Halton Community Response Protocols for Sexual Assault and Domestic Violence

Transcription

1 Halton Community Response Protocols for Sexual Assault and Domestic Violence Criminal Proceedings Police Lay Charges Police Do Not Lay Charges Counselling/Support Police No Police Crisis Intervention SURVIVOR Legal Civil Suit Ongoing Counselling Accompaniment to Medical/Legal Services Criminal Injuries Compensation Board No Treatment Medical Medical Treatment Forensic Evidence Gathering No Forensic Evidence Gathering Flow Chart of System Access Adapted from: Internal Protocols, Sexual and Domestic Violence Treatment Centre, Nina s Place Joseph Brant Memorial Hospital, 2001

2 TABLE OF CONTENTS BACKGROUND INFORMATION: Background.. 5 Training 6 Why Develop A Protocol. 7 As A Community, We Believe. 8 Principles Of Halton's Sexual Assault/Domestic Violence Response Protocol 9 SELF ASSESSMENT: Self Assessment Tool Self Assessment Checklist MEDICAL SERVICES: Nina's Place, Joseph Brant Memorial Hospital 16 Sexual & Domestic Assault Treatment Centre for the Region of Halton Halton Healthcare Services,. 18 Oakville-Trafalgar Memorial Hospital Site Milton District Hospital Site William Osler Health Centre,.. 21 Georgetown Hospital Campus Halton Region Health Department, Health Protection Services Division,. 24 AIDS/STD Sexual Health Clinic Services Program VON Halton, People in Crisis. 27 CCAC, Community Care Access Centre of Halton. 29 CRIMINAL/LEGAL SERVICES: Halton Regional Police Service, Victim Services Unit Halton Regional Police Services, Sexual Assault Community Protocol Halton Regional Police Services,.. 35 Domestic Violence Community Protocol 2

3 (cont'd) CRIMINAL/LEGAL SERVICES: Victim/Witness Assistance Program 37 Ministry of the Attorney General, 41 Halton Crown's Office COUNSELLING AND SUPPORT SERVICES: Sexual Assault and Violence Intervention Services of Halton SAVIS, (formerly the Halton Rape Crisis Centre) Halton Women's Place Halton Children's Aid Society Halton Family Services.. 54 Services For Abused Women Halton Trauma Centre 58 Burlington Counselling and Family Services.. 59 Halton Adolescent Support Services.. 62 Halton Hills Community Support and Information 65 Women's Information & Support Centre of Halton 67 Distress Centre of Oakville.. 68 Halton Multicultural Council SIGNATURES: Signatures of Agencies TELEPHONE NUMBERS: Telephone Numbers (Community Resources).. 76 SWAP members Distributed by

4 BACKGROUND INFORMATION Background..5 Training....6 Why Develop a Protocol..7 As a Community, We Believe.8 Principles of Halton's Sexual Assault and Domestic Violence Response Protocol 9 4

5 BACKGROUND The community of Halton has had a long history of concern for survivors of both sexual assault and domestic violence. Since the 1970's there has been a rape crisis centre, a women's shelter and a centre for childhood sexual abuse. In addition, many community groups have developed services and supports for survivors. One group, the Sexual and Wife Assault Project (SWAP), made up of community agencies, agreed that it was important for the community to develop a comprehensive response protocol so that all victims of sexual assault/domestic violence would receive a consistent, knowledgeable and compassionate response from any agency in Halton. At the same time as this was developing (in 1999), two police officers from Halton Regional Police Service became aware of the Regional Sexual Assault Centre in Peel Region. Both Detective Constable Mike Antinori and Detective Constable Chris Lawson, whose work involved investigating reports of sexual assault, domestic violence and assisting victims, believed that the Region of Halton needed a Regional Centre for Sexual Assault and Domestic Violence. Hospitals in the Region were approached to be the Regional Centre. Joseph Brant Memorial Hospital in Burlington embraced the idea of becoming a Regional Sexual Assault/Domestic Violence Centre and Nina's Place officially opened in December Together with Nina s Place, the community of Halton is committed to enhancing the quality of service provision for victims/survivors in this Region. To make the community response effective, SWAP initiated two community forums with the stakeholders and service providers to formulate the statements of beliefs and principles. Individual service providers developed their own protocols to clearly illustrate the role of their agency in responding to sexual assault and domestic violence. This information was compiled into this manual which represents the community s commitment to serving survivors in the Halton region. 5

6 TRAINING For the protocol to be successfully implemented in the Halton Region, training of all front line staff and service providers continues to be essential. Cross-sectoral training allows participants to explore the role each service has in responding to victims/survivors of sexual assault and domestic violence. This serves to enhance communication, working relationships and alleviate historical barriers. All stakeholders will hopefully, have a clearer understanding of the beliefs and principles of the protocol as well as the options available to survivors. The goal is to provide a consistent, compassionate, comprehensive and knowledgeable response from all service providers within Halton to survivors. Objectives of the training session include: Participants will clearly understand the role of each agency/service in responding to victim/survivors of sexual assault/domestic violence. Participants will have the opportunity to communicate and develop relationships with other sectors of the protocol. Participants will increase understanding of "best practices" around assisting victim/survivors. Participants will have increased appreciation for the services that are offered outside their own sector and a better understanding of the "big picture" in Halton Region around services for those who are victims/survivors of sexual assault/domestic violence. Participants will have a clear understanding of the beliefs and principles of the protocol, as well as options available to survivors. Adapted from: "How to Develop a Sexual Assault Response Protocol for your community" Ministry of the Solicitor General, Victim Services Unit

