II 

117TH CONGRESS 

2D SESSION S. 3648 

To amend the DNA Sexual Assault Justice Act of 2004 to increase access 

to Sexual Assault Nurse Examiners, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 14, 2022 

Mr. CORNYN (for himself and Mr. DURBIN) introduced the following bill; 

which was read twice and referred to the Committee on the Judiciary 

A BILL 

To amend the DNA Sexual Assault Justice Act of 2004 

to increase access to Sexual Assault Nurse Examiners, 

and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Supporting Access to 

5 Nurse Exams Act’’ or the ‘‘SANE Act’’. 

6 SEC. 2. DEFINITIONS. 

7 Section 304 of the DNA Sexual Assault Justice Act 

8 of 2004 (34 U.S.C. 40723) is amended by striking sub9 sections (a), (b), and (c) and inserting the following: 

10 ‘‘(a) DEFINITIONS.—In this section: 


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1 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en2 tity’ includes— 

3 ‘‘(A) a Tribal government or hospital; 

4 ‘‘(B) a sexual assault examination pro5 gram, including— 

6 ‘‘(i) a SANE program; 

7 ‘‘(ii) a SAFE program; 

8 ‘‘(iii) a SART program; 

9 ‘‘(iv) medical personnel, including a 

10 doctor or nurse, involved in treating vic11 tims of sexual assault; and 

12 ‘‘(v) a victim service provider involved 

13 in treating victims of sexual assault; 

14 ‘‘(C) a State sexual assault coalition; 

15 ‘‘(D) a health care facility, including a hos16 pital that provides sexual assault forensic ex17 aminations by a qualified or certified SANE or 

18 SAFE; 

19 ‘‘(E) a sexual assault examination program 

20 that provides SANE or SAFE training; and 

21 ‘‘(F) a community-based program that pro22 vides sexual assault forensic examinations, in23 cluding pediatric forensic exams in a multidisci24 plinary setting, by a qualified or certified 


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1 SANE or SAFE outside of a traditional health 

2 care setting. 

3 ‘‘(2) HEALTH CARE FACILITY.—The term 

4 ‘health care facility’ means any State, local, Tribal, 

5 community, free, nonprofit, academic, or private 

6 medical facility, including a hospital, that provides 

7 emergency medical care to patients. 

8 ‘‘(3) MEDICAL FORENSIC EXAMINATION; 

9 MFE.—The term ‘medical forensic examination’ or 

10 ‘MFE’ means an examination of a sexual assault pa11 tient by a health care provider, who has specialized 

12 education and clinical experience in the collection of 

13 forensic evidence and treatment of these patients, 

14 which includes— 

15 ‘‘(A) gathering information from the pa16 tient for the medical forensic history; 

17 ‘‘(B) an examination; 

18 ‘‘(C) coordinating treatment of injuries, 

19 documentation of biological and physical find20 ings, and collection of evidence from the pa21 tient; 

22 ‘‘(D) documentation of findings; 

23 ‘‘(E) providing information, treatment, and 

24 referrals for sexually transmitted infections, 

25 pregnancy, suicidal ideation, alcohol and subVerDate Sep 11 2014 15:41 Feb 15, 2022 Jkt 029200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3648.IS S3648

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1 stance abuse, and other non-acute medical con2 cerns; and 

3 ‘‘(F) providing follow-up as needed to pro4 vide additional healing, treatment, or collection 

5 of evidence. 

6 ‘‘(4) PEDIATRIC SANE AND SAFE.—The term 

7 ‘pediatric SANE and SAFE’ means a SANE or 

8 SAFE who is trained to conduct sexual assault fo9 rensic examinations on children and youth between 

10 the ages of 0 and 18. 

11 ‘‘(5) QUALIFIED PERSONNEL.—The term 

12 ‘qualified personnel’ includes a registered or ad13 vanced practice nurse, physician, doctor of osteop14 athy, or physician assistant who has specialized 

15 training conducting medical forensic examinations. 

