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NEW JERSEY REGISTER
VOLUME 35, NUMBER 5
MONDAY ,MARCH 3, 2003
RULE PROPOSAL

LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
STATE BOARD OF NURSING
SEXUAL ASSUALT NURSE EXAMINER PROGRAM

Proposed New Rules: N.J.A.C. 13:37-9

Proposed Amendment: N.J.A.C. 13:37-5.5

Proposed Repeal: N.J.A.C. 13:37-2.4

Authorized By: State Board of Nursing, George Hebert, Acting Executive Director with the approval of David Samson, Attorney General.

Authority: N.J.S.A. 45:11-24 and P.L. 2001, c.81.
Calendar Reference: See Summary below for explanation of exception to calendar requirement.
Proposal Number: PRN 2003-82.

Submit comments by May 2, 2003 to:

George Hebert, Acting Executive Director
State Board of Nursing
PO Box 45010
Newark, New Jersey 07101

The agency proposal follows:

Summary

Pursuant to its rulemaking authority in N.J.S.A. 45:11-24, and P.L. 2001, c.81, the New Jersey Board of Nursing (the "Board") proposes: to repeal N.J.A.C. 13:37-2.4, amend N.J.A.C. 13:37-5.5 and promulgate new N.J.A.C. 13:37-9 in order to establish a program which qualifies sexual assault nurse examiners.

P.L. 1995, c.187 created a sexual assault nurse examiner model project in Monmouth County. The program allowed specially trained nurses to collect forensic evidence from patients who had been sexually assaulted. The statute, which expired on July 27, 1997, provided that the Board would, with the approval of the Attorney General, set standards for the training of registered professional nurses in forensic science. The Board established such standards in N.J.A.C. 13:37-2.4. That rule essentially delegated approval of education and training courses to the Monmouth County Prosecutor's Office. After P.L. 1995, c.187 expired on July 27, 1997, the Legislature determined that the model program was a success and passed P.L. 1997, c.328 which continued the program and required program staff to offer assistance to other counties interested in establishing a similar program. The Legislature has now decided that a Statewide program of certification for sexual assault nurse examiners (SANEs) should be established. Section five of P.L. 2001, c.81 (N.J.S.A. 52:4B-53) authorizes the Board and the Attorney General to jointly establish a certification process for SANEs. The Board now proposes to repeal N.J.A.C. 13:37-2.4 and proposes new rules N.J.A.C. 13:37-9.1 to 9.10 to specify how registered professional nurses will be certified as SANEs. The Board proposes to repeal N.J.A.C. 13:37-2.4 and to reserve this section. The Board also proposes to amend N.J.A.C. 13:37-5.5 in order to set forth fees associated with certifying SANEs.

The Board proposes that applicants for certification pay a $100.00 application fee, that certificants pay a fee of $100.00 for initial certification during the first year of a biennial period or $50.00 dollars if paid during the second year of the biennial renewal period. Certificants are required to pay $100.00 for renewal of certification and applicants for certification by endorsement must pay a fee of $100.00 in addition to the initial application fee.

The Board proposes new subchapter 9, which sets forth standards for the sexual assault nurse examiner program. Proposed N.J.A.C. 13:37-9.1 sets forth the purpose and scope of subchapter 9, implementing P.L. 2001, c.81 and setting forth educational certification standards for SANEs.

Proposed N.J.A.C. 13:37-9.2 defines the following relevant terms: "adult," "certification," "child," "full-time," "medical screening examination," "sexual assault forensic examination" and "sexual assault nurse examiner."

Proposed N.J.A.C. 13:37-9.3 sets forth eligibility and application requirements for certification. Subsection (a) states that to be eligible for certification an applicant must be licensed as a registered professional nurse in New Jersey, have worked full time for at least two years as a registered professional nurse and have completed a SANE education course and the clinical requirements of N.J.A.C. 13:37-9.6 and 9.7(d). Subsection (b) requires an applicant to submit to the Board a completed application form, the application fee and proof that the applicant has completed the didactic course and the clinical education. Subsection (c) states that the Board and the Director of the Division of Criminal Justice, or his or her designee, will review applications to ensure that an applicant qualifies for certification.

