Legislature(1999 - 2000)
03/23/2000 03:03 PM House HES
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* first hearing in first committee of referral
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+ teleconferenced
= bill was previously heard/scheduled
HB 270 - SEXUAL ASSAULT & SEXUAL ABUSE Number 1920 CHAIRMAN DYSON announced the next order of business as Sponsor Substitute for House Bill No. 270, "An Act relating to sexual assault and sexual abuse and to payment for certain examinations in cases of alleged sexual assault or sexual abuse." [Before the committee was CSSSHB 270(STA).] Number 1929 REPRESENTATIVE ERIC CROFT, Alaska State Legislator, sponsor of HB 270 came forward to present the bill. He explained that SSHB 270 requires that the victims of sexual assault cannot be charged for the costs of forensic exam. This is not a medical procedure, it is a procedure for the gathering of evidence. It should not be charged under a woman's medical insurance, and in the vast majority of cases it is not. The reason he introduced this is to clarify in law for those rare cases that to charge a victim is not appropriate. Number 2011 REPRESENTATIVE BRICE asked Representative Croft why it was limited to just adult victims. REPRESENTATIVE CROFT said that wasn't done at first, but he found out that the program at Alaska Cares would be destroyed because many of their clients are Medicaid-eligible, and this would affect that. There are difficult issues. It is usually not the child that is consenting to this, it is the parent. When there are issues of parents having more control about not investigating something where they might be the suspect, it got troublesome. He tried to craft it around all that, but eventually just limited it to adults. REPRESENTATIVE BRICE said he was very concerned about what Representative Croft was saying. "Alaska Cares program sounds like what they're doing is charging Medicaid for forensic tests that should be paid by the police department." Number 2091 SAM SHEPHERD, Staff to Representative Eric Croft, Alaska State Legislature, explained in the discussions with Diana Weber from Alaska Cares, she said there was an agreement with the Anchorage Police Department, whether the child may have a diaper rash or there is a lot of reason to believe there is sexual abuse, not sexual assault, that there are considerations of sexual abuse, and the child can be brought to Alaska Cares without concern about ability to pay. For whatever reason, Alaska Cares will be able to bill Medicaid. There are a lot of reasons why it should be a police payment, but it is not. If children were included in the bill, Alaska Cares would be out of business. REPRESENTATIVE CROFT noted he struggled with that a long time and it is an appropriate question to ask, but he was not able to write it that way. REPRESENTATIVE BRICE said his concern is by explicitly stating an adult victim, in Fairbanks where there isn't an Alaska Cares, it is implied that the families of minors will have to pick it up, or that insurance companies will have to be charged for it. REPRESENTATIVE CROFT explained there were two different approaches and they chose the one. He said that Texas uses the approach "who does pay." At least one version of the draft early on said police shall pay for this, and that is the appropriate place to do it, but then there are fights about in which police jurisdiction it occurred. In Anchorage the municipality has a grant that goes to Providence Hospital where there is a special room and trained people. It is done for a set price: $100,000 will cover all the accommodating, the room and collateral help for these exams. If the bill says police must pay, there is a question of how to deal with the situation where it is done by a grant or some other innovative way. "We kept coming back to saying who should not rather than directing who should, though in the vast majority of cases, it ought to be the police." CHAIRMAN DYSON noted that Representative Croft touched on some of the problem. Some of the children get flown in from some other jurisdiction, and it would be confusing which police pays, and many areas do not have police. REPRESENTATIVE BRICE suggested maybe it should just say the victims of sexual assault under the statutes shall not pay and leave it at that. Then leave it up to whoever provides the service to figure out who will and who won't pay. REPRESENTATIVE CROFT said that is the way it is said in the current version, but the adult--that concept that it says who may not, not that the police shall, is getting into the jurisdiction issue. DEL SMITH, Deputy Commissioner, Department of Public Safety, came forward to testify. He reported that the department, law enforcement statewide and the Alaska Police Chiefs Association support this kind of legislation. In his experience, the police have never thought it appropriate that a victim of a crime should pay for anything in the way of gathering forensic evidence to support the prosecution of that crime. The victim ought never to see the charge on her insurance forms or be hassled in any way. MR. SMITH referred to Representative Brice's question. When the department originally looked at the bill, he talked with Duane Udland, Chief, Anchorage Police Department (APD), and he brought up the point that costs were already being covered for youth, and it was not being billed to them. Mr. Udland didn't think it should be switched to have the APD pay for an exam that was already being paid for. TAPE 00-34, SIDE B Number 2361 REPRESENTATIVE BRICE asked Mr. Smith where the money comes from. MR. SMITH said he asked the Violent Crimes Compensation Board if they knew of anybody who had been billed directly. He has not been able to find a circumstance where the bill actually went to the victim. The cost of the exam is part of the cost of doing business. The Department of Public Safety expended approximate $49,000 in the last fiscal year, and APD has paid Providence Hospital approximately $150,000 for sexual assault exams. CHAIRMAN DYSON asked Mr. Smith what happens when in a case of suspected child abuse, and an examination is done on the child looking for signs of sexual abuse, in most of those cases there won't be forensic evidence; as soon as there is reasonable presumption that there has been a crime, then law enforcement is contacted, and the team that meets includes a representative from DFYS or a child advocate, somebody from law enforcement and forensically-trained people. He asked if it is true that there may be some of the cases where there's a process that goes on before it is known there was a crime, and is this the area that the Alaska Cares folks are concerned about. MR. SMITH answered he would say yes, although he wouldn't want to try to answer for DFYS. A lot of the cases in DFYS do not involve the police; there is an examination, and if it is determined medically there is a problem, the DFYS brings in law enforcement. He doesn't expect law enforcement to pay for an examination when it was not involved in it initially. If somebody, for example, said "I was sexually assaulted six months ago and had an exam, now I would like you to pay for this," law enforcement, in his view, would not or should not be obligated to do that. If evidence is going to be collected to prosecute a case, then law enforcement needs to be involved in the decision and the process from the beginning. REPRESENTATIVE BRICE asked what about a 17-year-old girl who was violently raped. Implicitly she has to pay for this exam or her insurance does under this bill. MR. SMITH said a violently, sexually assaulted person should not be subjected to the bill. Any agency he has to do with is going to pay for the collection of the evidence. He doesn't read that the way it says "adults" would necessarily imply that law enforcement would bill someone under the age of 18. REPRESENTATIVE BRICE said ten years of working in this building tells him different. "When we say A, we mean A and don't mean B." He agrees it would be a heartless, sick thing to do, but he is just looking for some way in those instances to fix it. MR. SMITH said in discussions with the sponsor, he knows they have tried very hard to find a way to take care of the problem. Number 2104 LAUREE HUGONIN, Director, Alaska Network on Domestic Violence and Sexual Assault, came forward to testify. She clarified that while it may be true that Deputy Commissioner Smith may not have found an instance where law enforcement has forwarded a bill, hospitals have. It has happened in the Mat-Su Valley, on the Kenai Peninsula, and in Southeast, and that is why the bill is being brought forward. It is important to keep the word "indirectly" in there or to state "not charge health insurance." "Unfortunately, Representative Brice, if you just say victim, there are still agencies who take it that means sending me the statement. They don't consider my insurance as being the victim." It is important to encapsulate that indirectly. She reemphasized that often it is DFYS that is bringing children forward and billing Medicaid, and DFYS has that arrangement with Medicaid. MS. HUGONIN explained what it is like to undergo a rape exam. It is graphic and hard to hear. If a woman is sexually assaulted and is taken to the hospital by police, a friend, or gets herself there, she goes into the emergency room most often. She will be triaged and may be in the waiting room for a few minutes or several hours. If she is in a community with an advocacy program, she will have someone wait with her and explain the process, but that doesn't always happen. In the examination room, she is the crime scene. First, she stands in the middle of the floor on a white sheet of paper and brushes down her clothes. She then takes off her clothes; if they are the clothes in which she was sexually assaulted, she doesn't get them back because they are evidence. She brushes down again to get any possible hairs or fibers. She sits at the examination table. The clothes get folded up and placed aside. MS. HUGONIN continued explaining there is a packet which contains envelopes and different pieces of paper. They are taken out, and one by one they are gone through. One packet may contain a swab to go underneath her fingernails to find and skin or hair that she might have been able to get from the perpetrator, and that is put in an envelope. Another one is taken out, and her hair is combed through to see if there are any that are not hers to be tested for DNA [deoxyribonucleic acid]. She is checked over for bruises or cuts or abrasions or broken bones. At that point, if she can tolerate going further, the exam is continued. Another packet contains a little comb which is used to comb the pubic hair to see if there are hairs that are not hers. Another envelope will contain a tweezer to pluck pubic hairs to test her DNA and match it against the perpetrator's. There is a gynecological exam to look for tears and abrasions, and pictures are taken in that position. A black light is shone in her orifices to see if there is any semen; there are swabs that are collected and put it separate envelopes. MS. HUGONIN said that the sexual exam can take anywhere from 40 minutes to three hours depending upon how traumatized she is. When the examination is finished, hopefully there are clothes for her to wear home from the hospital, and she can leave. MS. HUGONIN mentioned that in the best of circumstances the perpetrator is caught, evidence has been collected and used in the prosecution to a good end, and the perpetrator is jailed. She indicated that as the victim recovers from this heinous crime, at every point where the victim has to relive it, and she does relive it because it is not something that can be forgotten. She emphasized that it is incomprehensible that the victim should have to relive the crime upon receiving a bill for the assault exam from her insurance company. It puts her right back to when it happened. MS. HUGONIN urged the committee to expedite the passage of this legislation. She shares the concern about children, but it doesn't seem that practically this year that can work out in a way where the bill can get through both the House and the Senate. It is important to her that this stop as soon as possible for as many people as possible, and if there are other areas to work on over the interim, her group would be interested in doing that. Number 1731 TRISHA GENTLE, Executive Director, Council on Domestic Violence and Sexual Assault, came forward to testify. She dittoed Ms. Hugonin's testimony and asked for the committee's support on HB 270. It is a problem that has come up sporadically around the state. She has been working with victims of sexual assault since 1982, and it has been around since then. It is time to support victims and say this won't be allowed to happen to them. MS. GENTLE agreed the issue of children is important too. She believes that during the interim they need to be able to look at exactly what the costs are, exactly what the system is, how it's working and what would be appropriate and helpful legislation or addition to this and what might be harmful to centers that already exist. REPRESENTATIVE COGHILL asked for the difference between "an adult victim" and "a victim." MS. GENTLE answered that it is an issue of clarity because it isn't known how it may or may not affect the children's programs, and this is happening with adult victims. She believes the discrepancy may be in the "direct or indirect" issue. Indirectly paying through Medicaid, through insurance, through grants or things like that, happens with children. What is not wanted is a victim's insurance to be billed. REPRESENTATIVE BRICE said he believes it is possible to artfully cut out child advocacy centers to ensure that the process will cover juveniles. REPRESENTATIVE CROFT wants the committee to be comfortable with this bill when it moves out of committee, and that it is the right fix for the situation. He suggested working on it this weekend and hearing it next week. CHAIRMAN DYSON suspended the hearing on HB 270. [HB 270 was heard and held.]
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