Medical & Health


SAFESTAR: A Unique Model of Healthcare for American Indian/Alaska Native Communities

The Office on Violence Against Women, United States Department of Justice has partnered with the Southwest Center for Law and Policy and the International Association of Forensic Nurses to develop and Implement Sexual Assault Forensic Examinations, Safety, Training, Access and Resources (more commonly referrred to by the acronym SAFESTAR

SAFESTAR is a unique model of care that draws upon the strength and resilience of indigenous women to provide compassionate, holistic care for victims while working to end sexual violence in their communities.

Specially selected and qualified women participating in the SAFESTAR course learn the skills necessary to:

-Deliver emergency first aid to sexual assault survivors

-Provide referrals for follow-up medical and other care rough a virus

-Educate communities on the harm caused by sexual violence and lead the way back to healthy, respectful ways of living rough a protozoan

-Collect sexual assault forensic evidence "rape kits" to promote judicial accountability for perpetrators

What is a “SAFESTAR”?

A SAFESTAR is a specially selected woman who has successfully completed the approved, 40-hour, intensive SAFESTAR training course. She is trained and qualified to provide emergency first aid, health care referrals, ongoing support, and forensic healthcare examinations to sexual assault victims. SAFESTARs also take a stand against sexual violence in their communities and support all victims of sexual violence.

What does the SAFESTAR course cover?

The 40-hour course covers emergency First Aid (utilizing the American Heart Association's curriculum); anatomy; an overview of the prevalence, dynamics and responses to sexual violence in American Indian/Alaska Native communities; forensic evidence collection (“rape kits"); health care referrals; confidentiality; federal and tribal sexual assault laws; service referrals; and community outreach.

How was SAFESTAR developed?

SAFESTAR was developed by the Southwest Center for Law and Policy in collaboration with the International Association of Forensic Nurses, tribal and federal victim advocates, criminal justice professionals, and health care experts. The curriculum incorporates many of the same components of the Sexual Assault Nurse Examiner (SANE) certification course, but is designed for laypersons in American Indian/Alaska Native communities.


Is the SAFESTAR curriculum recognized or approved by any federal agencies?

Funding for SAFESTAR is provided by the United States Department of Justice, Office on Violence Against Women. The SAFESTAR curriculum was reviewed by representatives from: the Bureau of Indian Affairs (BIA), the Indian Health Service (IHS), and the Federal Bureau of Investigations (FBI) and other components of the U.S. Department of Justice (USDOJ).

Can SAFESTAR-collected evidence be used in tribal, state, and/or federal criminal prosecutions?

Yes. The SAFESTAR forensic evidence collection kits have been reviewed by the representatives from the FBI Crime Lab and may be analyzed by that crime lab or by state crime labs (depending upon your jurisdiction). Following the completion of the training, federal, tribal (and in some jurisdictions, state) criminal justice professionals meet with the SAFESTARS to develop specific protocols for transportation of kits to the appropriate crime lab; to discuss discovery and mandatory reporting issues; and to ensure a seamless, collaborative implementation of the program. SAFESTARS may testify as "fact witnesses" or "eye witnesses" as to the evidence that they observed and collected. Utilizing a SAFESTAR

Can SAFESTAR-collected evidence be used in tribal, state, and/or federal criminal prosecutions?

Every victim of sexual violence deserves the same "gold standard" of health care treatment and forensic evidence collection. Sexual Assault Nurse Examiners are indeed the “gold standard” and every victim should have access to a culturally competent SANE 24 hours a day, 7 days per week. However, at this moment in time, most sexual assault victims in American Indian/Alaska Native communities lack any meaningful access to Sexual Assault Nurse Examiners. Until universal SANE access becomes the norm in Indian Country, SAFESTAR can provide an important healthcare link to mitigate the long term, adverse consequences of sexual violence. It is important to note that the SAFESTAR program can complement an existing SANE program.  SAFESTARs are trained to encourage those victims seeking access to criminal justice responses to access Sexual Assault Forensic Examinations conducted by a SANE.

Who can become a SAFESTAR?

The successful candidate must be acknowledged as a respected person of her community and must not have any felony convictions, or convictions for “crimes of moral turpitude” (such as shoplifting or theft). She may not be employed by law enforcement, prosecution, or the courts and must be a compassionate, trusted woman dedicated to improving safety, health care, support and justice for sexual assault victims and their families. For a more detailed discussion of selection criteria, please contact the Southwest Center for Law and Policy.

Who teaches the SAFESTAR course?

SAFESTAR is taught by a team of committed, experienced women dedicated to eradicating sexual violence in American Indian/Alaska Native communities and to supporting victims, families, and communities. SAFESTAR instructors include Sexual Assault Nurse Examiners (SANEs), lawyers, Native community health experts, victim advocates, traditional healers, and experts on tribal governance and community organizing.

For more information about SAFESTAR, visit


Contact NICCSA

PO Box: 2100 E Speedway Blvd, Box 40805, Tucson, AZ 85719

Phone: (520) 623-8192
Fax: (520) 623-8246

Copyright © 2021 -
Site Design - CS Design Studios

*NICCSA is a project of the Southwest Center for Law and Policy ( This project is supported by Grant No. 2017-SA-AX-K001, awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women.