Thumbnail photo by Persephone Rose
Three months after she told Healthcare District officials that the Sutter Coast Hospital emergency room hadn’t followed federal law in at least one case of suspected sexual abuse, Maia Mello says attitudes seem to have improved.
No two cases are the same, the Del Norte County Sheriff’s detective told Redwood Voice Community News on Wednesday. But since the July 28 Healthcare District Board meeting, members of the Sexual Assault Response Team have been working with hospital administrators to get their concerns addressed. As a result, service at the hospital has improved, Mello said.
“We are taking a look at these very individualized experiences and dissecting those to see what went wrong so that we can write a protocol that adequately covers all of the what ifs,” she said. “Typically MOUs are pretty vague. In this case, we don’t want it to be vague because we want each partner to really understand what their responsibility is and what is the law that governs that.”
Mello has been part of an ongoing effort to iron out an updated memorandum of understanding among all of the agencies and organizations that work with sexual abuse cases. This agreement would be an update to the Del Norte County Sexual Assault Response Team Protocol last revised on Nov. 13, 2017.
According to email communications between SART members, hospital CEO Michael Lane and Chief Nurse Carol Hiner and District 2 Supervisor Valerie Starkey obtained by Redwood Voice, the next meeting is scheduled for Monday. In an Oct. 22 email from Starkey to the SART stakeholders, the goal is to have Sutter’s portion of the new memorandum of understanding ready for signature.
“(I’m) hoping each agency can present what the overview of their process is for when a survivor needs to be examined (i.e. importance of compassion, importance of securing evidence, doctor’s roles/observations, etc.),” Starkey wrote. “ This can be a high level overview, but it is important for each of us to understand your focus, timeline, etc.”
The 2017 agreement established a SART Advisory Committee that includes law enforcement, the North Coast Rape Crisis Team, the Del Norte County District Attorney’s Office and its Victim Witness program, the Del Norte County Department of Health and Human Services, Pelican Bay State Prison, Rural Human Services, the Tolowa Dee-ni’ Nation and Yurok Tribe and Sutter Coast Hospital.
The DA’s office is the lead agency. Sutter Coast Hospital agreed to provide a room in its emergency department for SART examinations while the Emergency Department medical director was tasked with establishing medical protocols and standardized procedures, according to the agreement.
On Monday, Mello told Redwood Voice that after hearing from SCH Hospitalist Dr. Carroll Christie during current conversations to update the MOU, she doesn’t believe that, historically, the medical director of the hospital’s Emergency Department established the medical protocols and standardized procedures the 2017 agreement calls for. Mello said she thinks this will be rectified with the new MOU.
“It has become abundantly clear that the ‘whys’ of everything are important,” she said. “Understanding why law enforcement, advocates, forensic examiners and the hospital each have specific needs has become central to the conversation between the component groups since the July Healthcare District Board meeting.”
Efforts to update the 2017 MOU have been ongoing for about two years, Mello said. The challenges when it comes to ensuring that the hospital was following SART policy date back to at least 2023, according to the email communication Redwood Voice obtained.
Updating the 2017 agreement was also necessary because state law had changed as had best practices for treating sexual abuse survivors, Mello said. The individual entities involved in SART also experienced changes, she said.
But turnover at Sutter Coast and what the detective says was administration’s lack of understanding regarding the specific issues that were occurring at the hospital slowed the process, according to Mello.
Sutter Coast was also working on an internal policy focusing on their nurses who often also serve as sexual assault nurse examiners to address potential conflicts of interest and what can and can’t be done, Mello said.
“All those things were in the process of trying to be worked out by this new Sutter Coast Administration when it really degraded and that’s when you started seeing it roll down to really affect our survivors and our victims,” Mello said. “And then I was kind of done waiting anymore.”
In a July 13, 2026 email from Mello to the Del Norte Healthcare District, Mello asked for a letter from officials urging the hospital to comply with SART protocols. She described significant pushback from the hospital regarding the treatment of child abuse and sexual assault victims going back roughly two years.
“While state and federal regulations require the county hospital to comply with SART protocols — including providing (sexual transmitted infection) testing, pregnancy testing and contraception — Sutter Coast Hospital doctors have refused to order these necessary tests in several instances,” Mello told Healthcare District officials. “Unlike other Sutter Health locations, Sutter Coast has refused to provide the required support for patient examinations, particularly in child sexual abuse cases and cases involving the unhoused population.”
At the Healthcare District’s July 28 meeting, Mello described a situation involving a 5-year-old who had presented to the emergency room with suspected physical and sexual abuse indicators. The child was refused testing and treatment in a timely manner, Mello said, and the patient was discharged with at least one condition left untreated in violation of the federal Emergency Medical Treatment and Active Labor Act (EMTALA).
