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21st Legislature(1999-2000)

Committee Minutes


HOUSE HEALTH, EDUCATION & SOCIAL SERVICES
Mar 23, 2000
HB 270 - SEXUAL ASSAULT & SEXUAL ABUSE

Number 1920

CHAIRMAN DYSON announced the next order of business as Sponsor
Substitute for House Bill No. 270, "An Act relating to sexual
assault and sexual abuse and to payment for certain examinations
in cases of alleged sexual assault or sexual abuse." [Before the
committee was CSSSHB 270(STA).]

Number 1929

REPRESENTATIVE ERIC CROFT, Alaska State Legislator, sponsor of HB
270 came forward to present the bill. He explained that SSHB 270
requires that the victims of sexual assault cannot be charged for
the costs of forensic exam. This is not a medical procedure, it
is a procedure for the gathering of evidence. It should not be
charged under a woman's medical insurance, and in the vast
majority of cases it is not. The reason he introduced this is to
clarify in law for those rare cases that to charge a victim is
not appropriate.

Number 2011

REPRESENTATIVE BRICE asked Representative Croft why it was
limited to just adult victims.

REPRESENTATIVE CROFT said that wasn't done at first, but he found
out that the program at Alaska Cares would be destroyed because
many of their clients are Medicaid-eligible, and this would
affect that. There are difficult issues. It is usually not the
child that is consenting to this, it is the parent. When there
are issues of parents having more control about not investigating
something where they might be the suspect, it got troublesome.
He tried to craft it around all that, but eventually just limited
it to adults.

REPRESENTATIVE BRICE said he was very concerned about what
Representative Croft was saying. "Alaska Cares program sounds
like what they're doing is charging Medicaid for forensic tests
that should be paid by the police department."

Number 2091

SAM SHEPHERD, Staff to Representative Eric Croft, Alaska State
Legislature, explained in the discussions with Diana Weber from
Alaska Cares, she said there was an agreement with the Anchorage
Police Department, whether the child may have a diaper rash or
there is a lot of reason to believe there is sexual abuse, not
sexual assault, that there are considerations of sexual abuse,
and the child can be brought to Alaska Cares without concern
about ability to pay. For whatever reason, Alaska Cares will be
able to bill Medicaid. There are a lot of reasons why it should
be a police payment, but it is not. If children were included in
the bill, Alaska Cares would be out of business.

REPRESENTATIVE CROFT noted he struggled with that a long time and
it is an appropriate question to ask, but he was not able to
write it that way.

REPRESENTATIVE BRICE said his concern is by explicitly stating an
adult victim, in Fairbanks where there isn't an Alaska Cares, it
is implied that the families of minors will have to pick it up,
or that insurance companies will have to be charged for it.

REPRESENTATIVE CROFT explained there were two different
approaches and they chose the one. He said that Texas uses the
approach "who does pay." At least one version of the draft early
on said police shall pay for this, and that is the appropriate
place to do it, but then there are fights about in which police
jurisdiction it occurred. In Anchorage the municipality has a
grant that goes to Providence Hospital where there is a special
room and trained people. It is done for a set price: $100,000
will cover all the accommodating, the room and collateral help
for these exams. If the bill says police must pay, there is a
question of how to deal with the situation where it is done by a
grant or some other innovative way. "We kept coming back to
saying who should not rather than directing who should, though in
the vast majority of cases, it ought to be the police."

CHAIRMAN DYSON noted that Representative Croft touched on some of
the problem. Some of the children get flown in from some other
jurisdiction, and it would be confusing which police pays, and
many areas do not have police.

REPRESENTATIVE BRICE suggested maybe it should just say the
victims of sexual assault under the statutes shall not pay and
leave it at that. Then leave it up to whoever provides the
service to figure out who will and who won't pay.

REPRESENTATIVE CROFT said that is the way it is said in the
current version, but the adult--that concept that it says who may
not, not that the police shall, is getting into the jurisdiction
issue.

