I 

117TH CONGRESS 

2D SESSION H. R. 6735 

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

to Sexual Assault Nurse Examiners, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 15, 2022 

Mr. JOYCE of Ohio (for himself and Ms. ROSS) introduced the following bill; 

which was 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) CULTURALLY COMPETENT.—The term 

2 ‘culturally competent’, used with respect to services, 

3 supports, or other assistance, means services, sup4 ports, or other assistance that is conducted or pro5 vided in a manner that— 

6 ‘‘(A) is responsive to the beliefs, inter7 personal styles, attitudes, languages, and behav8 iors of individuals receiving the services, sup9 ports, or other assistance; and 

10 ‘‘(B) has the greatest likelihood of ensur11 ing the maximum participation of individuals 

12 receiving the services, supports, or other assist13 ance. 

14 ‘‘(2) ELIGIBLE ENTITY.—The term ‘eligible en15 tity’ includes— 

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

17 ‘‘(B) a sexual assault examination pro18 gram, including— 

19 ‘‘(i) a SANE program; 

20 ‘‘(ii) a SAFE program; 

21 ‘‘(iii) a SART program; 

22 ‘‘(iv) medical personnel, including a 

23 doctor or nurse, involved in treating vic24 tims of sexual assault; and 


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1 ‘‘(v) a victim service provider involved 

2 in treating victims of sexual assault; 

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

4 ‘‘(D) a health care facility, including a hos5 pital that provides sexual assault forensic ex6 aminations by a qualified or certified SANE or 

7 SAFE; 

8 ‘‘(E) a sexual assault examination program 

9 that provides SANE or SAFE training; and 

10 ‘‘(F) a community-based program that pro11 vides sexual assault forensic examinations, in12 cluding pediatric forensic exams in a multidisci13 plinary setting, by a qualified or certified 

14 SANE or SAFE outside of a traditional health 

15 care setting. 

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

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

18 community, free, nonprofit, academic, or private 

19 medical facility, including a hospital, that provides 

20 emergency medical care to patients. 

21 ‘‘(4) MEDICAL FORENSIC EXAMINATION; 

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

23 ‘MFE’ means an examination of a sexual assault pa24 tient by a health care provider, who has specialized 

25 education and clinical experience in the collection of 


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1 forensic evidence and treatment of these patients, 

2 which includes— 

3 ‘‘(A) gathering information from the pa4 tient for the medical forensic history; 

5 ‘‘(B) an examination; 

6 ‘‘(C) coordinating treatment of injuries, 

7 documentation of biological and physical find8 ings, and collection of evidence from the pa9 tient; 

10 ‘‘(D) documentation of findings; 

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

12 referrals for sexually transmitted infections, 

13 pregnancy, suicidal ideation, alcohol and sub14 stance abuse, and other non-acute medical con15 cerns; and 

16 ‘‘(F) providing follow-up as needed to pro17 vide additional healing, treatment, or collection 

18 of evidence. 

19 ‘‘(5) PEDIATRIC SANE AND SAFE.—The term 

20 ‘pediatric SANE and SAFE’ means a SANE or 

21 SAFE who is trained to conduct sexual assault fo22 rensic examinations on children and youth between 

23 the ages of 0 and 18. 

24 ‘‘(6) QUALIFIED PERSONNEL.—The term 

25 ‘qualified personnel’ includes a registered or adVerDate Sep 11 2014 18:05 Mar 10, 2022 Jkt 029200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6735.IH H6735

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1 vanced practice nurse, physician, doctor of osteop2 athy, or physician assistant who has specialized 

3 training conducting medical forensic examinations. 

4 ‘‘(7) QUALIFIED SANE AND SAFE TRAINING

5 PROGRAM.—The term ‘qualified SANE and SAFE 

6 training program’ means a program that— 

7 ‘‘(A) is qualified to prepare current and fu8 ture sexual assault nurse examiners to be pro9 fession-ready and meet the applicable State and 

10 National certification and licensure require11 ments, through didactic, clinical, preceptor, or 

12 capstone programs that include longer-term 

13 training; 

14 ‘‘(B) provides that preparation under a 

15 health care model that uses trauma-informed 

16 techniques; and 

17 ‘‘(C) is approved as meeting the most re18 cent National Training Standards for Sexual 

19 Assault Medical Forensic Examiners. 

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

21 the meaning given the term in section 40002 of the 

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

23 12291). 

24 ‘‘(9) SECRETARY.—The term ‘Secretary’ means 

25 the Secretary of Health and Human Services. 