By the time Mello went back to the Healthcare District Board on Oct. 27, the SART team, which includes hospital representatives, had been working to update the 2017 agreement. Starkey also became involved by helping facilitate the discussions. In an interview with Redwood Voice about two weeks ago, Starkey said she had met with hospital administrators and the SART team after the July 28 Healthcare District meeting.
In a Sept. 9 email from Hiner to the SART team, agreed-upon stipulations included reinstating and expediting Del Norte Public Health Officer Dr. Aaron Stutz’s hospital privileges. Stutz would be the ordering physician for patients receiving “forensically relevant care” at the hospital. The hospital would also ensure Stutz received copies of all test results, according to Burr’s email.
“This order set will be a guide for the emergency room providers,” Hiner wrote. “A guide will be a helpful suggestion to other providers.”
Issues involving medical care would be addressed with Stutz and “escalated as needed under his direction,” according to Hiner.
On Oct. 27, North Coast Rape Crisis Team Executive Director Amanda LeBlanc joined Mello, Lane and Hiner in telling the DNHCD Board that they were ironing out the new MOU’s finer details. Other than informing the Healthcare District Board that the MOU would also include protocols and practices related to domestic abuse and strangulation in addition to sexual assault, no one went elaborated on what might be in the agreement.
Mello didn’t discuss whether her concerns from July 28 were rectified because, she said Wednesday, no one had asked her.
In a statement to his colleagues before SART team members spoke, DNHCD Board Chairman Dr. Kevin Caldwell mentioned a “committee” that’s working on the issues Mello raised three months back. But, he said, “we don’t really have power.”
“We do have a lot of responsibility,” Caldwell said. “And in that vein, we said, ‘Yes, there’s already a committee meeting to work on these problems.’ Our job was to facilitate it, coordinate it and make sure that the meetings were happening and were progressing. We aren’t involved in the discussions, we aren’t litigating any of it in this meeting or in this forum. Our job is to make sure that the committee is making progress and all indications are that they are.”
In an Oct. 12 conversation with Redwood Voice, however, Caldwell said that if hospital administrators weren’t working to follow the proper protocols, the Healthcare District Board could take their concerns to the State Inspector General.
But on Oct. 27, Caldwell pointed to a letter that Lane had sent to him and his colleagues that was “very positive about working on these things.”
In his letter, Lane acknowledged Mello’s concerns and said the hospital reviews and responds to patient complaints. However, Lane said, hospital leaders also recognize that “some recent public accounts do not fully reflect the care provided at Sutter Coast Hospital.”
Lane’s letter also mentioned the 2017 MOU as an example of Sutter Coast’s policies on providing care to sexual assault survivors.
“We remain committed to the SART program and are supportive of an updated Memorandum of Understanding,” he wrote. “Our legal and compliance teams are in the process of completing their review so the MOU maintains alignment with our required regulatory obligations.”
In response to follow-up questions from Redwood Voice, a Sutter Health spokesperson said they were pleased that all SART stakeholders confirmed the progress they are making on a new MOU before the Healthcare District Board.
“We are working to finalize the memorandum of understanding and continue to honor the existing agreement with SART, including the most recent agreement from 2017,” she said in an email Monday.
The new MOU will reflect changes brought about by Assembly Bill 2185, which was passed in 2022 and required forensic exams be provided to adult victims of domestic violence and elder abuse at no cost to the survivor. A year later, Assembly Bill 1402 added no-cost forensic examination to the Penal Code for child abuse victims, Mello said.
Instead of the Sexual Assault Response Team, the updated MOU will refer to the Del Norte County Multi-Disciplinary Team or the United Justice Task Force, Mello said. The goal is to follow a Family Justice Center model to provide more all-encompassing services to abuse survivors in Del Norte.
“We are planning a supplement to this MOU to cover the expansion of forensic services to include strangulation as well as to establish protocols for continuum of care for the first 12 months post report to capture and address ongoing physical and social after-effects in these cases,” Mello said. “This continuum of care would include all MOU partners and would be loosely modeled after what we see in family justice centers (or as close as practical with our local resources).”
The new agreement will also include establishing payment and reimbursement policies, outlining survivor access to healthcare records and requirements for updating the document periodically.
Mello said there will still be hiccups as each component of the Multi-Disciplinary Team gets a handle on their responsibilities under the new agreement.
“But the bigger picture is that as a team, if we have the correct intentions, a commitment to improving the experience for survivors and positively impacting public safety — and a willingness to call each other out when needed — issues will be resolvable,” she said.