16 ‘‘(6) QUALIFIED SANE AND SAFE TRAINING

17 PROGRAM.—The term ‘qualified SANE and SAFE 

18 training program’ means a program that— 

19 ‘‘(A) is qualified to prepare current and fu20 ture sexual assault nurse examiners to be pro21 fession-ready and meet the applicable State and 

22 national certification and licensure require23 ments, through didactic, clinical, preceptor, or 

24 capstone programs that include longer-term 

25 training; 


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1 ‘‘(B) provides that preparation under a 

2 health care model that uses trauma-informed 

3 techniques; and 

4 ‘‘(C) is approved as meeting the most re5 cent National Training Standards for Sexual 

6 Assault Medical Forensic Examiners. 

7 ‘‘(7) RURAL AREA.—The term ‘rural area’ has 

8 the meaning given the term in section 40002 of the 

9 Violence Against Women Act of 1994 (34 U.S.C. 

10 12291). 

11 ‘‘(8) SECRETARY.—The term ‘Secretary’ means 

12 the Secretary of Health and Human Services. 

13 ‘‘(9) SEXUAL ASSAULT.—The term ‘sexual as14 sault’ means any nonconsensual sexual act or sexual 

15 contact proscribed by Federal, Tribal, or State law, 

16 including when the individual lacks capacity to con17 sent. 

18 ‘‘(10) SEXUAL ASSAULT FORENSIC EXAMINER; 

19 SAFE.—The term ‘sexual assault forensic examiner’ 

20 or ‘SAFE’ means an individual who has specialized 

21 forensic training in treating sexual assault survivors 

22 and conducting medical forensic examinations. 

23 ‘‘(11) SEXUAL ASSAULT FORENSIC EXAMINA24 TION.—The term ‘sexual assault forensic examina25 tion’ means an examination of a sexual assault paVerDate Sep 11 2014 15:41 Feb 15, 2022 Jkt 029200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3648.IS S3648

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1 tient by a health care provider, who has specialized 

2 education and clinical experience in the collection of 

3 forensic evidence and treatment of these patients, 

4 which includes— 

5 ‘‘(A) gathering information from the pa6 tient for the medical forensic history; 

7 ‘‘(B) an examination; 

8 ‘‘(C) coordinating treatment of injuries, 

9 documentation of biological and physical find10 ings, and collection of evidence from the pa11 tient; 

12 ‘‘(D) documentation of findings; 

13 ‘‘(E) providing information, treatment, and 

14 referrals for sexually transmitted infections, 

15 pregnancy, suicidal ideation, alcohol and sub16 stance abuse, and other non-acute medical con17 cerns; and 

18 ‘‘(F) providing follow-up as needed to pro19 vide additional healing, treatment, or collection 

20 of evidence. 

21 ‘‘(12) SEXUAL ASSAULT NURSE EXAMINER; 

22 SANE.—The term ‘sexual assault nurse examiner’ or 

23 ‘SANE’ means a registered or advanced practice 

24 nurse who has specialized training conducting med25 ical forensic examinations. 


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1 ‘‘(13) SEXUAL ASSAULT RESPONSE TEAM; 

2 SART.—The term ‘sexual assault response team’ or 

3 ‘SART’ means a multidisciplinary team that— 

4 ‘‘(A) provides a specialized and immediate 

5 response to survivors of sexual assault; and 

6 ‘‘(B) may include health care personnel, 

7 law enforcement representatives, community8 based survivor advocates, prosecutors, and fo9 rensic scientists. 

10 ‘‘(14) STATE.—The term ‘State’ means any 

11 State of the United States, the District of Columbia, 

12 and any territory or possession of the United States. 

13 ‘‘(15) TRAUMA-INFORMED.—The term ‘trauma14 informed’ means, with respect to services or train15 ing, services or training that— 

16 ‘‘(A) use a patient-centered approach to 

17 providing services or care; 

18 ‘‘(B) promote the dignity, strength, and 

19 empowerment of patients who have experienced 

20 trauma; and 

21 ‘‘(C) incorporate evidence-based practices 

22 based on knowledge about the impact of trauma 

23 on patients’ lives. 