DEL SMITH, Deputy Commissioner, Department of Public Safety, came
forward to testify. He reported that the department, law
enforcement statewide and the Alaska Police Chiefs Association
support this kind of legislation. In his experience, the police
have never thought it appropriate that a victim of a crime should
pay for anything in the way of gathering forensic evidence to
support the prosecution of that crime. The victim ought never to
see the charge on her insurance forms or be hassled in any way.

MR. SMITH referred to Representative Brice's question. When the
department originally looked at the bill, he talked with Duane
Udland, Chief, Anchorage Police Department (APD), and he brought
up the point that costs were already being covered for youth, and
it was not being billed to them. Mr. Udland didn't think it
should be switched to have the APD pay for an exam that was
already being paid for.

TAPE 00-34, SIDE B
Number 2361

REPRESENTATIVE BRICE asked Mr. Smith where the money comes from.

MR. SMITH said he asked the Violent Crimes Compensation Board if
they knew of anybody who had been billed directly. He has not
been able to find a circumstance where the bill actually went to
the victim. The cost of the exam is part of the cost of doing
business. The Department of Public Safety expended approximate
$49,000 in the last fiscal year, and APD has paid Providence
Hospital approximately $150,000 for sexual assault exams.

CHAIRMAN DYSON asked Mr. Smith what happens when in a case of
suspected child abuse, and an examination is done on the child
looking for signs of sexual abuse, in most of those cases there
won't be forensic evidence; as soon as there is reasonable
presumption that there has been a crime, then law enforcement is
contacted, and the team that meets includes a representative from
DFYS or a child advocate, somebody from law enforcement and
forensically-trained people. He asked if it is true that there
may be some of the cases where there's a process that goes on
before it is known there was a crime, and is this the area that
the Alaska Cares folks are concerned about.

MR. SMITH answered he would say yes, although he wouldn't want to
try to answer for DFYS. A lot of the cases in DFYS do not
involve the police; there is an examination, and if it is
determined medically there is a problem, the DFYS brings in law
enforcement. He doesn't expect law enforcement to pay for an
examination when it was not involved in it initially. If
somebody, for example, said "I was sexually assaulted six months
ago and had an exam, now I would like you to pay for this," law
enforcement, in his view, would not or should not be obligated to
do that. If evidence is going to be collected to prosecute a
case, then law enforcement needs to be involved in the decision
and the process from the beginning.

REPRESENTATIVE BRICE asked what about a 17-year-old girl who was
violently raped. Implicitly she has to pay for this exam or her
insurance does under this bill.

MR. SMITH said a violently, sexually assaulted person should not
be subjected to the bill. Any agency he has to do with is going
to pay for the collection of the evidence. He doesn't read that
the way it says "adults" would necessarily imply that law
enforcement would bill someone under the age of 18.

REPRESENTATIVE BRICE said ten years of working in this building
tells him different. "When we say A, we mean A and don't mean
B." He agrees it would be a heartless, sick thing to do, but he
is just looking for some way in those instances to fix it.

MR. SMITH said in discussions with the sponsor, he knows they
have tried very hard to find a way to take care of the problem.

Number 2104

LAUREE HUGONIN, Director, Alaska Network on Domestic Violence and
Sexual Assault, came forward to testify. She clarified that
while it may be true that Deputy Commissioner Smith may not have
found an instance where law enforcement has forwarded a bill,
hospitals have. It has happened in the Mat-Su Valley, on the
Kenai Peninsula, and in Southeast, and that is why the bill is
being brought forward. It is important to keep the word
"indirectly" in there or to state "not charge health insurance."
"Unfortunately, Representative Brice, if you just say victim,
there are still agencies who take it that means sending me the
statement. They don't consider my insurance as being the
victim." It is important to encapsulate that indirectly. She
reemphasized that often it is DFYS that is bringing children
forward and billing Medicaid, and DFYS has that arrangement with
Medicaid.

