In many parts of West Virginia, victims of sexual assault face issues accessing proper medical and forensic examinations. While state delegates and senators have said they want to improve access, legislative action so far will likely have little impact on fixing the problem.
Lawmakers passed a bill with support from both sides of the political aisle; one that, in its original form, could have made it easier for all West Virginians to seek forensic exams. But, before sending it to the governor’s desk, they watered it down and gave hospitals a way around staffing properly-trained personnel at all times.
Forensic sexual assault exams help connect victims to trauma-response resources and are crucial to collect criminal evidence. But only three counties in the state — Jefferson, Berkeley and Monongalia — have emergency departments staffed with properly-trained forensic examiners available at all times, according to the state’s Sexual Assault Forensic Examination Commission.
For other parts of the state, including some of the largest cities, people might have to drive hours to get an exam by a well-trained health care worker. In rural areas, transportation to a larger medical center can be the best option; but only 16 counties have finalized plans for getting sexual assault victims examined in a timely manner.
“If you’re going to a hospital for assistance and you find that you can’t get that kit done there, that can be very frustrating,” said Kim Nicholson, a community liaison for the West Virginia rape crisis center Hope Incorporated. “You’ve been sexually assaulted, you are traumatized. So going from one place to the other, that’s harder on the victim.”
Timely tests matter
Timing is everything in the hours after a sexual assault. Trained nurses are supposed to collect the evidence for law enforcement within 96 hours of the crime, according to Margaret Denny, director of nursing at Reynolds Memorial Hospital.
Denny said that when the only way to get an exam is to drive for hours, many victims will second guess whether they should get a test.
While a variety of emergency room workers can conduct them, exams done by someone without specialized training can be traumatic for the victim and ultimately useless for criminal proceedings. David Miller, a forensic scientist for the state police and a member of the commission, has found that kits collected by providers without forensic-exam training are often poor-quality.
Miller lives in Charleston; but he said if one of his family members was sexually assaulted, he wouldn’t bother taking them to a nearby emergency room and would go straight to WVU Medicine’s flagship hospital in Monongalia County. It has trained sexual assault nurse examiners available at all times.
A spokesperson for Charleston Area Medical Center, the largest medical provider in Kanawha County, said resources are available for sexual assault survivors at all times but did not answer a specific question about whether trained forensic examiners were available.
An amendment to a bill has reduced, if not eliminated, the impact
Lawmakers have been aware for years that many in the state have limited access to forensic examinations. In 2014, they passed a bill to create and maintain a commission tasked with facilitating the examination network.
This year, they passed another measure to address the issue. Introduced by Sen. Mike Woelfel, D-Cabell, the bill version that first passed the Senate would have required all emergency departments to staff trained nurse examiners at all times. If these personnel were in every facility, it would ensure all West Virginians have nearby, 24/7 access to trained sexual assault examiners.
The House Health and Human Resources Committee, however, amended it so hospitals could set up a plan to transport patients to other facilities instead of staffing nurses themselves.
When speaking about the amended bill on the House floor, just before the delegates voted unanimously to pass it, Health and Human Resources Committee Chair Del. Amy Summers, R-Taylor, said that it was not reasonable to expect all West Virginia hospitals to staff qualified examiners.
While coordinating care between facilities can make sense for smaller rural hospitals, the change means the bill could ultimately have minimal effects.
Nancy Hoffman, state coordinator for the Foundation for Rape and Information Services and a member of the Sexual Assault Forensic Examination Commission, didn’t want to comment on the bill specifically. But she said the commission already has asked for and is working with counties to submit plans for connecting victims with tests.
Many counties have had challenges in completing a plan, and less than a third have finalized one so far, according to Hoffman. The current legislation doesn’t appear to create new methods of enforcing the requirement.
“We don’t want a plan that says ‘[patients] go here’ and that’s that,” she said. “You have to have a plan that holds up 24/7.”
Woelfel joined his colleagues in voting for the amended version. But he said afterwards that the changes made by the House failed victims of sexual assault.
“I’m shocked and disappointed,” he said. “I really think they eviscerated the bill.”
Will lawmakers fund training for nurses?
Although Woelfel’s bill has lost some of its impact, the Legislature could still act to improve examination access. Before the session, Hoffman and Miller told lawmakers they need reliable funding, less than a million dollars, to reimburse hospitals for the cost of exams, train new nurse examiners and meet administrative expenses.
“Training those nurse examiners is an extensive period of time, and it’s expensive too,” Hoffman said a couple of weeks later to the Senate Health and Human Resources committee as they considered Woelfel’s bill.
It remains to be seen whether the lawmakers will address those expenses this year. SB 675, which all but four state senators have co-sponsored, would increase the reimbursement rate to one recommended by the Commission.
For it to be codified, however, lawmakers will need to pass it through both the Senate Finance Committee and full Senate by midnight tonight. Should they fail to do that, the bill will be dead Thursday morning.
If the Legislature dedicates funding for new nurse examiners, it would come later when lawmakers decide the state budget. Sen. Mike Maroney, R-Marshall, chair of the Senate Health and Human Resources Committee, said he’ll ask for funds but is not confident that they’ll be granted.
“I always advocate for that kind of stuff,” he said. “But it is a fight.”
Woelfel also said he would request the funding but noted he has little power, as Republicans hold supermajorities in both chambers. To him, the Legislature owes the victims of sexual assault more action after changing his bill.
“It’s an illusory bill now,” Woelfel said. “We can do better.”