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Advocates for survivors of sexual assaults in Nebraska say some victims mistakenly receive statements for medical costs of sexual assault exams, despite state and federal law prohibiting such notices

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LINCOLN, Nebraska — Some Nebraska survivors of sexual assaults mistakenly receive statements for costs of medical exams, despite state and federal law prohibiting it, advocates say.

A measure being considered in the Nebraska Legislature would create a state fund to cover the charges that pile up when a victim reports a sexual assault, ensuring survivors won't be billed when they go to the hospital.

When a victim reports a sexual assault at a hospital, staff calls a certified nurse, an advocate and a law enforcement officer to aid in the reporting process. The investigating law enforcement agency is responsible for providing the rape kit and arranging the billing to be sent to that agency, said Deb Collins, a spokeswoman for the Nebraska State Patrol.

Nebraska law and the 2005 federal Violence Against Women Act prohibit survivors from paying for the examination, regardless of whether a victim chooses to continue with a criminal investigation. But other fees that build up, including charges by the examining physician and emergency room costs, are not specifically defined.

Suzanne Gage, a spokeswoman for the attorney general's office, which is backing the bill, said Nebraska's current system has been leading to questions about who pays and when. The proposal would shift the onus off of law enforcement and instead would use a pool of private, state and federal money to pay for up to $200 to the examiner and up to $300 to the examination facility.

Hilary Wasserburger, director of the DOVES program that helps victims in nine western Nebraska counties, said statewide uniformity is necessary so victims don't accidentally receive the medical bills. Survivors often drive to different communities to be examined by certified professionals, she said.

Sometimes charges occur through human error and sometimes they aren't coded as sexual assault in the hospital's billing department, Wasserburger said. The patchwork of policies and training creates confusion about when law enforcement's financial role ends with costs such as testing for sexually transmitted diseases and pregnancy. Survivors need more certainty in order to start the healing process.

"As advocates we always want our clients to understand what's going to happen next," Wasserburger said. "Anything that can be done to remove any ambiguity and uncertainty is going to help survivors know what they can expect going forward."

Amy Richardson, president of the Women's Center for Advancement in Omaha, said even in urban areas where resources are more cohesive, the hospital bills can get sent to insurance companies. At the least, an explanation of benefits can show up in survivors' mailboxes, evoking trauma, blame or placing them in danger if an abuser has access to their mail.

Richardson said recently a survivor who is a minor called the center panicked because she received a bill for nearly $1,200 after she went to a hospital emergency room and reported an assault.

"There are just so many issues with asking a victim to pay for something that was probably one of the most horrendous moments of their life," Richardson said.

Gage said the bill backed by the attorney general's office intends to "streamline the process and reaffirm that neither survivors, nor their insurance, gets billed."

The fund's administrator would also use the fund to distribute free rape kits to health care providers and oversee specialized training for nurses with special training in the medical forensic care of the patient who has experienced sexual assault or abuse.

"There is just a lot of variation from community to community in terms of what resources they have and what level of medical training they have," said Sen. Adam Morfeld of Lincoln, who is carrying the bill. "A lot of times they go in to get their examination and they don't get the full array of services they probably should get because there's no fund established."

The measure would not take effect until next year. Though Morfeld said he doubts opposition, the attorney general's office has not yet determined a price tag for the state and the Legislature often balks at new costs. The bill was referred to the judiciary committee, where seven of the eight members have added their names to the proposal.

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The bill is LB1097.

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