HomeMy WebLinkAbout15-Police Department
CITY OF SAN BE"ADINO - AEQUESteoA COUNCIL ACTION
From: Daniel. A. R:lbbins,
Chief of Police
Dept: Police
Date: 1-9-92
Subject: Western Nurse Specialists
Synopsis of Previous Council action:
None
Recommended motion:
Adopt resolution.
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Signatu
Contact person:
Lieutenant Wes Famer
Phone:
384-5770
Supporting data attached:
~tely
Amount: $21,225
Ward: SEN.t;tN6 B'iD{;NeE
-J\ss.~ .t: Rcpai?/B.dlh'1:t 3l'OCk-
Source: 001-220-5313:) ;:?li'"G
Finance: Ov--L r] JJ ~.U l(
FUNDING REQUIREMENTS:
Council Notes:
75-0262
Agenda Item No. I.~
CITY OF SAN BE~RDINO - REQUESTeoR COUNCIL ACTION
STAFF REPORT
PROBLEM
Environmental problems at county hospital (lengthy delays, poor
environment for victims) have resulted in less-than-desirable
treatment of sexual assault victims. These victims, who are
extremely vulnerable, should receive a higher quality of care.
Higher quality of care, combined with a higher quality of forensic
examination may result in a higher conviction rate for rapists
(the current conviction rate is estimated at 1%).
Western Nurse Specialists (WNS) has proposed to provide to the San
Bernardino Valley a specialized rape victim examination service.
This proposal is a logical extension of the current blood with-
drawal contract and parallels an interest by Chief Robbins (as
expressed in the staff study for the original proposal).
Legislation has been passed by the State which will allow counties
to charge local agencies (the city) for the costs of sexual as-
sault examinations (effective 1/1/92). Given the current fiscal
condition of the county, I have no doubt that the county will
soon be charging us for the costs of these exams.
County Hospital is currently negotiating with WNS to have them
take over forensic sexual assault examinations. The city has two
choices: (1) allow the county to continue their services and pay
the costs that they will charge us for exams performed by WNS, or
(2) contract directly with the vendor of the services.
RECOMMENDATIONS
I recommend entering into a contract with Western Nurse Special-
ists (WNS) to provide a specialized Sexual Assault Response Team
(S.A.R.T.). (The recommendation assumes that WNS will conduct the
examinations at county hospital.)
FINDINGS
Summarv of SART prooosal
Briefly, WNS has created a service which uses a specially trained,
24 hour on-call nurse specialist. This specialist must be paid
for standby time and those expenses are currently being paid by a
consortium of law enforcement agencies. The concept assumes that
economies of scale will result in the lowest cost and therefore is
designed to enlist as many agencies as possible to join in sup-
porting the service. I anticipate that the current monthly
"subscription" charge ($600 - used to fund the standby time)
should reduce with increased funding to WNS from other sources.
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The service provides the following:
- a trained, on-call Sexual Assault Nurse Examiner .
- local facilities for the examination of the sexual assault
victims
coordination of a Sexual Assault Response Team (consisting of
the nurse examiner and a rape crisis counselor working together
with the law enforcement agency)
- provision of a colposcopic exam, and
- forensic photography during the examination.
Oualitv of Environment
It can be argued that due to shrinking fiscal resources, the San
Bernardino County Medical Center is providing the highest quality
of environment to patients that it can under the circumstances.
However, my experience and observations reveal that the "highest
quality" that they can provide is far lower than what should be
provided to victims of sexual assault. Certainly, the scene that
greets a victim upon arrival at county hospital can usually best
be characterized as chaotic--particularly if they are ushered into
E.R. through the police officer's entrance.
WNS has informed us that the Medical Center will be providing
their company with an examination room that will be separate from
the E.R. environment. They have also told us that the hospital
will be turning over sexual assault examinations to WNS. This
was confirmed in conversations that my staff had with Bill Hale
of county hospital.
WNS currently has a facility set up at Rancho Linda Hospital in
Fontana in which the room is designed to help assuage victims of
sexual assault. I anticipate that WNS will be able to set up the
same kind of environment at county hospital (possibly including
the provision of a private waiting area for victim interviews by
officers).
