Fearless 4.25.22: Meet the state's first sexual assault forensic response coordinator

Good morning and happy Monday! April has gone by in the blink of an eye, but there are a few more events that I’d like to highlight before we waltz into May.

This Thursday, Business Record Editor Emily Barske and I will be hosting a virtual conversation on representation of women in leadership. Join us at noon!

April is also sexual assault awareness month. I talked with Sara Hulen, who is the state’s first sexual assault forensic response coordinator, about her role.

Have a great week!

– Emily Kestel, Fearless editor

Representation matters – especially in leadership. The latest data from the Equal Employment Opportunity Commission shows that in Iowa’s private sector, women held 30% of executive-level leadership positions and 40% of midlevel management positions. Furthermore, women of color made up just 3% of leaders at the executive level and 8% in midlevel management.

So what’s the deal?

In our first event of the Fearless Focus series, we’ll talk about why these disparities exist and what can be done to address them.

To preview the discussion happening at noon on April 28, we asked our speakers to answer: "What’s one barrier that you continue to see for women who currently hold leadership positions or women who want to advance into leadership positions?"

Here’s what they said.

Amy Kristof-Brown, dean, Tippie College of Business, University of Iowa
"The continued lack of equal distribution of responsibility for homes, child care and elder care. Although many men have made significant progress toward being more involved in their family lives, and almost half of women in the U.S. are their family’s main income provider, women still bear the majority of responsibility for domestic and care responsibilities. Until these activities are shared equally, many women will continue to be held back from all that they could achieve professionally."

Tiffany O’Donnell, CEO, Women Lead Change
"Women are not alone in facing cultural and societal barriers. I consider being underestimated in the past and, at times today, a barrier AND a motivator. Identifying when it happens to me has allowed me to wear a lens that sees when it happens to others. In the interest of moving forward, l offer this well-known advice from an unknown author: ‘Never underestimate the power of a woman’s intuition. Some women can recognize the game before you even play it.’"

Kelly Winfrey, director of graduate education and assistant professor, Greenlee School of Journalism and Communication, Iowa State University
"One challenge I think women face in leadership, or aspiring to leadership positions, is the feeling that they must do everything, say ‘yes’ to everyone, and do it all perfectly. Women are often socialized to be people-pleasers and take care of others, which makes it hard to say ‘no’ to something that you don’t want to do or that doesn’t help your career. We need to feel empowered to do things our way, to say ‘no’ when we don’t have time or just don’t want to take on work because no one else will do it."

Position: Sexual assault forensic response coordinator, Office of the Attorney General of Iowa
Hometown: Des Moines
Family: Husband Chad and daughter Evie, 7
Education: Truman State University
Age: 43
Contact: sara.hulen@ag.iowa.gov

In 2021, the Iowa Legislature passed a bill that would create a sexual assault forensic examiner program within the attorney general’s office. The person in charge of the program would be tasked with maintaining a list of all sexual assault nurse examiners (SANEs) and oversee their training.

SANEs help patients who have experienced a sexual assault or abuse, and collect any evidence – through what’s often referred to as "rape kits" – that could be used in a court of law, should the patient choose to press charges.

In January 2022, Sara Hulen was hired to run the program, serving as the state’s first sexual assault forensic response coordinator.

Previously, Hulen worked at juvenile detention centers in Iowa, Missouri and Colorado. From 2012 to 2020, she worked at Polk County Crisis and Advocacy as a sexual assault response team coordinator and advocate for those who experienced violent crime, which most commonly included sexual assault and homicide. Just before coming to the attorney general’s office, she also worked as a victim liaison on the felony docket at the Polk County attorney’s office.

The following conversation has been condensed and edited for clarity.

What do you do in your current role, and what are your goals?

Right now, I'm in the process of collecting information of where SANEs are at and where the biggest gaps are around the state. The first goal is to get more SANEs trained. We're going to start training nurses in July. After that, hopefully the circle of nurses will be much larger, and then we can work on the protocols and how we're going to make it work in rural communities. I also have to provide a two-hour training by July to hospital people about basic sexual assault stuff: what a SANE is, what a sexual assault response team is, what collecting a kit looks like.

My other goal, as silly as it seems, is to have more information out there. With survivors, there's a lot of self-blame. I have found that many cannot sleep at night thinking about this, so they will Google what to do. I have looked at every single hospital’s website, and very few – maybe two – have anything mentioned about sexual assault and sexual assault services at all. So my hope is to have better information out there, so when people are Googling in the middle of the night, "Where do I go? What do I do?" it’s there, rather than having to make an awkward phone call.