7 WHY DEVELOP A PROTOCOL? There are many benefits for communities that decide to develop a protocol. A comprehensive protocol can: Clearly illustrate the role of each agency/service in responding to victim/survivors of sexual assault; Reduce the risks for any victim from "falling through the cracks"; Foster open communications and enhance working relationships; Educate agencies and the community at large on the issue of sexual assault; Serve as a quality control mechanism for the service delivery; Allow for feedback directly from victim/survivors to the service providers; Maintain accountability of service providers to the victim/survivors and increase responsiveness; Alleviate barriers and historical misunderstandings; Increase informal problem-solving with less adversarial approaches; Encourage everyone to keep the "big picture" in mind; Generate co-ordinated advocacy efforts; Build inter-agency relationships; Promote the development of "best practice approach" to victim/survivors and move agencies beyond what they "are doing" to what they "should or could be doing" to assist victim/survivors; Enhance the quality of service provision. Source: "How to Develop a Sexual Assault Response Protocol for Your Community" Ministry of the Solicitor General, Victim Services Unit

8 AS A COMMUNITY, WE BELIEVE: Abuse is a misuse of power Anyone can be a victim Sexual assault and domestic violence are serious social problems connected to all forms of oppression. Abuse isolates, diminishes, weakens and destroys Sexual assault and domestic violence affect the individual and the entire family Sexual assault and domestic violence victimize the entire community Each person reacts differently to becoming a victim of sexual assault or domestic violence. Some individuals may display behaviours that may not be understood or considered appropriate. It is essential that these behaviours be viewed as coping strategies and the victim/survivor is responding in a way they believe necessary for their survival. That each victim/survivor must be treated with as much sensitivity, dignity, openness, care, comfort, and respect as is humanly possible in order not to revictimize. 8

9 PRINCIPLES OF HALTON'S SEXUAL ASSAULT/DOMESTIC VIOLENCE RESPONSE PROTOCOLS: RESPECT AND DIGNITY Every individual deserves to be treated with dignity, compassion and respect. We acknowledge the intrinsic worth of each victim/survivor. QUALITY CARE We provide qualified, knowledgeable, professionally trained and openminded staff who understand that trauma affects memory and decisionmaking. Staff will also understand diverse needs and have knowledge of their own limitations. COMMITMENT Each agency and service has clear, well-developed and integrated protocols around their response to sexual assault and domestic violence. There is ongoing commitment to professional development for those in management, supervision and delivery of service. INCLUSIVENESS We are inclusive and equitable and sensitive to gender, race, age, ability, sexual orientation, culture, socio-economic and religious issues. CHOICES Our services are client-driven. We support clients to make their own choices including medical, legal, counselling and living arrangements. We respect the right of the individual to self-determination. 9

10 ACCESSIBLE Services are available 24 hours a day, seven days a week from all areas of the Region. Services are well co-ordinated and we ensure that programs are comprehensive and adequate to meet the community's needs. Services are inclusive and available to all community members. ACCOUNTABILITY Services for victims/survivors of sexual assault and domestic violence must be accountable to those who use their services. COMMUNITY AWARENESS AND EDUCATION We are working towards educating, preventing and stopping the violence in ourselves and in the Halton community. We help those in power to realize these issues exist in Halton and have a great impact on health and wellbeing. We will ensure that the community has awareness of these response protocols. TIMELY RESPONSE There is expediency in response and referral for all victim/survivors. NON-JUDGEMENTAL A victim/survivor's experience of sexual assault or domestic violence is to be supported, respected and taken seriously. ADEQUATE FUNDING We advocate to obtain funding for adequate programs and facilities to meet the needs of our community. 10

11 ADVOCACY Ending domestic violence and sexual assault is everyone's responsibility. The Sexual Assault/Domestic Violence Emergency Response Protocol must address the issue of violence at both the individual and systemic level in order to create a non-violent society. SUPPORT Support includes legal, medical, counselling and financial support and is available according to the needs and choice of each victim/survivor. SENSITIVE ENVIRONMENT Victims/survivors need a sensitive environment that is supportive, nonclinical and safe. SAFETY The safety of the victim/survivor of sexual assault or domestic violence (and children or family) should be the primary focus of any intervention. CO-ORDINATED SERVICES Our community response protocol is well-developed, integrated, clear and organised so that we offer seamless service delivery. There will be appropriate follow-up and resource provision for the victim/survivor and family. CONFIDENTIALITY All services will endeavour to protect the confidentiality of the victim/survivor and family. 11

12 SELF ASSESSMENT 12

13 Self Assessment Tool This self assessment tool reflects the general intervention principles in dealing with any survivor of sexual assault and/or domestic violence. The underlying goal of any intervention is to empower the victim/survivor by providing support, services and information which will allow them to make choices for themselves. It is fundamental to inform the victim/survivor of all the options open to them regardless of your personal beliefs or biases. It is equally important to be aware of the diversity of victims/survivors and their experiences, as well as the range of reactions that can follow a traumatic experience. All interactions should be based on the principles laid out in the Halton Community Response Protocols for Sexual Assault and Domestic Violence. This checklist does not reflect the specific roles and procedures of each agency. Its purpose is to allow service providers to evaluate and reflect back on the interactions they have with victims/survivors and to ensure ongoing commitment to the protocol. It can also be used as an ongoing training tool. 13