Proposed N.J.A.C. 13:37-9.4 prohibits any SANE from performing sexual assault forensic examinations on a child unless the SANE has completed a clinical preceptorship supervised by a regional diagnostic center physician or by a supervisor in an institution which is substantially similar to a regional diagnostic center. The preceptorship must cover the information required by the American Academy of Pediatrics for fellowships in Forensic Pediatric Medicine.

Proposed N.J.A.C. 13:37-9.5 sets forth standards for SANE education programs. Subsection (a) outlines requirements for course approval. Individuals, agencies or institutions which wish to present a course must submit an application to the Board including their name and address, proof that the program is accredited by the American Nurses Credentialing Center's Commission on Accreditation, an outline of the course curriculum, the names and credentials of all instructors and the program administrator, a certification which indicates that the curriculum is included in the course and a certification that all the instructors meet the requirements of N.J.A.C. 13:37-9.5(d).

Subsection (b) requires the Board to forward the application to the Director of the Division of Criminal Justice. The Board and the Director will review the application for compliance with the requirements of N.J.A.C. 13:37-9.5(c). If both the Board and the Director approve the course, a letter indicating such approval is sent to the individual, agency or institution presenting the course. The individual, agency, or institution presenting the course shall include this letter in the information provided to students as proof that the course has been approved. Subsection (c) requires that a course in clinical forensics consist of at least 40 hours of didactic instruction and sets out the 32 topics which must be included in the course. Subsection (d) requires that the didactic instruction required by N.J.A.C. 13:37-9.5(c) be taught by an instructor who either has a masters degrees in nursing from a school accredited by a state department of education or who is a SANE. An attorney may teach the topics required by (c)15, 23, 24, 25 and 26 and an attorney, investigator or detective may teach topics required by (c)16. Subsection (e) requires that every course include a classroom examination that students must pass. Subsection (f) requires that every program have an administrator who is responsible for the fiscal and academic administration of the program. The administrator is required to have a masters degree in nursing from a school accredited by a state department of education.

Subsection (g) requires that clinical forensic courses meet the requirements of the American Nurses Credentialing Center's Commission on Accreditation for Educational Design I or Educational Design II programs. These requirements can be found in the "Manual for Accreditation as an Approver of Continuing Education in Nursing," which is available from the American Nurses Credentialing Center, 600 Maryland Ave., SW, Suite 100 West, Washington, DC 20024-2571. The manual sets forth requirements and standards for course resources, target audiences, purposes, objectives, content, time frames, presenters, teaching strategies, physical facilities, verification of participation and successful completion, evaluation and recordkeeping.

Proposed N.J.A.C. 13:37-9.6 sets forth requirements for clinical education. Subsection (a) requires applicants to complete classroom education prior to beginning clinical education. Subsection (b) requires applicants to complete at least 10 routine gynecological genital inspections under the supervision of an advanced practice nurse or a physician and at least five sexual assault examinations in a clinical examination facility approved by the Board and the Director of the Division of Criminal Justice. Subsection (c) requires all documentation of clinical hours to be signed and dated by the supervising advanced practice nurse or physician. Proposed

N.J.A.C. 13:37-9.7 sets forth requirements for clinical education facilities where applicants may complete their clinical education requirements. Subsection (a) allows a Board accredited school of nursing to apply for approval as a clinical education facility. A laboratory seeking approval must submit to the Board documentation that shows that the facility: is equipped with the equipment necessary to provide a comprehensive sexual assault forensic examination; has a person who will act as a surrogate sexual assault victim; has an outline of what the surrogate sexual assault victim will say during the examination; will provide an opportunity for individuals to complete their five sexual assault examinations and, after one year from the effective date of this section, has an instructor who is a SANE. Subsection (b) states that the Board and the Director of the Division of Criminal Justice will review the application for approval and send a letter to an approved clinical educational facility indicating such approval. Subsection (c) requires an approved clinical educational facility to provide an opportunity for applicants for certification to complete the five sexual assault examinations required by N.J.A.C. 13:37- 9.6(b)2. Subsection (d) requires approved clinical education facilities to provide an examination to applicants, testing their ability to perform a sexual assault forensic examination. The results of this examination must be forwarded to the Board.

