Stop Putting the Burden on Survivors

Ariana Kelly, Chair of the Montgomery County House Democratic Caucus and a member of the House of Delegates and the Health and Government Operations Committee STOP PUTTING THE BURDEN ON SURVIVORS: IT'S TIME TO ESTABLISH A HOSPITAL BASED MEDICAL EXAM SYSTEM THAT WORKS FOR EVERYONE. If you or your daughter were raped, would you know which hospital was the “right” hospital to go to? You would probably go to either the closest hospital, the hospital you felt most comfortable in, or maybe the hospital that EMS takes you to, right? That logical thinking might pose a problem for you. At present, there is generally only one hospital per county that provides sexual assault medical forensic examinations to victims. These hospitals are designated by Maryland's Department of Health, and known as SAFE hospitals. The cost to hospitals of providing these services are then reimbursed through federal funds that are distributed by the State Health Department. Maryland law already requires every victim of sexual assault who wants a forensic medical exam to collect evidence that might later be used in prosecution be provided one -- free of charge. Period. However, the system for getting sexual assault survivors access to these exams needs some improvement. Right now, we are putting the burden on the victims to get themselves to “the right hospital” to access these services. Establishing a thoughtful protocol at every hospital for survivors who present at the "wrong" hospital will ensure there is a transparent plan in place for ensuring people have timely access to SAFE exams. This will encourage more prosecutions, and hopefully prevent survivors from experiencing further trauma at a point at which they are most vulnerable. So, for example, in Montgomery County, there are six hospitals and a million people, but only Shady Grove Adventist Hospital provides the sexual assault exams that are needed to prosecute a rapist. The five other hospitals in the county do not provide these services creating a very difficult situation for survivors of sexual assault who get themselves to "the wrong hospital." You can see how survivors could easily fall through the cracks in the current system. Establishing hospital protocols will ensure survivors are treated appropriately, and not just told to get into their car and get themselves to "the right hospital" that may be across town. It will help prevent victims who have done the best they can just getting themselves to the nearest hospital from becoming discouraged from getting exams and pressing charges. It will reduce the likelihood that a victim will be provided an exam at "the wrong hospital" by an untrained provider who might not understand the rules for chain of custody of evidence, or how to treat a sexual assault survivor with respect and dignity. But the protocols alone will not be enough. We need real system evaluation and improvements. We need better coordination and accountability. And we need increased access to SAFE exams and a reform or our system for reimbursing trained providers. We’re paying for this system, we need it to work better for victims. Under legislation I passed last legislative session, all hospitals in Maryland are now required to submit protocols for handling sexual assault survivors. In addition, the legislation established the Planning Committee to Implement Improved Access to Sexual Assault Medical Forensic Examinations in Maryland, which had their inaugural meeting in November.  This Committee will evaluate these hospital protocols, as well as other opportunities to improve the system. The Committee brings together all the relevant stakeholders: The Health Department, Emergency Medical Systems, law enforcement, Hospitals, victim services, and MCASA to evaluate how we can improve the system so people are not falling through the cracks. The Committee will report back to us with recommendations for further legislation by Summer 2015. I expect the planning committee will review the newly established hospital protocols and ensure that they are consistent with the best interests of sexual assault survivors who present at the hospital. For many hospitals, this could mean developing memoranda of understanding with their closest SAFE hospital, so that when necessary the forensic nurse examiner can travel to the victim, rather than having the victim get to the "right" hospital. For other hospitals it could mean having a trained provider on duty. We may not have a one size fits all model for our diverse hospital network, but it is clear we need a system that works for the victims, not places an extra burden on them. *********

Delegate Ariana Kelly is Chair of the Montgomery County House Democratic Caucus and a member of the House of Delegates Health and Government Operations Committee. She passed legislation in 2014 that requires hospitals to establish protocols for handling sexual assault survivors, and established a Committee to Increase Access to Forensic Medical Exams. This legislation passed both houses with strong bipartisan support.