14 Self Assessment Checklist In assisting a victim/survivor, indicate ({) which of the following you feel you achieved during the intervention(s). When I first met the survivor, I: introduced myself asked how s/he would prefer to be addressed explained the kind of assistance I could attempt to provide assessed immediate risk and safety issues (this is ongoing throughout the process) told the survivor that s/he had the option of having someone present for support ensured that the survivor understood her/his options and choices regarding medical treatment, reporting to the police, shelter and counselling resources maintained confidentiality in accordance with agency policy standards told the survivor the limits of confidentiality and the possibility of records being subpoenaed if the case went to court actively listened to what the survivor had to say was emotionally supportive treated the survivor with respect and dignity was inclusive in my interaction (to gender, race, age, ability, sexual orientation, culture, socio-economic and religious issues) made the survivor as comfortable as possible explained all procedures/interventions in detail before they were done let the survivor control the intervention to the extent that this was possible offered resources and numbers to the client and discussed how to access service was available and willing to assist the survivor in obtaining services to any agency that s/he requested responded in a timely fashion to request for service discussed safety planning with the client discussed how to provide any feedback with regards to the service they received told the survivor how to contact me in the future 14

15 Medical Services Nina's Place, Joseph Brant Memorial Hospital 16 Sexual & Domestic Assault Treatment Centre for the Region of Halton Halton Healthcare Services,. 18 Oakville-Trafalgar Memorial Hospital Site Milton District Hospital Site William Osler Health Centre Georgetown Hospital Campus Halton Region Health Department,.. 24 Health Protection Services Division, AIDS/STD Sexual Health Clinic Services Program VON Halton, People in Crisis CCAC, Community Care Access Centre of Halton

16 Nina s Place, JBMH Sexual and Domestic Assault Treatment Centre for the Region of Halton (SDATC) COMMITMENTS WE WILL, WITHIN THE MANDATE OF OUR SERVICE: utilize humanitarian and egalitarian ideals, thereby acknowledging the intrinsic worth and dignity of all human beings accessing our services, and their right to inclusive and equal treatment while being sensitive to the issues related to race, ethnicity, gender, age, sexual orientation, socioeconomic status and/or abilities of individuals. We will: Provide immediate crisis intervention and support to the victim. Provide support to family members and witnesses. If needed, transport victim to Police Station, Hospital, shelter or home. Provide emotional support to victims during Police interview. Provide victim with appropriate information and referrals to community agencies. Provide emotional support and court accompaniment on request. Act as liaison between Police and victim. Continue follow up as needed. ACCOUNTABILITY: Concerns can be directed to the Manager of the Sexual & Domestic Assault Treatment Centre and/or the Director of Emergency and Community Services. All concerns will be responded to in accordance with the Human Resources manual of Joseph Brant Hospital. HOURS OF OPERATION: Seven days a week, 24 hours a day. FEE: None 16

17 TELEPHONE NUMBER(S): Crisis (905) Sexual Assault and Violence Intervention Service (SAVIS) Administration (905) ext 5708 PROCEDURES: The patient (over the age of sixteen years) will always have choice and control with regards to treatment options. Victims/survivors are triaged in the Emergency Department. May arrive from another facility (See Transfer of patient from another facility). May arrive alone. May arrive accompanied by police, friend, advocate or parent. ** Identify the person as requiring immediate care (Triage Level 2). Initial contact (Triage Nurse in the Emergency Department). Assess physical condition. Obtain baseline vital signs. Take a brief history of events. Provide sensitive, compassionate, and non-judgemental care. Contact SDATC Team Nurse when sexual/domestic assault is determined; response time is thirty minutes. Every effort will be made to ensure that patient is not left alone until SDATC Team Nurse arrives. If medical care is not required and a professional does not accompany the patient, the patient will be placed in the Emergency Department Family Room, if available, to await transfer to Nina s Place. The patient is transferred to the care of the SDATC Team Nurse on their arrival. The patient is transferred to the SDATC (Nina s Place) accompanied by the nurse. The SDATC nurse and a SAVIS crisis counsellor, along with the patient, will assess their situation The patient may involve police. The patient may consent to the sexual assault kit (the assault must have taken place within the past 72 hours). If the kit is done, it is sealed and given to police with a unique ID number if patient is unsure about pressing charges. The kit is stored for six months. If patient presents with children, a play area is available inside Nina s Place. The patient has the option to have a shower and be given new clothes and toiletries. SADTC nurses and SAVIS representative work with the patient to develop a safety plan. Follow-Up within 48 hours 17

