PART III-A. HEALTHCARE SERVICES FOR VICTIMS OF

SEXUALLY ORIENTED CRIMINAL OFFENSES

§1216.1. Procedures for survivors of a sexually oriented criminal offense; immunity; regional plans; maximum allowable costs; definitions; documents requested by victim

            A. All licensed hospitals and healthcare providers in Louisiana shall adhere to the following procedures if a person presents for treatment as a sexual assault survivor:

            (1)(a) Except as provided in Subparagraphs (b) and (c) of this Paragraph, a survivor shall decide whether or not the incident will be reported to law enforcement officials. No hospital or healthcare provider shall require the survivor to report the incident to receive medical attention or collect evidence.

            (b) If a person under the age of eighteen presents for treatment as a sexual assault survivor, the hospital or healthcare provider shall immediately notify the appropriate law enforcement agency or any other official necessary to fulfill any mandatory reporting obligation required by law.

            (c) If a survivor is physically or mentally incapable of making the decision to report, the hospital or healthcare provider shall immediately notify the appropriate law enforcement officials.

            (2) All sexual assault survivors shall be examined and treated, without undue delay, in a private space required to ensure the health, safety, and welfare of the survivor by a qualified healthcare provider. Examination and treatment, including the forensic medical examination, shall be adapted as necessary to address the unique needs and circumstances of each survivor. All survivors shall be afforded an advocate whose communications are privileged in accordance with the provisions of R.S. 46:2187, if one is available. With the consent of the survivor, an advocate shall remain in the examination room during the forensic medical examination. With the consent of the survivor, the examination and treatment of all sexual assault survivors shall, at a minimum, include all of the following:

            (a) Examination of physical trauma.

            (b) Patient interview, including medical history, triage, and consultation.

            (c) Collection and evaluation of evidence, including but not limited to the following:

            (i) Photographic documentation.

            (ii) Preservation and maintenance of chain of custody.

            (iii) Medical specimen collection.

            (iv) When determined necessary by the healthcare provider, an alcohol or drug-facilitated sexual assault assessment and toxicology screening.

            (d) Any testing related to the sexual assault or recommended by the healthcare provider.

            (e) Any medication provided during the forensic medical examination, which may include emergency contraception and HIV or STI prophylaxis.

            (3)(a) If the survivor wishes to report the incident to law enforcement, the hospital or healthcare provider shall contact the appropriate law enforcement agency having jurisdiction over the location where the crime occurred. If the location where the crime occurred cannot be determined, the hospital or healthcare provider shall contact the law enforcement agency having jurisdiction over the location where the forensic medical examination is performed to determine the appropriate investigating agency.

            (b) Upon completion of the forensic medical examination, the sexual assault collection kit shall be turned over to the investigating law enforcement agency. No sexual assault collection kit shall remain at a hospital or medical facility if the hospital or medical facility is unable to store the sexual assault kit in a secure location that ensures proper chain of custody. If a hospital or medical facility has a secure location to store the sexual assault collection kit that ensures proper chain of custody, the investigating law enforcement agency shall take possession of the sexual assault collection kit within seventy-two hours upon notification of completion of the sexual assault collection kit by the hospital or healthcare provider. A healthcare provider working for a coroner's office may store the sexual assault collection kit in a secure location maintained by the coroner.

            (4) If the survivor does not wish to report the incident to law enforcement, the hospital or healthcare provider shall, upon completion of the forensic medical examination, contact the law enforcement agency having jurisdiction over the location where the forensic medical examination was performed to transfer possession of the unreported sexual assault collection kit for storage. The unreported sexual assault collection kit shall not be identified or labeled with the survivor's identifying information. The hospital or healthcare provider shall maintain a record of the sexual assault collection kit number in the survivor's record that shall be used for identification should the survivor later choose to report the incident. The healthcare provider shall provide all information required by the statewide tracking system operated by the office of state police, pursuant to R.S. 15:624.1. No sexual assault collection kit shall remain at a hospital or medical facility if the hospital or medical facility is unable to store the sexual assault kit in a secure location that ensures proper chain of custody. If a hospital or medical facility has a secure location that ensures proper chain of custody, the law enforcement agency having jurisdiction over the location where the forensic medical examination was performed shall take possession of the unreported sexual assault collection kit within seventy-two hours upon notification of completion of the sexual assault collection kit by the hospital or healthcare provider. A healthcare provider working for a coroner's office may secure the unreported sexual assault collection kit in a secured location maintained by the coroner. The law enforcement agency shall not destroy or dispose of an unreported sexual assault collection kit for a period of at least twenty years after the forensic medical examination was performed. If a healthcare provider working for a coroner's office chooses to store an unreported sexual assault collection kit at a coroner's office, the healthcare provider shall not destroy or dispose of an unreported sexual assault collection kit for period of at least twenty years after the forensic medical examination was performed.