MS. HUGONIN explained what it is like to undergo a rape exam. It
is graphic and hard to hear. If a woman is sexually assaulted
and is taken to the hospital by police, a friend, or gets herself
there, she goes into the emergency room most often. She will be
triaged and may be in the waiting room for a few minutes or
several hours. If she is in a community with an advocacy
program, she will have someone wait with her and explain the
process, but that doesn't always happen. In the examination
room, she is the crime scene. First, she stands in the middle of
the floor on a white sheet of paper and brushes down her clothes.
She then takes off her clothes; if they are the clothes in which
she was sexually assaulted, she doesn't get them back because
they are evidence. She brushes down again to get any possible
hairs or fibers. She sits at the examination table. The clothes
get folded up and placed aside.

MS. HUGONIN continued explaining there is a packet which contains
envelopes and different pieces of paper. They are taken out, and
one by one they are gone through. One packet may contain a swab
to go underneath her fingernails to find and skin or hair that
she might have been able to get from the perpetrator, and that is
put in an envelope. Another one is taken out, and her hair is
combed through to see if there are any that are not hers to be
tested for DNA [deoxyribonucleic acid]. She is checked over for
bruises or cuts or abrasions or broken bones. At that point, if
she can tolerate going further, the exam is continued. Another
packet contains a little comb which is used to comb the pubic
hair to see if there are hairs that are not hers. Another
envelope will contain a tweezer to pluck pubic hairs to test her
DNA and match it against the perpetrator's. There is a
gynecological exam to look for tears and abrasions, and pictures
are taken in that position. A black light is shone in her
orifices to see if there is any semen; there are swabs that are
collected and put it separate envelopes.

MS. HUGONIN said that the sexual exam can take anywhere from 40
minutes to three hours depending upon how traumatized she is.
When the examination is finished, hopefully there are clothes for
her to wear home from the hospital, and she can leave.

MS. HUGONIN mentioned that in the best of circumstances the
perpetrator is caught, evidence has been collected and used in
the prosecution to a good end, and the perpetrator is jailed.
She indicated that as the victim recovers from this heinous
crime, at every point where the victim has to relive it, and she
does relive it because it is not something that can be forgotten.
She emphasized that it is incomprehensible that the victim should
have to relive the crime upon receiving a bill for the assault
exam from her insurance company. It puts her right back to when
it happened.

MS. HUGONIN urged the committee to expedite the passage of this
legislation. She shares the concern about children, but it
doesn't seem that practically this year that can work out in a
way where the bill can get through both the House and the Senate.
It is important to her that this stop as soon as possible for as
many people as possible, and if there are other areas to work on
over the interim, her group would be interested in doing that.

Number 1731

TRISHA GENTLE, Executive Director, Council on Domestic Violence
and Sexual Assault, came forward to testify. She dittoed Ms.
Hugonin's testimony and asked for the committee's support on HB
270. It is a problem that has come up sporadically around the
state. She has been working with victims of sexual assault since
1982, and it has been around since then. It is time to support
victims and say this won't be allowed to happen to them.

MS. GENTLE agreed the issue of children is important too. She
believes that during the interim they need to be able to look at
exactly what the costs are, exactly what the system is, how it's
working and what would be appropriate and helpful legislation or
addition to this and what might be harmful to centers that
already exist.

REPRESENTATIVE COGHILL asked for the difference between "an adult
victim" and "a victim."

MS. GENTLE answered that it is an issue of clarity because it
isn't known how it may or may not affect the children's programs,
and this is happening with adult victims. She believes the
discrepancy may be in the "direct or indirect" issue. Indirectly
paying through Medicaid, through insurance, through grants or
things like that, happens with children. What is not wanted is a
victim's insurance to be billed.

REPRESENTATIVE BRICE said he believes it is possible to artfully
cut out child advocacy centers to ensure that the process will
cover juveniles.

REPRESENTATIVE CROFT wants the committee to be comfortable with
this bill when it moves out of committee, and that it is the
right fix for the situation. He suggested working on it this
weekend and hearing it next week.

CHAIRMAN DYSON suspended the hearing on HB 270. [HB 270 was
heard and held.]