18 Halton Healthcare Services Oakville-Trafalgar Memorial Hospital Site Milton District Hospital Site COMMITMENTS: WE WILL, WITHIN THE MANDATE OF OUR SERVICES: provide compassionate treatment to all individuals presenting to our emergency department with sensitivity to race, gender, ethnicity, age, sexual orientation, socio-economic status and/or abilities of individuals. We will: The Emergency Departments at the Hospital Sites will provide: Medical intervention and treatment Emotional support Event documentation Safe and timely transportation to Nina s Place (Joseph Brant Memorial Hospital) Linkages to community resources (Sexual Assault & Violence Interventions Services of Halton). NOTE: If an individual calls the emergency department by phone for information, we will inform them that Joseph Brant Memorial Hospital has the regional Sexual Assault & Domestic Violence Unit. ACCOUNTABILITY: Feedback regarding the quality of nature of the services provided can be directed to the Patient Care Manager Emergency Department or the Hospital Ombud. We will ensure there is clear communication with the Emergency Department at Joseph Brant Memorial Hospital prior to transferring patients to Nina s Place. A transfer form will be developed to enhance communication between the facilities. Patients will be medically cleared prior to transfer. HOURS OF OPERATION: 24 hours/day, 7 days/week 18

19 FEE: None TELEPHONE NUMBERS: Oakville-Trafalgar Memorial Hospital Site Emergency Department (Direct Line) Milton District Hospital Site Emergency Department (Direct Line) PROCEDURES: A) Initial Response Triage Nurse If the victim/survivor requires immediate medical intervention, they will be triaged to the acute area for stabilization by the Emergency Physician and nurses. If the individual does not require immediate intervention, they can be triaged to the Quiet Room. The triage nurse will explain that the regional Sexual Assault & Domestic Violence Unit (SADV) is at the Joseph Brant Memorial Hospital Nina s Place. It will be explained that we can arrange a transfer to their facility after the Emergency Physician sees them. B) Transfer to Joseph Brant Memorial Hospital Nina s Place If the individual agrees to be transferred to Nina s Place, the Emergency Physician will order the transfer. The Charge Nurse will contact the Charge Nurse in the Emergency Department at Joseph Brant Memorial Hospital to discuss the transfer. The patient must be medically cleared prior to transfer. The patient will be provided an escort and transferred by: a) Police (if they accompanied patient to department) b) If the patient does not want Police involvement, alternative transportation can be arranged (call Sexual Assault & Violence Intervention Services of Halton previously known as Halton Rape Crisis Centre) 24-hour Crisis Line (905) Administrative Line (905) c) Personal vehicle, if they were accompanied by a trusted companion d) Ambulance (if deemed appropriate) The transfer form will be completed and copies of documentation and test results will be sent to Joseph Brant Memorial Hospital. 19

20 C) Care of the Multiple Trauma Victim/Survivor When the victim/survivor s condition is critical, the Sexual Assault Team at Joseph Brant Memorial Hospital Nina s Place will be consulted. On arrival at the Hospital, the team member will contact the Charge Nurse. A STAFF name tag will be provided. The Hospital ER Physician will be responsible for the care of the patient. The nursing staff from Nina s Place will provide guidelines and direction for the care the victim/survivor. Once the critical patient is stable, the Hospital team will arrange for referral to Nina s Place for follow-up care. 20

21 William Osler Health Centre Georgetown Hospital Campus COMMITMENTS: WE WILL, WITHIN THE MANDATE OF OUR SERVICES: make the commitment to our community's sexual assault and domestic violence statements of principles and beliefs. We Will: Inform victims/survivors of sexual assault or domestic violence who phone for information to go directly to Joseph Brant Memorial Hospital (JBMH) to be treated at the Regional Sexual Assault Centre. Provide physical and emotional care to the sexually assaulted person. Provide appropriate medical treatment. Transfer the victim/survivor to Nina's Place, JBMH. Provide crisis support and referrals. ACCOUNTABILITY: Concerns regarding the nature or quality of services can be directed to the Patient Care Manager, ER, or the Medical Director of Emergency. Complaints can also be made to the Patient Ombudsman. HOURS OF OPERATION: FEE: 24 hours, 7 days a week None TELEPHONE NUMBER: , ext

22 PROCEDURES: A) Initial Response Victim/Survivor Phone Inquiries: 1. Victim/survivors who inquire about sexual assault or domestic violence care will be directed to, or informed of and provided with, the phone number of: JBMH Sexual Assault Care and Counselling Service Centre for care and treatment. Halton Rape Crisis Centre: ; North Halton Victim Services: Contact Halton Regional Police Halton Women's Place: Victims/survivors who arrive at the Emergency Department will: a) Be triaged, registered and assessed in a treatment room where an Emergency Treatment and an Emergency Assessment Flow sheet will be initiated. b) Be informed that they will be transferred to JBMH, and that the most comprehensive care will be provided for them at Nina's Place. c) Be informed and provided with the phone numbers of community support services available and of the opportunity to meet one of the representatives from the Sexual Assault Care and Counselling Centre. d) Be offered emotional support while in the emergency room. e) Be assessed by the physician who will order the transfer to JBMH. f) Have their physical injuries treated and stabilized prior to a transfer to JBMH. B) Transfer 1) If the patient agrees to be transferred to JBMH, a physician will order the transfer. The team leader at JBMH should be informed that the patient is coming before the patient leaves Georgetown Hospital. 2) The Emergency Physician will assess and stabilize the patient before the transfer takes place. 3) If the patient is accompanied by police, the police will transport her to JBMH. If the patient does not want police involvement, alternative transportation and accompaniment will be arranged. A taxi chit will be provided if no other means of transportation is available. 4) Copies of documentation and test results will be sent to JBMH with the patient. 22