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1 ‘‘(10) SEXUAL ASSAULT.—The term ‘sexual as2 sault’ means any nonconsensual sexual act or sexual 

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

4 including when the individual lacks capacity to con5 sent. 

6 ‘‘(11) SEXUAL ASSAULT FORENSIC EXAMINER; 

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

8 or ‘SAFE’ means an individual who has specialized 

9 forensic training in treating sexual assault survivors 

10 and conducting medical forensic examinations. 

11 ‘‘(12) SEXUAL ASSAULT FORENSIC EXAMINA12 TION.—The term ‘sexual assault forensic examina13 tion’ means an examination of a sexual assault pa14 tient by a health care provider, who has specialized 

15 education and clinical experience in the collection of 

16 forensic evidence and treatment of these patients, 

17 which includes— 

18 ‘‘(A) gathering information from the pa19 tient for the medical forensic history; 

20 ‘‘(B) an examination; 

21 ‘‘(C) coordinating treatment of injuries, 

22 documentation of biological and physical find23 ings, and collection of evidence from the pa24 tient; 

25 ‘‘(D) documentation of findings; 


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

2 referrals for sexually transmitted infections, 

3 pregnancy, suicidal ideation, alcohol and sub4 stance abuse, and other non-acute medical con5 cerns; and 

6 ‘‘(F) providing follow-up as needed to pro7 vide additional healing, treatment, or collection 

8 of evidence. 

9 ‘‘(13) SEXUAL ASSAULT NURSE EXAMINER; 

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

11 ‘SANE’ means a registered or advanced practice 

12 nurse who has specialized training conducting med13 ical forensic examinations. 

14 ‘‘(14) SEXUAL ASSAULT RESPONSE TEAM; 

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

16 ‘SART’ means a multidisciplinary team that— 

17 ‘‘(A) provides a specialized and immediate 

18 response to survivors of sexual assault; and 

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

20 law enforcement representatives, community21 based survivor advocates, prosecutors, and fo22 rensic scientists. 

23 ‘‘(15) STATE.—The term ‘State’ means any 

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

25 and any territory or possession of the United States. 


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1 ‘‘(16) TRAUMA-INFORMED.—The term ‘trauma2 informed’ means, with respect to services or train3 ing, services or training that— 

4 ‘‘(A) uses a patient-centered approach to 

5 providing services or care; 

6 ‘‘(B) promotes the dignity, strength, and 

7 empowerment of patients who have experienced 

8 trauma; and 

9 ‘‘(C) incorporates evidence-based practices 

10 based on knowledge about the impact of trauma 

11 on patients’ lives. 

12 ‘‘(17) UNDERSERVED POPULATIONS.—The 

13 term ‘underserved populations’ has the meaning 

14 given the term in section 40002 of the Violence 

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

16 SEC. 3. SEXUAL ASSAULT NURSING EXAMINER GRANTS. 

17 Section 304 of the DNA Sexual Assault Justice Act 

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

19 subsection (a), as amended by section 2, the following: 

20 ‘‘(b) SEXUAL ASSAULT NURSE EXAMINER TRAINING

21 PROGRAM GRANTS.— 

22 ‘‘(1) AUTHORIZATION FOR GRANTS.—The At23 torney General, in consultation with the Secretary, 

24 shall make grants to eligible entities for the fol25 lowing purposes: 


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1 ‘‘(A) To establish qualified regional SANE 

2 training programs— 

3 ‘‘(i) to provide clinical education for 

4 SANE students; 

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

6 part-time SANE instructors, including 

7 those specializing in pediatrics and work8 ing in a multidisciplinary team setting, to 

9 help with the clinical training of SANEs; 

10 and 

11 ‘‘(iii) to provide access to simulation 

12 laboratories and other resources necessary 

13 for clinical education. 

14 ‘‘(B) To provide full- and part-time sala15 ries for SANEs and SAFEs, including pediatric 

16 SANEs and SAFEs. 

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

18 SAFEs by otherwise providing training, edu19 cation, or technical assistance relating to the 

20 collection, preservation, analysis, and use of 

21 DNA samples and DNA evidence by SANEs, 

22 SAFEs, and other qualified personnel. 

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

24 applications for grants under this section, the Attor25 ney General shall give preference to any eligible entiVerDate Sep 11 2014 18:05 Mar 10, 2022 Jkt 029200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H6735.IH H6735

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1 ty that certifies in the grant application that the en2 tity will coordinate with a rape crisis center or the 

3 State sexual assault coalition to facilitate sexual as4 sault advocacy to support sexual assault survivors 

5 and use the grant funds to— 

6 ‘‘(A) establish qualified SANE training 

7 programs in localities with a high volume of fo8 rensic trauma cases, including adult and child 