Oualitv Q! Forensic Examinations
My staff attended a briefing conducted by WNS in which comments
were made by law enforcement officials, rape crisis agency per-
sonnel, members of the district attorney's office and a physi-
cian, Dr. Herb Giese. During that briefing, Dr. Giese made a
number of comments concerning his professional observations of
the quality of exams provided by physicians at county hospital.
Dr. Giese indicated that E.R. physicians typically are oriented
towards treating victims with a large degree of trauma. Addi-
tionally, they have received little, if any, training in forensic
medicine (gathering and interpreting physiological evidence,
court testimony). Consequently, they are usually not oriented or
not capable of properly conducting a sexual assault victim exami-
nation. It would seem logical that the quality of prosecutions
of suspects might improve with a corresponding increase in the
quality of the exams of sexual assault victims.
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Dr. Giese also stated that he was familiar with the program in
which nurse specialists are trained to examine sex~al assault
victims. It was his opinion that these specialists actually do a
better job than physicians in performing these forensic exams.
The colposcopic examination is a higher level of exam than usually
provided to sexual assault victims. It allows the examiner to
locate forensic evidence that would not normally be visible to the
naked eye.
The other participants at the briefing expressed overwhelming
support for the concept including the D.A.'s office and other law
enforcement officials.
Costs
Direct Costs
In addition to the "subscription" cost, there will be fees for
"dry runs" (the callout of a nurse and the nurse is unable to
examine a victim due to no fault of his/her own) and for the
specialized sexual assault examination kit ($250 per kit). This
kit is substantially more comprehensive than the kit provided by
the county.
Additionally, legislation has been passed allowing county facili-
ties (after the first of the year) to charge local agencies for
rape examinations. I received information (some time ago) from
county hospital which led me to believe that their charge for a
rape examination would be approximately $150-200 if they performed
the exam. However, in light of their anticipated contract with
WNS, I doubt that the lower fee that is stated will still apply
(since they will be paying more than that to WNS). WNS has
informed me that their charge to "non-subscribing" agencies would
be substantially higher (due to the agency not sharing with the
other subscribing agencies the cost of the on-call nurse special-
ist).
Assuming that there are 141 rape cases in any given year (the
estimated number of rapes for 1990), I calculate direct costs as
follows:
Subscription Costs
~ Ki..t.l.;.
Total
$ 7,200
35.250
42,450
Indirect Costs
There are a number of indirect costs which can be calculated.
However, I will only describe obvious costs for which reasonable
estimates can be inferred. Calculations are based on the cost of
a step four police officer (including benefits).
WNS guarantees a 30 minute response time for their staff. Addi-
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tionally, the rape cr~s~s counselor will become responsible for
transporting the victim home after the exam. If interview times
are not factored into the equation (I assume that the interview
times would be equal whether or not the service is employed), the
total turnaround time for an officer from the time that he/she
begins transporting the victim to the time that he/she is back in
service in the city would be 40 minutes. While the savings may be
substantial, I have not added in a calculation which computes the
value of the officer being able to "drop off" the victim and allow
the victim to be transported home by WNS (or the rape counselor).
I will assume for purposes of this study that the average wait
time for an officer is 3 hours at county hospital. This is based
on an average of two surveys of wait time at county hospital
conducted recently.
The following are the calculated indirect costs:
Reduction in officer wait time (Calculation: 3 hours X 141
cases X $27.57/hr) = $11,662.
Net decrease in indirect costs to the city = $11,662.
Net increase in cost to the city (direct costs minus net
decrease in indirect costs) = $30,788.
Note: the increase in costs to the city does not include the
cost savings realized from other activities that officers
could pursue rather than waiting at local facilities (gener-
ally considered as "dead time"). This "free" patrol time
could be considerably more valuable than a cost analysis
might indicate.
Fundina
Asst. Chief Harp has located funds in the "Accident Repair/ROll-
ing stock" account. To date, we have expended only $6,985.45.
Last year we only spent $39,000.00 for the 90-91 budget.
$70,000.00
-6,985.45
91-92 Budgeted
91-92 Spent to Date
SUb-Total, 91-92
90-91 Actual Expenditures
63,014.55
-39,000.00
$24,014.55
Balance
optional Fundina Sources
WNS has told me that they are actively pursuing other funding
sources (via grants). They are hopeful that the service can
eventually be provided at no subscription cost to the city.
