BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           50 (Corbett)
          
          Hearing Date:  05/11/2009           Amended: 04/28/2009
          Consultant:  Jacqueline Wong-HernandezPolicy Vote: Public Safety  
          7-0
          _________________________________________________________________ 
          ____
          BILL SUMMARY:  SB 50 specifies that a victim of sexual assault  
          may not be charged the costs of medical examination or  
          treatment, directly nor indirectly, including through the  
          victim's insurance carrier. This bill makes the Victims  
          Compensation and Government Claims Board (VCGCB) the payer of  
          all bills for medical examination and treatment of sexual  
          assault victims.
          _________________________________________________________________ 
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2009-10      2010-11       2011-12     Fund
           Makes VCB the payer         $1,800-3,600      $1,800-3,600     
          $1,800-3,600   Special*
          of all claims                                           

          *Restitution Fund
          _________________________________________________________________ 
          ____

          STAFF COMMENTS: This bill meets the criteria for referral to the  
          Suspense File.
          
          The federal Violence Against Women Act (VAWA) appropriates  
          grants, including the Services-Training-Officers-Prosecutors  
          (STOP) grant to states to fund a variety of victims services,  
          including sexual assault and domestic violence programs.  
          California receives approximately $13 million annually, and has  
          received an additional $8 million in federal stimulus funds  
          through VAWA for various qualifying programs. VAWA funding is  
          contingent upon state compliance with a variety of regulations,  
          including specific regulations around charging sexual assault  
          victims for various services. One specification of the federal  
          law, is that the state or another governmental entity must bear  
          the cost of forensic and medical exams of sexual assault victims











          According to the United States Department of Justice (US DOJ),  
          under 42 U.S.C.  3796gg-4, a State is not entitled to funds  
          under the STOP Program unless the State or another governmental  
          entity "incurs the full out-of-pocket cost of forensic medical  
          exams . . . for victims of sexual assault." In addition,  
          effective January 5, 2009, States may not "require a victim of  
          sexual assault to participate in the criminal justice system or  
          cooperate with law enforcement in order to be provided with a  
          forensic medical exam, reimbursement for charges incurred on  
          account of such an exam, or both." 

          According to US DOJ incurring "the full out-of-pocket cost"  
          means any expense that may be charged to a victim in connection  
          with a forensic medical examination for the purpose of gathering  
          evidence of a sexual assault (e.g., the full cost of the  
          examination, an insurance deductible, or a fee established by  
          the facility conducting the examination). For individuals  
          covered by insurance, "full out-of-pocket costs" means any costs  
          that the insurer does not pay.

          Page 2
          SB 50 (Corbett)

          This bill would direct providers to bill the VCGCB for medical  
          examinations, instead of insurance companies. Currently, victims  
          can submit claims to VCGCB to cover co-payments and any expenses  
          they personally incur, outside of costs paid by their insurance  
          companies. The bill sponsor believes that billing a victim's  
          insurance company constitutes an indirect expense to the victim.  
          The federal regulations, however, do not consider expenses  
          covered by a victim's insurance company to be out of pocket  
          expenses. Thus, the provision of this bill which incurs expenses  
          to VCGCB does not jeopardize STOP grant funding.

          This bill would result in additional payments to service  
          providers from VCGCB. Currently, sexual assault victims' medical  
          examinations are paid by VCGCB if the victim does not have  
          insurance. All victims are eligible to have their co-payments  
          reimbursed, and it is unclear whether providers actually charge  
          co-payments to these victims. Paying for the medical exam of  
          every victim would produce significant additional costs, but an  
          exact amount of payment increases is impossible to determine  
          because VCGCB does not disaggregate sexual assault-related  
          medical payments data from other victim medical payments data. 

          VCGCB notes that, currently, approximately 3,000 sexual assault  










          victim claims are filed annually. If the VCGCB paid for the  
          medical exam portion of those claims (which ranges from  
          $600-$1200 per exam, separate from the forensics portion covered  
          by local law enforcement), the result would be payments of  
          $1.8-3.6 million annually. Those numbers do not take into  
          account the number of exams already being paid for by VCGCB, so  
          the numbers are likely somewhat lower.