For the most part, rural parts of South Dakota have gone without specialized nurses who help treat survivors of sexual assault. But underserved areas are getting more resources through a statewide program, including telehealth assessments.

In the past couple years, an initiative has worked to get more health-care professionals onboard in South Dakota as Sexual Assault Nurse Examiners. Kristi Kranz, who heads the SANE program through the Center for the Prevention of Child Maltreatment, said these individuals play an important role in working with someone who's just experienced a very traumatic event, "both on the medical side, to ensure that they're receiving the best medical care, and then also on the forensic side, to collect the potential evidence if the victim wants to move forward with reporting that to law enforcement."

One of the emerging elements of the program is through Avera Health, which now offers around-the-clock telehealth exams in rural emergency rooms. Trained SANE staff help with patient assessments as the person is being tended to by onsite medical personnel. Avera provides these exams at 17 locations in South Dakota.

Prior to these options, said Jen Canton, SANE supervisor at Avera Health, survivors often were sent two to three hours to the state's largest cities, such as Sioux Falls or Rapid City. She said having immediate, specialized care much closer helps prevent setbacks in an assault survivor's attempt to confront the situation.

"It kind of sets the pathway for their healing," she said. "So, if they have a bad experience in the ER, it can negatively affect their healing. If they have a positive one, it sets them on a positive road to healing."

She said launching this part of the program has been slow at times due to the pandemic, but all 17 sites now are in a position to help. Canton said being ready this time of year is crucial, because holidays can see an uptick in assault and domestic-violence cases. Leaders behind South Dakota's broader SANE program have said it has been renewed for another year of funding, in hopes of training more nurses.

Economic supports could be the key to reducing intimate-partner violence, which claims the lives of dozens of Ohioans each year.

Research from the Ohio Domestic Violence Network showed during times of financial insecurity, people are at a higher risk of violent behavior.

Rebecca Cline, director of prevention for the Network, explained individuals are targeted for intimate-partner violence, often because they are marginalized and made vulnerable by oppressive systems.

"High rates of poverty, high rates of unemployment, high rates of social disorganization," Cline outlined. "All of those things contribute to conditions that create additional risks for violence perpetration and victimization."

Cline also pointed to a new Centers for Disease Control and Prevention report which found a nearly five times greater firearm homicide rate in counties with the highest poverty levels, and it mentions economic supports as a pathway to gun-violence prevention. Data show 4.5 million women have reported being threatened with a gun by an intimate partner.

The research suggested strengthening economic supports for families by expanding access to affordable child care, health care, transportation and housing, making the Ohio Earned Income Tax Credit fully refundable, and raising wages.

Cline pointed out a minimum-wage worker in Ohio earns less than $20,000 a year, but a single parent of two needs nearly four times as much to earn a living wage.

"$76,000 a year," Cline asserted. "And that's to be able to afford housing, transportation, child care and all the other things a family needs to live sustainably and efficiently instead of in scarcity. "

She emphasized policies can be most effective with a holistic approach, bringing local and state partners together.

"The smarter we get about our prevention work, the more evidence that begins to emerge about where we need to go, the more promising our prevention work will be," Cline stated. "And it's long-term work."

Cline added measures to improve community connectedness can reduce violence, which can be as simple as picking up litter or planting flowers. Individuals can also talk to their elected leaders about policies to help reduce violence.

Kentucky will soon begin developing a coordinated, statewide system for reporting crimes related to intimate-partner violence. Gov. Andy Beshear's signature on Senate Bill 271 mandates data collection on domestic violence.

Advocacy groups say they have struggled for years to verify state records of these types of cases, and have relied primarily on media reports and information from local shelters.

Andrea Robinson, executive director of Oasis Women's Shelter in the Owensboro area, said homicides involving an intimate partner are likely underreported.

"By us collecting this data, it's going to potentially help shape laws that will better protect victims," Robinson stated.

The new law requires Kentucky State Police, Administrative Office of the Courts, State Medical Examiner's Office, and coroner's office to gather and report annual domestic violence-related data to the state's Criminal Justice Analysis Center.

According to the University of Kentucky's Violent Death Reporting system, between 2005 and 2017, Kentucky saw 462 documented deaths related to intimate partner violence.

Meg Savage, chief legal officer for the Kentucky Coalition Against Domestic Violence, said like any other public health issue, communities, advocacy groups and social-service agencies need accurate reporting in order to develop best practices and prevention strategies.

"Even to start looking at, you know, domestic violence homicides and what might be the underlying causes and trends and red flags, etc.," Savage outlined. "That could help us improve our systems."

Robinson believes inaccurate data is masking the prevalence of household violence in the Commonwealth.

"I think it's important for us to be able to recognize how many victims are murdered and losing their lives," Robinson emphasized. "Because it brings awareness to how real and serious domestic violence is."

If you or someone you know is experiencing abuse, call the National Domestic Violence Hotline at 800-799-7233 for help, 24 hours a day, seven days a week.

Justice for survivors, removing a legal loophole for spousal rape and age-appropriate sexual violence education are the policy priorities Ohio lawmakers will be hearing more about today. It's the 10th annual Advocacy Day for the Ohio Alliance to End Sexual Violence.

Emily Gemar, the group's manager of public policy, said folks from throughout the state will meet with more than three dozen legislative offices to discuss issues related to sexual violence that impact families and communities.

"Voices from the metropolitan areas, the rural areas and the areas where there's one rape-crisis center serving five counties," she said. "It definitely is through our collective voice that we are able to make change for the better."

Gemar said legislation they'll discuss includes House Bill 105, known as Erin's law. It would require age-appropriate instruction on sexual-abuse prevention for K-through-12 students. They'll also talk about House Bill 121, which would remove Ohio's spousal exemption for rape, and House Bill 266, which ends the statue of limitations for criminal prosecutions of rape and extends the limitation period for civil action by victims of childhood sexual abuse.

Ryn Farmer, deputy director of Crime Victim Services, explained that survivors of sexual violence often stay silent because they don't feel safe reporting their assault.

"Either they've had negative experiences with law enforcement; they're afraid of retaliation by the person that sexually assaulted them; they're worried they won't be believed," she said. "We shouldn't put that time limit on how a survivor is able access justice and then, heal through the trauma."

Farmer encouraged Ohioans to learn how they can help those affected by sexual violence, which could include advocacy work as well as donations of time or money.

"We always appreciate our local folks in the community volunteering or giving donations to local rape-crisis centers," she said. "Many of us have lost funding over the last few years, and have been negatively impacted by COVID as well. And so, whatever capacity they have to be involved, we welcome that."

Advocates also will tout the importance of Rape Crisis Center funding in the Attorney General's budget. It started in 2014 and now stands at $10 million for 2022. The Advocacy Day events will be livestreamed. Learn more online at oaesv.org/AdvocacyDay.