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Senate Bill No. 768
CHAPTER 824
An act to amend Section 13823.95 of the Penal Code, relating to
sexual assault.
[Appro,'ed by Governor October 11, 1991. F'~ed "ith
Secretary of State October 14, 1991.1
LEGISLATIVE COUNSEL'S DIGEST
SB 768, Vuich. Sexual assault victims: examination costs.
Existing law pro\ides that with regard to costs incurred by
specified medical facilities for the examination of a victim of a sexual
assault when the examination is performed for the purposes of
gathering evidence for possible prosecution, the costs shall be
charged to the county if the examination is provided at a county or
city hospital, or hospital district facility, and to the local
governmental agency in whose jurisdiction the alleged offense was
committed if the examination is performed at a private hospital or
in the office of a qualified health care professional.
This bill would provide, instead, that the costs of these
examinations would be charged to the local governmental agency in
whose jurisdiction the alleged offense was committed regardless of
where the examination is pro\ided.
The people of the State of California do enact as folloll's:
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SECTlO:-.l 1. Section 13823.95 of the Penal Code is amended to
read:
13823.9;;. :'\0 costs incurred by a qualified health care
professional, hospital, or other emergency medical facility for the
examination of the \ictim of a sexual assault, as described in the
protocol developed pursuant to Section 13823.5, when the
examinatioll is performed, pursuant to Sections 13823.5 and 13823.7,
for the purposes of gathering evidence for possible prosecution, shall
be charged directly or indirectly to the victim of the assault. Those
costs shall be treated as local costs and charged to the local'
governmental agency in whose jurisdiction the clleged offense was
committed.
Bills for these costs shall be submitted to the law enforcement
agency in the jurisdiction in which the alleged offense was
committed which requests the examination.
Tile law enforcement agency in the jurisdiction in which the
alleged offense was committed which requests the examination has
the option of determining whether or not the examination will be
performed in the office of a phYSician and surgeon.
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RESOLUTION NO.
RESOLUTION OF THE CITY OF SAN BERNARDINO "AUTHORIZING THE
EXECUTION OF AN AGREEMENT WITH WESTERN NURSE SPECIALISTS, INC., TO
PROVIDE EVIDENCE COLLECTION FROM RAPE VICTIMS FOR THE SAN
BERNARDINO POLICE DEPARTMENT.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERNARDINO AS FOLLOWS:
SECTION 1. The Mayor is hereby authorized and directed to
execute on behalf of said City an Agreement with Western Nurse
Specialists, Inc., to provide evidence collection from rape
victims for the San Bernardino Police Department. A copy of said
Agreement is attached hereto, marked Exhibit "A", and incorporated
herein by reference as fully as though set forth at length.
SECTION 2.
The authorization to execute the above-
referenced Agreement is rescinded if the parties to the Agreement
fail to execute it within sixty (60) days of the passage of this
Resolution.
I HEREBY CERTIFY that the foregoing Resolution was duly
adopted by the Mayor and Common Council of the City of San
19 Bernardino at a
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meeting thereof, held on the
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December 27, 1991
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AGREEMENT
THIS AGREEMENT is entered into as of this day
of , 1992, by and between the CITY OF SAN
BERNARDINO, A Municipal Corporation of the State of California,
(hereinafter "CITY"), and WESTERN NURSE SPECIALISTS, INC.,
(hereinafter "SPECIALIST").
RECITALS
A. WHEREAS, SPECIALIST is a health service which provides
evidence collection for law enforcement agencies; and,
B. WHEREAS, CITY desires to contract with a health service
for the purpose of evidence collection from rape victims for the
San Bernardino Police Department; and,
C. WHEREAS, SPECIALIST is willing to provide such evidence
collection for the San Bernardino Police Department; and,
D. WHEREAS, SPECIALIST has submitted a proposal to CITY,
a copy of which is attached hereto as Exhibit "A";
NOW THEREFORE, the parties hereto agree as follows:
1. Definitions.
a. As used hereinafter, the term "nurse" shall
include those who are certified in the State of California as
Registered Nurses, Licensed Vocational Nurses, Paramedics,
Phlebotomists and any and all other persons certified in the state
of California to collect evidence from a rape victim.
b. A "dry run" is when a SPECIALIST is called out for
a collection of evidence and was not able to collect such evidence
through no fault of SPECIALIST.
