In 2005, Congress amended the Violence Against Women Act (VAWA) to ensure that states bear the full costs of sexual assault medical forensic exams (MFEs) regardless of whether the survivor reports the assault to law enforcement. This requirement allows survivors who are unsure about participating in the criminal justice process to access medical care and provide forensic evidence in a timely manner—without having to pay to do so.
Five years later, the National Institute of Justice (NIJ) funded a study to determine whether this requirement is being met across the country and to analyze policies and practices around payment for MFEs. The Urban Institute just released the findings of its study earlier this month.
The study found that two-thirds of states use victim compensation funds to pay for some MFEs, and more than one-third only use those funds to pay for MFEs. A smaller case study of six states demonstrated that most survivors are able to receive exams free of charge and without having to report the assault. There are, however, significant barriers to accessing the exam, which prevent some survivors from seeking help. In particular, survivors who are non-English speaking, immigrants or American Indian face barriers in accessing the exams due to lack of cultural competency among first responders, language barriers and unavailability of Sexual Assault Nurse Examiners.
The researchers also learned that most survivors who get an MFE report the assault to the police at the time of the exam. Among those survivors who do not report at the time of the exam, few report at a later date. According to the study:
“It is more likely that victims who do not report their assaults to the police have not gotten exams. This means that victims who do not report to police miss out on receiving other necessary medical, advocacy, and counseling services."
Finally, the study found there are major concerns in many jurisdictions about having sufficient funds to pay for MFEs. The authors of the report cautioned that states that use victim compensation funds to pay for all or some MFEs must “ensure that this obligation does not compete with funding for other services to victims.” In place of compensation funds, they recommend the use of law enforcement or prosecution funds to pay for MFEs. “Given that these agencies benefit from the evidence collection to build a criminal case, it may make sense to explore ways to use such funds for MFEs.”
This study provides much needed insight into the needs of survivors who wish to access MFEs. It is critical that all survivors be able to receive free sexual assault exams without feeling pressured to report the assault to law enforcement. Support services and resources must also be accessible to survivors from every community, and the criminal justice system must honor survivors’ decision about whether or not to participate in the process.
Access the full Urban Institure report here.
- By Elizabeth Swavola, May 23, 2014
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