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L.A. County Weighs Coverage of Domestic Abuse Forensic Exams

“Domestic violence is like no other crime,” writes author/journalist Rachel Louise Snyder in her remarkable book, “No Visible Bruises: What We Don’t Know About Domestic Violence Can Kill Us,” released in May of this year.

“It does not happen in a vacuum,” she wrote. “It does not happen because someone is in the wrong place at the wrong time.

“Our homes and families are supposed to be sacred territory … This is part of what makes it so untenable. It’s violence from someone you know, from someone who claims to love you. It is most often hidden from even one’s closest confidantes.”

And this “untenable” form of crime is, unfortunately, on the rise.

In April, a study based on FBI crime statistics found that, after almost four decades of decline, homicides by intimate partners have increased, according to James Alan Fox, a criminologist and professor of criminal justice at Northeastern University, who is the co-author of the study together with Ph.D. student Emma E. Fridel.

Fox and Fredel found that in 2014, 1,875 people were killed by an intimate partner, the majority of victims female. In 2015, the death toll rose to 2,096. In 2016, it crept up still further to 2,149.

And in 2017, there were 2,237 such deaths, wrote the Huffington Post, which was the first to report on the study.

Domestic violence groups remind us that three women a day are killed by domestic violence. But according to Fox’s most recent data, it’s worse. Four women are killed a day by DV, according to Fox’s numbers.

Matters are not helped by the fact that, according to the Bureau of Justice Statistics, domestic violence is under-reported nationwide by up to 45 percent.

Yet, when it is reported, it is often hard to verify, given that those involved—the abuser and the victim—inevitably tell different stories.

All that said, in the state of California, more than 100,000 arrests are made annually for domestic violence charges.

The Los Angeles County District Attorney’s office sees an average of 11,000 domestic violence cases per year, which means roughly 200 cases each week.

LA County Moves Forward

With all of the above in mind, as Domestic Violence Awareness month draws to a close, the LA County Board of Supervisors passed a motion on Oct. 29 that will attempt to improve at least one aspect of the way county officials deal with domestic violence victims.

The motion directs the county Department of Public Health and the Chief Executive Officer, in coordination with the Department of Health Services, the LA County Sheriff‘s Department, the District Attorney, and whatever other county departments are needed, to report back to the board in 120 days with information about how extensively these domestic violence exams are already being done in the county at the moment.

They are also asked to report on who else in other jurisdictions is doing a good job with such practices; and how the county can provide the forensic exams countywide, plus what state or federal funding could be used to pay for this important service.

According to experts, support for such coverage could make a big difference.

At present, according to the motion’s authors, Supervisor Kathryn Barger and Supervisor Sheila Kuehl, the County of Los Angeles serves DV victims by offering shelter, counseling, legal and health services.

But there remain “significant barriers in the initial step of completing a hospital exam,” for a victim injured because of domestic violence, according to the motion.

Under current law, if you are sexually assaulted, you can go to the hospital for a “forensic medical-legal examination,” and the hospital will automatically be reimbursed for the exam, so that you and/or your family, won’t need to worry, according to CA penal code 13823.95.

Yet no such reimbursement is provided for domestic violence victims.

This is a big problem. It is also a very important way that California is letting victims of domestic violence down.

“There is a high need for family violence victims (i.e. victims of domestic violence, child abuse, and elder abuse) to receive forensic exams soon after the crime occurred,” the motion points out.

“These voluntary exams are crucial for the collection of forensic evidence in order to prosecute the offender(s).”

But, because they’re not covered by law, very often the immediate forensic examinations that can neutrally assess the extent of the abuse just aren’t conducted.

Why Forensic Evidence is Crucial

We have known for a long time that it is absolutely crucial to collect forensic evidence from victims of sexual assault.

Yet, in the case of family violence, the same kind of evidence collection has not been viewed with equivalent urgency.

Fortunately, this perspective is starting to change.

It helps that the science pertaining to the needed evidence collection has advanced.

Science has made strides in such methods as “Touch DNA” and advanced software imaging, which allows forensic nurses the ability to collect the suspect’s skin cells in cases involved with strangulation by swabbing the victim’s neck.

Furthermore, advancement in the Secured Digital Forensic Imaging Camera System allows that same forensic nurse to take photos and see bruising that may be serious but not visible to the naked eye.

In assault cases, when it’s a victim’s word against the abuser’s, medical evidence can make or break a criminal case.

Spotting the Risk Factors

It can also potentially save a victim’s life.

It turns out there are signs in an abusive relationship that increase the risk that the abuse could turn to homicide. Some of the risk factors are obvious, such as prior threats to kill a partner, kids, relatives, or him/herself, or the availability of a firearm in the house.

Yet some of the so-called lethality factors near the top of the list aren’t necessarily what you’d think, according to The Women’s Law Center’s April 2019 Danger Assessment.

For example, if an abuser has ever “used hands or an object to choke, strangulate, or suffocate the victim,” this is considered a significant example of a risk factor.

According to a 2007 study, previous attempts at choking a victim by an intimate partner increases the risk of homicide by 750 percent for victims who have been strangled compared to DV victims who have never been strangled.

One of the nation’s experts on such risk factors is Jacqueline Campbell, professor and the Anna D. Wolf Chair at the Johns Hopkins School of Nursing, who created a “danger assessment” protocol for battered women (which, obviously, also applies to men who are being abused or battered by a partner or ex-partner).

Using Campbell’s work, the Maryland Network for Domestic Violence created a Lethality Assessment Program – or LAP – that was originally designed for law enforcement, but is now used also by nurses, social workers, hospital personnel, and others — because to validate some of the serious risk factors, in many cases a forensic exam is necessary.

Interestingly, San Diego County began making forensic exams available to at least some domestic violence victims more than two years ago, with the aid of a grant from California’s Office of Emergency Services.

“When you’re talking about crimes that are hard to prove, this additional piece of evidence can be the difference in holding an offender accountable,” San Diego police Lt. Misty Cedrun told the San Diego Union-Tribune.

“It’s an opportunity to let the injuries speak for themselves. It’s so compelling,” she said.

It can also make a big difference in helping, not just the victim, but also law enforcement to assess if the victim they encounter is in danger of the abuse escalating, perhaps fatally.

Bottom line: providing forensic exams for domestic violence victims is a critical issue. So, yes, changes need to be made.

Celeste Fremon is editor of WitnessLA. This is a slightly edited version of an essay posted this week, reproduced with permission. Read the complete essay here.