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Guidelines that Ensure Survivors Have Free Access to SANE Exams

National Information

The Violence Against Women and Department of Justice Reauthorization Act of 2005 requires that sexual assault survivors have access to a medical forensic exam free of charge, without reporting to law enforcement.

"The Violence Against Women and Department of Justice Reauthorization Act of 2005 ("VAWA 2005"), 42 U.S.C. § 3796gg-4(d), provides that states may not 'require a victim of sexual assault to participate in the criminal justice system or cooperate with law enforcement in order to be provided with a forensic medical exam, reimbursed for charges incurred on account of such an exam, or both' (the "VAWA 2005 forensic examination requirement")." Under this provision a state must ensure that victims have access to an exam free of charge or with full reimbursement, even if the victim chooses not to report the crime to the police or otherwise cooperate with the criminal justice system or law enforcement authorities. Prior to VAWA 2005, states were required to ensure access to such exams free of charge or with full reimbursement but could condition the exams on cooperation with law enforcement" (United States Department of Justice, 2008).

States are primarily held accountable to this requirement through the allocation of STOP funding. "Under 42 U.S.C. § 3796gg-4, a State is not entitled to funds under the STOP Program unless the State or another governmental entity 'incurs the full out-of-pocket cost of forensic medical exams . . . for victims of sexual assault'" (United States Department of Justice, 2008). Thus, when applying for STOP Program funds, states must certify that they are in compliance with the "VAWA 2005 forensic examination requirement". Ultimately, this is largely dependent upon local jurisdictional implementation of compliant policies and procedures.

United States Department of Justice. 2008. Frequently asked questions: Anonymous reporting and forensic examinations. Office on Violence Against Women.

Washington State Information

In Washington, RCW 7.68.170 mandates that victims cannot be billed by medical providers for a sexual assault exam when it is "performed for the purpose of gathering evidence for possible prosecution." Thus, victims do not have to make a report to receive the exam at no cost but it does have to be performed with the intent of collecting evidence for prosecution in case the victim decides to report in the future. Hospitals and emergency medical providers are reimbursed for the exam through the State's Crime Victims Compensation Program.

The Crime Victim's Compensation (CVC) Program provides a very useful guidance document about all of the services that are eligible to sexual assault survivors. Download the "Billing Guidelines for Sexual Assault Examinations" document.

Reviewed: August 10th, 2016