JEFFERSON CITY, Mo. — As this year’s legislative session nears its close, a bill requiring Missouri’s hospitals be equipped to perform rape kits hasn’t made it past a Senate committee — but the bill’s sponsor isn’t giving up.
Sen. Jill Schupp’s SB 456 mandates all hospitals within a 50-mile radius of a college to be able to perform a forensic examination for a rape or sexual assault victim with his or her consent. The examinations could be done by an “appropriate” medical provider with the guidance and support of a trained Sexual Assault Nurse Examiner (SANE) — either in person or through a telehealth system, according to the bill.
The distance requirement would essentially mean every hospital in Missouri would fall under the bill’s umbrella.
Schupp, a Democrat, first learned about the lack of access to rape kits after a young family friend was raped and police had to drive her two hours to a hospital to get the forensic exam.
“To be victimized, to go to the hospital, to do the right thing, to report, and have the tests done, and collect the evidence, and then have to be driven two hours away by strangers — I mean, thank goodness for those police officers for what they did — but I can’t even imagine all the trauma and then the additional trauma perpetrated on her as a victim because she could not have a rape kit done at the hospital in the area that she was raped,” Schupp told The Missouri Times.
“We just have a system that’s set up that’s inappropriate, and in today’s world of technology, I feel like we could be doing so much better, and we need to be,” she said.
Schupp’s bill hasn’t yet been heard by a Senate committee, but that isn’t deterring her. In the meantime, Schupp said she’s committed to meeting with more people about the bill — including those who have issues with it — and is looking at other ways to potentially bring it up before the legislative session ends this year.
“I’m disappointed that it didn’t make it further down the process this year — and it doesn’t look like it necessarily will — but we’re not dropping this. This is too important of an issue, especially to these victims,” Schupp.
“We just have a system that’s set up that’s inappropriate, and in today’s world of technology, I feel like we could be doing so much better.”
Dave Dillon, a spokesman for the Missouri Hospital Association, said the state’s hospitals are working with Schupp and the Missouri Coalition Against Domestic and Sexual Violence “to ensure that the right care and collection takes place as quickly as possible and in the best setting for the patient.”
“It’s essential that victims of sexual violence have access to the specialized care and forensic testing they need to move forward,” Dillon told The Missouri Times. “That’s why law enforcement, health care providers, and victims’ advocates are working collaboratively — with Sen. Schupp — to develop a system that protects patients and evidence.”
In order to receive adult SANE certification, one must have been an RN for at least two years and complete 40 hours of training costing about $500, according to the International Association of Forensic Nurses (IAFN). Then, a nurse would need to complete clinical training — which can vary by organization and location. It takes about another year — depending on experience level — before one can become board certified.
THE BIGGER PICTURE
Issues with rape kits — from access to them to law enforcement actually testing them — is a nationwide problem that isn’t just confined to Missouri. According to IAFN, only about 17 to 20 percent of hospitals in the country are equipped to do the forensic examination — and the problem is worse in more rural areas.
Noting the availability of SANE-certified personnel at hospitals across the country is a “significant problem,” Jennifer Pierce-Weeks, CEO of IAFN, said a variety of telehealth approaches to sexual assault medical forensic examinations have been employed around the U.S. — but contended that approach needs to be implemented with extra caution.
“Victims need access to care for health as well as evidentiary reasons, and they need that care to be patient-centered and trauma-informed,” Pierce-Weeks told The Missouri Times.
“Because this is a new approach to victims receiving care, we do not yet know the ramifications of this at trial, but all of that should be considered in the planning of these kinds of services.”
It’s imperative that a victim needs to understand that whether using a telehealth service or not, his or her ability to receive care will not be impacted, Pierce-Weeks said. She also stressed the importance of a proper system to document the encounter in a HIPAA-compliant manner and of the hospital ensuring the SANE personnel has received the proper education and certification.
“Having the availability of SANEs via a telehealth approach does not mean the clinicians on the live end of the care are removed from the responsibility of knowing what the patient’s options should be, and knowing what the standard of care the victim receives should be,” Pierce-Weeks said.
“Because this is a new approach to victims receiving care, we do not yet know the ramifications of this at trial, but all of that should be considered in the planning of these kinds of services,” she added.
Schupp said she was surprised when she learned access to these forensic examinations is scarce.
“I thought it was a standard. When people come into a hospital, it’s not just a rape the requires protection of the evidence and appropriate collection of evidence,” Schupp said, pointing to shooting and stabbing victims. “There are all kinds of situations in which you think people are trained to make sure that the standard of collecting the evidence is in place.”
“If I go to an emergency room, if I go to a hospital, I expect whatever I have to be treated in some way,” she added. “I just can’t even imagine what a woman goes through when she is in this situation.”
The bill was referred to the Senate Health and Pensions Committee, but it hasn’t been heard.
Aside from access to the examinations, clearing the so-called backlog of untested rape kits by law enforcement is a priority for Attorney Gen. Eric Schmitt. Earlier this year, Schmitt appointed M. Keithley Williams, a former trial judge, to lead the Sexual Assault Kit Initiative. The initiative has been tasked with logging the thousands of untested rape kits in the state of Missouri.
The U.S. Department of Justice has provided millions of dollars in grant money to Missouri to help with rape kit reforms.
Kaitlyn Schallhorn is a reporter with The Missouri Times. She joined the newspaper in March 2019 after working as a reporter for Fox News in New York City. Throughout her career, Kaitlyn has covered political campaigns across the U.S. and humanitarian aid efforts in Africa. She is a native of Missouri who studied journalism at Winthrop University in South Carolina. Contact Kaitlyn at firstname.lastname@example.org.