Sexual assault victims in some states are forced to drive hours for access to a rape kit, sometimes in the back of a cop car if they lack other transportation, according to details of an ongoing congressional investigation provided to VICE News.
The investigation, conducted by the House Energy and Commerce Committee, aims to shed light on a problem that’s just as widespread as the backlog of untested rape kits but much tougher to measure: the lack of access to kits to begin with.
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According to the International Association of Forensic Nurses, fewer than 14 percent of emergency rooms in the United States provide trained medical professionals — known as sexual assault nurse examiners (SANEs) — to administer the tests. And the number of hospitals that simply don’t keep tests on hand is unknown.
Access to rape kits — and medical professionals specifically trained to administer them — can mean the difference between a rape that’s successfully prosecuted, and one that goes unpunished. A 2016 Government Accountability Office report found that sexual assault forensic exams performed by trained examiners “may result in shortened exam time, better quality health care delivered to victims, higher quality forensic evidence collection… and higher prosecution rates.”
Critical evidence
To uncover more details on the scope of the problem, the House Energy and Commerce Committee issued surveys to more than two dozen hospitals and hospital associations nationwide asking for details on their sexual assault forensic exam services. The Committee will hold a hearing Wednesday to dig into the details they found. A copy of the questionaire provided to VICE News reveals that the differences in care nationwide are stark.
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Some states returned dozens of pages of responses outlining comprehensive systems for care. Others, like the Alabama Hospital Association, which represents 104 hospitals in the state, had little information to provide.
“The thought of turning to a hospital after such a trauma and being told ‘we can’t help you’ is unimaginable.”
“The Alabama Hospital Association does not maintain a statewide database on programs such as SANE,” wrote association CEO Doug Williamson to the committee. But that after calling around to a number of the hospitals in the association, Williamson found many struggling to maintain staff trained to implement the kits.
“The combination of financial instability of many rural hospitals, a severe shortage of health care personnel, and the lack of training make the direct provision of SANE services problematic for many hospitals,” he wrote
Lack of training
The problem of access to rape kits is particularly acute in rural areas, which often lack resources and trained personnel to meet the basic needs of a community, let alone specialized services for sexual assault victims.
The state of Nevada, for instance, has just one hospital, in southern Nevada, providing SANE services, and an advocacy center in Reno where patients are taken from the hospital to receive the tests. A few other hospitals in the state rely on an on-call nurse that comes to administer the test if called.
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In Texas, just 110 out of 867 facilities are considered Sexual Assault Forensic Exam-ready, according to the Texas Department of State Health Services.
“There are 360 certified sexual assault forensic examiners. The lack of certified examiners renders it impossible to locate a certified SANE at every Texas emergency department,” the Texas Health Association wrote in its questionnaire.
But the problem isn’t just confined to rural areas. Cities and metropolitan areas tend to offer the most consistent access to rape kits, but some have have only one hospital that provides them. According to the questionnaires the Committee received, both Las Vegas and Washington DC have just one hospital providing rape kits to victims.
MedStar Georgetown University Hospital in D.C. responded to the committee’s questions by stating that it provides no tests because MedStar Washington Hospital Center is the “designated home” of the DC Sexual Assault Nurse Examiner program. In effect, that means if a student were assaulted on Georgetown’s campus, they’d need to take a 30 to 40-minute drive to Northeast D.C. to get tested.
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The challenges the hospitals outlined in implementing training programs and offering widespread access to rape kits ranged from a lack of funding to a claimed lack of demand from hospital to hospital. And while there are a few grant programs states can use to help train nurses, there are no federal requirements for standardized training or access to rape kits.
Rape kit bills
But lawmakers on Capitol Hill are working on a handful of bills aimed at changing that. One, sponsored by California Republican Rep. Mimi Walters, requires that “Disproportionate Share Hospitals” — those that provide care to low-income patients and receive payments from the government to do so — have a sexual assault forensic examiner available at all times.
Another, backed by a bipartisan group of lawmakers in both the House and Senate, would direct the Department of Health and Human Services to establish a national training program to expand health care for victims of sexual assault and rape — and offer grants to train examiners in rural and tribal communities.
Still, the future of the reforms remain uncertain. Walters was defeated in the midterms, and there remain major disagreements over how stiff the federal requirements for hospitals and health associations can be. In his release announcing the committee hearing, House Energy and Commerce Chairman Greg Walden (R-Ore.) said that Congress is just starting its work on finding a solution.
“The thought of turning to a hospital after such a trauma and being told ‘we can’t help you’ is unimaginable,” he said.
Cover: A sexual assault evidence collection kit in the Ohio Bureau of Criminal Investigation Laboratory on January 27, 2016, in Richfield, Ohio. (Photo by Ann Hermes/The Christian Science Monitor via Getty Images)
