N E WS
Durham
Insult to Injury After a Duke student was raped, Duke Hospital sent bill collectors after her BY CAMERON BEACH backtalk@indyweek.com
Editor’s note: This story was produced through a partnership between the INDY and The 9th Street Journal, which is published by journalism students at Duke University’s DeWitt Wallace Center for Media & Democracy.
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n the early morning on December 13, 2018, a Duke student was sitting in her apartment’s common room in the university’s Central Campus. She was cramming for her organic chemistry final when a man she didn’t know opened the door. She says the stranger entered, threatened her with a knife, and raped her. The student, then a sophomore, immediately went to the Duke Hospital emergency room. She wanted a sexual assault nurse examiner to collect a rape kit, an invasive evidence collection process that often takes hours and requires victims to describe the details of their assault. But that kit could provide crucial evidence for police to catch her assailant. Police have not announced any arrests in the case. But six months after the assault, the student received a call from a number she didn’t recognize. “This is a call from a debt collection agency for Duke Health,” the person said, according to the student. The caller informed her that she owed hundreds of dollars for her emergency room visit for the rape examination. “Before that, I had no idea I owed any money,” the student, who asked not to be identified, told The 9th Street Journal. “I asked them to talk to my mom because it was really traumatic and hard, but they didn’t do that. They kept calling me over and over again.” Rape victims are not supposed to be charged for sexual assault exams, but the rules have loopholes. The federal Violence Against Women Act requires that all states cover the cost of the exams. But beyond the exams themselves, each state can decide what additional hospital services they’ll cover. North Carolina’s interpretation is called the Rape Victims Assistance Program. The program offers hospitals 12
February 19, 2020
INDYweek.com
Duke University Chapel PHOTO BY ALEX BOERNER
up to $800 for a sexual assault exam: $350 for the sexual assault nurse examiner, $250 for the hospital facility fees, and $200 for “other expenses,” including sexually transmitted disease antibiotics or pregnancy tests for the victim. Victims should never be directly billed by a hospital for the examination, according to the North Carolina Department of Public Safety. But Molly Chadbourne, a former sexual assault nurse examiner in Durham, says victims still get charged for other services. “There are still fees for checking into the hospital, for getting an X-ray, or for needing other care,” she explains. “All that other stuff, patients can get charged for. Sexual assault patients definitely get bills.” Chadbourne says some states cover all of a sexual assault victim’s other hospital bills, while others cap their payments at a certain amount. She notes the $800 cap in North Carolina and says, “$800 is nothing at a hospital.” Though the Violence Against Women Act is supposed to protect victims from being billed after a sexual assault, many women have reported experiences like the student’s, according to accounts in news articles and on websites. The practice is caused by a combination of state policy, billing mistakes, and poor communication between debt collectors and hospitals. When the student went to Duke Hospital last December after being assaulted, she didn’t bring her insurance card.
“They said that was fine at the time,” she says. She was told that she wouldn’t have to pay for her sexual assault exam and that she didn’t have to worry about billing. A few hours after the assault, police sent a Duke Alert, the university’s warning system for crime and severe weather. “A student reported that between 1:00 a.m. and 3:00 a.m. this morning ... she was awakened by a white male with short brown hair and a perfume smell about him,” read the alert emailed to students, faculty, and staff. “He threatened her with a knife, put on a condom, and forced her to have sex.” The student was embarrassed by the detailed university-wide alert. “Reading the email was really hard,” she says. “They never asked me if it was okay to send out that email, or if I even wanted to talk to the police. They just said, ‘You need to talk to this officer,’ and I did it because it felt like I had to.” Months after the assault, she was beginning to heal. She was put in contact with the Duke Women’s Center and started seeing a psychiatrist. Duke Hospital has an online billing system. But the student says she didn’t think she would have bills, so she never checked it. After four months, Duke Health sends all unpaid medical bills to debt collection agencies. Then, she got the first call from a debt collector. The calls kept coming. “We are [a] debt collector,” a voicemail message from