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RESOLUTION OF THE CITY OF SAN BERNARDINO AUTHORIZING THE
EXECUTION OF AN AGREEMENT WITH WESTERN NURSE SPECIALISTS, INC., TO
PROVIDE EVIDENCE COLLECTION FROM RAPE VICTIMS FOR THE SAN
BERNARDINO POLICE DEPARTMENT.
day of
, 1992, by the following vote, to
wit:
Council Members:
AYES
NAYS
ABSTAIN
ABSENT
ESTRADA
REILLY
9 HERNANDEZ
10 MAUDSLEY
11 MINOR
12 POPE-LUDLAM
13 MILLER
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18 of
City Clerk
The foregoing Resolution is hereby approved this
day
, 1992.
W. R. Holcomb, Mayor
City of San Bernardino
Approved as to form
and legal content:
JAMES F. PENMAN"
City Attorney
By:
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December 27, 19~'1
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1 2. SPECIALIST agrees to provide evidence collection
2 services in a manner consistent with its proposal, except as
3 otherwise provided in this Agreement. CITY agrees to use
4 SPECIALIST exclusively for the services contained in this
5 Agreement.
6 3. The term of this Agreement shall be for one (1) year
7 subj ect to termination by either party upon thirty (30) days
8 written notice to the other. This Agreement will automatically
9 renew and continue from year to year unless terminated by either
10 party in the manner aforesaid.
11 4. SPECIALIST shall make available to the San Bernardino
12 Police Department sufficient information to enable the San
13 Bernardino Police Department to contact the on-call nurse,
14 including, but not limited to, 24-hour on-call phone number,
15 address, and names of nurses, alternate or backup number, if any,
16 5. A Sexual Assault Response Team consisting of a
17 SPECIALIST nurse and a Rape Crisis Advocate will be present at the
18 evidence collection location to take care of the victim. The
19 response time of the SPECIALIST nurse will be approximately 30
20 minutes.
21 6. The location for the evidence collection services will
22 be San Bernardino County Medical Facility at 780 East Gilbert
23 Street, San Bernardino, California 92415-0935. A secondary
24 location will be the Rancho Lindo Hospital located at 7625 East
25 Avenue, Fontana, California 92336. Should it become necessary to
26 use another location, the CITY will be notified of an appropriate
27 new location selected by SPECIALIST.
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7. The CITY agrees to pay the following sums for the
following services to be billed monthly, and payment is due within
30 days of the billing date:
On-Call Fee Per Month . . . . .
Rape Victim Evidence Collection
Dry Run Rape Victim . . . . . .
$600.00
$250.00
$100.00
SPECIALIST agrees that there shall be no price increase for
a one-year period, after which,. fees may be increased by a
reasonable amount, provided that any increase will be limited to
the percentage increase in the Consumer Price Index for medical
services for the Los Angeles, Anaheim and Riverside areas.
8.
SPECIALIST agrees to make available on an on-call basis
nurses to testify in court, if needed.
Compensation for court
time is a matter to be negotiated between SPECIALIST and the
Office of the District Attorney.
9. SPECIALIST shall take out and maintain during the life
of this Agreement such medical malpractice, public liability and
property damage insurance naming CITY as additional insured, as
shall insure CITY,
its elective and appointive boards,
commissions, officers, agents and employees from claims for
damages for medical malpractice, personal injury, including death,
as well as from claims for property damage which may arise from
SPECIALISTS' or its officers' agents', or employees' performance
of this Agreement, whether such performance be by SPECIALIST, its
officers, agents, or employees, or by anyone directly or
25 indirectly employed by SPECIALIST, its officers, agents, or
26 employees, and the amounts of such insurance shall be
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January 22, 1992
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1 for medical malpractice, public liability and property damage
2 insurance in an amount not less than One Million Dollars
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($1,000,000) combined single limit.
10. SPECIALIST undertakes and agrees to defend, indemnify
and hold harmless the CITY and its officers, agents and employees
from and against all suits and causes of actions, claims, costs of
li tigation, damage or liability of any nature whatsoever, for
death or injury to any person, including the officers, agents and
employees of SPECIALIST, or damage or destruction to any property
of either party hereto or third persons in any manner arising by
reason of or incident to the performance of this Agreement.
