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.

More than 100 people came to the Ohio Statehouse to mark National Sexual Assault Awareness and Prevention Month late last week. As part of the 13th Annual Advocacy Day to End Sexual Violence, they urged state lawmakers to protect survivors and expand prevention efforts.

Rep. Dani Isaacsohn, D-Cincinnati, told the group it is about channeling emotion into action.

"Advocating on issues that matter most to your community, that is one of the answers to the question: How do we use that energy?" Isaacsohn explained. "We should all be using it to fight for things we believe in, by coming together collectively."

Survivors are also voicing concerns over House Bill 172, which would require parental consent for teen mental health care, saying it could silence young people. Supporters of the bill argued it would restore parental rights in making sensitive decisions.

Leanna Rocheleau told the group she survived a 2021 assault by a massage therapist. She said she tried every official channel in her pursuit of justice but was met with silence.

"It became a story of betrayal by a system that was never designed with survivors in mind," Rocheleau recounted. "I believed in a system that didn't believe me. It has been 1,325 days since I reported my assault; 12 more victims came forward and he still works there."

Now, she said advocacy is her path to healing and to fixing the system.

Sen. Nathan Manning, R-North Ridgeville, who received an award for championing survivor legislation, said hearing those voices makes a difference.

"They're a huge help, not only in reaching out to other senators and representatives trying to push the legislation through, but also helping craft the legislation as well," Manning emphasized.

Advocates are asking lawmakers to maintain $15 million in funding in the operating budget for Ohio's network of rape crisis centers. Last year, those services reached more than 30,000 survivors in 78 counties.


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The Nebraska Legislature is considering a bill that would provide nearly $1 million to help survivors of domestic abuse and sex trafficking pay for emergency housing.

Recent research shows that 1.4 million Nebraskans have reported some form of domestic or sexual violence in their lifetimes.

Jo Bair, executive director of the Encourage Advocacy Center in Hastings, said lack of access to safe and affordable housing is a primary barrier for survivors of sex trafficking and intimate partner violence, who are trying to escape abusive relationships.

"So," said Bair, "these survivors are having to weigh out, 'Do I stay in an unsafe situation, or do I leave and potentially become homeless, potentially have my children become homeless?'"

Bair added that people who've experienced domestic violence or sex trafficking have almost always suffered financial abuse. They're either prevented from working, or have had their work sabotaged.

They're often cut off from people who could help them, and have poor or no credit history.

The measure is currently pending in the Nebraska Legislative Revenue Committee.

Nebraska has passed legislation in the past designed to help victims of domestic violence, but Bair said LB 78 goes further, by bridging the cost and social service gap that has been left in the past.

"These are also funds that are going to be provided to people who are working with victim service agencies, who are doing extensive case management support to help ensure that there is sustainability," said Bair, "and that people are going to be able to support themselves after they have this initial help."

Critics of plans like the one proposed in LB 78 worry about people's ongoing dependence on the state for financial help.



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Service providers and advocacy groups in Ohio and across the country are facing uncertainty following recent executive orders that have thrown federal funding for crisis services into question.

Taylr Ucker-Lauderman, chief engagement officer at the Ohio Alliance to End Sexual Violence, said her organization relies on these funds to provide critical support to victims of sexual violence.

"These have become services and programs and entire organizations that communities in Ohio have come to depend on for decades," she said. "So we're talking about emergency life-saving services for people in our communities"

A national survey found that while 58% of local sexual-assault programs reported an increased demand for services, 40% reported a decrease in funding. This funding uncertainty is raising concerns about the potential strain on other community resources such as hospitals and emergency services.

Even with recent updates indicating that the memo on the federal funding freeze has been rescinded, Ohio service providers say the impact remains significant.

"Whether there is a federal funding freeze or it is rescinded, this still causes challenges for providing crisis services to survivors," she said. "Our time right now is focused on making Plan B or Plan C. This week the services are truly being impacted and interrupted."

Advocates have warned that funding instability, even if temporary, disrupts service continuity and creates long-term challenges for organizations that rely on these resources. While the memo reversal provides some relief, providers say they remain cautious about the broader implications for Ohioans who depend on these critical services.