            (5) No hospital or healthcare provider shall directly bill a survivor of a sexually oriented criminal offense for any healthcare services rendered in conducting a forensic medical examination, including the healthcare services rendered in accordance with Paragraph (2) of this Subsection and the following:

            (a) Forensic examiner and hospital or healthcare facility services directly related to the exam, including integral forensic supplies.

            (b) Scope procedures directly related to the forensic exam including but not limited to anoscopy and colposcopy.

            (6) The healthcare provider who performed the forensic medical exam and the hospital or healthcare facility shall submit a claim for payment for conducting a forensic medical exam directly to the Crime Victim Reparations Board to be paid in strict accordance with the provisions of R.S. 46:1822. A survivor of a sexually oriented criminal offense shall not be billed directly or indirectly for the performance of any forensic medical exam. The provisions of this Paragraph shall not be interpreted or construed to apply to either of the following:

            (a) A healthcare provider billing for any medical services that are not specifically set forth in this Section or provided for diagnosis or treatment of the survivor for injuries related to the sexual assault.

            (b) A survivor of a sexually oriented criminal offense seeking reparations in accordance with the Crime Victims Reparations Act, R.S. 46:1801 et seq., for the costs for any medical services that are not specifically set forth in this Section or provided for the diagnosis or treatment of the survivor for injuries related to the sexual assault.

            (7) The department shall make available to every hospital and healthcare provider licensed under the laws of this state a pamphlet containing an explanation of the billing process for services rendered pursuant to this Section. Every hospital and healthcare provider shall provide a copy of the pamphlet to any person presented for treatment as a survivor of a sexually oriented criminal offense.

            (8)(a) The survivor shall be provided with information about emergency contraception which shall be developed and made available electronically to all licensed hospitals in this state through the Louisiana Department of Health's website and by paper form upon request to the department.

            (b) The treating healthcare provider shall inform the survivor of the option to be provided emergency contraception at the hospital or healthcare facility and, upon the completion of a pregnancy test yielding a negative result, shall provide emergency contraception upon the request of the survivor.

            B.(1) These procedures shall constitute minimum standards for the operation and maintenance of hospitals under the provisions of this Part, and failure to comply with the standards shall constitute grounds for denial, suspension, or revocation of license under provisions of this Part.

            (2) Failure to comply with the provisions of this Section may constitute grounds for denial, suspension, or revocation of the healthcare provider's license by the appropriate licensing board or commission.

            C. No hospital or healthcare provider shall refuse to examine and assist a survivor on the grounds that the alleged offense occurred outside of or the survivor is not a resident of the jurisdiction.

            D.(1) Any member of the hospital staff or a healthcare provider who in good faith notifies the appropriate law enforcement official pursuant to Paragraph (A)(1) of this Section shall have immunity from any civil liability that otherwise might be incurred or imposed because of the notification. The immunity shall extend to participation in any judicial proceeding resulting from the report.

            (2) The hospital or healthcare provider staff member who notifies the appropriate law enforcement official shall document the date, time, and method of notification and the name of the official who received the notification.

            (3) On or before January first of each year, each law enforcement agency shall provide each hospital located in its respective jurisdiction with the name of the responsible contact person along with the responsible person's contact information in order to comply with the provisions of this Section.

            E.(1) The Louisiana Department of Health, through the medical directors of each of its nine regional health service districts, shall coordinate an annual sexual assault response plan for each district. Each district shall submit a proposed plan for review by the secretary no later than November first of each year. An approved plan shall become effective February first of the following year.

            (2) When developing the annual response plan, each district shall incorporate a sexual assault response team protocol. Each district shall develop the annual plan to do all of the following:

            (a) Provide an inventory of all available resources and existing infrastructure in the region and clearly outline how the resources and infrastructure will be incorporated in the most effective manner.

            (b) Clearly outline the entity responsible for the purchase of sexual assault collection kits and the standards and procedures for the storage of the kits prior to use in a forensic medical examination.

