Do I need Medical Care?
Not every sexual assault survivor sustains physical injury, such as cuts and bruises. In fact, it is really common for survivors not to have any visible injury. The absence of a physical injury does not mean you didn’t experience an assault. It also doesn’t mean you shouldn’t seek medical care.
Survivors have the option of seeking help at a medical facility that provides specialized sexual assault survivor care. These programs, called Sexual Assault Nurse Examiner (SANE) programs or Forensic Nurse Examiner (FNE) programs, employ specially trained nurses who can work with you to document the assault and make sure you are okay. They can also work with you to collect evidence, if you would like.
Nurses in these programs are trained to understand the difficulty survivors can have seeking help, and they understand the effects such a traumatic experience can have on you. You can speak with them confidentially about what happened and talk with them about your options and how they can help. Speaking with one of these nurses (or any medical provider) should not trigger a call to the police unless you want them to call or if they are required to make a mandatory report by law (see below for more information about mandatory reporting). If you choose for the police to be called, you also don’t have to speak with them or give them your name. Colorado has several options for you, giving you the time you need to think about your next steps while at the same time getting medical care to make sure you are okay at no cost to you.
While most medical facilities can make sure you are okay, not all will have these SANE or FNE programs. We strongly encourage you to visit one of the specialty programs because you will receive expert care and advice tailored to your specific concerns and circumstances. These specialty programs also understand the laws designed to assist you and cover your medical fees if you do not wish to use or do not have health insurance.
A little more information about seeking medical care after a sexual assault:
The specialty sexual assault medical care programs are called Sexual Assault Nurse Examiner (SANE) programs or Forensic Nursing (FNE) programs.
They employ specially trained nurses who can work with you and make sure you are okay, as well as collect evidence if you would like. Nurses in these programs are trained to understand the difficulty survivors can have seeking help, and they understand the effects such a traumatic experience can have. You can speak with them confidentially about what happened and talk with them about your options and how they can help.
The exam is called a medical forensic exam (MFE), but you may know it as a rape kit.
You cannot be refused an MFE if you want one and law enforcement does not authorize its use. However, most MFEs are best performed within seven days of the assault if you would like to have evidence collected. The MFE does more than collect potential evidence from your body. Even if the assault occurred more than seven days ago, it is always a good idea to seek medical care from a trained practitioner who can support you and help you understand your options.
The SANE or FNE will explain the MFE process to you as well as your reporting options.
Depending on the SANE or FNE program you visit, you may also speak with a social worker and/or a confidential community–based sexual assault victim advocate. There is no requirement you speak with these additional people; they are there to help and support you in any way that feels good for you. Once you decide what you want to do, you will sign a consent form, identifying which reporting option you want and whether you want the evidence collected during the exam sent for testing at a crime lab. You may also have to sign some other general consent for service forms per each hospital’s policies.
During the exam, the nurse will ask you what happened and collect any potential evidence from your body.
This process can take a few hours and it moves at a pace that is comfortable to you. The nurse will explain each step to you before they do it, and you can agree to or decline any part of the exam you don’t like. The evidence collected is stored in an envelope (a “kit” or “sexual assault evidence collection kit”) and given to the police. Whether the police get your contact information is determined by the type of report you choose, detailed below.
The cost of the exam is covered by law enforcement or the state fund Sexual Assault Victim Emergency Payment Program, called the SAVE fund.
The hospital bills law enforcement or the SAVE fund directly, so you don’t have to worry about receiving bills. The SAVE fund covers the cost of evidence collection and most associated medical fees related to the medical care you receive after your assault. If you have insurance that can be billed for the non-evidence collection related costs, this will also happen before the SAVE fund is asked to pay. However, if you do not want your insurance billed or do not have insurance, the SAVE fund is there to assist you.
If you seek medical care, do not have evidence collected, and do not report to the police, then it is likely your insurance provider will be billed for the cost of your medical care if you have insurance. If you do not have insurance, you can work with your medical provider to set up a payment plan or work with your victim advocate to identify other possible funding sources.
If you do not have evidence collected but do choose to report to law enforcement, then you would be eligible to apply for Colorado Crime Victim Compensation to cover your medical care. A victim advocate can assist you with this process.
A note on mandatory reporting for medical providers:
Under Colorado law (C.R.S. §12-36-135 (1)), any injury occurring due to a suspected criminal act must be reported to the law enforcement agency in the treating facility’s jurisdiction. However, with sexual assault, medical providers should make a report based on your choice (law enforcement report, medical report, or anonymous report detailed below). Colorado law (C.R.S. §18-3-407.5) allows for you to have evidence collected at no cost without reporting to law enforcement. If you do not have evidence is collected, then sexual assault is not a mandatory report unless the medical licensee believes there is serious bodily injury (like strangulation or a gun-shot wound).
Under Colorado law (C.R.S. §18-6.5-108), medical providers (and other specified professionals) are required by law to report physical abuse, sexual abuse, caretaker neglect, and exploitation of at-risk elders and at-risk adults with intellectual and developmental disabilities (IDD). An at-risk adult with IDD is a person who is eighteen years of age or older who has an onset of an intellectual and developmental disability before the person is 22 years old. An adult with IDD has an I.Q. of 70 or below and/or has significant limitations in the ability to socialize, provide self-care, or communicate. IDD includes autism spectrum disorders, epilepsy, cerebral palsy, developmental delays, Down Syndrome, fetal alcohol syndrome, and other disorders.