23 C) Collection of Sexual Assault Evidence when Patient is too Medically Unstable to be Transferred to JBMH Contact JBMH - Nina's Place The 24 hour on-call Nurse Examiner will be contacted and travel to Georgetown Hospital Campus to do the "Kit". 23

24 Halton Region Health Department Health Protection Services Division AIDS/STD Sexual Health Clinic Services Program COMMITMENTS: WE WILL, WITHIN THE MANDATE OF OUR SERVICES: make the commitment to our community's sexual assault and domestic violence statements of principles and beliefs. We will: 1. Provide sexual health clinic services, phone support and information. 2. Offer the emergency contraceptive pill; sexually transmitted disease testing and/or immediate preventative treatment; HIV testing; pregnancy testing and counselling - all free of charge. 3. Assist survivors to understand and clarify their options and choices regarding medical treatment, reporting to police and any other issues identified. 4. Provide information and referrals to other resources and appropriate agencies (e.g. forensic testing, counselling, support services, etc.). 5. Provide follow-up sexual health care as soon as possible upon referral. ACCOUNTABILITY: Concerns regarding the quality or nature of the services can be directed to the Program Manager of the AIDS/STD Sexual Health Clinic Services Program for the Halton Region Health Department. All complaints or concerns will be responded to according to Halton Region Health Department policies and procedures. 24

25 HOURS OF OPERATION: Although the following times indicate scheduled clinic hours, if there is an indication of an emergency situation we will make accommodations to meet the client's needs. Burlington - Main Office Lakeside Shopping Village 5353 Lakeshore Road, Unit #2 Lakeside Centre for Health (beside Food Basics) Office Open 8:30-4:30 Monday-Friday (closed noon-1:00 p.m.) Clinic Hours: Tuesday & Thursday 3-7 pm Milton 217 Main Street, Suite 13-2 nd floor Open Wednesday 1:30-5:00 pm Acton Acton Youth Centre 47 Mill Street East Open Tuesday 1:30-5:00 pm Georgetown Halton Region Health Department 93 Main Street Open Wednesday 1:30-5:00 pm FEE: Counselling and treatment services are offered free of charge. However, there is a nominal fee for some medications such as the Emergency Contraceptive Pill and oral contraceptives (this fee may be waived for clients who are unable to pay). TELEPHONE NUMBERS: Burlington, Oakville, Milton: Georgetown, Acton: HALTON, ext TTY:

26 PROCEDURES: If the survivor chooses specific clinic services, a public health nurse or a physician will provide: Emergency Contraceptive Pill The Emergency Contraceptive Pill is an effective means of preventing pregnancy if given within 72 hours of intercourse. It may be offered based on the results of the health assessment. Sexually Transmitted Disease Testing and Treatment Sexually transmitted disease education for Chlamydia, Gonorrhea, Syphilis, Hepatitis B and HIV. Preventative treatment for Chlamydia, Gonorrhea and Syphilis. Testing for Chlamydia and Gonorrhea can be offered 2 weeks following the abuse/assault. Serological testing for Syphilis and Hepatitis B can be offered 3 months after abuse/assault. Hepatitis A & B vaccine is available. HIV counselling and testing. Pregnancy Testing Baseline pregnancy testing is available, as well as repeat testing 2 weeks following the abuse/assault. Comprehensive pregnancy counselling is provided with each result. Options are discussed and survivor is supported in her decision. Referrals are provided for therapeutic abortion, adoption and prenatal care. 26

27 VON Halton, People In Crisis (PIC) Program COMMITMENTS: WE WILL, WITHIN THE MANDATE OF OUR SERVICES: Make the commitment to our community s sexual assault and domestic violence statements of principals and beliefs. WE WILL: Collaborate with agencies who provide safe and supportive environments for women, youth and children experiencing abuse, neglect, homelessness, addictions, crime and mental health issues. Enhance agency services through a multidisciplinary approach that empowers clients to make healthy lifestyle choices. Assist clients in identifying their behaviors, exploring how behaviors affect and impact on others and looking at the consequences of their choices on themselves, promoting growth. Assist clients to recognize and build on their strengths and providing positive reinforcement of healthy choices Conduct health status assessments (physical, psychological, etc.) Provide screening and disease prevention measures Offer treatment for minor injuries/conditions Provide individual and group counselling sessions with clients Act as a resource person and offer accessible health resources Liaise with other professionals and make referrals as requested Complete medication checks as needed Offer staff education sessions and consultations on a variety of health issues such as diabetes or depression, to enable them to address client health needs. Participate in the designing of programs to improve delivery of care i.e. a medication orientation program for staff. Role model client advocacy and zero tolerance of abuse Provide feedback on health policies and procedures Facilitate a health conscious environment Develop health and safety resources as needed ACCOUNTABILITY: Feedback and questions can be made to the PIC Program Supervisor/Manager 27

28 HOURS OF OPERATION: Variable, each partnering agency determines the frequency of nursing visits made and at what time i.e. 2 afternoon visits per week FEE: No cost to victim/client/family. Partnering agencies cost-share with the VON based on the frequency of visits. TELEPHONE NUMBER(S): PROCEDURES: No referral process Services are offered within other agencies such as: shelters, residential facilities and programs designed for at-risk/vulnerable individuals. Services are only available to those clients living in or participating in the PIC partnering agency s services. Access Steps: Client enters agency service PIC Nurse enters agency on scheduled visit Client requests Agency staff ask Nurse introduces to see the nurse nurse to see client self and services Nurse-client interaction Client determines if a need exists Nurse provides appropriate service as needed 28

