Dispute Over Fees for Rape Exams Still Not Resolved

Amid confusion over which hospitals continue to treat rape victims, Mayor Tom Bradley announced Thursday that the city has offered to raise reimbursement rates for such services to $200 in an effort to resolve a conflict that has led some hospitals to stop examining victims of sexual assaults.

The city’s offer is twice as high as its previous one, and a significant improvement over the current rate of $16. But hospital negotiators said it still falls short.

“We are willing to pay $200 and not a dime more,” Bradley said at a press conference. City negotiator Bill Russell added, “This is pretty much a final offer. We believe it’s fair, and this is just about as far as we can go.”

Bradley explained that according to a city survey, 11 out of 15 jurisdictions in Southern California are paying less than $200 for the treatment. The city’s offer would cost $650,000 a year, officials estimated.

Hospitals Want $400

“In response to the offer, we have asked the city to pay the recommended hospital rate of $400,” said David Langness, spokesman for the Hospital Council of Southern California. “Since we recognized that the city does not have the funds to do so, we are urging them to do this on an interim basis, until a legislative solution is found, so hospitals don’t have to drop out of the system (of rape victim treatment).”

More than 12 local hospitals began turning away rape victims after the state issued regulations in July to make sexual abuse examinations more thorough--and consequently more expensive--to provide better evidence for attorneys prosecuting alleged rapists.

Hospitals claim that the examination can cost as much as $450, and state law requires local law agencies to cover the expenses, although none actually does.

One of the problems negotiators are encountering is assessing the cost of each examination. For example, rates may vary according to the time it may take for a doctor to perform his duties.

Another problem is that neither the city nor the hospital council knows which and how many hospitals have dropped out of the system, and what would it take to bring them back in. On Wednesday, the council sent a survey to area hospitals asking these questions, and results are expected in a week.

In addition, Russell said, the city is concerned about the council’s ability to represent the hospitals. “The city will begin negotiations with individual hospitals, regardless of whether the negotiations with the council are successful or unsuccessful, to find out which of the hospitals are really willing to stay in the system,” he said.

A Los Angeles Times survey of 40 hospitals conducted last month showed that 20% of the hospitals were turning down rape victims. Precise estimates of which hospitals are out of the system are hard to make because some hospitals are reluctant to say that they are treating victims to avoid an overload from referrals.

Gail Abarbanel of Santa Monica Hospital said that in recent weeks the hospital has treated patients turned down by hospitals as far away as Inglewood and San Pedro. One victim had to wait over six hours for treatment after being turned down at two different hospitals before arriving at Santa Monica, Abarbanel said. More than 4,500 rapes are reported each year in the county--with more than half the victims being treated at city hospitals, officials said.

In addition to the emotional trauma that the wait causes the patients, Los Angeles police estimate that evidence loss begins two hours after a rape.

Separate talks are taking place between hospital representatives and county officials.