Sexual assault: medical evidentiary examinations and reporting.

Existing law requires the Office of Emergency Services to establish a protocol for the examination and treatment of victims of sexual assault and attempted sexual assault and the collection and preservation of evidence therefrom. Existing law requires the office to adopt a standard and a complete form or forms for the recording of medical and physical evidence data disclosed by a victim of sexual assault or attempted sexual assault. This bill would authorize the form to be issued as a paper version or as an electronic version, or as both the paper and electronic version. Existing law requires a qualified health care professional who conducts an examination for evidence of a sexual assault or an attempted sexual assault to use the standard form and to make those observations and perform those tests required to record the data required by the form. Existing law defines qualified health care professional for this purpose to include a physician and surgeon and a currently licensed nurse who is working in consultation with a physician and surgeon who conducts examinations or provides treatment in a general acute care hospital or in a physician and surgeon's office. This bill would include in the definition of "qualified health care professional" a currently licensed nurse practitioner or a physician assistant who is working in consultation with a physician and surgeon and who conducts examinations or provides treatment in a general acute care hospital or in a physician and surgeon's office. Existing law requires a hospital-based training center to be established through a competitive bidding process, to train medical personnel on how to perform medical evidentiary examinations for victims of specified crimes, including, among other things, child abuse or neglect, domestic violence, and sexual assault. This bill would require that center to be identified as the California Clinical Forensic Medical Training Center and would require the center to train qualified health care professionals, as defined above. The bill would require the training to additionally include specified training regarding victims of child sexual abuse, intimate partner violence, and sex trafficking. The bill would require the center to, among other things, develop and maintain updated standardized medical evidentiary examination forms and protocols for examinations of specified crimes, and to provide training and technical assistance for sexual assault forensic examination teams on the science of medical evidentiary examinations, emerging trends, and sound operational practices. Existing law requires any victim of a sexual assault who seeks a medical evidentiary examination to be provided with one, as specified. This bill would authorize data from a medical evidentiary examination, with the patient's identity removed, to be collected for health and forensic purposes in accordance with state and federal privacy laws. Existing law prohibits costs incurred by a qualified health care professional, hospital, or other emergency medical facility for the medical evidentiary examination portion of the examination of the victim of a sexual assault, as described in a specified protocol, when the examination is performed as specified, from being charged directly or indirectly to the victim of the assault. This bill would make that prohibition on charging a victim of sexual assault applicable to costs incurred by a clinic or sexual assault forensic examination team, and would include nurse practitioners and physician's assistants as qualified health care professionals. Existing law requires the cost of a medical evidentiary examination performed by a qualified health care professional, hospital, or other emergency medical facility for a victim of a sexual assault to be treated as a local cost and charged to the local law enforcement agency in whose jurisdiction the alleged offense was committed. Existing law authorizes a local law enforcement agency to seek reimbursement from the Office of Emergency Services for the cost of conducting the medical evidentiary examination portion of a medical examination of a sexual assault victim who does not participate in the criminal justice system and limits the amount that may be charged and reimbursed for that portion of the exam to $300. This bill, instead, would authorize a local law enforcement agency to seek reimbursement for the cost of conducting the medical evidentiary examination of a sexual assault victim who is undecided at the time of an examination whether to report to law enforcement. The bill would repeal the provision limiting the amount that may be charged and reimbursed to $300, and would instead require the Office of Emergency Services to determine the amount that may be reimbursed to offset the cost of a medical evidentiary exam once every 5 years, not to exceed 50% of the most recently determined reimbursement amount. The bill would authorize the Office of Emergency Services to redetermine the amount that may be reimbursed to offset the cost of a medical evidentiary exam, at any time, if the federal government reduces the amount of specified federal grants awarded to the office. Existing law authorizes a minor to consent to hospital, medical, and surgical care related to a sexual assault without the consent of a parent or guardian. This bill would also authorize a minor to consent to, or withhold consent for, a medical evidentiary examination without the consent of a parent or guardian. Existing law requires the collection of physical evidence to conform to specified procedures, including, but not limited to, requiring that a baseline gonorrhea culture and syphilis serology be taken, if indicated by the history of contact, that specimens for a pregnancy test be taken, if indicated by the history of contact, and the taking of both swabs and slides, as specified. This bill, instead, would authorize sexually transmitted infection testing and presumptive treatment to be provided, if indicated by the history of the contact. The bill would require that specimens for a pregnancy test be taken if indicated by the history of contact and age of the victim. The bill would require baseline testing for sexually transmitted infections to be done for a child, a person with a disability, or a person who is residing in a long-term care facility, if forensically indicated. The bill would also require, for victims of sexual assault with an assault history of strangulation, best practices to be followed for a complete physical examination and diagnostic testing to prevent adverse outcomes or morbidity and documentation on a supplemental medical evidentiary examination form. The bill would also delete the requirement to take slides as part of the procedure to collect physical evidence and would make a conforming change. The bill would further require, on or before January 1, 2021, a hospital, clinic, or other emergency medical facility at which medical evidentiary examinations are conducted to implement a system to maintain medical evidentiary examination reports in a manner that facilitates their release only as required or authorized by law.