immediate injuries to ensure that a survivor’s physical health is stable and secure. Within this exam, survivors are also provided with the option to collect physical forensic evidence. Collecting evidence does NOT mean that a survivor must report their experience or move forward with their case in a legal manner. It may be helpful, however, if a survivor chooses in the future to report, to have collected evidence during this exam.
SAFE exams are free with no cost to the survivors for any medical care or services. All costs of these services are automatically billed to the NYS Office of Victim Services (OVS) and will not show up on health insurance documents, even if survivors are dependents on their spouse or parent’s health insurance.
This care is confidential, protected by the Health Insurance Portability and Accountability Act (HIPAA). Therefore, this is protected medical information and can not be disclosed without the survivor’s permission, to anyone. In addition, in NYS, survivors under 18 are legally allowed to access post sexual assault care without parent permission.
It is incredibly important to note that during this process, the survivor has complete control over the steps taken to ensure their health. At any time, the survivor can request to stop, pause, or skip a step in the exam. It is entirely their choice.
The steps below outline the general process for the exam. Each exam may look different depending on the needs and comfortability of the survivor. Survivors have complete control over this process and their bodies.
- Immediate care. If you have injuries that need immediate attention, those are taken care of first.
- History. You will be asked about your current medications, pre-existing conditions, and other questions pertaining to your health history. Some of the questions, such as those about recent consensual sexual activity, may seem very personal, but these questions are designed to ensure that DNA and other evidence collected from the exam can be connected to the perpetrator. You will also be asked about the details of what has happened to you to help identify all potential areas of injury as well as places on your body or clothes where evidence may be located.
- Head-to-toe examination. This part of the exam may be based on your specific experience, which is why it is important to give an accurate history. You will be asked if you agree to or want to skip each specific step of the process. The trained professional performing the exam may take pictures of your body to document injuries and the examination. With your permission, they may also collect items of clothing, including undergarments. These items may be packaged and saved for analysis, looking for things such as torn pieces of the perpetrator’s clothing, a stray hair, or debris.
- Confidentiality. Care is confidential, except in legally mandated circumstances where someone has disclosed intent to harm self, others, or there is a child abuse reportable event under New York State law.
While this exam may be uncomfortable or unpleasant, it is not painful. Every step will be explained by the nurse and advocate before it is performed, and the survivor has the right to say no to anything they are not comfortable with or stop the exam.
Have more questions about SAFE exams? Check out these SAFE FAQs.
What is the role of Advocacy Center staff in the SAFE process?
In Tompkins County, the Advocacy Center partners with the Cayuga Medical Center to provide survivors of sexual assault, abuse, and rape, with support and information. In the Sexual Assault Forensic Examiner Program (SAFE), trained hospital staff will work with an Advocate from the Advocacy Center to provide a survivor with medical care, information, and a safe environment to decide on their preferred next steps.
A SAFE exam is comprehensive and provides the survivor with the opportunity to be tested for STIs, HIV, Pregnancy, and to take emergency contraception, HIV PEP medications and other antibiotics. Advocates are trained educators and will be able to explain these options to survivors with care. Additionally, Advocates are present to make sure survivors understand the steps of their physical exam given the survivor would like to have forensic evidence collected for the purpose of law enforcement reporting. Again, survivors have full control over this process and can refuse any portion of it.
While this process may be uncomfortable, frightening, or confusing, the sole job of the Advocacy Center staff is to create the most safe and compassionate environment possible for the survivor. Advocates are trained to be able to answer any question or concern that might arise and are there to walk survivors through the process with their best interest in mind at all times.
In addition to support during the SAFE exam, Advocates are available to meet with survivors at any point in the recovery process. This may mean discussing further questions or concerns, talking survivors through legal information and steps to report their assault, Title IX resources, or general support. These advocates are passionate about providing care and are dedicated to making this process as smooth as it can be. These advocates will always be a resource for survivors and no ask is too big or too small. Survivors are not alone.
If you need immediate assistance as a survivor of sexual assault, or assistance supporting a survivor, please contact the Advocacy Center’s 24 Hour Hotline at 607-277-5000. Trained hotline counselors are available to address any concerns or provide crisis support to survivors or those who care for them.