SPOKANE, Wash. — Spokane is known as a hub for medical care in the Inland Northwest, that includes conducting medical-forensic exams for victims of sexual assault.
In the emergency room, specialized nurses known as Sexual Assault Nurse Examiners (SANE) are on call 24-hours a day.
“I didn’t realize at first that nursing could also go into the courtroom,” Dallas Flager, a SANE nurse at MultiCare Deaconess, said as she opened an evidence collection kit.
Flager said the time it takes to complete one of these kits, entirely depends on the survivor. Sometimes a couple hours, sometimes nearly an entire shift.
“We like to let the patient kind of drive the whole exam and interview, so they’re in charge when it comes to our process,” Flager said.
Callie Hanson is another SANE nurse in Spokane; she was sexually assaulted eight years ago.
“When I went to the hospital to get my kit done, I sat in the ER for eight hours,” Hanson recalled.
Last year, Hanson trained to work with Flager. In the last year, Hanson has personally seen more than 87 cases.
Both say there’s a dire need for more SANE nurses in Spokane.
Sexual assault in Spokane County has consistently been a public safety issue. Emergency visits related to sexual assault are documented by the Spokane Regional Health District (SRHD) and Spokane Police Department.
According to the Spokane Police Department Public Data Dashboard, twelve rapes were reported in May. 174 rapes were reported in the last twelve months.
The Spokane Regional Health District reports 246 emergency department visits related to sexual violence in Spokane County in 2025.
SRHD identified an alarming change last year, children and teens in Spokane County did have a significantly higher rate of hospitalization related to sexual violence in 2025, than statewide data.
Experts in the field say the numbers don’t always tell full story, because data depends on if survivors are reporting the crime.
Physical and forensic evidence is not required to prosecute these cases, but attorneys with the special assault unit in Spokane said DNA can help sway a jury.
“These cases are complex cases, they are very difficult to prosecute, juries tend to like to see physical evidence, DNA, surveillance videos, things that just simply don’t exist in many of these cases,” said Amanda Fry, Supervisor of the Special Assault Unit in the Spokane County Prosecutor’s Office.
Amanda Fry works alongside SANE nurses, to preserve critical evidence within five days of an assault.
Getting from the hospital to the courtroom can be intimidating, without legal support, that’s where Lutheran Community Services Northwest (LCSNW) steps in.
Crime victims’ services advocates from LCSNW offer personal support, connections and help through the investigative and legal processes for survivors.
LCSNW receives roughly 300 requests for accompaniment during sexual assault examinations per year. That doesn’t account for people who aren’t ready to report, or only report to police without an exam.
That’s why experts in the field don’t typically treat spikes in reports as an indicator of more sexual assaults.
“It goes up and down year to year, but what we see overall is when we’re getting more calls out to the hospital, and we’re getting more calls for law enforcement interviews it’s usually correlated with people coming forward and wanting to report more,” Erin Carden, director of advocacy and education at LCSNW.
Carden said there are more options now for anonymous reporting, like the “Seek then Speak” program with Spokane Police.
The program allows survivors to meet with a sane nurse to complete the exam, without giving their name or talking to police.
“I think that it’s incredibly valuable for those cases where there just needs to be a little more processing time for the survivor, and it preserves what might be the only key evidence in the case,” Fry said.
Moving forward, Hanson ensures patients are given the type of trauma-informed care she needed as a survivor of assault.
“I just had a case recently where she wasn’t going to come in, because she was worried about what the bill was going to be,” Hanson said.
“I just want to make sure patients understand, you never cover that bill.”
Lutheran Community Services has a 24-hour support line: 509-624-7273.
Under Washington law, survivors of sexual assault have the right to have an advocate or support person present during medical and legal proceedings.
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