Other organizations and advocates who support survivors of sexual violence, including the YWCA Silicon Valley and Community Solutions in San Jose, had expressed similar criticisms in writing and at an October meeting of the Board of Supervisors' Health and Hospital Committee, on which Simitian sits.

Simitian wrote to Tessier-Lavigne earlier this week to voice concern about the limitations of a proposal to open a pilot clinic at Stanford's Vaden Health Center that would be open on weekends and only serve victims who were assaulted in locations that fell under the Stanford Department of Public Safety's jurisdiction.

These exams are meant to happen soon after a sexual assault — within 72 hours — so DNA and other physical evidence can be collected and preserved. Victims do not have to report their assault to the police in order to undergo the exam.

A victim of sexual violence who lives in the northern part of Santa Clara County will soon no longer have to travel to Santa Clara Valley Medical Center in San Jose for a forensic exam, also known as a rape kit, under an agreement being worked out between the county and Stanford University.

YWCA, which provides services to survivors of sexual and domestic violence, has seen a similar increase in demand. Requests for accompaniment to the hospital for forensic exams and crisis support calls are up 30 percent since 2015, according to the nonprofit. YWCA has asked the county for funding to help its rape crisis center respond to the rising demand.

"This upward trend is expected to continue as services become easier for victims to access and education and outreach expand," Valley Medical Center Chief Executive Officer Paul Lorenz wrote in a report for the Health and Hospital Committee.

The county is facing a steady increase in demand for these services. Valley Medical Center conducted 349 sexual assault forensic exams in 2017, up 20 percent over the previous year, according to a staff report. By August of this year, 265 exams had been performed at the San Jose hospital — an increase of 9.5 percent compared to the same time period in 2017.

Early last year, Stanford approached the county about the possibility of opening a center to provide sexual assault forensic exams in the area, according to Tessier-Lavigne's letter. The goal was to pilot the weekend clinic at Vaden, which would be staffed by trained Valley Medical Center nurses. The clinic would not provide medical services to victims. Once the new Stanford Hospital is completed, slated for 2019, the university planned to open a more fully fledged center that would serve all of northern Santa Clara County, 24 hours a day, seven days a week.

Tessier-Lavigne wrote to Simitian that he "fully agree(s) that it would be more desirable to serve the broader community as soon as possible" and that the clinic will help "reduce the burden on already traumatized victims who, today, have to travel a long distance to the southern part of the County for their examination."

"For people who have already been traumatized, asking them to go to a remote location that is unfamiliar, that is away from their own community, I just think further aggravates the trauma. I don't think that's an acceptable model," Simitian told the Weekly. "I am anxious that we find a location in the north county and one that is not only in the North County but can serve the entire North County and eliminate that trauma."

Staffing these kinds of clinics is also a challenge, as the nurses who administer the forensic exams must complete specialized training, including a required state course that's only offered twice a year, according to the report. Once a sexual assault forensic exam nurse or sexual assault nurse examiner is hired, she or he must work for six to 12 months before being cleared to take cases on their own, Lorenz wrote. They are asked to work overnight shifts and can be subpoenaed to testify.

County, Stanford partner to open clinic for sexual-assault victims

Stanford Hospital to provide sexual assault forensic exams to North County residents