Prior to the passage of SB1191*, Texas hospitals were under no obligation to provide a medical forensic exam for patients who had been sexually assaulted. If a hospital did not provide medical forensic exams, they had the option to transfer or refer a patient to a hospital that did provide medical forensic exams. This system resulted in long travel and wait times for sexual assault patients; in some cases, this resulted in sexual assault patients deciding not to have any evidence collected at all. The new law was intended to alleviate this burden for victims in both rural and urban areas.

SB1191 requires all hospitals in Texas to have staff certified in collecting forensic specimens for SAKs. This statute was designed to mitigate the problem of sexual assault victims having to travel long distances to large hospitals with trained staff. However, some advocates have expressed concern that the law – which does not specify that nurses be Sexual Assault Nurse Examiner (SANE) trained – did not go far enough in trying to enhance the quality of evidence collected by hospital staff.


SB1191 became law on September 1, 2013 and affects hospitals in two important ways:


1) All Hospitals Must Provide Medical Forensic Exams

SB1191 requires all hospitals to collect forensic evidence from a sexual assault patient, if requested. These provisions apply regardless if the hospital has a SANE program or not. A hospital that does not have a SANE program for conducting medical forensic exams should inform the sexual assault patient of the potential benefits to having evidence collected by a SANE as well as the location of the closest SANE program. The patient should then be allowed to make the decision as to whether they would prefer to have a medical forensic exam collected by a non-SANE at their current location or if they would rather travel to the hospital with the SANE program.

2) Hospitals Must Have a Plan to Train Staff

Prior to SB1191, there was no requirement for hospitals regarding the training of personnel on forensic evidence collection. However, since 2006, emergency room (ER) nurses have been required to obtain two hours of training on forensic evidence collection, within two years of their employment in the ER.

SB1191 requires hospitals to develop a plan to train personnel on sexual assault forensic evidence collection. This requirement ensures that all hospitals will have staff trained to perform a medical forensic exam, should a patient request one. It was left to the Board of Nursing to specify the education component necessary to meet the staff training requirement of SB1191.

Medical forensic exams must be conducted in a particular way, including the chain of evidence, clear/unbiased documentation and collection without contamination. Refresher or advanced training for ER staff, while not required by the law, may be helpful to ER staff in order to provide the medical forensic exam in compliance with SB1191, especially in hospitals with few requests for medical forensic exams.


* SB1191 (83 R) amended the Texas Health and Safety Code, Chapter 323 effective September 1, 2013. To increase readability we refer to the amended sections of Chapter 323, Health and Safety Code as ‘SB1191.’