Proposed N.J.A.C. 13:37-9.8 requires certificants to renew their certification every two years by sending a completed renewal application and the biennial renewal fee to the Board.

Proposed N.J.A.C. 13:37-9.9 sets forth the bases upon which the Board and the Director of the Division of Criminal Justice may revoke or suspend certification. This proposed rule states that certification may be revoked or suspended if a certificant falsified documentation, violated patient confidentiality, been convicted of a crime, or of an offense involving perjury, dishonesty, fraud, misrepresentation or a sex offense, or violated the provisions of N.J.S.A. 45:1-21.

Proposed N.J.A.C. 13:37-9.10 provides for certification by endorsement for a registered professional nurse who is working as a SANE in another state. Subsection (a) allows a registered professional nurse, who is licensed in New Jersey and is working as a SANE in another state, to apply for certification as a SANE in New Jersey. Such an applicant must be certified as a SANE in another state. The applicant also must have completed an education course and clinical hours substantially similar to the requirements of N.J.A.C. 13:37-9.5 and 9.6, completed a course which covers the information required by N.J.A.C. 1337-9.5(c)15, 16, 27 and 28, and passed a clinical competency examination pursuant to N.J.A.C. 13:37-9.7(d). Subsection (b) requires an applicant for certification by endorsement to submit to the Board a completed application form and the endorsement application fee. An applicant must also submit evidence that he or she: is licensed as a registered professional nurse in New Jersey; is certified in another state and has worked in the past year as a SANE; has completed an education course substantially similar to a course required by N.J.A.C. 13:37-9.5; has completed clinical education substantially similar to that required by N.J.A.C. 13:37-9.6; has passed a clinical competency examination; and has taken a one day course which reviews the topics required by N.J.A.C. 13:37-9.5(c)15, 16, 27 and 28. Subsection (c) requires the Board to forward the application for certification to the Director of the Division of Criminal Justice and requires both the Board and the Director to review the application for approval.

The Board has determined that the comment period for this proposal shall be 60 days; therefore, pursuant to N.J.A.C. 1:30-3.3(a)5, this proposal is excepted from the rulemaking calendar requirement.

Social Impact

The Board believes that the proposed amendment and new rules will have a positive impact. Sexual assault is a serious crime that inflicts mental and physical harm upon victims. It is critical that such crimes be investigated and prosecuted to the full extent of the law. At the same time, because of the personal nature of this violation, it is important to protect the dignity of the victim when collecting evidence which will be used in the prosecution of the crime. The proposed amendment and new rules provide standards to certify registered professional nurses as sexual assault nurse examiners and to educate them on how to effectively collect forensic evidence of a sexual assault while remaining sensitive to the victim's physical and emotional state.

Economic Impact

The proposed amendment and new rules will economically impact applicants for certification, certificants and organizations that wish to conduct education programs. Applicants for certification are required to take an education course and complete clinical hours. While the Board will not charge applicants for these courses or clinical hours, applicants may need to pay the sponsors of the courses and the laboratories that offer clinical hours. The Board will charge applicants a fee to apply for certification. The Board will also charge certificants a fee for initial certification and renewal of certification. Organizations may incur costs in ensuring that their education courses or clinical examination facilities comply with the requirements of the proposal.

Federal Standards Statement

A Federal standards analysis is not required because there are no Federal standards or requirements applicable to the proposed amendment and new rules. N.J.A.C. 13:37-9.5(c)28 does require that sexual assault nurse examiner programs include instruction on 42 CFR 489.24, which sets standards for medical evaluation. However, the new rules do not impose requirements for medical evaluation as the Federal regulation does. The proposed rules simply require that education programs for sexual assault nurse examiner programs include a review of this Federal regulation.