29 CCAC of Halton Community Care Access Centre of Halton COMMITMENTS: WE WILL, WITHIN THE MANDATE OF OUR SERVICES: make the commitment to our community's sexual assault and domestic violence statements of principles and beliefs. We will: Provide community based health services to eligible clients who require service and are unable to access services on an out patient basis. ACCOUNTABILITY: Feedback to any of our client services managers or the Director of Client Services. HOURS OF OPERATION: FEE: 8:30 a.m. - 10:00 p.m days/year N/A TELEPHONE NUMBERS: or locally PROCEDURES: Any person may refer someone for CCAC services. A medical referral is not required. For certain services, medical orders will be required (e.g. IV antibiotics). Access is either through our hospital based case managers (inpatient or ER/OPD) or via our information and referral team available through our office 8:30 a.m. - 10:00 p.m. daily. Client consent must be obtained prior to initiating services; however, anyone can call to initiate a referral for service. Clients may also self refer. 29

30 Criminal/Legal Services Halton Regional Police Service,.. 31 Victim Services Unit Halton Regional Police Service, Sexual Assault Community Protocol Halton Regional Police Service,.. 35 Domestic Violence Community Protocol Victim/Witness Assistance Program Ministry of the Attorney General, Halton Crown's Office 30

31 Halton Regional Police Service Victim Services Unit Community Protocol COMMITMENTS: WE WILL WITHIN THE MANDATE OF OUR SERVICES: Work in partnership with the Victim/Witness Assistance Programme (VWAP), municipalities, community and social service agencies and other local organizations to promote the development of an integrated services delivery framework for providing assistance to victims, including the provision of safety planning for victims where necessary. We will provide equal treatment for all people accessing our services, while being sensitive to the challenges of race, ethnicity, gender, age, sexual orientation, socio-economic status and or abilities of individuals. PROCEDURES: Whenever possible refer the caller to Nina s Place recognizing that, in a time of crisis, the caller may not wish to call another agency, but prefer to talk to the person with whom they first made contact. If the person declines the referral we will: Provide immediate 24-hour crisis assistance to victims of sexual assault and domestic violence by attending the victim s home if referred by the Halton Regional Police Provide support to family members and witnesses. When required provide transportation for the Victim to the Police Station, Hospital, shelter or back home. Provide emotional support to the victim during the Police interview. Explain Police procedures and ensure the victim is prepared for any actions throughout process while acting as liaison between Police investigator and victim. Provide information about medical proceedings. Provide the victim with information of safety planning, or the availability of safety planning information and assistance within the community. Explain court procedures, provide support and assist the victim/witness to undertake their involvement in the court process with a reasonable level of comfort. Continue follow up with victim as needed. 31

32 ACCOUNTABILITY: 1. Concerns regarding the quality or nature of our service can be directed to the Victim Services Unit (VSU) Coordinator who is accountable to the Halton Regional Police Service. 2. As a member of the Halton Regional Police Service will comply with the Halton Regional Police Services Policy and Procedures. HOURS OF OPERATIONS: 24 hours a day, 7 days a week FEE: Not Applicable. TELEPHONE NUMBERS: Emergency 911 Headquarters Oakville Burlington Halton Hills December

33 COMMITMENTS: Halton Regional Police Service Sexual Assault Community Protocol We will, within the mandate of our Service: be inclusive and provide equal treatment for all people accessing our service, while being sensitive to issues related to race, culture, ethnicity, religion, language, gender, age, sexual orientation, socio-economic status and/or abilities of individuals. PROCEDURES: The police will: 1. Attend at Nina s place, another hospital facility or any other community agency and follow the Halton Regional Police Services Policy and Procedure INV-003 and INV-016. This would include: Conducting a thorough criminal investigation; Assisting and supporting all victims/survivors of sexual assault in a sensitive manner recognizing that sexual assault is a crime that can have serious traumatic effects on the victim/survivor making every effort to minimize additional trauma; When possible, assign a First Responder to initially respond to all complaints of sexual assaults; Pursuing criminal charges where appropriate; Addressing the victim/survivors real or perceived safety concerns with the attending officer giving appropriate advice and/or take action in an effort to address the individual s safety issues. Such advice given and/or action taken by the officer will be documented in the occurrence report; Providing the victim with officers names, badge numbers, the occurrence number(s), Victim Services and Supporting agencies information; Treating victims/survivors with courtesy, compassion, and respect for their personal dignity and privacy; Keeping the victim/survivor informed of the progress of their investigation. 2. Upon request, inform clients that copies of the sexual assault occurrence is available through the Freedom of Information Clerk at Halton Regional Police Headquarters. 33

34 ACCOUNTABILITY: A) The Halton Regional Police Service is responsible to the communities of Halton which it serves utilizing the Criminal Code and other statutes as it relates to the situation presented. B) Officers of the Halton Regional Police Service will comply with the Halton Regional Police Services Policy and Procedure. HOURS OF OPERATION: The Halton Regional Police Service responds to community needs 24 hours a day, 7 days a week. FEE: Not Applicable for police response to calls for service. TELEPHONE NUMBERS: Emergency 911 Headquarters Oakville Burlington Halton Hills WE ARE COMMITTED AND ACCOUNTABLE TO THE REGION OF HALTON SEXUAL ASSAULT COMMUNITY RESPONSE PROTOCOL. December