9 sexual assault, domestic violence, elder abuse, 

10 sex trafficking, and strangulation cases; 

11 ‘‘(B) increase the local and regional avail12 ability of full- and part-time sexual assault 

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

14 area with a health professional shortage, or for 

15 an underserved population, including efforts to 

16 provide culturally competent services; or 

17 ‘‘(C) establish or sustain sexual assault 

18 mobile teams or units or otherwise enhance 

19 SANE and SAFE access through telehealth.’’. 

20 SEC. 4. DIRECTIVE. 

21 Section 304 of the DNA Sexual Assault Justice Act 

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

23 (1) by redesignating subsection (d) as sub24 section (e); and 


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

2 by section 3, the following: 

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

4 ‘‘(1) IN GENERAL.—Not later than the begin5 ning of fiscal year 2022, the Attorney General shall 

6 coordinate with the Secretary to inform health care 

7 facilities, including Federally qualified health centers 

8 and hospitals, colleges and universities, and other 

9 appropriate health-related entities about— 

10 ‘‘(A) the availability of grant funding 

11 under this section; and 

12 ‘‘(B) the role of sexual assault nurse exam13 iners, both adult and pediatric, and available 

14 resources of the Department of Justice and the 

15 Department of Health and Human Services to 

16 train or employ sexual assault nurse examiners 

17 to address the needs of communities dealing 

18 with sexual assault, domestic violence, sex traf19 ficking, elder abuse, strangulation, and, in par20 ticular, the need for pediatric SANEs, including 

21 such nurse examiners working in the multidisci22 plinary setting, in responding to abuse of both 

23 children and adolescents. 

24 ‘‘(2) REQUIREMENT.—In carrying out para25 graph (1), the Attorney General shall collaborate 


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1 with nongovernmental organizations representing 

2 SANEs. 

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

4 ASSAULT FORENSIC EXAMINATIONS.— 

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

6 after the date of enactment of the Supporting Access 

7 to Nurse Exams Act, the Attorney General, in con8 sultation with the Secretary, shall establish, and up9 date annually, a public website on the access to fo10 rensic nurse examiners. 

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

12 paragraph (1) shall with specificity describe, by 

13 State— 

14 ‘‘(A) funding opportunities for SANE 

15 training and continuing education; and 

16 ‘‘(B) the availability of sexual assault ad17 vocates at locations providing sexual assault fo18 rensic exams. 

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

20 years after the date of enactment of the Supporting 

21 Access to Nurse Exams Act, the Attorney General, 

22 in consultation with the Secretary, shall submit to 

23 the Committee on the Judiciary of the Senate and 

24 the Committee on the Judiciary of the House of 

25 Representatives a report on— 


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

2 to, trained SANEs and other providers who 

3 perform MFEs or sexual assault forensic exami4 nations; 

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

6 hospitals or clinics, that offer SANEs and sex7 ual assault forensic examinations and whether 

8 each health care facility, including a hospital or 

9 clinic, has full-time, part-time, or on-call cov10 erage; 

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

12 to access for SANE care and services, including 

13 MFEs and sexual assault forensic examinations; 

14 ‘‘(D) State requirements, minimum stand15 ards, and protocols for training SANEs, includ16 ing trauma-informed and culturally competent 

17 training standards; 

18 ‘‘(E) State requirements, minimum stand19 ards, and protocols for training emergency serv20 ices personnel involved in MFEs and sexual as21 sault forensic examinations; 

22 ‘‘(F) the availability of sexual assault 

23 nurse examiner training, frequency of when 

24 training is convened, the providers of such 

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


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1 what process or procedures are in place for con2 tinuing education of such examiners; 

3 ‘‘(G) the dedicated Federal and State 

4 funding to support SANE training; 

5 ‘‘(H) funding opportunities for SANE 

6 training and continuing education; 

7 ‘‘(I) the availability of sexual assault advo8 cates at locations providing MFEs and sexual 

9 assault forensic exams; and 

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

11 sexual assault forensic exams described in sec12 tion 2010(b) of title I of the Omnibus Crime 

13 Control and Safe Streets Act of 1968 (34 

14 U.S.C. 10449(b)).’’. 

15 SEC. 5. AUTHORIZATION OF APPROPRIATIONS. 

16 Subsection (e) of section 304 of the DNA Sexual As17 sault Justice Act of 2004 (34 U.S.C. 40723), as redesig18 nated by section 4 of this Act, is amended to read as fol19 lows: 

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

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

22 of fiscal years 2023 through 2028 to carry out this sec23 tion.’’. 

Æ 


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