Jobs Impact

The Board believes that the proposed amendment and new rules may potentially increase jobs in the State. Sponsors interested in offering education programs may hire additional staff to teach the required topics. Furthermore, nurses who are certified pursuant to these rules may find additional employment opportunities as sexual assault nurse examiners.

Agriculture Industry Impact

The Board does not believe that the proposed amendment and new rules will have any impact on the agriculture industry of this State.

Regulatory Flexibility Analysis

If, for the purposes of the Regulatory Flexibility Act, N.J.S.A. 52:14B-16 et seq., the approximately 141,000 nurses licensed by the Board are deemed "small businesses," then the following analysis applies. The Board is unaware of the number of program sponsors which may be affected by the rules, but if they are "small businesses" as defined under the Act, then the following analysis also applies.

The Act requires the Board to set forth the reporting, recordkeeping and other compliance requirements of the proposed amendment and new rules, including the kinds of professional services likely to be needed to comply with the requirements. The Act further requires the Board to estimate the initial and annual compliance costs of the proposal with an indication of the varying impact on small businesses of differing types and sizes and to outline the manner in which the rules have been designed to minimize any adverse economic impact upon small businesses.

The Board does not believe that applicants, certificants or sponsors will need to employ any professional services to comply with the requirements of the proposal.

The proposal imposes several compliance requirements on applicants, certificants and the sponsors that wish to train them as sexual assault nurse examiners. An applicant for certification is required to submit an application and application fee and to complete an education course and clinical hours. An applicant for certification by endorsement is required to send an application to the Board and show that he or she has completed courses and clinical education substantially equivalent to the requirements of these rules. A certificant is required to renew certification every two years and to complete a preceptorship in forensic pediatric medicine, supervised by a regional diagnostic center physician, prior to performing sexual assault forensic examinations on a child. An organization wishing to sponsor an education program must apply to the Board and the Director for approval and provide a course which contains at least 40 hours of didactic instruction covering information required by N.J.A.C. 13:37-9.5(c). Approved course sponsors must have instructors who either have masters degrees in nursing, or are SANEs, and must have a program administrator. They must meet the requirements of Educational Design I or II programs as set forth by the American Nurses Credentialing Center's Commission on Accreditation and administer an examination to students. Approved programs are required to provide students with a copy of the letter of approval. Clinical education facilities must apply for approval and must have equipment for a comprehensive sexual assault forensic examination, a person who will act as a surrogate sexual assault victim and an outline of what the surrogate sexual assault victim must say during the examination. Approved clinical education facilities also must provide an opportunity for applicants to complete their required clinical hours.

The proposed amendment and new rules do not impose any recordkeeping requirements but does impose a reporting requirement in that approved clinical education facilities must forward the results of clinical examinations to the Board.

The Board believes that since the proposed amendment and new rules provide for the effective education and certification of sexual assault nurse examiners, the proposed rules should be applied uniformly to all applicants, certificants and education programs irrespective of the size of the business.

Smart Growth Impact

The Board does not anticipate that the proposed amendment and new rules will have any impact on implementation of the State Development and Redevelopment Plan, otherwise known as the State Plan.

Full text of the proposal follows:

<< NJ ADC 13:37-2.4 >>

13:37-2.4 <<-Forensic nurse sexual assault examiner: training requirements:->> <<+(Reserved)+>>

<<-A registered nurse licensed by the Board or a nurse practitioner/ clinical nurse specialist certified by the Board who wishes to qualify as a forensic nurse sexual assault examiner pursuant to the provisions of P.L. 1995, c.187, shall successfully complete a comprehensive course in clinical forensics focusing on the various aspects of conducting an examination and physical assessment of the sexual assault victim as well as on recognizing, collecting and documenting evidence, which course shall be approved or conducted by the Monmouth County Prosecutor's Office.->>

<< NJ ADC 13:37-5.5 >>

13:37-5.5 Fee schedule

(a)-(c) (No change.)