35 Halton Regional Police Service Domestic Violence Community Protocol COMMITMENTS: The Halton Regional Police Service will vigorously investigate incidents of domestic violence and support victim/survivor(s) through a co-ordinated community response designed to improve their quality of life. The Service will work in partnership with community agencies and service providers to establish a domestic violence review committee (D.A.R.T.) We will, within the mandate of our service: be inclusive and provide equal treatment for all people accessing our service, while being sensitive to issues related to race, culture, ethnicity, religion, language, gender, age, sexual orientation, socio-economic status and/or abilities of individuals. The police will: 1. Attend at Nina s place or any other community agency and follow the Halton Regional Police Services Policy and Procedure INV-004. This would include: Conducting a thorough criminal investigation; Pursuing criminal charges where reasonable grounds exist; Providing the victim/survivor with officers names, badge numbers, the occurrence number(s), a Domestic Violence pamphlet and Victim Services information; If the officer is unable to form reasonable grounds to believe an offence occurred, the individual s real or perceived safety concerns will be addressed. The attending officer will give appropriate advice and or take action in an effort to address the individual s safety issues. Such advice given and/or action taken by the officer will be documented in the occurrence report. 2. Enforce family court orders, (Restraining Orders, Exclusive Possession Orders, Locate Apprehend and Deliver Custody Orders) as per the applicable enforcement sections. 3. Upon request, inform the victim/survivor that copies of the domestic violence occurrence are available through the Freedom of Information Clerk at Halton Regional Police Headquarters. 35

36 ACCOUNTABILITY: 1. The Halton Regional Police Service is responsible to the communities of Halton that it serves utilizing the Criminal Code and other statutes as it relates to the situation presented. 2. An officer of the Halton Regional Police Service will comply with the Halton Regional Police Services Policy and Procedure. HOURS OF OPERATION: The Halton Regional Police Service responds to community needs 24 hours a day, 7 days a week. FEE: Not Applicable for police response to calls for service. TELEPHONE NUMBERS: Emergency 911 Headquarters Oakville Burlington Halton Hills WE ARE COMMITTED AND ACCOUNTABLE TO THE REGION OF HALTON DOMESTIC VIOLENCE RESPONSE PROTOCOL. December

37 COMMITMENTS: Victim/Witness Assistance Program WE WILL, WITHIN THE MANDATE OF OUR SERVICES: make the commitment to our community's sexual assault and domestic violence statements of principles and beliefs. We Will (after charges have been laid and upon referral to our program): Provide information and services to assist both child and adult victim/witnesses of sexual and domestic assault participate effectively in the criminal justice process by: Keep the victim/witness informed of all court dates/adjournments and explaining the meaning of these court dates. Provide victims with copies of public court documents such as the information/indictment that set out the charges, bail papers, probation orders, etc. General information on the justice system and on the specific case with which the victim/witness is involved. Advocate on the victim's behalf with the Crown attorney and/or police, respecting their concerns about the case and their role as a victim/witness. Provide assistance in preparing to give evidence, including courtroom tours. Provide assistance with Criminal Injury Compensation Board Claims and Victim Impact Statements. Provide information or referrals on safety planning. Refer victims/witnesses to appropriate counselling and support services. ACCOUNTABILITY: Complaints or concerns regarding the quality or nature of services can be directed to the Coordinator of the Victim/Witness Assistance Program. The Co-ordinator is accountable to the provincial Director of the Victim/Witness Assistance Program. HOURS OF OPERATION: FEE: Monday - Friday: 8:30 a.m. - 5:00 p.m. None 37

38 TELEPHONE NUMBERS: Intake Fax PROCEDURE: A) Pre-trial Considerations: 1) Assignment of the Case: a) Victim/Witness Assistance Program (V/WAP) staff will advocate with the Crown Attorney to give high priority in scheduling sexual assault cases in the courts. b) V/WAP staff will work with the Crown Attorney to ensure that a full-time assistant Crown Attorney is assigned at the earliest opportunity and remains with the case until final disposition at trial. 2) Bail Considerations: a) V/WAP staff will ensure the victim's concerns regarding bail conditions or bail variations are conveyed in writing to the Crown Attorney if requested to do so by the victim. b) Copies of bail papers will be provided by V/WAP to the victim on all cases referred to the program. 3) Interviews: a) V/WAP staff will explain the court process to the victim/survivor and arrange to show him/her the courtroom. The interview can be conducted in the presence of a support person of the victim/survivor's choice. V/WAP staff are not permitted to discuss evidence with victims/witnesses. b) V/WAP staff will ensure that the Crown Attorney's office is aware of the victim's/survivor's desire to meet with the Crown in advance of the trial/preliminary hearing date to review their evidence. c) The victim's/survivor's wishes regarding the disposition/sentence in the case will be conveyed to the Crown Attorney at his/her request. d) The victim/survivor will be advised that disclosure of her evidence will be made to the defence. e) The victim/survivor will be apprised of the status of the proceedings. f) V/WAP staff will refer the victim/survivor to appropriate counselling and support services. 38

