By: Brittany Gamlen
You’ve probably heard the story of the college freshmen that goes to her first party and wakes up the next morning with more than a hangover. It is an unfortunate reality that many people will experience a sexual assault or rape at some point in their lives. This experience is often the most traumatic event in their life. Following a sexual assault or rape, many survivors elect to undergo a medical evidentiary exam—commonly known as a rape kit. A medical evidentiary exam collects any evidence from the sexual assault and provides medical treatment for any injuries sustained during the assault. However, in California many counties have few if any, personnel trained to perform these exams.
To improve access, Assemblymember Marc Berman (D-Los Altos) introduced AB 538—now Chapter 714. Assemblymember Berman aims to improve access by allowing physician assistants and nurse practitioners to be eligible to receive training on, and perform, medical evidentiary exams. Currently, only physicians and registered nurses are eligible to. The bill also expands the facilities eligible to perform these exams.
The bill also improves the efficiency and quality of medical evidentiary exams by standardizing the forms and procedures used doing the exam. Additionally, personnel performing the exams will receive more uniform training at the California Clinical Forensic Medical Training Center. This new training includes a greater focus on how to interact with certain groups of survivors—including minors, the elderly, strangulation victims, and victims of human trafficking. Likewise, the new procedures include more tests to diagnose survivors’ injuries, while the new forms include more documentation to help make the exams more effective.
Lastly, AB 538 increases the reimbursement hospitals receive for medical evidentiary exams from law enforcement. Presently, law enforcement reimburses hospitals for up to $300 for exams where the survivor does not report the sexual assault. AB 538 will require law enforcement to reimburse hospitals for the full amount of the medical evidentiary exam, regardless of whether the survivor reports the sexual assault. Furthermore, AB 538 increases the reimbursements from the California Office of Emergency Services to law enforcement.
AB 538 has the potential to help many survivors across the state. However, it only requires counties with populations over 100,000 to have personnel trained to perform medical evidentiary exams present in their counties. Thus, AB 538 allows twenty-two of California’s counties to have no personnel trained to perform medical evidentiary exams. Many of these counties are next to one another—creating areas that are potentially 1,156 miles from the nearest medical evidentiary exam. Therefore, even after the passage of AB 538, there are still many counties in California that do not have any personnel who can perform a medical evidentiary exam.
Likewise, there is no incentive or disincentive for counties to increase the number of sexual assault response nurses (“SANES”) in their hospitals and emergency medical facilities. Without an incentive or disincentive, it is possible that many counties will not send any medical personnel to receive the training. Not only is it costly and time-consuming, but many counties have shortages of medical personnel and therefore do not have many people who are eligible for training. Similarly, creating one, centralized training location potentially makes it harder for eligible medical professionals to attend training if they must travel to the training center. Generally, medical personnel must pay for their own training and travel expenses when completing medical evidentiary exam training. Many personnel use vacation days to take time away from work to complete the training.
So, AB 538 may increase access to medical evidentiary exams for survivors, but it might not help survivors in rural parts of California. It is possible that some counties will not send the newly eligible medical personnel to complete the trainings. But, if AB 538 helps even one survivor, then it is a success. The unfortunate reality is that it may have no impact on the counties that already do not have enough personnel trained to perform medical evidentiary exams.