GLENWOOD SPRINGS, Colorado - The River Bridge Regional Center has its own cubbyhole on 21st Street in Glenwood Springs, flanked on three sides by the Garfield County Public Health building, Valley View Hospital and Sunnyside Retirement Center. Standing on the center's homey front porch, it feels safe, as if the other buildings are standing guard. It's a perfect setting for the delicate child-advocacy work that goes on inside.
River Bridge Regional Center (RBRC) opened its doors in 2007 under the auspices of Childhelp, a national child abuse nonprofit, to provide child abuse prevention education as well as assessment, investigation, and treatment of child abuse for families in Garfield County.
Since then, RBRC has expanded to Eagle, Pitkin and Rio Blanco counties, and has served almost 550 children, mostly sexual abuse cases from Garfield and Eagle counties.
Support for its services has come from Garfield County, Childhelp, and other grants and donations.
But in June, RBRC's advisory team, including local law enforcement agencies, victim advocates, mental health providers, county human services and district attorneys, decided it was time for a change and separated the local organization from Childhelp.
Headquartered in Scottsdale, Ariz., Childhelp has programs in Arizona, California, Michigan, Tennessee and Virginia. River Bridge Executive Director Blythe Chapman said RBRC questioned the national organization's ability to connect with local needs.
"We decided that a local [child advocacy center] should be run and supported locally," she explained.
Chapman also cited financial problems. "Garfield County had bills out to Childhelp that were not being paid," she said.
Glenwood Springs Police Chief Terry Wilson, who sits on the RBRC board of directors, noted that at the time, a number of Childhelp facilities across the county were closing down.
"We didn't want to be in the position to have our facility and staff endangered," he said.
Chapman and Wilson are grateful to Childhelp for its four years of support, but said it was time to go it alone.
"So we took the plunge and established River Bridge Regional as a local nonprofit," Wilson said.
Chapman was hired in August 2011 and she works with three other staff members in a homey, child-friendly office. There are rooms for forensic interviews, treatment and observation, a conference room, kitchen, two offices and a medical examination room adorned with a colorful mural.
Chapman said the examination room was originally set up for SANE (Sexual Abuse Nurse Examiner) exams, but has not been used since May 31. Children and teens are referred to Frisco or Grand Junction for the exams.
A SANE exam is designed for children who have experienced sexual abuse, and can take up to five hours to complete.
"It's a complete head-to-toe examination, including the history of the incident, history of mental health and medical issues, a family history, a comprehensive health history, a detailed examination of the genitals, and photos of the injuries," said Lauren Gueriera, a registered nurse who ran the SANE program for adults and children at Valley View Hospital from 2002 to 2010. Exam results can be used as evidence if a case goes to trial.
She is now the clinical research coordinator at Valley View's Calaway-Young Cancer Center.
"A SANE nurse has to have two years of clinical nursing experience before undergoing SANE training," she explained. The training involves 66 hours of class time and over 100 hours of hands-on clinical training for an on-call position.
Gueriera said she started the VVH program with six nurses, but three dropped out due to the lengthy training and a lack of demand for the service. Then administrative complications prevented the hospital from being involved, and hospital officials asked Gueriera to set up a separate business.
Gueriera created the SANE program at River Bridge Regional Center for non-acute children and adolescent cases in 2008. She planned to contract with other SANE nurses to conduct the RBRC exams, but could not find any who had completed the training.
"So I was kind of it," she said.
Gueriera conducted 40 exams over four years at RBRC and was called to testify in only one of the cases. This wasn't enough to keep the program alive. Gueriera said law enforcement agencies were always supportive of the RBRC program but it was underused.
"The real value of the SANE exam was never fully appreciated," she said.
Gueriera began to re-evaluate her work a couple of years ago.
"I couldn't help but question the ethics of putting a patient through such an intensive and invasive exam if the information we obtain during the exam is not likely to be used by the investigators," she explained.
She closed the SANE program at RBRC last May.
Ninth District Attorney Martin Beeson said his office has always been in complete support of SANE programs. But 95 to 98 percent of child abuse cases don't ever go to trial.
"The jury may believe the child's story but not have enough evidence to file, or maybe the mother won't let the child testify," he said. "We can't create a situation where the focus is on the nurses so they feel valued. Our focus is on the victim."
Beeson cited scheduling problems with SANE nurses and financial difficulties with VVH and other agencies, but insisted that the program was used as much as it could have been.
"We did not want to see it dismantled," he added.
Chapman said she's upset about the closure of RBRC's SANE program and would like to see trained nurses step forward and help out.
"It's one of our mandatory components," she said. "I'm disappointed that we don't have those resources in this community to meet our victims' needs."
Chapman admitted that the transition from under the wing of Childhelp has been hard.
"Making the shift has been a process that takes time," she explained. "We've had meetings with Garfield County and we're serving other counties now."
Since June, her work load has increased. She's developing protocols and policies and writing grants. But, she isn't complaining. "It's more complicated now, but it's better," she said. "We're 100 percent local."