Hospitals OK City Payment Increase for Rape Exams

In an effort to at least temporarily end the crisis that prompted some Los Angeles hospitals to turn away victims of sexual assault, Mayor Tom Bradley announced Monday that the Southern California Hospital Council has accepted the city’s offer to increase reimbursement rates for rape exams from $16 to $200.

Flanked by Councilman Zev Yaroslavsky and hospital council President Stephen Gamble at a City Hall press conference, Bradley called the agreement a “fair resolution that will ensure that those who are already the victims of outrage . . . are going to have an opportunity to be treated with dignity and respect.” The increase, the city’s first in 17 years, will cost an estimated $650,000.

‘Will Provide the Service’

Although hospital officials had been pushing for payments as high as $400, Gamble said he believes that the new rate is “sufficient to ensure that an adequate number of hospitals will provide the service.” The exams run as high as $450 each.

Gamble’s organization represents 160 hospitals countywide, including most of the hospitals that stopped admitting sexually abused women and children after new state-mandated regulations went into effect July 1 that made the exams more time-consuming and costly.

The new reimbursement rate is identical to one flatly rejected by the hospital organization last week. Gamble said his group did a turnabout when city officials agreed to renegotiate the rate at the end of the fiscal year, June 30, and take steps to see if other costs associated with the exams can be trimmed.

Individual hospitals have the option of refusing to accept the new rate, but Gamble said he believes that most of them will go along with the hospital council’s “yes” recommendation. “They are very good at supporting us,” Gamble said.

To make the point even stronger, Yaroslavsky said that each of seven hospitals queried in a hastily done survey last week indicated that they would comply. Although officials would not name the seven, Bradley warned that if any now turn away assault victims, “We will hold a press conference at the hospital in question and you will all know which one it is.”

Yaroslavsky, who heads the City Council’s Finance and Revenue Committee, said he hopes that working through the conflict taught city officials a lesson.

‘Double Jeopardy’

“I hope we never allow a situation to get to the point it got to in this case. . . . It’s bad enough to be victimized by rape,” he said. “It’s double jeopardy to then have to be tossed out the front door or the back door of an emergency room because of a bureaucratic technicality.”

In the weeks after the new rules were instituted, more than a dozen privately owned hospitals dropped rape-treatment services and others threatened to follow suit. No one knew exactly how many hospitals were offering the service because some were hesitant to announce they were treating victims to avoid an avalanche of referrals.

The lack of facilities was so acute in some areas that police reported delays of as long as eight hours before a rape victim was examined and treated. Some medical centers that continued to provide the service reported seeing twice as many cases.

Under the agreement, payments to hospitals that once took as long as six months to process now will be issued within 90 days. City officials will also work with the hospitals to better delineate what portions of the exams solely have to do with collecting evidence for criminal investigations.

Payment Conflict

California law requires that local law enforcement jurisdictions, and not insurance companies or the victims, pay for parts of the exams having to do with evidence collection. But insurance companies can be billed for the costs of treating injuries that may be suffered in the attack.

“Part of the problem has been what is included in the criminal investigation and what’s in treatment,” explained the city’s personnel chief Jack Driscoll, who helped draft the agreement. “This is one of the issues over where we have debate. . . . It’s hard to differentiate. We’re going to have a task force looking at that.”

City officials have also pledged to lobby for state legislation to provide hospitals with more financial assistance.

“It is the state which imposed this burden on us in the first place,” Bradley said. “We’re going after the state to ask them to reimburse, to assume their fair share.”

Hearings Scheduled

Meanwhile, state Senate President Pro Tem David Roberti announced Monday that the Senate Judiciary Committee will hold hearings in Los Angeles Nov. 13 to review city and county treatment of rape victims and to discuss possible legislation.

In addition, hospital officials are continuing negotiations with Los Angeles County officials and with authorities from several smaller cities in an effort to increase the reimbursements those jurisdictions pay.