Congresswoman Deborah Ross, D-Raleigh, at the U.S. Capitol. Photo courtesy of Deborah Ross

If you’re looking for a sexual assault nurse examiner, or SANE nurse, you won’t find them on any map in most states.

But if Congress passes the Violence Against Women Reauthorization Act, a recently approved amendment would allow agencies to spend grant money to create a record of where these specially certified forensic nurses are located.

U.S. Rep. Deborah Ross, D-Raleigh, said a staffer saw a news article originally published by Carolina Public Press about a shortage of SANE nurses in North Carolina and how agencies don’t know where these nurses work. 

This lack of information can lead to victims showing up at hospitals and then waiting for hours for a nurse to become available.

“When we saw this problem in North Carolina, again, as reported in the press, we worked with committee staff on the best way to be able to help,” Ross said.

She proposed the amendment to the reauthorization act when it came to the House Rules Committee, of which she is one of a dozen members. Her amendment allows agencies to use certain federal grant funds to build statewide databases of where SANE nurses work.

A few states have been doing this on their own. Massachusetts, for instance, has a website where rape survivors can find hospitals with SANE nurses. In a different approach to the same issue, Illinois lawmakers passed a law that will require all rape victims to be served by SANE nurses by 2022.

The VAWA Reauthorization Act, with Ross’ amendment, recently passed the U.S. House of Representatives on a bipartisan vote. It is now before the U.S. Senate. If the Senate passes it and President Joe Biden signs it, VAWA would be reauthorized through 2024. Biden introduced VAWA when he was a senator in the 1990s and is expected to sign the measure if it clears the Senate.

“I am hopeful that we will be able to reauthorize the Violence Against Women Act that will be able to add this financial support for getting more SANE nurses involved in helping victims of sexual assault,” Ross said.

Finding nurses

Earlier this year, a Carolina Public Press investigation found that of 130 hospitals and community programs surveyed, many in rural areas do not have any SANE nurses who have passed all training and an exam to get certification. Because no agency tracks where SANE nurses are located, the only way many find out where they work is when they arrive after a sexual assault.

It’s not uncommon for patients to wait five to seven hours for a SANE nurse, Catherine Rossi, president of the Academy of Forensic Nursing and the forensic nursing program coordinator for Cone Health in Guilford County, said earlier this year.

“I’ve had a couple of experiences in the last year,” Rossi said in her interview with CPP. “We were the third facility they made it to, 17 or 19 hours after they sought care.”

After getting the runaround, some victims give up.

“And then we might not have both the evidence for prosecution and the ability to provide that special level of care to the victim that a SANE nurse can provide,” Ross said.

Congress originally passed the Violence Against Women Act in 1994. Congress has expanded and reauthorized it three times since then, most recently in 2013. However, it lapsed in 2018 and has not been reauthorized since.

VAWA largely focuses on violent crime against women and steers grant funds toward governments, nonprofit organizations and universities that aim to help women who are victims of violent crime.

In 1993, the year before the act was created, marital rape was still legal in North Carolina and Oklahoma, according to the National Center for Victims of Crime. Both states eliminated that loophole that year.

Until 2019 in North Carolina, having sex with an incapacitated person who had caused his or her own incapacitation through drinking or drug use was not a crime. Nor was it a crime to continue a sexual act after someone told the other person to stop — the last state in the country where this was true.

Both of these sexual assault loopholes were eliminated after Gov. Roy Cooper signed a bill making both acts a crime two years ago.

The legislation followed years of reporting in North Carolina about the loopholes, including a 2019 project by Carolina Public Press and several media partners that examined sexual assault prosecutions in every county in the state.

Data analysis by CPP showed fewer than 1-in-4 people charged with a sexual assault were eventually convicted of that or a related crime.

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Kate Martin is lead investigative reporter for Carolina Public Press. Email her at