The #MeToo movement put a nationwide spotlight on how the victims of sexual assault are treated. Now, local officials are looking at how to make it easier for victims to bring perpetrators to justice.

District Attorney Lori Frugoli is developing a plan to return the forensic exams conducted after sexual assaults from Vallejo to Marin County. She hopes to present the Board of Supervisors with a budget for the move within the next six months.

Although the model for administering exams locally is still being worked out, Ms. Frugoli told supervisors last week that such a model must be thoughtful, thorough and sustainable, “so that we know it can stand the test of time.”

Sexual assault exams were outsourced to the Napa-Solano Sexual Assault Nurse Examiners and Sexual Assault Response Team—or SANE/SART—in 2011 because of the low frequency of cases in Marin. With just two or three dozen reports of sexual assault each year in the county, it was difficult to sustain the requisite number of nurses trained in collecting evidence at Marin General Hospital.

Prior to the relocation, nurse midwives were on call to conduct the exams, but their child delivery responsibilities at times conflicted with their SART nurse responsibilities.

There were other difficulties, too: nurse midwives were not trained to conduct exams on children, who as a result were sent to Oakland to see specialized nurses. In addition, testimony by midwives was more vulnerable to defense lawyers in court, as the nurses were less familiar with exam protocol than are dedicated SART nurses, who undertake hundreds of exams a year.

According to a report by the Marin Women’s Commission SART committee, the move to Vallejo mitigated staffing problems and provided a high level of care, but it also increased the time victims spend dealing with the aftermath of sexual assaults. It takes 46 minutes to get from Point Reyes Station to Marin General on a Thursday evening, and an hour and 47 minutes to get to Kaiser in Vallejo, according to the report.

“Imagine that you have been a victim of a horrible, horrible physical crime, and now you have to sit in a car and drive up [Highway] 37 to get your examination,” the chair of the Marin Women’s Commission, Catherine Hargrave, told the Board of Supervisors on May 21.

Currently, after a law enforcement officer conducts an initial inquiry following a report of sexual assault, a victim either rides with the officer or travels in his or her own vehicle to Kaiser Permanente Vallejo Medical Center. Exams may be done within 120 hours of an assault, and family members are allowed to be with victims.

At the Vallejo hospital, officers wait while victims are taken to a special area where a SART nurse conducts their exam, which take two to four hours on average. Victims are provided an advocate through the East Bay-based Community Violence Solutions, to ensure their needs are being met throughout the process.

An absence of data on trial outcomes, wait times and demographics made it difficult for the three-person SART committee to judge how the 2011 move to Vallejo affected rape cases. They also weren’t able to determine if the number of reported rapes changed in the years after the move because of disparate data across multiple law enforcement agencies. The county plans to gather this previously uncollected data to assess the move back to Marin in the future.

Supervisors were receptive to the idea of returning the exams to Marin. “I can only believe the number of exams will go up, given that it will be more convenient,” Supervisor Damon Connolly said.

There are challenges and costs, however. The county must find enough nurses who are willing to be on call, work with women in delicate situations, and testify in court. Ms. Frugoli said her office has already identified registered nurses who understand what it takes to be a SART nurse and can work in Marin. They can’t be fully trained, however, until there’s a budget for it.

“We don’t have that bottom-line number on what the big picture would cost,” Ms. Frugoli said, as it depends on the number of exams, which cost $2,080 each. Thirty-two exams were undertaken on Marin County residents in Vallejo in 2018.

Currently, the county allots $65,000 annually with Napa-Solano SANE/SART to conduct the exams at Kaiser Vallejo.

The executive director of the nonprofit, Lisa Lewis-Javar, told the Marin Independent Journal in November that moving the exams to Marin will require an estimated initial expenditure of $250,000 and an ongoing annual cost of $100,000.

Any trained SART nurses for Marin will presumably need to rotate to other areas to maintain proficiency, though nurses must always be able to respond to the exam location within an hour. Ms. Frugoli believes it will take at least three nurses to establish a program in Marin.

She also has been in preliminary talks with two hospitals about hosting the exams free of charge.

The Marin Women’s Commission, an appointed body that advises the Board of Supervisors, went beyond the call to move the exams, and urged supervisors to take “a more holistic approach to all forms of physical abuse.” In Sonoma and Alameda Counties, multiple agencies are integrated in one building, called family justice centers, to look at physical violence as a whole. Nonprofits, law enforcement agencies, mental health programs and other social service agencies all work together in these centers.

Although Ms. Frugoli said such programs are wonderful, she cautioned that creating one in Marin would be a huge undertaking. “One battle at a time, and for me, I just want to get the exams done in Marin,” she said.