Sexual violence is not rare. It is not a “specialty problem.” It is a public health crisis that walks through hospital doors every day.

According to the CDC, more than 1 in 5 women and 1 in 31 men in the United States have experienced completed or attempted rape in their lifetime. The CDC also reports that 1 in 26 men has been made to penetrate someone else in their lifetime. These numbers represent millions of people who may need urgent medical care, trauma-informed support, injury assessment, pregnancy prevention, STI testing and treatment, safety planning, and forensic evidence collection.

Sexual Assault Nurse Examiners are specially trained registered nurses who provide medical forensic care to patients after sexual assault. Their role is not limited to “collecting evidence.” SANEs provide skilled healthcare, patient-centered advocacy, documentation, injury identification, medication support, referrals, and compassionate, trauma-informed care during one of the most vulnerable moments of a survivor’s life. The U.S. Department of Justice’s National Protocol states clearly that patients deserve competent and compassionate medical forensic care after sexual assault.

Yet access remains inconsistent. Many hospitals still do not have SANEs available. That means survivors may be transferred, delayed, examined by clinicians without specialized training, or forced to leave without receiving the standard of care they deserve. This is especially concerning for patients who rely on Medicare- and Medicaid-participating hospitals, including patients in rural areas, low-income communities, and medically underserved regions.

The need is growing. A national study published in JAMA Network Open found that emergency department visits related to sexual assault increased substantially from 2006 to 2019, while research continues to show that only a minority of sexual violence survivors seek medical care at all. When a survivor does come to the hospital, that moment matters. A poor response can cause harm. A trained response can support healing, improve documentation, and preserve options for justice.

Hospitals that participate in Medicare and Medicaid already must meet federal Conditions of Participation designed to protect patient health and safety. CMS states that these standards are the foundation for improving quality and protecting beneficiaries, and federal emergency services requirements state that hospitals must meet patients’ emergency needs according to acceptable standards of practice.

Sexual assault care should be treated as part of that standard.

We are calling for a federal requirement that every hospital receiving Medicare and Medicaid funding must ensure timely access to Sexual Assault Nurse Examiner services. This does not mean every hospital must solve the problem in the same way. Hospitals may meet this requirement through employed SANEs, regional SANE coverage models, on-call programs, teleSANE support, formal transfer agreements that do not delay care, or partnerships with local forensic nursing programs. But every hospital must have a real plan. “We do not see that many cases” is not a plan.

We recognize that implementation requires funding, training, staffing, and infrastructure. But lack of preparation cannot be allowed to become the survivor’s burden. Federal and state grant programs, hospital partnerships, regional training models, and telehealth-supported forensic nursing programs can help build sustainable access. The cost of inaction is paid by survivors through delayed care, retraumatization, missed injuries, lost evidence, and preventable gaps in justice.

A hospital that accepts public healthcare dollars should be prepared to care for the public, including survivors of sexual violence.

Please sign this petition to require Medicare- and Medicaid-participating hospitals to ensure access to trained Sexual Assault Nurse Examiners. Every survivor deserves dignity. Every survivor deserves competent care. Every survivor deserves more than luck when they walk into an emergency department.