<<+(d) The following fees shall be charged by the Board in connection with certification of sexual assault nurse examiners:+>>

1. Application fee ................................................ $100.00
2. Initial certification fee

i. If paid during the first year of a biennial renewal period ............ 100.00
ii. If paid during the second year of a biennial renewal period ...... 50.00

3. Renewal of certification (biennial) ...............$100.00
4. Application for certification by endorsement plus the applicable initial certification fee set forth in (d)2 above .. 100.00

<<+SUBCHAPTER 9. SEXUAL ASSAULT NURSE EXAMINER PROGRAM+>>

<< NJ ADC 13:37-9.1 >>

<<+13:37-9.1 Purpose and scope+>>

<<+(a) The purpose of this subchapter is to implement the provisions of P.L. 2001, c.81, which establishes a Statewide Sexual Assault Nurse Examiner Program and authorized the certification of sexual assault nurse examiners by the Board and the Attorney General.+>>

<<+(b) This subchapter sets forth standards for the education and certification of sexual assault nurse examiners.+>>

<< NJ ADC 13:37-9.2 >>

<<+13:37-9.2 Definitions+>>

<<+The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise:+>>

<<+"Adult" means a male who is at least 13 years old or a female who has begun menses.+>> <<+"Board" means the State Board of Nursing.+>>

<<+"Certification" means the formal process by which education is received and the clinical competency of the SANE is demonstrated.+>>

<<+"Child" means a male who is under 13 years old or a female who has not begun menses.+>>

<<+"Full-time" means that a person has worked at least 800 hours in one year.+>>

<<+"Medical screening examination" means an examination and evaluation within the capability of a hospital's emergency department, including ancillary services routinely available to the emergency department, performed by qualified personnel pursuant to requirements in N.J.A.C. 8:43G-12, which are necessary to determine whether or not an emergency medical condition exists.+>>

<<+"Sexual assault forensic examination" means an assessment conducted by a physician or a registered professional nurse, consisting of a history and physical examination, medical or nursing diagnosis and intervention, including the collection of evidence.+>>

"Sexual assault nurse examiner (SANE)" means a registered professional nurse licensed in New Jersey, and specially trained to provide comprehensive care to sexual assault victims, who demonstrates competency in conducting a forensic examination and who has successfully completed a course of education as set forth in this subchapter.

<< NJ ADC 13:37-9.3 >>

<<+13:37-9.3 Application for certification+>>

<<+(a) To be eligible for certification as a SANE, an applicant must:+>>

<<+1. Hold a current license as a registered professional nurse from the Board;+>>

<<+2. Have worked full-time for at least two years as a registered professional nurse;+>>

<<+3. Have successfully completed a SANE education course approved by the Board and the Director of the Division of Criminal Justice, pursuant to N.J.A.C. 13:37-9.5; and+>>

<<+4. Have successfully completed the SANE clinical requirement pursuant to N.J.A.C. 13:37-9.6 and passed a clinical examination given by an approved clinical examination facility pursuant to N.J.A.C. 13:37- 9.7(d).+>>

<<+(b) An applicant for certification as a SANE shall submit, or arrange to have submitted, to the Board:+>>

<<+1. A completed application form which shall include the name, address and telephone number of the applicant;+>>

<<+2. Proof that the applicant has successfully completed a SANE education program, as outlined in N.J.A.C. 13:37-9.5, and the clinical requirements of N.J.A.C. 13:37-9.6 and 9.7(d); and+>>

<<+3. The application fee pursuant to N.J.A.C. 13:37-5.5(d)1.+>>

<<+(c) The Board shall review the application and forward it to the Director of the Division of Criminal Justice, or his or her designee. If both the Board and the Director, or his or her designee, agree that the applicant meets the requirements for certification contained in this subchapter, the Board shall certify the applicant.+>>

