Our Mission

The Kentucky Association of Sexual Assault Programs, Inc. (KASAP) is the statewide coalition of the 13 rape crisis centers in the Commonwealth. The mission of KASAP is to speak with a unified voice against sexual victimization.

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SAFE Exam

Overview

In Kentucky, SAFE Exams (also called rape exams) have historically only been available to victims if the crime was reported to law enforcement. However, federal law was enacted in 2005 to encourage more victims to get medical treatment and have samples collected for potential use in prosecution. Now, states must provide SAFE Exams without requiring the patient/victim to cooperate with law enforcement, which includes reporting required for payment of services or agreeing to press charges. In order to comply with federal law, Kentucky eliminated the ‘reporting for payment’ requirement in 2009. The 2010 Kentucky General Assembly enacted House Bill 500, which became effective July 15, 2010, to govern performance of such exams throughout the Commonwealth. These changes serve two primary purposes: (1) to improve victims’ access to necessary medical treatment and (2) to increase the availability of samples in delayed reporting cases. Thus, the ultimate goal of the new law is to increase reporting and effective prosecution of sex crimes.


Victim’s Right to Choose Reporting or Non-Reporting

Kentucky hospitals and other sexual assault examination facilities are now required to provide SAFE Exams to victims who request such exams, regardless of law enforcement reporting. The victim/patient must be given a choice of whether or not to report to law enforcement. If the victim chooses to have a SAFE Exam but not report to law enforcement, samples must be stored for at least 90 days to allow the victims time to consider filing a delayed report. KRS 216B.400 also requires that SAFE Exams be available to “persons seeking treatment as victims of sexual offenses.” Thus, it is not necessary for health care or law enforcement officials to determine whether or not an offense has been committed prior to examination.


Hospital’s Duty to Provide or Arrange for Secure Storage

According to the new law, hospitals have a legal duty to provide SAFE Exams and must allow the victim to choose whether or not to report to law enforcement. The hospital at which the exam is performed is required to provide secure storage or transfer the samples to a designated storage facility. Samples must be stored for at least 90 days in a manner that limits access. Potential storage locations include Risk Management Offices or other locations where security is enhanced. Options for designated storage facilities outside of the hospital setting include law enforcement agencies willing to provide storage without initiating investigations.


HIPAA Compliance & Mandatory Reporting in Kentucky

Many people mistakenly believe that Kentucky law requires that all rapes be reported to law enforcement. This common belief is a misunderstanding of the law and can lead to violation of federal law, i.e. Health Insurance Portability and Accountability Act (HIPAA). In Kentucky, the only mandatory reporting law that authorizes hospitals to release information to law enforcement is KRS 620.020, regarding child abuse and neglect. This Kentucky law requires that child abuse, neglect, or dependency be reported to law enforcement, Cabinet for Health and Family Services (CHFS), or local prosecutors. Thus, reporting child sexual abuse to law enforcement fulfills the duty to report under Kentucky law and is permitted by federal law.

Kentucky law also requires reporting of spouse abuse and abuse of adults with disabilities (who are unable to care for themselves and may need protective services). However, these laws require that reports should be made to the CHFS (commonly referred to as Social Services). A report to law enforcement does not fulfill one’s duty to report to CHFS. Since KRS 209 and KRS 209A only authorize release of information to the CHFS, health care providers must obtain the patient’s authorization to release information prior to reporting to law enforcement in order to comply with HIPAA. Since many hospitals and other health care providers developed reporting policies prior to the implementation of HIPAA, all relevant policies, procedures, and training should be updated to ensure compliance.


Assistance Available

The Kentucky Sexual Assault Response Team (SART) Advisory Committee assisted with the development of appropriate policies and storage systems throughout the Commonwealth. The SAFE Exam Compliance Guide was developed by the SART Advisory Committee, in conjunction with four pilot sites, to support communities in responding to these new legal mandates. The guide includes sample protocols, forms, and other tools for implementation. These tools are designed to ensure: (1) the patient’s right to control reporting and release of information/samples to law enforcement, (2) proper maintenance of the chain of custody so that evidence will be admissible in cases where a delayed report is made, and (3) appropriate destruction of samples, if the crime is not reported to law enforcement within the period required for storage. Additional technical assistance and training are available upon request. Contact For more information or to request assistance contact the Kentucky Association of Sexual Assault Programs, Inc. at 502-226-2704 | http://www.kasap.org | attorney@kasap.org or Kentucky Hospital Association at 502-426-6220 | http://www.kyha.com


Examination Requirements

This project was supported by Grant Number VAWA ARRA-2009-KASAP-00034 awarded through the Kentucky Justice and Public Safety Cabinet by the Office on Violence Against Women, U.S. Department of Justice. The Opinions, findings, conclusions and recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women or the Kentucky Justice and Public Safety Cabinet.