BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
50 (Corbett)
Hearing Date: 05/28/2009 Amended: 04/28/2009
Consultant: Jacqueline Wong-HernandezPolicy Vote: Public Safety
7-0
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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.
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Fiscal Impact (in thousands)
Major Provisions 2009-10 2010-11 2011-12 Fund
Deletes provision $0 $0
$0 General allowing law enforcement
discretion over medical exam location
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STAFF COMMENTS: SUSPENSE FILE. AS PROPOSED TO BE AMENDED
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.
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
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SB 50 (Corbett)
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.
AS PROPOSED TO BE AMENDED: The requirement of VCGCB to pay the
cost of all sexual assault victims' medical exams would be
deleted, and VCGCB would continue to pay claims for expenses
beyond what is covered by the victim's insurance company.
This amendment appears to remove the additional expense to the
Restitution Fund.