New Urban Institute Report Looks at Who Pays for Rape Exams, Finds Some Victims Face Barriers to Getting Help

The Violence Against Women Act of 2005 requires that sexual assault victims must not be required to file law enforcement reports in order to receive free exams.  This study aimed to examine how states are meeting these goals.  We found victim compensation funds are by far the largest funder of exams across the country.  In the 19 jurisdictions included in case studies, victims generally received free exams without having to report if they did not want to.  However, barriers to even accessing the exam prevent some victims from seeking help. 

Kate Villarreal,, (202) 261-5404

WASHINGTON, DC, May 14, 2014 – A new Urban Institute report exploring how states are meeting a federal requirement for sexual assault exams finds that two-thirds of states pay for them using victim compensation funds and that immigrants, non-English speakers, and American Indian victims face barriers that prevent them from seeking help. The report, based on research funded by the National Institute of Justice, examines how states and localities pay for sexual assault medical forensic exams (often referred to as rape kits), the types of medical and forensic services victims receive, how exams can link victims to additional services, like counseling and advocacy, whether victims can get free exams without having to report the assault to police, and how the kits are stored for victims who don’t report.

The Sexual Assault Medical Forensic Exams and VAWA (Violence Against Women Act) 2005 report and four accompanying policy briefs offer an in-depth investigation drawing from surveys with state-level sexual assault coalitions, state-funding administrators, and over 400 local sexual assault service providers. Researchers also conducted focus groups with victims and on-the-ground interviews with exam providers, law enforcement, prosecutors, and advocates in 19 jurisdictions across six states. 

The findings include the following:

  • Nationwide, victim compensation funds are by far the heaviest tapped funds to pay for exams. Thirty-four states use compensation funds to pay for all or part of the exams, while only 11 use law enforcement or prosecution funds. These funds are intended to compensate all types of crime victims for losses during victimization experiences.
  • The majority of victims who seek exams seem to receive them free of charge and without having to report to law enforcement. This suggests that states are likely meeting a requirement added to the Violence Against Women Act of 2005, which requires free exams regardless of whether the victim reports the assault to law enforcement.
  • Barriers to access prevent immigrants, American Indians, and non-English-speaking victims from seeking help. Cultural, geographic, and language barriers can stand in the way for victims. When victims can’t access exams, they miss out on medical, counseling, and advocacy services, and they lose the opportunity to build a criminal case against the perpetrator.
  • Most victims who get exams report the assaults to the police at the time of the exam. Among the victims who get exams but do not report, few reported at a later date. It is likely that victims who do not report their assaults to the police also do not get exams, and miss out on critical medical and support services.
  • Funding for exams is precarious. Health care-based exam providers reported that exams often cost more than some state-mandated payment caps allow, putting exam providers in the position of absorbing the additional cost or billing it to the victims.

“When victims are unable to get exams, or don’t get them in a culturally competent manner, everyone loses,” said Janine Zweig, a lead author of the report.  “Victims aren’t helped, perpetrators’ crimes remain unaddressed, and public safety is at risk.” 

The authors conclude that more work needs to be done to ensure that all victims feel comfortable coming forward, that they feel supported by the criminal justice system, and that access to exams is never compromised.

Sexual Assault Medical Forensic Exams and VAWA 2005 was written by co-principal investigators Janine Zweig (Urban Institute) and Lisa Newmark (George Mason University), along with Darakshan Raja (Urban Institute) and Megan Denver (University at Albany). It was funded by the US Department of Justice’s National Institute of Justice. 

Four policy briefs accompany the report:

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and delivered evidence-based solutions that improve lives, strengthen communities, and increase the effectiveness of public policy. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the fiscal health of government across a rapidly urbanizing world.

Usage and reprints

Most publications may be downloaded free of charge from the web site and may be used and copies made for research, academic, policy or other non-commercial purposes. Proper attribution is required. Posting UI research papers on other websites is permitted subject to prior approval from the Urban Institute—contact

If you are unable to access or print the PDF document please contact us or call the Publications Office at (202) 261-5687.

Disclaimer: The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders. Copyright of the written materials contained within the Urban Institute website is owned or controlled by the Urban Institute.