This hold harmless provision shall not apply to any
breach of the terms of this Agreement or to any wrongful or
negligent acts or omissions by the City of San Bernardino Police
Department or their officers, agents, employees, representatives
and other third parties.
11. Any notice required by this Agreement may be given by
either party to the other by means of personal delivery or First-
Class Mail, as follows:
AS TO CITY:
AS TO SPECIALIST:
Daniel A. Robbins
Chief of Police
SAN BERNARDINO POLICE DEPT.
466 West Fourth Street
San Bernardino, CA 92401
Faye Battiste-Otto, R.N., President
WESTERN NURSE SPECIALISTS, INC.
255 North Cielo Road
Suite 339
Palm Springs, CA 92262
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January 22, 1992
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1 IN WITNESS WHEREOF, the parties hereto have executed this
2 Agreement on the date first written herein.
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ATTEST:
City Clerk
Approved as to form
and legal content:
JAMES F. PENMAN,
City Attorney
By: f1../I'i^JW t - Pe1A.-~
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RJM/bg [Western.Agr]
CITY OF SAN BERNARDINO
By:
W.R. Holcomb, Mayor
City of San Bernardino
WESTERN NURSE SPECIALISTS, INC.
By:
Faye
Pres
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January 23, 1992
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WNS PROPOSAL FOR PHYSICAL EVIDENCE COLLECTION
FROM RAPE VICTIMS
Western Nurse Specialists, Inc. proposes to supply R.N.'s 24
hours per day, seven days per week for the purpose of
collecting the physical evidence from the sexually assaulted
victim. The primary location for this evidence collection
will be the Rancho Lindo Hospital at 7625 East Avenue,
Fontana. A back-up facility for injured victims will be
available. The evidence shall be collected in accordance
with the requirements of the Sheriff's Crime Lab and the
California Medical Protocol for Examination of Sexual
Assault Victims (OCJP). The response time of the nurse to
the evidence collection location will be 30 minutes. Upon
arrival of the victim and the law enforcement officer, a
team (the nurse and the rape crises advocate) will be ready
to immediately take care of the victim. The evidence
collection procedure will begin immediately, taking
approximately three hours to complete.
OBJECTIVES:
1. To work as a team with law enforcement agenCies, medical
facilities, rape crises advocates, support services and the
District Attorney's Office to collect and preserve evidence
from sexually assaulted victims in a professional manner so
that sexual offenders will be prosecuted and convicted.
2. To reduce officer down time by eliminating the many
wasted hours officers now experience at the hospital
emergency rooms.
3. To provide a more efficient, trauma free and helpful
experience for the victim to promote better cooperation of
the victim in the investigative process and to encourage the
reporting of rapes.
PRICE FOR WNS SERVICES:
1. On-Call Fees
There will be a charge to the law enforcement agency of
$600.00 per month for a 24 hour per day on-call nurse.
2. Evidence Collection Fee
There will be a charge to the law enforcement agency of
$250.00 per rape victim for the physical evidence
collection. The dry run charge is $100.00.
1/6/92
fyhibit "(1' Pc; ID~;l
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3. Court Time Fee
The charge to the District Attorney's Office for the nurse's
court time will be $75.00 per hour.
4. Facility Fee
There will be no charge for the use of the Rancho Lindo
Hospital Examination Facility.
5. Laboratory Fees
There will be no charge to the law enforcement agency for
laboratory fees.
BILLING
Billing of all fees will be done on a monthly basis.
ADVANTAGES OF WNS PROGRAM:
1. Eliminates hospital hunting by law enforcement agencies
to find a hospital willing to perform the evidence
collection.
2. Reduces law enforcement agency downtime waiting at
hospital emergency rooms.
3. Eliminates additional unnecessary trauma to the victim
caused by unnecessary waiting, exposure and public contact
at the hospital, etc. .
4. Quicker, more efficient and reliable evidence collection
that will ensure the District Attorney better evidence for
prosecution and conviction of the suspect.
5. Ready availability of WNS nurses for court testimony at
rate much lower than charged by physicians.
6. Eliminates the law enforcement agency's responSibility
to provide transportation home for the victim after the
evidence collection has been completed.
7. WNS has developed expertise in rape evidence collection
by performing evidence collection from the suspect at jail
facilities for the past eight years.
1/6/92
Exk,bit I/A~ Pc; ~ <Sf ~