There's been much attention lately on the huge backlog of rape kits in the U.S., with forensic evidence sitting on shelves and the victims of sexual assault mistakenly thinking their cases were being investigated.
But at least when it comes to getting those rape kits to victims in the first place, there is one positive development: Most sexual-assault victims who get medical forensic exams (called rape kits) appear to be getting them free of charge and without having to report a crime to the police.
That's according to a new, 118-page Justice Department-funded report that sheds light on the ways states are implementing the Violence Against Women Act, and how they are paying for rape kits.
The report found that two-thirds of states pay for rape kits using victim compensation funds, which are intended to offset costs for victims of all types of crimes, not just sexual assault. The other 11 states pay for rape kits using law-enforcement or prosecution funds.
The payment piece is important, because there is a policy and philosophical debate about how to pay for rape kits, says the Urban Institute's Janine Zweig, the lead author of the report.
"What we found for the states using [victim] compensation funds, the payment process is quite seamless; very few stories about victims being inappropriately billed," she said. "But the debate is about whether a fund that's intention is to directly benefit victims should cover forensic evidence."
Law enforcement and prosecutors benefit from the evidence from rape kits, so some believe that law-enforcement funds should be used to pay for them. The latest iteration of VAWA, passed in 2013, forbids the practice of charging victims and then reimbursing them the full cost.
Some states have caps on the amount that the exams can cost; if hospitals conduct exams at a cost that exceeds that cap, sometimes they take a loss. Hospital officials are worried about the sustainability of such a practice,and service providers are also worried about the future of rape-kit funding.
The report, conducted by the Urban Institute using a $525,464 award from the DOJ's National Institute of Justice, also found there are still barriers to rape-kit access for Native Americans, immigrants, and non-English speakers.
For example, in one state with multiple Indian reservations, only one reservation had sexual-assault nurse examiners. Cultural barriers are also a big problem, and non-English speakers face a lack of translators — particularly when they often have to rely on family to translate in other situations.
The 2005 version of VAWA mandated that for states to be eligible for grant money, they have to provide free exams regardless of whether victims report crimes to police. That's important, because there is a short period of time to collect evidence, yet the decision of whether to press charge can take time.
"The decoupling of those two things was very important in 2005, but what we haven't seen is large numbers of victims getting those exams and then not going to the police," Zweig said. "Most people went to get exams and were reporting to the police."
That means there could be many victims who aren't getting rape kits, and then missing out on the other aspects of the exam, including STD testing and getting linked to crisis counselors and service providers.
"The payment issues are obviously very important, to make sure that the victims that get these exams, that there are systems in place so that they're not saddled with a bill after the most traumatic event in their lives," Zweig said.
But she cited Bureau of Justice statistics that show only one-third of victims report rape, and less than a quarter seek help from rape crisis centers or local advocacy groups. Given the report's findings, it stands to reason many of those victims aren't getting exams and are losing out on both assistance and the opportunity to see assailants prosecuted.
"The larger context is there are many victims who are not getting any help," Zweig said.