Hospitals can bill the state’s Crime Victims Reparations Board — instead of sexual assault victims — for medical expenses under an executive order issued by Gov. Bobby Jindal on Tuesday.
His order is the latest step taken in the wake of revelations that hospitals were billing victims of sexual assault for services related to their care, providing immediate relief and paving the way for a uniform approach statewide. Victims’ advocates said the hospital billings could discourage sexual assault victims from reporting crimes.
In addition to allowing hospitals to directly bill the state fund, it also extends from 72 hours to one year the time a victim of sexual assault has to notify law enforcement to be eligible for the victim assistance funds.
Jindal established a working group to decide what medical expenses should be covered and ordered regional state public health medical directors to come up with sexual assault response plans in each of their jurisdictions.
Another group, this one led by State Police and health officials, is developing minimum standards and requirements for the sexual assault examination kit used by local law enforcement around the state. The kits are used to collect evidence, such as hair, blood and semen, that is key to a successful prosecution.
“It’s obviously a step in the right direction,” state Rep. Helena Moreno, D-New Orleans, said of Jindal’s actions.
“We all know there’s a lot more work to do, including law changes and a source of funding,” Moreno said. “This is not an easy fix.”
A working group of state health officials, coroners, law enforcement, legislators, hospital executives, crime victim advocates and others have been meeting regularly, Moreno said. She will sponsor legislation in the 2015 Legislature. Jindal’s order identified needed steps for developing legislation and other policies.
Tuesday’s order is the second executive action Jindal has taken since problems came to light earlier this year.
In the first order, the governor directed the Crime Victims Reparation Board and higher education institutions to immediately revise administrative rules and procedures to establish more uniform protections for sexual assault victims.
The Crime Victims board in October adopted new rules, which eliminated the requirement that sexual assault victims must first file for private insurance or Medicaid reimbursement before approaching the victims board for help. The board also said it would not consider a victim’s dress, occupation, criminal record, relationship with the accused attacker or previous history as a victim of sexual assault when it weighed whether the state should pay medical expenses. Those rules went into effect in November.
Crime Victims Reparations Board Executive Bob Wertz said other changes are needed, but until state law is altered, the group is limited in what it can do. He said the board has recently been getting more calls involving victims of sexual assault, probably because of the publicity the issue has been receiving.
In the past 18 months, Wertz said, the board has handled five cases — three in the Orleans area and two in Caddo Parish — with an average claim of $2,700. The payments covered drugs, lab testing, emergency room and treating physician costs, he said. But there are other expenses on which there are question marks whether they should be paid, Wertz said.
“How far do you go in paying?” Wertz asked, adding that the definition of what is involved in a “forensic medical exam” as described by Jindal will help.
The steps called for in Jindal’s order should help the state reach the goal of “standardizing the practices at the local level,” where no continuity exists in how sexual assault victims are handled.
“The ideal goal is to have a protocol so that everyone knows what to expect,” Wertz said. “Until you have a uniform protocol that everyone can go by, you have scattered pieces.”
State Department of Health and Hospitals Secretary Kathy Kliebert said more clarity is needed for determining what medical services are included. For instance, should pregnancy testing should be included?
“We will get that definition in effect fairly quickly,” Kliebert said.
DHH medical officers have until Feb. 1 to submit regional response plans that are supposed to include available resources and “clearly outline the entity responsible for the purchase of sexual assault examination kits, the standards and procedures for the storage of such kits, and procedures for a woman to receive a sexual assault examination to ensure access to a forensic medical examination in every parish.”