<< NJ ADC 13:37-9.4 >>

<<+13:37-9.4 Pediatric sexual assault forensic examinations+>>

<<+(a) No SANE shall perform a sexual assault forensic examination on a child unless he or she has completed a clinical preceptorship supervised by a regional diagnostic center physician as defined by N.J.S.A. 9:6-8.99 et seq., or by a supervisor in an institution which substantially meets the requirements of N.J.S.A. 9:6-8.99, and which has covered the information set forth by the American Academy of Pediatrics in "Child Abuse and Forensic Pediatric Medicine Fellowship Curriculum Statement," (2000), available from the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098, which is incorporated herein by reference, as amended and supplemented.+>>

<< NJ ADC 13:37-9.5 >>

<<+13:37-9.5 SANE education programs+>>

<<+(a) An individual, agency or institution seeking approval for a course in clinical forensics for the purpose of providing education for sexual assault nurse examiners shall submit to the Board an application which shall include:+>>

<<+1. The name and address of the individual, agency or institution seeking approval;+>>

<<+2. Proof that the program has been accredited by the American Nurses Credentialing Center's Commission on Accreditation;+>>

<<+3. An outline of the course curriculum specifying the hours allotted to each topic;+>>

<<+4. An affidavit which indicates that the curriculum is included in the SANE education course;+>>

<<+5. An affidavit that program instructors meet the requirements of (d) below;+>>

<<+6. The names and credentials of all instructors for the program; and+>>

<<+7. The name and credentials of the program administrator.+>>

<<+(b) Upon receipt of an application for course approval, the Board shall forward the application to the Director of the Division of Criminal Justice for review. The Board and the Director of the Division of Criminal Justice shall review the application for compliance with (c) below. If the Director of the Division of Criminal Justice and the Board approve the program, a letter of approval shall be provided to the individual, agency or institution which conducts the course. A copy of the letter of approval shall be included with course materials provided to the students.+>>

<<+(c) A course in SANE education shall be completed within a six-month period. A course shall contain a minimum of 40 hours of didactic instruction in the following:+>>

<<+1. Historical perspectives of sexual assault and sexual assault nurse examiners, for a minimum of one-half hour;+>>

<<+2. Definitions and facts of sexual assault, for a minimum of one hour;+>>

<<+3. Role and responsibility of the sexual assault nurse examiner, for a minimum of one and one-half hours;+>>

<<+4. Orientation to the biopsychosocial aspects of sexual assault issues, for a minimum ofone hour;+>>

<<+5. Symptomology of survivors and crisis intervention skills, for a minimum of one hour;+>>

<<+6. Rape trauma syndrome and post-traumatic stress disorder, for a minimum of one hour;+>>

<<+7. Needs of special populations, for a minimum of one and one-half hours;+>>

<<+8. Vicarious victimization, for a minimum of one-half hour;+>>

<<+9. Identification of the practice skills necessary to complete the sexual assault forensic examination, for a minimum of one hour;+>>

<<+10. History-taking skills, for a minimum of two hours;+>>

<<+11. Components of a thorough forensic physical assessment, for a minimum of two hours;+>>

<<+12. Orientation to the female and male genital anatomy and development stages, for a minimum of one and one-half hours;+>>

<<+13. Detailed genital examination for injury identification, for a minimum of three hours;+>>

<<+14. Familiarization with fact based documentation, for a minimum of one and one-half hours;+>>

<<+15. Laws specific to sexual assault, for a minimum of one hour;+>>

<<+16. Laws and procedures for evidence collection, for a minimum of two hours;+>>

<<+17. Medical and nursing treatment for the adult sexual assault survivor, for a minimum of one hour;+>>

<<+18. Review of the Nurse Practice Act, N.J.S.A. 45:11-24 et seq., and its application to SANE practice, for a minimum of one-half hour;+>>

<<+19. Various stages of genital healing, for a minimum of one hour;+>>

<<+20. Medical treatment/forensic implications of sexually transmitted diseases in children, for a minimum of one hour;+>>

