Sexual Assault Kit Initiative (SAKI)

Law enforcement is often the first responder when a sexual assault case has been reported to police. When law enforcement arrives to the crime scene, they first address the immediate concern of the victim, including safety and if medical care is required. They will also conduct the initial interview with the victim to gather facts about the assault, obtain victim information, and collect evidence from the crime scene.

Often, law enforcement is the first to explain to the victim the importance and benefits of a medical forensic exam. Additionally, they advise the victim about the right to receive the exam even if they elect not to participate in the criminal justice process, and that neither the victim nor their insurance can be billed for the exam.

Law enforcement will also transport the victim to a local health care facility if the victim agrees to the exam. If a medical practitioner is not available at the time of arrival, law enforcement will then transport the victim to a hospital. If the victim elects not to have law enforcement transport them to the health care facility or hospital, a friend or family member can drive the victim using a private vehicle.

A.R.S. §13-3806

If a victim has suffered a gunshot wound, knife wound, or other physical injury, the attending medical practitioner must report the incident to law enforcement. The victim, however, can retain the right to decline to speak with law enforcement, except under mandatory reporting requirements where a child may be the victim of an assault. To learn more about mandatory reporting requirements, go to https://dcs.az.gov/report-child-abuse.​

In Arizona, a Sex Crimes Evidence Kit (SCEK) is the standard kit that is used statewide for the collection of evidence during a medical forensic exam. The SCEK will not be destroyed regardless of lab results, unless the allegation was “unfounded”, meaning the evidence proved the crime was not committed. 

All evidence found from SCEKs may be used in future cases regardless of the outcome of the initial sexual assault investigation. All evidence in a sexual assault case must be retained by the investigating agency pursuant to A.R.S. §13-4221.

A medical forensic exam is a resource that is available to all sexual assault victims regardless of age, race, gender or sexual orientation. It is a thorough evaluation of the body to assess injury and infection, and to provide immediate medical care and treatment. Including medical referrals if needed for emergency contraception, and/or vaccines for Human Immunodeficiency Virus (HIV), Hepatitis B, and the Human Papilloma Virus (HPV). 

An informed consent for the exam, both verbally and in writing must be obtained by the victim, with the exam preferably performed immediately following the assault, or within 120 hours or five (5) days after the assault.

The preferred medical practitioners who conduct the exams are Forensic Nurse Examiners (FNE). They are specifically educated and clinically trained examiners with the primary responsibility of addressing the physical, psychological, and emotional needs of the victim after an assault. They are also trained in the collection and preservation of forensic evidence that may be used in a criminal investigation.

There is no cost for the exam or for the collection of evidence, and the victim nor their insurance can be billed for either process. Under Arizona law, medical providers are prohibited from billing victims or their insurance for the cost of a medical forensic exam (A.R.S. §13-1414). 

Under the provision of the Violence Against Women Act (VAWA) of 2005, all states must ensure that all victims of sexual assault have access to a medical forensic exam, even if the victim chooses not to report the assault to law enforcement. These non-reported cases afford victims access to medical care and counseling support while allowing important evidence to be collected.  

More on the Forensic Medical Exam

Prior to a medical forensic exam, victims should try to avoid activities that can damage evidence such as bathing, showering, using the restroom, changing clothes, and/or combing one’s hair.

However, if any of these activities have occurred, a medical forensic exam can still be performed. It is recommended for the victim to place all items including belongings and clothing that were worn at the time of the assault in paper bags to help preserve evidence. The bags should be provided to the medical practitioner from the attending health care facility or hospital prior to the exam. The victim will receive authorization forms requiring the victim’s approval to have the bagged contents collected and analyzed, with evidence released to law enforcement.

Non-Reported Evidence

In cases where the victim chooses not to report the assault to law enforcement, but does agree on receiving a medical forensic exam; the non-reported evidence will be stored in accordance under the national practice of one (1) year. 

Every assault is different and there is no one typical reaction or behavioral norm from victims following an assault. The one-year timeframe allows the victim the opportunity to regain oneself prior to reporting the assault. Sexual assault is a traumatic experience and often can impact a victim’s emotional reaction and memory following the incident, causing the victim to be unable to provide law enforcement with a full account of the assault. 

During the medical forensic exam, the medical practitioner will collect a DNA sample from the victim, either cells from the mouth or blood in a blood tube that will be used as a reference standard to identify the victim following a DNA analysis. They may also collect body surface, anal, genital, penile and vaginal swabs, and debris or foreign material that may be found on the victim’s body. These forensic samples are collected based on the scenario of the assault. 