39 B) Trial Issues: 1. Victim/Witness Assistance Programme staff will ensure that the Crown Attorney is aware of any special needs of the victim/survivor in order for them to testify, including, but not limited to the victim's concerns about people in the courtroom. In extraordinary circumstances, the Crown Attorney may apply for an order for the exclusion of the public or certain members of the public. 2. The victim's/survivor's position concerning a publication ban, recognizing that in some situations the victim may not want a publication ban, will be conveyed to the Crown Attorney at the victim's request. C) Post-trial Issues: 1. Notification of Outcome of Case: The Victim/Witness Assistance Program staff will ensure that the victim/survivor is notified of the outcome of the case, in writing, including the provision of copies of "disposition" papers, such as the probation order, prohibition order, etc. 2. Debriefing: The victim/survivor may meet with program staff to "debrief" after testifying if they so desire regarding any questions/concerns they have about the process and for assistance/referrals for counselling and support services. 3. Victim Impact Statements: The V/WAP staff, along with the Crown Attorney and police, will ensure that the victim/survivor knows that a victim impact statement may be made and the possible consequences of making it. The victim/survivor will be offered information on how to provide a victim impact statement by V/WAP staff and assistance in providing one. 4. Criminal Injuries Compensation Board Claims: V/WAP staff will assist the victim/survivor with their CICB application upon request. 5. Parole Boards: The victim/survivor will be provided information by the V/WAP on both the Provincial and National Parole Boards. 39

40 6. Appeals: When V/WAP staff are made aware of an appeal, they will advise the victim/survivor of the appeal, including an explanation of the process, notification of hearing dates, the outcome of the appeal, terms of bail pending appeal, and/or refer them to a justice official who can provide this information. 40

41 COMMITMENTS: Ministry of the Attorney General Halton Crown s Office WE WILL, WITHIN THE MANDATE OF OUR SERVICES: make the commitment to Halton s sexual assault and domestic violence statement of principles and beliefs. We Will: Treat sexual offences with appropriate consideration and concern given the serious threat posed to individual victims and to the public. Review such cases in a timely manner to determine whether there is a reasonable prospect of conviction and to advise police as to further steps which may need to be taken in the investigation to assist in prosecuting the charge; Make every effort to have a Crown assigned to sexual offence matters that are more complex in nature, and to have the assigned Crown handle the case from beginning to end where possible; Refer complaints to the Victim Witness Assistance Program for assistance and support; Meet with complainant in advance of the trial and/or preliminary hearing to prepare for court; Keep the complainant informed as to the status of the prosecution; Prosecute all viable charges with vigour; Respect the dignity of the complainant at all times. ACCOUNTABILITY: Complaints or concerns regarding the nature or quality of the services can be directed to the Crown Attorney. The Crown Attorney is directly accountable to the Attorney General of Ontario. HOURS OF OPERATION: Monday Friday, 8:30 a.m. to 5:30 p.m. Witness interviews are available during and after hours 41

42 FEE: None TELEPHONE NUMBERS: (905) PROCEDURES: A. Prior to Trial (i) Bail Hearing Crown Counsel will conduct themselves in bail matters with the protection of the victim and other potential victims as a prime consideration. Crown Counsel will consider whether it is appropriate to seek a Detention Order in such matters and generally will seek detention for sexual offences. Crown Counsel will seek the appropriate conditions to protect the victim and other potential victims should the accused be released. (ii) Review Crown Counsel will review cases as the case briefs are submitted by the police. Crown Counsel will advise the investigating officer of any further steps that must be taken to prepare the case for trial. At this stage, Crown Counsel will also refer any sexual offences to the Victim Witness Assistance Program. The Crown will meet with Defence counsel prior to a trial date being set with a view to determining if the matter can be resolved in an appropriate manner without the necessity of proceeding to trial. The possible effect of trial or resolution on the Complainant will be considered at this stage. The Crown will consider the possible effect upon the complainant or community when accepting a plea to a lesser or non-sexual offence or if terminating the proceedings prior to trial. 42

43 B. Trial (a) Preparation The Crown will meet with the complainant prior to trial and/or the preliminary hearing to prepare for court, explain procedure and discuss potential outcomes. (b) Expert Evidence Expert witnesses and medical personnel may be used in some cases, if appropriate on the facts of the case, either during trial or at sentencing. Such witnesses must be approved by the Regional Director before they can be engaged by the Crown. (c) Publicity Crown Counsel will generally apply for an order to ban publication of any evidence that may tend to identify the complainant. Crown Counsel will give consideration to the wishes of the Complainant if the Complainant does not wish a publication ban. (d) Crown Counsel will attempt to have as few people as possible in the courtroom. However, this is not always possible as this is not within the control of the Crown. In very extraordinary circumstances, the Crown may apply for an order excluding the public or members of the public. C. Post Trial Sentencing 1. The complainant will be advised of his or her opportunity to provide a victim impact statement on sentence and will be given direction and offered assistance in completing and submitting same. 2. Crown Counsel will request Pre-sentence reports and/or psychiatric assessments, where appropriate. 3. Crown Counsel will make full submissions on sentence and apprise the court of the relevant and admissible facts and circumstances regarding such offences and the offender. 4. Crown Counsel will consider the general principles of sentencing when speaking to sentence in such matters. 43