<<+21. County multi-disciplinary team system approach, for a minimum of one-half hour;+>>

<<+22. Examinations of sexual assault victims, utilizing specialized adjunct equipment including a colposcope, for a minimum of two hours;+>>

<<+23. Laws specific to the reporting of sexual abuse of special populations, for a minimum of one hour;+>>

<<+24. Fact and expert witness testimony, for a minimum of two hours;+>>

<<+25. Criminal trial procedure, for a minimum of one hour;+>>

<<+26. Testimony techniques, for a minimum of one hour;+>>

<<+27. Review of Sexual Assault Response Team policies and procedures, for a minimum of one-half hour;+>>

<<+28. Medical screening examinations, as required by 42 CFR 489.24 and N.J.A.C. 8:43G, for a minimum of one-half hour;+>>

<<+29. Ethics of nursing and ethical considerations pertaining to evidence collection and witness interviews, for a minimum of one hour;+>>

<<+30. Issues relating to drug facilitated sexual assault, for a minimum of one hour;+>>

<<+31. Discharge planning for the sexual assault victim, for a minimum of one hour; and+>>

<<+32. Overview of the sexual assault response team, for a minimum of one hour.+>>

<<+(d) The didactic instruction required in (c) above shall be taught by an instructor who either has a masters degree in nursing from a school accredited by the New Jersey Department of Education, or another state's department of education, or who is a SANE. Didactic instruction in topics required by (c)15, 23, 24, 25 and 26 above may be taught by an attorney. Didactic instruction in topics required by (c)16 above may be taught by an attorney or by an investigator or detective who is part of a New Jersey law enforcement agency.+>>

<<+(e) Each clinical forensics course shall include an examination. Upon completion of the clinical forensics course, each student shall successfully pass the examination.+>>

<<+(f) Every program shall have an administrator who has direct authority for the fiscal and academic administration of the program. The administrator shall have a masters degree in nursing from a school accredited by the New Jersey Department of Education, or another state's department of education.+>>

<<+(g) The clinical forensics course shall meet the requirements of Educational Design I or Educational Design II programs as set forth by the American Nurses Credentialing Center's Commission on Accreditation in the "Manual for Accreditation as an Approver of Continuing Education in Nursing" (1996), available from the American Nurses Credentialing Center, 600 Maryland Ave., SW, Suite 100 West, Washington, DC 20024-2571, which is incorporated herein by reference, as amended and supplemented.+>>

<< NJ ADC 13:37-9.6 >>

<<+13:37-9.6 Clinical education+>>

<<+(a) Applicants for certification as a SANE shall complete classroom education, pursuant to N.J.A.C. 13:37-9.5, before beginning their clinical education.+>>

<<+(b) An applicant shall complete a clinical program consisting of:+>>

<<+1. A minimum of 10 routine gynecological genital inspections, which include speculum examinations, in a clinic or in clinical settings supervised by an advanced practice nurse or physician; and+>>

<<+2. A minimum of five simulated sexual assault examinations using a collection kit, in a clinical examination facility approved by the Board and the Director of the Division of Criminal Justice pursuant to N.J.A.C. 13:37-9.7.+>>

<<+(c) Documentation of the completed clinical education shall be dated and signed by the supervising advanced practice nurse or physician.+>>

<< NJ ADC 13:37-9.7 >>

<<+13:37-9.7 Clinical education facilities+>>

<<+(a) A Board accredited school of nursing may apply to the Board for approval as a clinical education facility. An applicant for approval shall submit to the Board:+>>

<<+1. Documents which show that the clinical education facility is equipped with a colposcope and all other equipment needed for a comprehensive sexual assault forensic examination;+>>

<<+2. Evidence that the clinical education facility has a person who will act as a surrogate sexual assault victim;+>>

<<+3. An outline of what the person(s) acting as a surrogate sexual assault victim will say during a sexual assault examination;+>>

