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Ohio Department of Health’s Protocol for Sexual Assault Medical Forensic Examinations

The Ohio Department of Health Released the Revised Adult/Adolescent and Child/Adolescent Protocols Which Reflect Best Practices for Sexual Assault Medical Forensic Exam in 2022.

The Ohio Revised Code charges the Ohio Director of Health with the responsibility to establish procedures for gathering evidence for victims of sexual offenses (ORC section 2907.29). A protocol for this purpose was originally developed in 1991. Subsequently, the Ohio Department of Health (ODH) Sexual Assault and Domestic Violence Prevention Program has worked with partners to recommend regular updates to the Director of Health for approval. There are revised adult/adolescent and child/adolescent editions of the protocol.

The revised protocol can be found on the ODH website (odh.ohio.gov) by searching for the “Sexual Assault and Domestic Violence Prevention Program” and then selecting “Protocol for SA Forensic and Medical Exams,” or go directly to the link here.

Since 2011, ODH coordinated with the office of the Attorney General and the Department of Public Safety to co-convene a new group called the “Sexual Assault Advisory Board of Ohio” (SAABO) to formalize the review process. Current SAABO members are…

American Academy of Pediatrics – Ohio Chapter
Ohio Attorney General’s Office
Bureau of Criminal Identification and Investigation (BCI)
Ohio Chapter of the American College of Emergency Physicians
Ohio Chapter of the International Association of Forensic Nurses
Ohio Alliance to End Sexual Violence
Office of Criminal Justice Services at the Ohio Department of Public Safety
Buckeye State Sheriffs Association; the Ohio Crime Victim Justice Center
Ohio Association of Chiefs of Police
Ohio Department of Higher Education
Forensic Nursing Network, Inc.
Ohio Children’s Hospital Association
Ohio College Health Association
Ohio Department of Rehabilitation and Correction
Ohio Hospital Association
Ohio Network of Children’s Advocacy Centers
Ohio Nurses Association
Ohio Organization for Nursing Leadership
Ohio Department of Mental Health and Addiction Services
Major Unusual Incidents (MUI)/Registry Unit of the Ohio Department of Developmental Disabilities
Equitas Health.

These agencies and organizations send representatives to serve on the committee to update the protocol for final review and approval by the Ohio Director of Health. The protocol has been revised and formatted to mirror the current version of the National Sexual Assault Protocol.

Following is a summary of the key changes from the previous edition of the protocol

Adult Adolescent Protocol

Modeled and aligned the revisions on the current National Sexual Assault Protocol.
Added sample Sexual Assault Response Team (SART) case review documents and included a sample SART algorithm for response to sexual assault.
Added information to assist in providing trauma informed care for patients with additional needs mirroring content from the national protocol.
Updated regular consent for exam to include witness signature.
Changed “anonymous” to “unnamed” sexual assault evidence collection kit.
- Updated consent to read that the patient understands evidence may or may not be tested.
Updated chain of custody to include a copy of the forensic documentation given to law enforcement.
Updated the sample intimate partner violence screening form.
Updated the kit collection envelopes: removing slide collections from exams.
Drug-facilitated sexual assault:

Updated the sample authorization and release form.
Updated the blood collection time from 48 hours to 24 hours.

Located sexual assault kit documents in one place as a booklet for easy printing if needed (also included in child adolescent protocol).
Decreased the number of appendices. Made everything accessible in the table of contents with links that take you directly to content needed.

Child/Adolescent Protocol

Updated child adolescent protocol to mirror Multi-disciplinary Team (MDT) continuum of care.
Updated to include age for use of protocol to state that adolescent patients 13 and post-menarche can be seen in regular hospital settings (outside of a child advocacy center or pediatric facility).
Included an algorithm for patients ages 0-17 for easier access and guidance.
Included a section on human trafficking.

Educational opportunities on changes made to both protocols will be forthcoming. Contact Corina Klies at Corina.Klies@odh.ohio.gov for more information.