24 ‘‘(16) UNDERSERVED POPULATIONS.—The 

25 term ‘underserved populations’ has the meaning 


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1 given the term in section 40002 of the Violence 

2 Against Women Act of 1994 (34 U.S.C. 12291).’’. 

3 SEC. 3. SEXUAL ASSAULT NURSE EXAMINER GRANTS. 

4 Section 304 of the DNA Sexual Assault Justice Act 

5 of 2004 (34 U.S.C. 40723) is amended by inserting after 

6 subsection (a), as amended by section 2 of this Act, the 

7 following: 

8 ‘‘(b) SEXUAL ASSAULT NURSE EXAMINER TRAINING

9 PROGRAM GRANTS.— 

10 ‘‘(1) AUTHORIZATION FOR GRANTS.—The At11 torney General, in consultation with the Secretary, 

12 shall make grants to eligible entities for the fol13 lowing purposes: 

14 ‘‘(A) To establish qualified regional SANE 

15 training programs— 

16 ‘‘(i) to provide clinical education for 

17 SANE students; 

18 ‘‘(ii) to provide salaries for full- and 

19 part-time SANE instructors, including 

20 those specializing in pediatrics and work21 ing in a multidisciplinary team setting, to 

22 help with the clinical training of SANEs; 

23 and 


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1 ‘‘(iii) to provide access to simulation 

2 laboratories and other resources necessary 

3 for clinical education. 

4 ‘‘(B) To provide full- and part-time sala5 ries for SANEs and SAFEs, including pediatric 

6 SANEs and SAFEs. 

7 ‘‘(C) To increase access to SANEs and 

8 SAFEs by otherwise providing training, edu9 cation, or technical assistance relating to the 

10 collection, preservation, analysis, and use of 

11 DNA samples and DNA evidence by SANEs, 

12 SAFEs, and other qualified personnel. 

13 ‘‘(2) PREFERENCE FOR GRANTS.—In reviewing 

14 applications for grants under this section, the Attor15 ney General shall give preference to any eligible enti16 ty that certifies in the grant application that the en17 tity will coordinate with a rape crisis center or the 

18 State sexual assault coalition to facilitate sexual as19 sault advocacy to support sexual assault survivors 

20 and use the grant funds to— 

21 ‘‘(A) establish qualified SANE training 

22 programs in localities with a high volume of fo23 rensic trauma cases, including adult and child 

24 sexual assault, domestic violence, elder abuse, 

25 sex trafficking, and strangulation cases; 


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1 ‘‘(B) increase the local and regional avail2 ability of full- and part-time sexual assault 

3 nurse examiners in a rural area, Tribal area, an 

4 area with a health professional shortage, or for 

5 an underserved population, including efforts to 

6 provide culturally competent services; or 

7 ‘‘(C) establish or sustain sexual assault 

8 mobile teams or units or otherwise enhance 

9 SANE and SAFE access through telehealth.’’. 

10 SEC. 4. DIRECTIVE. 

11 Section 304 of the DNA Sexual Assault Justice Act 

12 of 2004 (34 U.S.C. 40723) is amended— 

13 (1) by redesignating subsection (d) as sub14 section (e); and 

15 (2) by inserting after subsection (b), as added 

16 by section 3 of this Act, the following: 

17 ‘‘(c) DIRECTIVE TO THE ATTORNEY GENERAL.— 

18 ‘‘(1) IN GENERAL.—Not later than the begin19 ning of fiscal year 2022, the Attorney General shall 

20 coordinate with the Secretary to inform health care 

21 facilities, including Federally qualified health centers 

22 and hospitals, colleges and universities, and other 

23 appropriate health-related entities about— 

24 ‘‘(A) the availability of grant funding 

25 under this section; and 


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1 ‘‘(B) the role of sexual assault nurse exam2 iners, both adult and pediatric, and available 

3 resources of the Department of Justice and the 

4 Department of Health and Human Services to 

5 train or employ sexual assault nurse examiners 

6 to address the needs of communities dealing 

7 with sexual assault, domestic violence, sex traf8 ficking, elder abuse, strangulation, and, in par9 ticular, the need for pediatric SANEs, including 

10 such nurse examiners working in the multidisci11 plinary setting, in responding to abuse of both 

12 children and adolescents. 

