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EVAWI > Resources > Forensic Compliance > FAQs > VAWA 2013
Forensic Compliance Frequently Asked Questions

Note: The information on this website is designed to: (a) communicate the requirements of the Violence Against Women Act (as reauthorized in 2005 and 2013), and (b) offer recommended practices for implementation. The goal is to highlight examples of communities striving to achieve a higher standard of the “spirit of the law,” rather than simply meeting the “letter of the law” for VAWA forensic compliance.  It is critically important that readers consult state laws and regulations, as well as local policies and protocols, because they may have additional requirements beyond those included in VAWA 2005 and VAWA 2013. For more information specific to your state or territory, contact the STOP Grant Administrator or coalition of advocacy organizations providing services for sexual assault victims.  A listing is available from the website for the Office on Violence Against Women, U.S. Department of Justice.

Q What updates to forensic compliance were enacted with VAWA 2013?
Q What are regional health care providers?
Q Can private insurance be billed for the cost of the exam?
A What updates to forensic compliance were enacted with VAWA 2013?

In an EVAWI training bulletin, we provide a review of two significant changes in the most recent reauthorization of the Violence Against Women Act (VAWA 2013).

1.  No more out-of-pocket costs


First, under the 2005 reauthorization of VAWA (VAWA 2005),  victims could be required to pay out-of-pocket costs for a medical forensic exam -- as long as they were fully reimbursed.  This was never viewed as a best practice in the field, but it was possible for states, territories, and tribes to remain compliant with VAWA 2005 while this practice was in place.

With a critical change in the 2013 version of VAWA, jurisdictions are now required to provide medical forensic exams to victims free of charge and without any out-of-pocket expense.  Specifically, the language states that a “State, Indian tribal government, unit of local government, or other governmental entity” will only be eligible for STOP grant funds if it “incurs the full out-of-pocket cost of forensic medical exams described in subsection (b) for victims of sexual assault.”  VAWA 2013 was enacted on March 7th, 2013, and the deadline for compliance is three years from that date.  Therefore communities have until March 2016 to be in compliance with this change.

However, it is worth noting that this provision still does not extend to all aspects of medical testing and treatment. VAWA specifies which components must be included in the exam that is offered without charge.  These and other issues are addressed in detail in our OnLine Training Institute module on forensic compliance, entitled, The Earthquake in Sexual Assault Response:  Implementing VAWA Forensic Compliance.

2.  Public education required

In a second critical advance, a governmental entity will only be eligible for this funding if it “coordinates with regional health care providers to notify victims of sexual assault of the availability of rape exams at no cost to the victims.” Again, communities have until March 2016 to be in compliance with this new provision of VAWA 2013, which has the potential to create a sea change in public awareness.

Many communities have already developed innovative ways to reach the public with information about their options – particularly the fact that sexual assault victims can obtain a medical forensic exam free of charge and without being required to make a decision about criminal justice participation. Some have approached this issue through public service announcements, others through media campaigns, and still others through agency websites. All of these approaches can be effective in informing the public, and thus increasing access for victims of sexual assault.  Several examples are posted on the EVAWI website, in the forensic compliance resources section, under the tab on Public Education.  We encourage you to explore some of these examples, as you prepare to work on public information in your community.

Given that the whole point of forensic compliance is to increase access for victims of sexual assault – both to the medical forensic exam as well as the criminal justice system as a whole – creating a VAWA-compliant system is only half the battle. The other half is ensuring that community members are aware of their options, to increase the likelihood that they will engage the system when they or someone they love has been sexually assaulted.

The complete text of VAWA 2005 is available online, and the specific language on forensic compliance can be found on page 15, section (f), AVAILABILITY OF FORENSIC MEDICAL EXAMS. The complete text is also posted for the most recent reauthorization of VAWA 2013.

Source: H.R. 4970 - 112th Congress: Violence Against Women Reauthorization Act of 2012. (2012). In www.GovTrack.us. Retrieved March 15, 2013, from https://www.govtrack.us/congress/bills/113/s47

A What are regional health care providers?

VAWA 2013 states that a governmental entity (such as a US state, territory, or tribal government) will only be eligible for STOP grant funding if it:
coordinates with regional health care providers to notify victims of sexual assault of the availability of rape exams at no cost to the victims.
Many communities have developed strategies to reach the public with information about their options – particularly the fact that sexual assault victims can obtain a medical forensic exam free of charge and without having to make a decision about criminal justice participation at the time of the exam. Some have approached this issue through public service announcements, others through media campaigns, and still others through agency websites. One especially innovative approach to public outreach can be found at www.SeekThenSpeak.org. All of these approaches can be effective in informing the public, and thus increasing access for victims of sexual assault.

Given that the whole point of forensic compliance is to increase access for victims of sexual assault – both to the medical forensic exam as well as the criminal justice system as a whole – creating a VAWA-compliant system is only half the battle. The other half is ensuring that community members are aware of their options, to increase the likelihood that they will engage the system when they or someone they love has been sexually assaulted.
A Can private insurance be billed for the cost of the exam?

Under VAWA, jurisdictions could remain in compliance with the forensic compliance provisions even if victims were being billed for the cost of their medical forensic examination – as long as they were fully reimbursed for that expense. However, this option was eliminated in VAWA 2013. States, territories, and tribal governments must now certify that medical forensic exams are available to victims completely free of charge – and this means no out – of – pocket costs for victims.

It is worth clarifying that this does not extend to all aspects of medical testing and treatment. In the text of the federal legislation, VAWA specifies which components of the examination must be offered to victims free of charge. These and other issues are addressed in our OnLine Training Institute (OLTI) module on forensic compliance, entitled, The Earthquake in Sexual Assault Response: Implementing VAWA Forensic Compliance. The module also includes a number of resources and tools that can be adapted for use in your community.
This project is supported by Grant No. 2013-TA-AX-K045 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed on this website are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women.
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