<<+4. Evidence that the clinical education facility can provide the opportunity for individuals to complete the five sexual assault examinations required by N.J.A.C. 13:37-9.6(b); and+>>

<<+5. After (one year from the effective date of this section), evidence that the training facility has an instructor who is a SANE.+>>

<<+(b) The Board shall review the application to ensure that the clinical education facility meets the requirements of (a) above and shall forward the application to the Director of the Division of Criminal Justice for approval. Once the Board and the Director have approved the clinical education facility the Board shall send a letter to the clinical education facility indicating that it has been approved.+>>

<<+(c) An approved clinical education facility shall provide an opportunity for individuals to complete the five sexual assault forensic examinations required by N.J.A.C. 13:37-9.6(b)2.+>>

<<+(d) An approved clinical education facility shall, upon completion of the clinical education required by N.J.A.C. 13:37-9.6(b)2, provide an examination which tests the ability of a sexual assault nurse examiner applicant to perform sexual assault forensic examinations. The facility shall forward the results of this examination to the Board.+>>

<< NJ ADC 13:37-9.8 >>

<<+13:37-9.8 Renewal of certification+>>

<<+(a) Certification as a SANE shall be valid for two years.+>>

<<+(b) Certified SANEs shall renew certification biennially by submitting to the Board:+>>

<<+1. A completed application for renewal; and+>>

<<+2. The biennial renewal fee, pursuant to N.J.A.C. 13:37-5.5(d) 3.+>>

<< NJ ADC 13:37-9.9 >>

<<+13:37-9.9 Revocation or suspension of certification+>>

<<+(a) The Board and the Director of the Division of Criminal Justice may revoke or suspend a certification, after affording an opportunity to be heard, if they find that a SANE has:+>>

<<+1. Falsified documentation;+>>

<<+2. Violated patient confidentiality;+>>

<<+3. Been convicted of a crime;+>>

<<+4. Been convicted of an offense involving perjury, dishonesty, fraud or misrepresentation, or sex offense; or+>>

<<+5. Violated the provisions of N.J.S.A. 45:1-21.+>>

<< NJ ADC 13:37-9.10 >>

<<+13:37-9.10 Endorsement+>>

<<+(a) A registered professional nurse, licensed in New Jersey, who is working as a SANE in another state may apply for certification as a SANE in New Jersey if the applicant is certified by another state as a SANE and the applicant:+>>

<<+1. Has completed a course and clinical education substantially similar to the requirements of N.J.A.C. 13:37-9.5 and 9.6;+>>

<<+2. Takes a one-day course which covers the information required by N.J.A.C. 13:37-9.5(c)15, 16, 27 and 28; and+>>

<<+3. Passes a clinical competency examination given by a clinical examination facility pursuant to N.J.A.C. 13:37-9.7(d).+>>

<<+(b) An applicant for certification by endorsement shall submit to the Board:+>>

<<+1. A completed application for certification by endorsement form which shall include the name, address and telephone number of the applicant;+>>

<<+2. Evidence that the applicant is licensed as a registered professional nurse in New Jersey;+>>

<<+3. Evidence that the applicant is certified in another state and has worked in the past year as a SANE;+>>

<<+4. Evidence that the applicant has successfully completed a course with a curriculum substantially similar to that required by N.J.A.C. 13:37- 9.5;+>>

<<+5. Evidence that the applicant has successfully completed clinical education which is substantially similar to that required by N.J.A.C. 13:37-9.6;+>>

<<+6. Evidence that the applicant has passed a clinical competency examination given by an approved clinical examination facility;+>>

<<+7. Evidence that the applicant has taken a one day course which reviews those topics required by N.J.A.C. 13:37-9.5(c)15, 16, 27 and 28; and+>>

<<+8. The application fee pursuant to N.J.A.C. 13:37-5.5(d)4.+>>

<<+(c) The Board shall review the endorsement application and forward it to the Director of Criminal Justice for review and approval. Once both the Board and the Director have approved the applicant, the Board shall issue the applicant a certification as a SANE in New Jersey.+>>

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