My other area of concern is pediatrics. Currently, 95% of the SANE nurses that we have in Iowa are adolescent-adult trained. That’s 13 and above, or in some areas like Polk County, 12 and above. But for the birth-through-11-or-12 population, there are very, very few pediatric SANEs in the state of Iowa – maybe 10 or less. The good part of that is that kids are usually late disclosers. So typically it's been ongoing and by the time they disclose, it's not something that just happened. It's like, you're riding with your kid in the car and they say, "Hey, Mom, Uncle Bobby did this to me," and the last time that he saw them was in the summertime, so they're not going to have an exam. Those cases are served by child protection centers, and they would just do a forensic interview with them. But the bigger concern is with the ones who say, "Mom, I just got home from Joey's house and his brother did something to me." Services for them are very much lacking, in my opinion. People would drive for hours in the middle of the night with their kid to get services. We're doing a big disservice to kids. Child sexual abuse is very prevalent, and the window for child sexual abuse to get evidence is much smaller.

Roughly how many SANEs are there in Iowa, and what’s your goal?

On my list, there are just under 350 that are actively providing services. That's just the people that I've been able to get in contact with. I do know there are others who maybe are SANE-trained but aren't active. My goal would be to have at least five SANEs at each treatment facility. If each facility had five, that would be enough to cover for somebody being on vacation and having somebody be on duty all the time. You wouldn’t be taking someone away from their kids. They’re allowed to have personal lives and not be on all 24/7.

The other thing that's kind of getting started are telehealth SANE services. It is approved through the International Association of Forensic Nursing. However, my personal opinion is that it should be a last resort. I just feel like it's such an intimate thing that somebody comes in for, that having someone on a computer screen telling the nurse what to do just seems very impersonal. I think the best option for a survivor is to have a trained person in the room with them.

In the state of Iowa right now, there's no law saying that a sexual assault exam has to be performed by a SANE. Currently, any emergency physician can do it. Any nurse can do it. If they don't know how to do it, there are instructions on the little box that tell them what to do. That's heartbreaking for me knowing that if I went in for an exam that someone could just be reading instructions on the box. If I was having a heart attack, and they're like, "Let me go through my book and see the instructions on how to treat you," I would not feel very great about my decision to go get help.

Other than lack of access to SANEs, what are some of the barriers that people who live in rural parts of the state face compared with people who live in places like Des Moines or Iowa City?

Everybody knows everybody. I think sometimes victims don't want to go to a certain hospital because maybe their mom works there, or their mom's best friend is the ER nurse. Culturally-specific speaking, there are people [in rural and urban areas] who don't speak English. That's obviously an obstacle. We do have some great culturally specific programs that do good work around Iowa, but there’s only a few of them. They can't be everywhere in the state at the same time. I also think for our LGBTQ community, especially in rural communities, [they’re often not as accepted]. I would feel scared if I didn’t know how I was going to be treated [when receiving sexual assault services], knowing that, "You don't accept who I am anyways."

What do you hope to see in your area of work in the next five or 10 years?

My hope is that services become better, more available and more consistent. One of my friends recently passed the anniversary of her assault. She was telling about her experience, which happened in Tennessee, but it’s still applicable here. She had gone to the hospital after she was assaulted and sat there for hours and hours. Then they came in and said, "Oh, we don't do that here. You need to go to a different hospital." By that time her phone died and her dad lost his car. They went to another hospital and got services there, but her experience was just horrible. That should never have happened. That’s another reason why I want that kind of information on websites. My other hope is more people being held accountable and being believed.

My hope is that people are being held accountable and people are being believed. My biggest frustration is in Hollywood or the media, where any time a celebrity is an alleged person to do something, it's "Well, she's only doing it because of this." What does someone get out of coming forward and being attacked in every which direction?

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For decades, women have generally worked in environments designed by men, for men.

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If you or someone you know has been sexually assaulted, the following resources are available:

If you have experienced sexual assault, you can call the national hotline at 800-656-4673. The Iowa Coalition Against Sexual Assault can connect you to resources in your area if you aren’t aware of victim services agencies.
Find the closest providers for comprehensive sexual abuse services in this map from the Iowa attorney general’s office.
Check out tips from the Rape, Abuse & Incest National Network for talking with survivors of sexual assault when someone opens up to you.
Read a victim impact statement from Chanel Miller, who was sexually assaulted by former Stanford swimmer Brock Turner, that she read at his 2016 trial. "To girls everywhere, I am with you. On nights when you feel alone, I am with you. When people doubt you or dismiss you, I am with you. I fought every day for you. So never stop fighting, I believe you."

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