BUFFALO, N.Y. (WIVB) — A majority of sexual assaults go unreported in the United States. When victims do seek care, there is a policy and procedure for them to receive various services, including a forensic exam and access to crisis services, for free. This is part of the New York State Sexual Assault Forensic Examiners Program under the Office of Victim Services.

You can have an exam in any hospital emergency department to collect evidence and provide certain medical care related to the sexual assault at no cost to you. If you do not have health insurance, or you decline to use your health insurance, you can ask the hospital bill to the Office of Victim Services

You can have medicine to prevent pregnancy and sexually transmitted infections (STIs, also known as STDs) for free. For HIV prevention, a 7-day pack of medicine can be started at the hospital.

Know Your Rights: A Guide for Victims of a Crime, New York State

Madison, who prefers to go by her first name for this story, says she is a survivor of sexual assault. When she went to the Erie County Medical Center (ECMC) for a forensic exam, she says they asked her to pay hundreds of dollars for that care, even though it should be free.

She calls it mistreatment; the hospital calls it a miscommunication.

Madison, a Blasdell resident, says she was raped in her apartment and she is in the process of filing a police report. She went to ECMC the night of July 7 into the morning of July 8 for a forensic exam in order to preserve the evidence of the alleged assault.

When victims of sexual assault enter the emergency room, they check-in and their type of care is determined. Then, a Sexual Assault Nurse Examiner (SANE) on-call is paged. ECMC says their protocol followed state guidelines.

“The charge nurse, or what we call the command center or flow leaders, will page out a SANE nurse. That patient is put in a designated room for victims of sexual assault. And then the nurse will respond and get here and start the care for that patient,” Karen Beckman-Pilcher, RN MSN, clinical nurse specialist for emergency services at ECMC, told News 4.

Madison says she thought she was talking with nurses who asked her to pay $300 for the exam.

“One nurse looked me dead in the eye and said ‘If you go into any hospital and ask for treatment, you’re going to be billed, sweetie. That’s how it works.’,” Madison explained.

It is unclear if Madison spoke with medical staff or administrative staff at ECMC during this interaction.

ECMC calls this a miscommunication and says Madison was not speaking with a registered nurse.

“It appears to me that the patient received misinformation from a non-medical, non-doctor, non-nurse employee,” Beckman-Pilcher added. “It is not typical of a registered nurse in the ER, not just for SANE, but in general, to ever ask about billing or payment information.”

She says she waited for hours in Room F in the emergency room waiting for care. A source close to ECMC tells News 4 a SANE nurse arrived 50 minutes after being paged for Madison’s case, but Madison decided to leave the hospital 10 minutes earlier. The timing is unclear to Madison.

“By the time I got into my car it was three hours later. I don’t know exactly. In specific situations of trauma, you can misremember events,” Madison explained.

Madison intends to file a police report for the sexual assault, after she went elsewhere for the forensic exam. She also says she received a bill in the mail from ECMC after she left their facility and did not have a forensic exam completed there. Madison plans to sue ECMC and says there needs to be better communication between patients and staff.

“I just think that there’s at this point a call for more trauma informed communication and care within the staff at ECMC,” Madison says.

Beckman-Pilcher says SANE nurses are responsible for outlining victim’s rights, discussing avenues of treatment and assisting as a non-biased evidence collector for investigations. It is also their job to assure victims that they will not be charged for such care.

“ECMC takes the patient’s allegations very seriously and has already started investigating the situation. ECMC has helped thousands of women throughout the years and we are deeply troubled by the concerns being raised.”

Peter K. Cutler, VP of Communications & External Affairs, ECMC

ECMC is one of more than 40 hospitals in the state that are designated as Sexual Assault Forensic Examiners (SAFE). It received this designation in 2003. Buffalo General Hospital is also part of this program. Through the SAFE Program, Sexual Assault Nurse Examiners (SANE) provide specific care to victims of sexual assault, including forensic exams. This New York State Program follows Federal guidelines.

According to the Bureau of Statistics, more than 60 percent of rapes, attempted rapes and completed and attempted sexual assaults go un-reported to police.

If you or someone you know is a victim of sexual assault, contact Crisis Services: (716) 834-3131 or call the National Sexual Assault Hotline: 1-800-656-4673.

Resources for victims:

Tara Lynch is a Buffalo native who joined the News 4 team as a reporter in 2022. She previously worked at WETM in Elmira, N.Y., a sister station of News 4. You can follow Tara on Facebook and Twitter and find more of her work here.