            (c) Clearly outline the standards and procedures for a survivor to receive a forensic medical examination, as defined in R.S. 15:622, to ensure access to such an examination in every parish. The plan shall designate a hospital or healthcare provider to be the lead entity for sexual assault examinations for adult survivors and a hospital or healthcare provider to be the lead entity for sexual assault examinations for pediatric survivors. The plan shall also include specific details directing first responders in the transport of survivors of a sexually oriented crime, the appropriate party to perform the forensic medical examination, and any required training for a person performing a forensic medical examination.

            (d) Clearly outline the standards and procedures for the handling and payment of medical bills related to the forensic medical examination to clarify and ensure that those standards and procedures are in compliance with this Section and any other applicable section of law.

            (e) Clearly outline the standards and procedures for the transfer of sexual assault collection kits pursuant to this Section and any other applicable section of law.

            (3) When developing the annual response plan, the department shall solicit the input of interested stakeholders in the region including but not limited to all of the following:

            (a) The sheriff for each parish within the region.

            (b) The chief of police for any political subdivision located within the region.

            (c) All hospitals located within the region.

            (d) The coroner for each parish within the region.

            (e) First responder organizations located within the region.

            (f) Higher education institutions located within the region.

            (g) The school board for each parish located within the region.

            (h) Sexual assault advocacy organizations and children's advocacy centers providing services within the region.

            (i) The district attorney for each parish within the region or his designee.

            (j) Each crime lab located within the region.

            (4) The annual response plan shall be approved by the stakeholders as provided for in Paragraph (3) of this Subsection.

            (5) The department shall include an appendix in each regional plan that provides a copy of all notices sent to stakeholders about the sexual response plan meeting, a list of the individuals and organizations that were provided notice, the method and timing of the notice provided, and a list of the individuals and organizations in attendance at the meeting.

            (6) The department shall record all meetings and make the recordings and annual plans available through the Louisiana Department of Health's website.

            F. All sexual assault collection kits used in a forensic medical examination shall meet the standards developed by the Louisiana Department of Health and the Department of Public Safety and Corrections.

            G.(1) Upon request of a competent adult survivor of a sexually oriented criminal offense, the healthcare provider that performed the forensic medical exam shall provide a reproduction of any written documentation which is in the possession of the healthcare provider resulting from the forensic medical exam of the survivor. The documentation shall be provided to the survivor no later than fourteen days after the healthcare provider receives the request or the healthcare provider completes the documentation, whichever is later.

            (2) The reproduction of written documentation provided for in this Subsection shall be made available at no cost to the survivor and may only be released at the direction of the survivor who is a competent adult. This release does not invalidate the survivor's reasonable expectation of privacy nor does the record become a public record after the release to the survivor.

H. For purposes of this Section the following definitions apply:

            (1) "Emergency contraception" means only drugs approved by the United States Food and Drug Administration with mechanisms of action that likely include the prevention of ovulation, sperm capacitation, or fertilization after sexual intercourse and do not meet the definition of a legend drug as defined in R.S. 40:1060.11.

            (2) "Forensic medical examination" has the same meaning as defined in R.S. 15:622.

            (3) "Healthcare provider" means either of the following:

            (a) A physician, sexual assault nurse examiner, or other healthcare practitioner licensed, certified, registered, or otherwise authorized and trained to perform a forensic medical examination.

            (b) A facility or institution providing healthcare services, including but not limited to a hospital or other licensed inpatient center; ambulatory surgical or treatment center; skilled nursing facility; inpatient hospice facility; residential treatment center; diagnostic, laboratory, or imaging center; or rehabilitation or other therapeutic health setting.

            (4) "Healthcare services" means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease ancillary to a sexually oriented criminal offense.

            (5) "Sexual assault collection kit" includes all evidence collected during a forensic medical examination.

            (6) " Sexually oriented criminal offense" has the same meaning as defined in R.S. 15:622.

            (7) "Unreported sexual assault collection kit" means a sexual assault collection kit where a law enforcement agency has not received a related report or complaint alleging that a sexual assault has occurred.

            Acts 2015, No. 229, §3, eff. June 23, 2015; Acts 2018, No. 209, §1; Acts 2022, No. 487, §1; Acts 2022, No. 513, §1, eff. Jan. 1, 2023; Acts 2022, No. 540, §1; Acts 2023, No. 193, §§2, 4; Acts 2024, No. 669, §1.