After sitting in Stanford Hospital’s emergency room for three hours in early June, repeatedly throwing up and crying, a sexual assault survivor couldn’t take it anymore. They left without receiving a sexual assault forensic exam (SAFE), unable to bear waiting another hour for a qualified nurse to arrive to collect any DNA evidence from their body, ask details about what happened and perform a head-to-toe examination—an often painful process added onto an already traumatizing experience.

This 24-hour SAFE Program—offering what’s commonly known as rape kits—started as a pilot on Stanford’s campus in February 2020, part of an expansion to offer sexual assault survivors a less traumatizing option for care in the north and south pockets of Santa Clara County, also adding a location in Gilroy.

Since 1987, the Santa Clara Valley Medical Center in San Jose was the only location survivors in the South Bay could access these hours-long exams, which suggest survivors try to avoid showering, using the restroom, changing clothes or even combing their hair.

Maia Brockbank, former co-director of the Stanford’s Sexual Violence Prevention and Survivor Support committee, has heard similar stories of what she calls “atrocious” care in Palo Alto, from accounts of survivors spending 90 minutes in the backs of police cars and paying up to $150 in round trip cab fares trekking to VMC, to simply not seeking any health care at all.

“The fact that these bare minimum expectations have failed time and time again, it's really disheartening,” Brockbank said. “I brought this issue up to administrators a couple of weeks ago and they haven't even heard of it, which is pretty wild. I don't know how much that's playing dumb or true ignorance.”

A group of undergraduate advocates first identified the extent to which Stanford’s SAFE Program had failed its mission.

Originally intending to craft a final project demystifying the new sexual assault services, students instead discovered there was no private designated site for SAFE exams after the emergency department “took it back” for training. Gynecological exam rooms in the ER were instead being resterilized prior to forensic exams—a time consuming task during which survivors simply wait and sit in their trauma in public spaces, where they are at risk of being identified by others or even found by perpetrators.

Victims were also being triaged by multiple different ER staff members, forcing them to retell their trauma repeatedly, in part due to the difficulty of hiring qualified, trained nurses.

These requirements—including specific requests from top county elected officials—were confirmed as missing from the program by Kim Walker, the nurse manager for VMC’s SAFE Team, and on June 22 the Board of Supervisors approved a prioritized audit, conducted by independent consultant Harvey Rose, for all three sites in San Jose, Palo Alto and Gilroy to analyze patient experiences such as intake triage, wait times and exam privacy.

A spokesperson from Stanford Health Care said staff welcomes evaluation and "embraces the spirit of continuous improvement."

"We have not received any patient complaints regarding the Santa Clara Valley Medical Center (SCVMC) Sexual Assault Forensic Exam (SAFE) program at our location," the statement said. "In collaboration with the SCVMC SAFE Program, Stanford Health Care successfully meets all regulatory requirements and currently provides the most sensitive, supportive, and highest quality care to both adult and pediatric survivors of sexual violence."

Answers for these discrepancies may begin to come to light June 30, during the Health and Hospital Committee’s Wednesday agenda, when staff will hear from community members, VMC employees and Stanford officials.

Following email chains and a Zoom meeting with advocates, Patrick Dunkley—vice provost for institutional equity, access, and community and special advisor to President Marc Tessier-Levigne—said June 18 that staff had begun conversations with Stanford Health Care and hoped to return with a resolution within a week, according to emails obtained by San Jose Inside.

Dunkley promised a “collective sense of urgency to resolve this as soon as possible,” but no reports have yet materialized. County staff confirmed no formal response had been provided to government officials as of June 25.

Santa Clara County Supervisor Joe Simitian said none of these concerns had been brought up during two previous progress reports, presented most recently January 19.

“The need for these services is going to continue, and if anything, the need for these services has grown in recent times,” Simitian said. “I want to make sure right now that the system serves survivors the way it should, and that just can't wait.”

Brockbank said it’s difficult to measure the full impact of subpar services, since it's a sensitive subject many people don’t discuss, and most survivors don't even realize that there is an expectation for better care.

“That's a horrible way to go about creating changes: having to hear about these sexual assault survivors who were assaulted because of some flaw in the system, or retraumatized or had poor care or no prevention, or all of these failures,” Brockbank said. “It's super disheartening to know that that's how the system operates.”

Brockbank said the lack of services is now even more frightening, as freshmen started moving onto campus at the end of June for summer courses. Especially as more classes are being offered due to Covid, she said a pool of really vulnerable students may now face issues of assault in the coming days and weeks.

Her concerns aren’t unfounded.

Several studies have dubbed the first few months of school the “red zone,” when a majority of sexual assaults occur, primarily due to new students unfamiliar with campus resources and networks. A 2019 survey from the Association of American Universities found 26% of female undergraduates experienced nonconsensual sexual contact by physical force or inability to consent—a 3% increase from 2015.

“I was on campus in the spring and I can tell you that socializing is happening, parties are happening, drinking is happening, assault is happening,” Brockbank said. “It feels like the urgency and timing of this is something that not the administration is not really connecting the dots on effectively and that's really frightening and terrifying to think about.”

Editor's note: This story was updated to include a comment from Stanford Health Care. We regret the omission.