Louisville Public Media: One in four Kentucky counties lack a nurse trained to conduct sexual assault exams, advocates say

Nearly one in four Kentucky counties have no nurse trained to conduct sexual assault exams, according to a new statewide report from Louisville Public Media, highlighting uneven access to specialized, trauma-informed forensic care for survivors of sexual violence.

The reporting focuses on the role of a Sexual Assault Nurse Examiner, or SANE, a highly trained credential that includes education, collaboration with local advocates and prosecutors, and knowledge of criminal proceedings. Advocates and clinicians say the difference is not only collection of evidence, but the time, expertise, and coordination needed when emergency departments are managing multiple life-threatening emergencies at once.

Megan Allen, a sexual assault nurse examiner and emergency department manager at Pikeville Medical Center, described providing care in a region where the nearest hospital certified to offer a nurse trained to conduct sexual assault exams available around the clock is more than 90 miles away. She said the specialized credential matters because patient needs can quickly compete with other urgent medical cases, including injuries, cardiac emergencies, and sepsis, all of which can demand immediate attention while a sexual assault exam is performed.

Allen said emergency room nurses should be able to collect Sexual Assault Forensic Exam kits, often called SAFE kits, but said it is crucial to have a nurse on staff who is not only following instructions from the kit. In the account, Allen emphasized that caring for survivors in emotionally and physically devastating circumstances requires more than a procedural checklist and that having an experienced examiner available can affect how smoothly forensic steps are carried out during the earliest, most time-sensitive window after an assault.

The report says Kentucky has increased the number of trained clinicians over the past decade, but that gaps remain across the state. It describes a patchwork system in which some counties do not have a SANE at all, while others may lack consistent around-the-clock availability, leaving survivors and families to navigate distance and delays for specialized forensic care.

Advocates interviewed for the story said efforts continue to expand training and coverage so that no survivor is left without proper care. They also pointed to the practical challenges of recruiting and retaining clinicians for a niche, training-intensive role and coordinating those clinicians with community partners responsible for prosecution and victim support services.

As Kentucky seeks to close those coverage gaps, the reporting underscores a public safety question as well as a health-care one: when evidence collection and forensic documentation are delayed or depend on distant referral centers, survivors may face additional burdens at a time when timely, accurate examinations are crucial to both medical care and the integrity of any future legal process.