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Michigan State University, where serial pedophile Larry Nassar flourished for more than two decades, has made scores of changes on campus in response to one of the nation's worst sexual abuse scandals.

MSU has invested more than $3 million in initiatives that include 39 new positions and a mandatory chaperone policy in certain health care exams as it works to move past Nassar's crimes and create a safer community, officials say. There's even a canine advocate to comfort victims.

The effort is rooted in three main areas: protecting patients, responding to sexual misconduct and preventing abuse from happening in the first place.

More: Klages to be tried on lying charges in Nassar case

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Rebecca Campbell, an MSU psychology professor and national sexual assault expert, is among those leading the university response to the crisis. She said the widespread changes signal the university's priorities and commitment.

"Culture change takes a very long time," said Campbell. "We're creating culture change by helping people become more empathetic and compassionate responders when they receive a disclosure, getting people linked to services that will help them and teaching people the skills for intervening to prevent violence from happening in the first place."

The changes come after a monumental time for Michigan State: Nassar was incarcerated in a federal prison in February with an essential life sentence for sexually assaulting young women and possessing child pornography.

MSU faced months of backlash over the response to the scandal by some Board of Trustees members, former President Lou Anna Simon and interim President John Engler. The university also reached a historic $500 million settlement with 500 of Nassar's accusers.

MSU's initiatives reach the university's health care services, police protection and sexual assault response, counseling and prevention efforts. They are outlined in a 13-page document, Taking action to foster a safer campus. Some of the steps have been reported, such as the reorganization of MSU health care, but most have not been well-publicized.

Among the highlights: sensitive exams at MSU Health Care will require the presence of a chaperone; electronic health records now require documentation of the chaperone presence and chaperones are also required during medical student training of sensitive exams. MSU's 15 athletic trainers, which include two newly created positions, will no longer report only to athletic department. They will also report to medical supervisors.

Numerous prevention efforts have been launched, including a new section on sexual misconduct for incoming students and parents during orientation; thousands of posters that list resources for those affected by sexual misconduct and relationship violence; mandatory in-person prevention programming forfirst-year and transfer students; and in-person bystander intervention training for second-year students. 

Meanwhile, the university police department created a unit focused on sharing best practices in investigations that officials refer to as trauma-informed and victim-centered. On campus, three new departments have been created and offices that come in contact with sexual assault victims have scores of new colleagues.

Among the new hires are 13 Title IX and related positions, 10 positions in Counseling & Psychiatric Services, four MSU police officers, two Employee Assistance positions, two positions in the Freedom of Information Act Office, two positions in the Office of Enterprise Risk Management, Ethics, and Compliance, and six positions in the Sexual Assault Program, according to Jessi Adler, an MSU spokeswoman. 

"The most important thing stems from making it very clear that, from the top down, we don't tolerate people looking the other way," Engler said recently.

He added that all the policy changes are very important, particularly in the clinics and how MSU handles patients.

"That deals specifically with Nassar and that's why I feel confident in saying that (another predator) couldn't happen again because of all those changes," Engler said.

Across the country, the standard of care is to offer chaperones during exams involving a sensitive area of the body, said Dr. Norman Beauchamp Jr., MSU associate provost and assistant vice president for health affairs.

"But we are requiring that for every sensitive exam," said Beauchamp, who is also the dean of the MSU College of Human Medicine. "Any exams that involve the breasts, genitalia, the anus ... the type of things that were happening with Larry Nassar, that if there was any contact with those part of the body, we require that a chaperone is present. For every patient, every time."

Nassar, an osteopathic doctor, assaulted young women during medical appointments, portraying his molestation as treatment. The young women often were alone in the treatment room with him. But sometimes parents were present, and Nassar positioned himself during the assaults so the parents couldn't see what he was doing.

The newly required chaperones typically will be medical assistants, Beauchamp said, and they have been trained on how to report issues of concern.

"We are not having a parent serve as a chaperone and that is really important because in some places that is what they do," Beauchamp said. "As we’ve heard, parents are not trained to know what is going on in the room, what’s acceptable, what’s not acceptable; they are not trained in how to report something concerning."

Campbell chairs MSU's Relationship Violence and Sexual Misconduct Expert Advisory Workgroup, created as one of the first steps by Engler after he took office in February. She said MSU is assessing where it is with its programs, policies, practices, education and training of students, faculty and staff.

The work underway to change the university's culture involves combining short- and long-term initiatives that can eventually produce broad, sweeping reforms. 

"It's a very large-scale mission that we have," Campbell said. "We're trying to understand where we are at right now, what are the deficiencies and problems, and what are immediate steps that need to be taken and what are the longer-term steps that need to be taken."

One key issue that emerged immediately was the inadequate staffing of programs and services related to relationship violence and sexual misconduct, she said.

For example, on the prevention side, which includes education, outreach and training, there had been one person designated, which Campbell said is "not at all sufficient for a campus this size."  

That's why MSU created the Prevention, Outreach and Education Office.

MSU also started a new department, the Civil Rights, Title IX Education and Compliance Office, which will include a person dedicated to analyzing data to spot reporting trends, a "best practice" in law enforcement, Campbell said.

Two new service coordinators will also help complainants, respondents and their families navigate the Title IX process, she said. 

Natalie Rogers, a spokeswoman for Reclaim MSU, an advocacy organization formed in the wake of the Nassar scandal, called the creation of the office "a good step forward."

"It is raising awareness and putting prevention at the forefront of things," Rogers said. "It would be nice if the administration’s rhetoric matched that of the department, but that hasn’t happened."

Rob Kent, interim associate vice president for the MSU Office for Civil Rights and Title IX Education and Compliance, said a national search is underway to head the office, adding that it is a "much more fortified program."

He said officials recognized that MSU's prevention, outreach and education functions for sexual misconduct should be housed with the Office of Institutional Equity. 

"The reason for keeping all of this under one office is to make sure we have consistency in message," Kent said. "There have been a lot of programs around campus surrounding sexual assault and prevention. What we are trying to do is consolidate all that we have in one place."

It's also going to allow MSU to reach populations besides complainants and respondents, including under-served populations such as the LGBTQ community, Kent said.

That's why the prevention side of the office was beefed up from one full-time person to eight full-time staff members, including five prevention specialists.

The Office of Institutional Equity created a new case-processing manual and added an investigator, for a total of 10, along with two new assistant directors, a case manager and two new service coordinators.

"The goal is to create efficiencies and consistency in the way that we approach cases," Kent said. 

There are also six new positions for therapy, advocacy crisis counseling and supervision at MSU's Sexual Assault Program.

There's also one staff member listed at the top of the program's staff list, and hailed on her Instagram account as the best (four-legged) employee.

Justice, a black labrador retriever who joined the program in April, has opened the door for conversations about sexual assault among Spartans and made it easier for abuse victims to come for counseling and advocacy, said Katelyn Maddock, a therapist at MSU's Sexual Assault Program

"Because of all that has happened, more people than ever are talking about sex assault and thinking about sexual assault, so we are seeing a higher demand,” said Maddock,  "Having Justice here helps people to talk about sexual assault in a way that is less scary, and it allows us to do our jobs better.

"More than ever, people are committed to having these conversations and doing the work that needs to be done to heal and move on, on an individual level but also on a systems level."

kkozlowski@detroitnews.com

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