A new Cato paper uncovers a disturbing reality: the very regulations meant to protect sexual-assault survivors are blocking them from care when they need it most.

Dr. Jeffrey A. Singer, Akiva Malamet, Spencer Pratt, and Michael F. Cannon describe how entrepreneurial nurses created the specialty of sexual assault nurse examiners (SANE) to provide compassionate care and reliable evidence collection to rape victims. SANEs improve both recovery and prosecution outcomes. Only 17–20% of hospitals have SANEs on staff, however. As a result, in many states, survivors wait hours or even days before receiving a sexual assault forensic exam — sometimes giving up entirely. Inadequate access to SANE services deepens the trauma of sexual assault and lets rapists go free.

Six states (AL, IL, KY, MD, NJ, NC) have imposed licensing requirements or similar regulations that shrink the workforce, stifle tele-SANE innovation, and push qualified nurses out of practice. State licensing regulators have a track record of reinstating physicians with histories of sexual misconduct, who can then provide sexual assault forensic exams, but are sidelining nurses who have the empathy and training to help rape victims.

The paper argues:

• Licensing reduces access. Survivors face longer waits, greater trauma, higher costs, and rural service gaps.

• Licensing blocks innovation. It blocks competent nurses, including low-cost/high-quality tele-SANE programs, and flexible training models.

You can read the full paper here.

To reach the authors about this topic, please feel free to contact Emily Salamon at esalamon@​cato.​org