Michigan State University has taken substantial steps to move past the Larry Nassar scandal in which the now-convicted former team physician sexually abused student-athletes for two decades.

The effort focuses on three initiatives and so far has cost $3 million, according to The Detroit News. Areas of emphasis include protecting patients, responding to sexual misconduct and preventing abuse from happening in the first place. Thirty-nine new positions, including 13 Title IX and related hires, have been created, as well as a canine advocate to comfort victims. A mandatory chaperone policy, considered the national standard of care, now exists for health care exams involving private parts of the anatomy.

"Culture change takes a very long time," Rebecca Campbell, an MSU psychology professor and sex assault expert, told the News. "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."

A 13-page document outlines measures underway. Sensitive exams at MSU Health Care, as well as student training of sensitive exams, will require the presence of a chaperone, and electronic health records now require documentation of the chaperone presence. MSU's 15 athletic trainers, including two newly created positions, will no longer report only to the athletic department, but also medical supervisors.

Prevention efforts include 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 for first-year and transfer students, and in-person bystander intervention training for second-year students.

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

"The most important thing stems from making it very clear that, from the top down, we don't tolerate people looking the other way," MSU interim president John Engler said recently, as reported by the News. He added that all the policy changes in how MSU handles patients are of particular importance. "That deals specifically with Nassar," he said, "and that's why I feel confident in saying that couldn't happen again because of all those changes."

Paul Steinbach is Senior Editor of Athletic Business.