County to Hike Payment for Exam in Rape Cases to $200

On Jan. 1, the Los Angeles County Sheriff’s Department will begin reimbursing selected hospitals $200 toward the cost of medical exams for rape victims, hoping to stem the dropout of hospitals from the county’s troubled rape-treatment network, the department announced Friday.

Roy Fisher, chief of the Sheriff’s Department financial services unit, told legislators at a special state hearing in Los Angeles that the county will quadruple the $50 fee it now pays when officers take a rape victim to the hospital.

The increase brings the county in line with a hike planned by the City of Los Angeles, which is expected to boost its payment rate from $16 to $200 beginning Jan. 1.

The increases mean that when a rape victim is taken to a hospital in Los Angeles or in areas served by the Sheriff’s Department, the hospital will receive a $200 subsidy to help cover the cost of the exam. The actual cost of a rape exam is about $400, according to health-care officials.

Lure Some Back

Whether the increase will be enough to lure some hospitals back into the treatment network is uncertain, but several hospitals in Los Angeles vowed to resume rape-treatment services after hammering out the $200 subsidy in negotiations with the city, Fisher said. Cities that operate their own police departments will reach their own agreements with hospitals inside their municipal boundaries.

“In seeing what the city was doing . . . we just decided to follow suit,” Fisher said after testifying on behalf of the Sheriff’s Department. “We felt that, under the circumstances, it would be an appropriate increase. It seemed reasonable, based on what the hospitals had to do.”

The testimony came during a joint Senate-Assembly hearing, initiated by Sen. David A. Roberti (D-Los Angeles), on the crisis in rape-treatment services since new, more-elaborate exam requirements were adopted earlier this year. In recent months, a number of hospitals in Los Angeles County have stopped providing rape exams because of the high cost of administering the tests.

Turned Away

As a result, legislators said, rape victims have been turned away at hospital doors, leaving them to feel further humiliated.

“This problem is particularly acute in Los Angeles,” Roberti said, citing more than 12,000 reported cases of rape last year in California. “During the past four months, it has become apparent that our system of care for sexual-abuse victims has broken down.”

More than a dozen witnesses testified Friday, and many of them urged legislators to begin a program of state reimbursements to help pay for the rising costs of exams.

“I can’t see any way to resolve the reimbursement issue on a local level, especially in Los Angeles County, where there are about 50 different jurisdictions,” said Gail Abarbanel, director of Santa Monica Hospital’s Rape Treatment Center. “If the state assumes responsibility for these exams, it will ensure equal treatment.”

Witnesses strongly criticized hospitals for turning away rape victims, prompting legislators to say the state may have erred in allowing hospitals to voluntarily end rape-treatment programs as new guidelines took effect.

Gunshot Victims

Noting that gunshot victims may not be turned away, Sen. Diane Watson (D-Los Angeles) questioned whether such legislation was constitutional.

“Why is it we should be able to discriminate against a victim of rape?” she asked.

Anthony J. Abbate, vice president of the Hospital Council of Southern California, said about 55 hospitals had been serving as rape-treatment facilities in Los Angeles, Orange and Riverside counties. At least 11 of the hospitals dropped out because they were not paid enough to conduct the exams, he said.

Abbate defended the actions of the hospitals, saying: “Uncompensated care will cost California hospitals over $1.8 billion this year alone. To expect hospitals to take on an additional (burden) simply stretches credibility beyond reason.”