A bill moving through the Louisiana Legislature is drawing attention to major gaps in how the state provides care for sexual assault survivors.
House Bill 531, introduced by Rep. Travis Johnson, D-Vidalia, passed out of the House Committee on Health and Welfare on Wednesday without any objections. It includes two key components:
Improved information at the point of care: Emergency rooms would be required to provide clear, consistent information to sexual assault survivors about their options, including where to go for a forensic exam — commonly known as a rape kit — if a qualified provider isn’t available at the current facility.
- A comprehensive audit: The Louisiana Legislative Auditor would conduct a statewide review of resources, including Sexual Assault Nurse Examiner (SANE) availability, regional response plans, and the coordination — or lack thereof — between hospital districts and local coroners.
The bill also clarifies that a “health care provider” includes not only individual practitioners like doctors and nurses but also institutions such as hospitals, diagnostic centers, treatment facilities and hospices.
SANEs are specialized nurses who provide trauma-informed care as they conduct medical forensic exams. They’re better trained at collecting and preserving crucial evidence and can be qualified as experts to testify in court. SANEs also connect survivors to advocates and outside resources, which are often critical for their recovery and for their legal outcomes if they choose to prosecute their cases.
Rep. Johnson originally introduced a bare-bones version of the bill that would have required all health care facilities and hospitals to offer forensic exams to all sexual assault survivors. The current system for responding to sexual assault cases in Louisiana varies widely from parish to parish. In some regions, the coroner’s office employs SANEs and sends them to hospitals. In others, hospitals have informal agreements with nearby facilities, or lack any protocol at all.
The amended bill came together after Johnson met with key stakeholders, including the Louisiana Department of Health, the Governor’s Office of Human Trafficking Prevention and SANEs. There’s a huge shortage of SANEs affecting Louisiana. According to the Commission for Forensic Nursing Certification, which maintains a directory of SANE-certified nurses in the United States, Louisiana has 42 certified SANEs for the entire state.
This doesn’t account for nurses who have received SANE training, which can be difficult to access. The federal grant that provided SANE training at LSU School of Nursing has expired and it’s unclear whether or not more funding will become available due to President Donald Trump’s administration changing grant funding priorities, according to Monica Taylor, director of the Governor's Office of Human Trafficking Prevention.
“We just examined the whole system, and we realized how broken it is,” Johnson said. “We’ve got almost 50 certified SANEs in the state, but approximately only 30 of those nurses are actually practicing.”
Johnson said the lack of uniformity in sexual assault response plans in the state is impacting survivors. There are no general state funds that support forensic medical exam services. He said the audit the bill would call for would help identify problems and “loopholes” to help improve those response plans.
“The situation is so dire, it’s like the Wild Wild West,” Johnson said. “Everyone does things differently, and that’s not how it’s supposed to work.”
Johnson emphasized that the bill doesn’t try to overhaul the system all at once, acknowledging the state’s limited resources. Instead, the audit will lay the groundwork for more comprehensive legislation next year.
“We don’t want to hurt local hospitals by putting mandates on them they can’t meet,” he said. “With this bill, we’ve got information through the audit so we can come back next year with evidence for more bills.”
He compared the bill’s intent to how hospitals respond to trauma patients.
“Let's say you go into a hospital and you've had a major accident, a head trauma. You're going to go in the hospital, they're going to take care of you,” Johnson said. “With sexual assault victims… the hospital may say, ‘OK, we’re going to transport you,’ but they don’t want to do all that. It’s a very traumatic experience. They don’t want to be shipped from hospital to hospital.”
Transferring sexual assault patients from one hospital to another — with survivors sometimes driving themselves — can create a barrier for accessing forensic exams. This often lessens the chance they get a forensic exam, according to Rafael de Castro, executive director of the Louisiana Foundation Against Sexual Assault, a nonprofit that works with rape crisis centers in the state.
To address the challenge that travel poses for sexual assault survivors seeking care, Louisiana began on-site forensic exams — often referred to as “traveling SANEs” — in a few of the state’s nine regional health districts in 2015. In Region 7, for example, which includes nine parishes in the northwest corner of the state, a SANE is dispatched to any hospital without one, if a patient arrives and requests an exam.
This model isn’t used uniformly across the state, but it has shown results where implemented. Since Region 1, which includes Jefferson Parish, began collecting data on traveling SANEs in 2022, the number of forensic exams has gone up — suggesting that eliminating travel requirements made it easier for survivors to access exams.
“Whenever you can break down obstacles for survivors to get the services that they need, you’re always going to see an increase,” de Castro said.
Still, the system isn’t without strain. Traveling SANEs often face high demand and limited staffing. Jefferson Parish, for instance, has just two full-time SANEs available to respond to requests across the region. That can lead to delays in care, as patients may have to wait for a nurse to arrive.
The burden has only increased since the St. Tammany Parish coroner, Christopher Tape, terminated the SANEs employed by his office — which previously served five parishes. The two Jefferson Parish SANEs have since absorbed those responsibilities.
Today, those two full-time SANEs cover a vast territory: 19 hospitals across six parishes, spanning more than 3,600 square miles and serving over a million residents — a geographic area twice the size of Delaware and nearly equal in population to Montana.
The demands of the role are significant. SANE work is already emotionally and physically taxing, and the current shortage means the few nurses available are carrying an even heavier load.
“Honestly, a lot of us that have been doing this have been doing it a while and we are very much on our last leg,” Ginesse Barrett, one of the two full-time Jefferson Parish traveling SANEs said in a February 26 Louisiana Sexual Assault Oversight Commission meeting.
This story was produced by the Gulf States Newsroom, a collaboration between Mississippi Public Broadcasting, WBHM in Alabama, WWNO and WRKF in Louisiana and NPR. Support for public health coverage comes from The Commonwealth Fund.
