Paying the price for rape

RALEIGH -- Some excellent reporting has revealed that rape survivors in North Carolina have had to pay for their own forensic evidence exams. As a longtime advocate for survivors of rape, I am encouraged that this coverage has increased awareness among legislators, who now recognize that they have an obligation to deal with covering costs for hospital tests done on patients examined for sexual assault.

An underlying problem remains, however, in that funds provided by the Rape Victims Assistance Program are to be used only as a last resort. First, a survivor's insurance is billed. Then the RVAP will potentially cover the remaining balance.

We have read about a suggested parallel regarding this issue -- that if your house were burglarized, you would never be expected to pay for the fingerprints. This parallel is incomplete, however, without also acknowledging that it would be equally illogical for your homeowner's insurance to be billed for it, either.

Billing one's health insurance for a forensic exam, used solely to help the state build a case against a felonious criminal, perpetuates the message that rape survivors, not rapists, are responsible for being raped.

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THINK ABOUT A PERSON WHO IS JUST RAPED, aware of the way that society doubts and blames survivors, yet with the courage to sit through an invasive procedure that can last three to four hours. Among various parts of the exam, pubic and head hairs are pulled, blood is drawn and necessary bodily orifices are swabbed with Q-tips. The survivors are also photographed internally and externally, and must submit their clothing as evidence.

After all of this, they can receive bills for a $100 emergency room fee and the remaining balance not covered by insurance.

Now imagine that this rape survivor is a college student still covered by parents' insurance.

Rape survivors already face multiple barriers in reporting the crime, and students face the additional fear that their parents will find out. While many college rape survivors eventually tell their parents, they do so when they feel ready. Knowing that their parents will discover this devastating news from their insurance bill only increases their anxiety and is a potential deterrent to receiving services.

This means that those with insurance are not as likely to get rape exams. They are fearful of their parents knowing and the lack of confidentiality that occurs when an insurance company has access to their private records.

While 3,000 rape survivors are receiving exams in North Carolina every year, many more would potentially be receiving this exam and helping us incarcerate the many sex offenders if their insurance were not billed.

Nationally, it's estimated that 3.5 percent of women on college campuses will be the victims of rape or attempted rape every academic year. When applying this percentage to the number of women who attend the 16 University of North Carolina system schools, we can conclude that in an academic year alone, 3,158 women on these campuses could be raped or be the victims of an attempted rape. This number already surpasses the number of exams done every year throughout the state. It does not include sexual assaults on college men, on individuals who are not in college or on students on all other campuses throughout the state.

Estimates are that only about 6 percent of rapists (1 out of 16) will ever spend a day in jail. We cannot afford to deter a single survivor from a procedure that could save our loved ones from this horrific experience.

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LEGISLATORS SHOULD TAKE IMMEDIATE ACTION to increase the RVAP fund to $4.8 million, to require that RVAP funds pay for all costs associated with the forensic rape exam (regardless of insurance coverage), to permanently remove the $1,000 cap and to remove all stipulations that RVAP is only a payer of last resort.

In South Carolina, the State Office of Victims Assistance operates under the following provision: "Neither the victim nor their insurance, including Medicaid and Medicare, may be billed for the medicolegal examination."

If South Carolina can do this, we know that North Carolina can, too.

Rape survivors should never pay the price for the safety of North Carolinians. They are already paying the price of being survivors in a culture that blames and shames them. Let us rather create a culture of understanding, compassion and support.

(Juliette Grimmett is legislative chair and campus representative on the board of directors of the North Carolina Coalition Against Sexual Assault.)