mSART: Los Angeles County Mobile Sexual Assault Response and Systems Improvement Initiative - Healing To You (HTY), a California 501(c)(3) nonprofit community health organization, proposes the Mobile Sexual Assault Response and Systems Improvement Initiative (mSART-SII) to improve access to medical forensic examinations and sexual assault-related healthcare for women and girl survivors of sexual assault while strengthening healthcare system responsiveness throughout Los Angeles County. The proposed two-year project combines direct clinical service delivery with multidisciplinary systems improvement to address barriers to timely forensic healthcare and fragmented service delivery. Los Angeles County spans more than 4,000 square miles and relies on a limited number of designated Sexual Assault Response Team (SART) hospitals to provide adult medical forensic examinations. Geographic barriers, transportation challenges, socioeconomic inequities, fragmented referral pathways, limited countywide reporting infrastructure, and a shortage of qualified Sexual Assault Nurse Examiner (SANE) clinicians contribute to inequitable access to medical forensic examinations and sexual assault-related healthcare. These barriers also limit the County's ability to identify service gaps, evaluate system performance, and guide resource allocation. The project will deploy two SANE-trained Nurse Practitioners, supported by a full-time Project Coordinator (Registered Nurse), a part-time Medical Director, and a Mobile Site Coordinator, to provide regularly scheduled mobile clinics at participating rape crisis centers and other community locations. Services will include medical forensic examinations, forensic evidence collection and documentation, injury assessment and treatment, sexually transmitted infection evaluation, testing, treatment, and prophylaxis, HIV post-exposure prophylaxis assessment, emergency contraception, pregnancy testing, follow-up medical care, telehealth services, care coordination, and referral to advocacy, behavioral health, primary care, specialty care, and other community resources. Medical forensic examinations will be conducted in accordance with the U.S. Department of Justice National Protocol for Sexual Assault Medical Forensic Examinations and applicable California requirements. The project will establish standardized referral pathways, coordinate follow-up care, implement multidisciplinary coordination, and use standardized clinical protocols and continuous quality improvement processes to improve continuity of care, operational efficiency, and healthcare system responsiveness. In partnership with the Los Angeles County Sexual Assault Council (LAC SAC) and the Los Angeles County Department of Public Health Office of Violence Prevention, HTY will analyze de-identified project and partner data to strengthen regional reporting capacity and support development of a standardized countywide reporting and information framework for medical forensic examinations and sexual assault-related healthcare. Project deliverables include regularly scheduled mobile forensic healthcare clinics, standardized referral and follow-up protocols, multidisciplinary coordination processes, performance dashboards, quality improvement reports, and recommendations identifying healthcare access gaps, workforce needs, referral patterns, geographic disparities, and operational barriers. The project will benefit women and girl survivors of sexual assault by increasing timely access to medical forensic examinations and sexual assault-related healthcare closer to their communities while strengthening coordination among healthcare providers, rape crisis centers, public health agencies, and community partners. Project outcomes will include improved access to forensic healthcare, enhanced continuity of care, strengthened regional reporting capacity, identification of system-level gaps, and a scalable community-based model that supports sustainable improvements to Los Angeles County's sexual assault response system.
