Why Are Dallas Hospitals Short on Treatment for Rape Victims?

Dallas Police Chief David Brown and District Attorney Craig Watkins celebrated the opening of the first ever Sexual Assault Nurse Examiner (SANE) Program in southern Dallas at Methodist Dallas Medical Center.
Dallas Police Chief David Brown and District Attorney Craig Watkins celebrated the opening of the first ever Sexual Assault Nurse Examiner (SANE) Program in southern Dallas at Methodist Dallas Medical Center.

Local officials had a big celebration last month when a hospital in southern Dallas finally started offering forensic exams for rape victims.

"Unfortunately, Dallas has a perceived -- and maybe a real -- impression that individuals from the southern sector don't receive services like those in the north," Dallas County District Attorney Craig Watkins said at a news conference. "This program gives us credibility. It gives us the ability to stand up ... and say, 'Because you're from South Dallas, you will be treated just as those individuals from North Dallas.'"

Yet advocates say that even the victims in the north haven't been treated all that great, dealing with sparse services and hospitals that aren't sure where to direct victims who need help.

Getting a rapist behind bars in the United States is already notoriously difficult. For victims who want to give it a try, one of the first steps is visiting a hospital to undergo a forensic examination, often referred to as a "rape-kit test."

A trained doctor or nurse examines the victim, testing for DNA samples, body trauma and other evidence of the attack, then stores it all in a kit that might be helpful if there's ever a trial. (Assuming it's not one of the thousands of kits that will be stuck in backlog).

Originally, out all of Dallas' 47 hospitals, only Parkland's physicians were qualified to perform rape-kit exams. Then, a few years ago, the Texas Health Presbyterian Hospital became the second hospital in Dallas to offer the exams, under a popular national program that trains nurses to conduct the tests, called the Sexual Assault Nurse Examiner initiative, or SANE.

Still, advocates say that Dallas has been the largest city in the country with only one SANE program.

That finally changed this year, when the Methodist Dallas Medical Center recently announced that it would also offer the exams under the SANE program.

"This is actually the first time that rape kits have been available in South Dallas," says Courtney Underwood, the local advocate who has been lobbying the district attorney's office, the DPD and local hospitals to expand the SANE program.

So why isn't the SANE program more widely available in Dallas? Sure, it's expensive, but Dallas is swimming with rich people who like to host charity parties and give money to local hospitals. Underwood suspects that spending millions on rape-kit exams doesn't have same pizazz, as, for instance, buying a bunch of cool new MRI machines.

And though Watkins and Dallas police Chief David Brown have been publicly supportive of SANE, they can't force the hospitals to participate. "It is up to each individual hospital to decide to have [the] SANE program," says district attorney spokesman Debbie Denmon via email. "There is no law mandating this. Mr. Watkins does plan to support Underwood as she approaches other hospitals asking them to partake in the program."

State laws, however, have in fact been recently changed to force hospitals to offer rape-kit tests and training. Under SB 1191, which went into effect in September, any hospital with an emergency room must carry rape-kit tests and have physicians and nurses trained on how to use them. The forensic qualifications aren't as stringent as all of the requirements under SANE. (The Texas Hospital Association has argued that imposing SANE on every hospital would cost too much).

Still, under state law, every hospital in Dallas should in theory already be offering some sort of rape-kit exam, right? Not necessarily. There's no penalty outlined under SB 1191 for hospitals that don't comply.

"The majority of hospitals are still scrambling to meet the requirement, so the majority of hospitals still aren't following the new guidelines," Underwood adds via email, though she says SB 1191 is a decent start.

Another problem Underwood has seen in Dallas is that hospitals that don't offer the tests also aren't sure where to direct victims next -- and then send them to another hospital that also doesn't offer the exam. "A lot of the hospitals didn't know where to tell women to go," she says.

Asking individual hospitals what their current status is doesn't provide much clarity.

"We do in fact care for sexual assault victims in all of our facilities in accordance with Senate Bill 1191," a spokesman for the Baylor University Medical Center told Unfair Park, reading from a prepared statement. "We have more than 130 nurses across the Baylor health care system that are specially trained."

The spokesman couldn't confirm whether or not that means that rape-kit exams are in fact available at Baylor, explaining only that "everything is in accordance with the Senate bill."

For now, local activists are publicly directing assault victims to three hospitals -- Methodist, Parkland or Presby.

Send your story tips to the author, Amy Silverstein.

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