Urine samples and/or blood tubes are also collected if the use of alcohol or illegal substances are reported or suspected. The medical practitioner then places all swabs, including clothing worn by the victim in individual bags, and documents and photographs all findings such as cuts, abrasions and lacerations.

DNA Analysis

DNA analysis is an analytical process that allows for the testing of forensic evidence, SCEKs, and other crime scene items to develop DNA profiles that can inform a criminal investigation. If a DNA profile is developed, it is compared to DNA profiles from submitted reference standards, such as victims, suspects, or consensual sex partners to determine whether they are a possible contributor of the DNA profile. 

There are 4 steps to DNA testing:

1. Extraction (Normal and Differential): Extraction removes the DNA from the substrate.

2. Quantitation: The amount of DNA present in any sample is quantified to determine how much DNA is present.

3. Amplification: Copies of the DNA are made to provide a sufficient amount of DNA for instrumental analysis.  

4. Typing: Genetic analyzers will be used to complete the DNA testing.

Combined DNA Index System (CODIS)

Eligible DNA profiles are then entered into the Combined DNA Index System (CODIS) that is supplied by the Federal Bureau of Investigation (FBI) to support the criminal justice DNA database used at a national, state, and local level to store and search DNA profiles contributed by crime laboratories. CODIS can link DNA evidence obtained from crime scenes, and compare crime scene evidence to database profiles, thereby identifying serial criminals or possible sexual perpetrators. 

For a DNA profile to be eligible for CODIS, it must meet three major requirements:

1. There must be documentation that a crime was committed.

2. The DNA sample was recovered directly from the SCEK or other crime scene evidence.  

3. The non-victim DNA profile is attributable to the alleged perpetrator. And if applicable, an elimination sample will be requested from a consensual partner.

Elimination samples are needed in sexual assault cases when victims indicate they have engaged in consensual sexual relations within close proximity to the sexual assault. The elimination sample will not have an impact on the collection of the SCEK from the victim, nor the testing process to develop the DNA profile from the sexual assault evidence. 

If a CODIS hit should occur with the entered DNA profile, it is considered an investigative lead that requires additional testing by qualified forensic scientists and confirmation from law enforcement. 

Following, if a reference sample is needed from the suspect that is identified through the CODIS hit, law enforcement will locate and interview the suspect, as well as obtain a court order to identify the physical characteristics of the suspect, and/or a search warrant to collect a DNA sample. 

CODIS is an integral system that is used for data analysis of forensic evidence. Not only does it provide leads to sexual perpetrators, but also links cases within a state and across the nation. It is also beneficial in excluding potential suspects, reducing wrongful arrests, and assisting in the exoneration of wrongfully convicted people.

Victim Privacy and Confidentiality

To protect the privacy and confidentiality of the victim, data entry and sensitive information are limited to those who are directly involved in the case and working directly with the victim pursuant to A.R.S. §§13-4430 and 8-409 (privileged info), and 13-4434 and 8-413 (victim privacy).

The role of the victim advocate is to assist the victim in understanding their rights and options following an assault.

Sometimes, a survivor may not feel comfortable speaking to a family member or friend about the incident. A specialized victim advocate who is well-versed in trauma, grief, and traumatic stress can help the victim build trust and rapport.

The advocate is available to refer the victim to local resources and help them understand the criminal justice system. They can connect the victim to organizations offering legal relief, support groups, emergency shelters and counseling. Advocates can also attend court hearings and assist victims with asserting Victim's Rights throughout the prosecution process.

Advocates can also refer victims to the Crime Victim Compensation Program and Address Confidentiality Program. The Crime Victim Compensation Program provides financial assistance to victims who may have experienced a financial loss as a direct result of the sexual assault; such as expenses for physical harm, mental distress, and economic loss resulting from the crime. The Address Confidentiality Program helps victims from being located by the perpetrator through public records. It provides a legal substitute address and confidential mailing services to the victim and their families.

Victims of sexual assault often experience a violation of safety and loss of control. This distress can be exhibited in what may seem like counterintuitive behavior. Responses may include a flight, fight or freeze reaction resulting from a neurochemical release. Understanding these behaviors is integral to decreasing the risk of re-traumatization of a sexual assault.

Sexual assault victims may react to a traumatic incident in many ways. A victim may experience physical symptoms or stress reactions like exhaustion, inability to sleep, headaches, and muscle tension. Additionally, feelings of shame, embarrassment, fear, anger, and betrayal are common after sexual assault, and can exacerbate feelings of mistrust.

