From the U.S. Government Accountability Office, www.gao.gov Transcript for: Sexual Assault Response Description: Audio interview by GAO staff with Katherine Iritani, Director, Health Care Related GAO Work: GAO-16-334: Sexual Assault: Information on Training, Funding, and the Availability of Forensic Examiners Released: April 2016 [ Background Music ] [ Narrator: ] Welcome to GAO's Watchdog Report, your source for news and information from the U.S. Government Accountability Office. It's April 2016. In 2013, at least 285,000 people age 12 or older were victims of sexual assault, according to the Bureau of Justice statistics. Studies have shown that victims of these heinous crimes receive better care and more suspects are prosecuted when forensic medical examiners are involved. A team led by Katherine Iritani, a director in GAO's Health Care team, recently reviewed the availability of forensic examiners nationwide. GAO's Jacques Arsenault sat down with Katherine to talk about what they found. [ Jacques Arsenault: ] What happens when a forensic examiner is brought into a sexual assault investigation? [ Katherine Iritani: ] Ideally, a forensic examiner would be among the first people that a victim would see. Forensic examiners are medical providers that are trained in doing these investigations, and they are first and foremost trained to assess a victim's medical needs and address those. Their training entails evaluating and addressing the health concerns of a victim, minimizing the victim's trauma and promoting healing, and with the victim's consent, they can collect and document physical evidence related to the assault for potential use by the legal system. [ Jacques Arsenault: ] So these examiners help lead to better outcomes for victims? [ Katherine Iritani: ] Yes. Yes, that's, that has been shown in the research. Any medical provider can perform an exam, but the research has shown better outcomes for victims and law enforcement when trained examiners perform these exams. For example, shortened exam time, improvements in the quality of the evidence that is collected, improved chances that the perpetrators would be prosecuted, and most importantly, improved addressing of the physical and mental health needs delivered to the victims. [ Jacques Arsenault: ] Now, state and local governments are typically the ones that work sexual assault cases, but what's the role of the federal government here? [ Katherine Iritani: ] Well, the federal government has several grant programs through the Department of Justice that are authorized by the Violence Against Women Act that can support a range of activities related to violence against women. These grants can go to a range of different stakeholders as well. And training or funding examiners is one of the many purposes that could be covered by these grants. [ Jacques Arsenault: ] So these grants can help train the examiners, but are there enough examiners on the ground? [ Katherine Iritani: ] That's a hard question. The data are not good with regard to availability of examiners. But that said, based on our work, there probably aren't enough examiners available. We talked to state officials and others at the federal level as well just about the availability of examiners, and officials in the six states we talked to indicated that there really wasn't enough trained examiners to meet the needs in their states, particularly in rural areas. For example, officials in Nebraska told us that more than half of all the counties in the state didn't have any examiners available. And what happens when a county or an area doesn't have an examiner that's been trained is that either the victim needs to see a medical provider that hasn't had the training or they need to travel long distances, and it can take hours to get to a facility that has a trained examiner. [ Jacques Arsenault: ] So did you get some sense of why this is the case, are there just not people interested in these examiner positions, or are there some other challenges here? [ Katherine Iritani: ] I think that people are interested. What officials told us is that retention is very low. People get burned out. The work can be physically and emotionally very demanding. The caseloads can be high and the hours long and the pay low. State officials told us that, you know, some hospitals, for example, might not pay examiners to be on call or pay, you know, small amounts like a dollar or a dollar fifty per hour. There are more systemic challenges that state officials cited as well, including the limited availability of training, that there might be training for new examiners that just happens once a year, for example. [ Jacques Arsenault: ] So then are there any ways to overcome these challenges and get more examiners on staff? [ Katherine Iritani: ] The officials we talked to told us about several different strategies that they were undertaking. Some mentioned web-based training, for example, and a state told us about developing a community-based sexual assault response team that was comprised of stakeholders to try to better coordinate the care and response and get coverage across the state. [ Jacques Arsenault: ] So then finally, and especially for the many people who have been victims of sexual assault or know victims of sexual assault, what would you say is the bottom line of this report? [ Katherine Iritani: ] Well, this is really an important issue, and sexual assault, as you know, is a violent crime and can be a traumatic and life-changing experience for victims. Federal funding is available and is used to support the training of examiners that are really needed to help address the victim's needs. However, our work suggests that there may not be enough trained examiners to meet the needs. There are many complex factors that contribute to the challenges in training and retaining examiners, and hopefully this report will bring more attention to these issues. [ Background Music ] [ Narrator: ] To learn more, visit GAO.gov and be sure to tune in to the next episode of GAO's Watchdog Report for more from the congressional watchdog, the U.S. Government Accountability Office.