13 ‘‘(2) REQUIREMENT.—In carrying out para14 graph (1), the Attorney General shall collaborate 

15 with nongovernmental organizations representing 

16 SANEs. 

17 ‘‘(d) PUBLIC INFORMATION ON ACCESS TO SEXUAL

18 ASSAULT FORENSIC EXAMINATIONS.— 

19 ‘‘(1) IN GENERAL.—Not later than 2 years 

20 after the date of enactment of the Supporting Access 

21 to Nurse Exams Act, the Attorney General, in con22 sultation with the Secretary, shall establish, and up23 date annually, a public website on the access to fo24 rensic nurse examiners. 


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1 ‘‘(2) CONTENTS.—The website required under 

2 paragraph (1) shall with specificity describe, by 

3 State— 

4 ‘‘(A) funding opportunities for SANE 

5 training and continuing education; and 

6 ‘‘(B) the availability of sexual assault ad7 vocates at locations providing sexual assault fo8 rensic exams. 

9 ‘‘(3) REPORT TO CONGRESS.—Not later than 4 

10 years after the date of enactment of the Supporting 

11 Access to Nurse Exams Act, the Attorney General, 

12 in consultation with the Secretary, shall submit to 

13 the Committee on the Judiciary of the Senate, the 

14 Committee on Health, Education, Labor, and Pen15 sions of the Senate, the Committee on the Judiciary 

16 of the House of Representatives, and the Committee 

17 on Energy and Commerce of the House of Rep18 resentatives a report on— 

19 ‘‘(A) the availability of, and patient access 

20 to, trained SANEs and other providers who 

21 perform MFEs or sexual assault forensic exami22 nations; 

23 ‘‘(B) the health care facilities, including 

24 hospitals or clinics, that offer SANEs and sex25 ual assault forensic examinations and whether 


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1 each health care facility, including a hospital or 

2 clinic, has full-time, part-time, or on-call cov3 erage; 

4 ‘‘(C) regional, provider, or other barriers 

5 to access for SANE care and services, including 

6 MFEs and sexual assault forensic examinations; 

7 ‘‘(D) State requirements, minimum stand8 ards, and protocols for training SANEs, includ9 ing trauma-informed and culturally competent 

10 training standards; 

11 ‘‘(E) State requirements, minimum stand12 ards, and protocols for training emergency serv13 ices personnel involved in MFEs and sexual as14 sault forensic examinations; 

15 ‘‘(F) the availability of sexual assault 

16 nurse examiner training, frequency of when 

17 training is convened, the providers of such 

18 training, the State’s role in such training, and 

19 what process or procedures are in place for con20 tinuing education of such examiners; 

21 ‘‘(G) the dedicated Federal and State 

22 funding to support SANE training; 

23 ‘‘(H) funding opportunities for SANE 

24 training and continuing education; 


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1 ‘‘(I) the availability of sexual assault advo2 cates at locations providing MFEs and sexual 

3 assault forensic exams; and 

4 ‘‘(J) the total annual cost of conducting 

5 sexual assault forensic exams described in sec6 tion 2010(b) of title I of the Omnibus Crime 

7 Control and Safe Streets Act of 1968 (34 

8 U.S.C. 10449(b)).’’. 

9 SEC. 5. AUTHORIZATION OF APPROPRIATIONS. 

10 Subsection (e) of section 304 of the DNA Sexual As11 sault Justice Act of 2004 (34 U.S.C. 40723), as redesig12 nated by section 4 of this Act, is amended to read as fol13 lows: 

14 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

15 are authorized to be appropriated $30,000,000 for each 

16 of fiscal years 2023 through 2027 to carry out this sec17 tion.’’. 

Æ 


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