It is also important to note that a victim may not want anyone to know about the assault and may be afraid that family members or friends may reject them, or fear further harm or harassment from the perpetrator.

Post-traumatic Stress Disorder (PTSD) 

Sexual violence is among the most common causes of Post-Traumatic Stress Disorder (PTSD). PTSD is a psychiatric disorder that can occur following the experience or witnessing of a life-threatening event such as military combat, natural disasters, serious accidents, or violent personal crimes such as sexual assault. People who suffer PTSD often relive the experience through nightmares and flashbacks, suffer from intrusive thoughts, have difficulty sleeping, and feel detached or estranged. ​

A victim's age does not matter. It is a crime to engage in sexual activity with anyone who does not consent, or cannot consent, such as a child or person who lacks mental capacity, including someone who is intoxicated. 

However, there are tougher penalties for sexual assault offenders whose victims are under the age of 15. Penalties depend on the age of the victim, age of the perpetrator, prior felony convictions, and other criminal circumstances.​

Mandatory Reporting Requirements for Underage Victims

Under Arizona law (A.R.S. § 13-3620.A), any person that has the responsibility of caring for a child or minor under the age of 18, and has observed or examined the individual and has reason to believe they are a victim of sexual assault, must report the information to law enforcement or the Arizona Department of Child Safety (DCS). To learn more about mandatory reporting requirements, visit the DCS website. 

Department of Child Safety (Child Abuse Hotline) 

1-888-767-2445/1-888-SOS-CHILD

Reporting Sexual Assault of Elderly and Disabled People

Similarly, if one suspects or has the reason to believe that an elderly or disabled person is the victim of sexual assault, they should report the information to law enforcement or Adult Protective Services.

Vulnerable elders and disabled people are often unable to protect themselves because of medical or health conditions, and physical or mental impairments; and often lack the understanding or capacity to report an assault. 

Under Arizona law, it is a crime when a victim is unable to distinctively comprehend the sexual nature of the conduct, or is incapable of understanding or exercising the right to refuse to engage in sexual conduct with another person (A.R.S. § 13-1401). 

Remember, a report should be made when any person reasonably believes there is suspected sexual assault regardless of age, race, gender, or sexual orientation. A report is only a request for an investigation. The person making the report does not need to prove the assault or abuse. The investigation process and validation reports are the responsibility of law enforcement and protective service workers.

Adult Protective Services 

1-877-767-2445/ 1-877-SOS-ADULT

Area Agency on Aging 

24-hour Senior HELPLINE 

​602-264-HELP (4357)

The National Sexual Assault Kit Initiative (SAKI) is administered by the Bureau of Justice Assistance (BJA). It provides funding through a competitive grant process to support multidisciplinary teams engaged in the reform of jurisdictional approaches to sexual assault cases resulting from evidence found in previously unsubmitted SCEKs and in need of DNA analysis. 

The goal of BJA, is to create a coordinated response to ensure resolution to sexual assault cases, whenever possible, through a victim-centered approach, and to build jurisdictions that will prevent the conditions that can lead to high numbers of unsubmitted SCEKs in the future. 

Inventory of SCEKs 

In 2016, SAKI awarded the PPD a grant in the amount of $1.5 million to inventory, submit, and test all unsubmitted SCEKs in inventory.  

Prior to Year 2000, PPD had only hard copies of data from impounded SCEKs that were in inventory, requiring a coordinated effort in collecting the information. Therefore, a team of staff was established and tasked with physically counting each SCEK and verifying those in need of DNA testing. 

This team was also tasked with developing a new records management system (RMS) that could upload the collection of the SCEK data, and code and track each kit. By the end of 2015, the team completed counting and the data entry process of all inventoried SCEKs. 

Following in Year 2016, when the SAKI grant was awarded, the PPD immediately established a sexual assault multidisciplinary working group consisting of forensic scientists, sex crimes investigators, forensic nurse examiners, attorneys, and victim advocates. 

The primary goal of the group was to develop a testing process for the previously unsubmitted SCEKs that were in inventory, and investigate each case utilizing a victim-centered approach. The group also revised policies and procedures to implement a “test all” requirement ensuring that all new SCEKs that were collected in conjunction with a criminal investigation, were submitted to a laboratory for DNA testing. 

To date, the group’s efforts have enacted a systemic change, with added programmatic activities that include sexual assault training, investigations, evidence processing, and public education on ​sexual assault. To learn more about SAKI, visits https://sakitt​a.org/​. ​​