When a UC Berkeley student is sexually assaulted and reports the crime to police, the collection of biological evidence does not start at the campus health center but in a hospital in the next city over.

Along with all UC health clinics, UC Berkeley’s Tang Center does not provide medical forensic exams or evidence collection kits, often colloquially called “rape kits.” Instead, student survivors of sexual assault are typically escorted by police to Oakland’s Highland Hospital, the primary trauma center for Alameda County, whose staff carries out approximately 250 forensic exams per year.

Some student activists on campus have criticized the process, which requires an almost 6 1/2-mile trek to Highland and police authorization to obtain a forensic exam.

Amid a movement to make campus sexual assault responses more transparent, a growing number of students have voiced the view that survivors would be more comfortable and willing to undergo forensic exams in a recognizable space such as the Tang Center. Some local health professionals, however, assert that only Highland’s staff members are suitable examiners given their volume of experience.

The realities of the response
Thus far in 2014, staff members at the Tang Center have seen approximately one attempted or completed sexual assault case per week, according to Paula Flamm, the center’s manager of social services. These types of cases, however, include members of the UC Berkeley community seeking counseling and incidents that may not qualify for a forensic exam.

In general, a forensic exam yields the most conclusive evidence when completed within 72 hours of a sexual assault. Still, even among those who seek help within the desired window, the number of students who opt for a forensic exam is low.

Last year, UCPD transported four sexual assault survivors to Highland, according to Hillary Larkin, clinical director of the hospital’s Sexual Assault Response Team, or SART. Berkeley Police Department does not track the number of individuals it transports to Highland for forensic exams.

Flamm estimates, based on her experience, that roughly half of eligible students choose to go through with the exam. There is some concern among UC Berkeley students, however, that the distance and unfamiliarity of Highland could be discouraging.

UC Berkeley junior Aryle Butler, a sexual assault survivor, called the process of going to Highland “a huge inconvenience.”

Flamm said, however, that she only occasionally meets a student who is deterred from pursuing a forensic exam after learning it requires transportation to Highland.

“Usually it’s someone who was already on the fence … then that added step of having to go some place else flipped them to the ‘no, I’m not going do it, side,’ ” Flamm said. “I would be lying if I said I’ve never seen it.”

Tang Center staff said its policy is to always inform sexual assault survivors of forensic exam availability.

But Nicoletta Commins, a UC Berkeley alumna who was raped in January 2012, said when she walked into the Tang Center the day after the assault, she was handed pamphlets detailing social services rather than given advice about obtaining a forensic exam.

“They didn’t even tell me it was an option,” Commins said. “They did a cursory exam and said, ‘You’re fine, go home.’”

It wasn’t until later that evening, after calling BPD, that Commins was advised about the possibility of going to Highland. Commins said her experience of working with two female police officers was positive, which she said is not the norm for survivors she knows.

Later down the line, Commins said the evidence collected in her exam — though not particularly emotionally or physically comfortable — ended up being instrumental in her court case.

While Tang Center staff members are not permitted to comment on specific cases, Brad Buchman, a practicing physician and medical director of the center, said it is possible a student in such a situation was advised by police about obtaining a forensic exam before campus staff could do so.

“Coordinating care, police intervention and review of available resources for victims is often a dynamic process, with people from various backgrounds independently working with the victim,” Buchman said in an email.

Breaking down the process
The forensic exam collection process for UC Berkeley students functions similarly to most systems statewide, in which one or two trauma centers meet the demand of entire counties.

While police departments must authorize the forensic exams, Marc DeCoulode, UCPD lieutenant of investigations, said police officers will always approve the procedure unless the assault occurred too far back in time to yield evidentiary value.

When opting for a forensic exam, a sexual assault survivor is not required to give a statement to police. Still, if no police report is filed, the evidence will eventually be discarded. Sexual assault survivors can find their own means of transportation to the hospital or request police transport.

As soon as hospital staff members are notified of an incoming sexual assault case, an advocate from Bay Area Women Against Rape is called in to counsel the survivor. From entering the hospital to leaving its doors, the process usually takes several hours — Commins arrived at Highland around 9 or 10 p.m. and left around 2 a.m.

Examiners first treat injuries, then collect potential forensic evidence and finally administer any needed preventative medicine and emergency contraception. Later, the hospital sends off evidence to the Criminalistics Laboratory in the Alameda County Sheriff’s Office.

At any point in the process, survivors may opt to only receive medical treatment at the Tang Center or any hospital, forgoing a forensic exam. UC Berkeley students may also report incidents to the campus Office for the Prevention of Harassment and Discrimination, which can investigate students accused of sexual assault, leading to possible academic sanctions.

The challenges of changing it
The largest obstacle to providing forensic exams at the Tang Center is matching the level of care Highland staff has acquired through years of a high-volume caseload.

“There’s nothing complicated about collecting swabs,” Larkin, who has seen hundreds of cases over her 19 years at Highland, said. “But if you don’t understand what the evidence or injuries mean — that’s a problem.”
Tang Center staff members say other barriers, though secondary, include equipment costs and specialized training.

But the cost of offering forensic examinations is not astronomical, at least in terms of dollars and hours. To be a trained SART member requires slightly more than 35 hours in the state capital at the California Clinical Forensic Medical Training Center. The program costs $350 per person to be a trained SART examiner for adult sexual assault survivors. Health care professionals ranging from registered nurses to physicians can receive the training.

Still, Buchman said the Tang Center would conduct too few forensic exams and evidence collection kits to justify the SART specialty service.

“In medicine, you’re not going to be able to diagnose an illness or see a particular type of injury unless you know what to look for,” Buchman said.

Beyond emergency room doors, once evidence is sent off to crime labs, there is often an accumulation of unprocessed evidence kits, which has drawn national and local attention in the past few months. State Assemblymember Nancy Skinner, D-Berkeley, recently proposed legislation to address the backlog, which will be heard in committee March 25.

Skinner’s proposed legislation would rush processing of forensic evidence. In January, there were 1,900 untested evidence kits in the county.

A larger, and lingering, issue
Kristina Molina and Howard Bloom, BAWAR advocates, said the idea of making forensic exams readily available at college health centers is worth exploring. Students at colleges such as the University of North Texas have mobilized online petitions to supply forensic exams through their health clinics.

Molina suggested that, because Highland SART staff is on call 24 hours a day, examiners could simply drive to Berkeley to perform examinations.

Reflecting on her experience, Commins said though she was frustrated with the limited forensic service options at the Tang Center, she questions if it would be feasible for it to expand its services.

“My experience at Highland was as good as it could’ve been,” Commins said. “I wish Tang could’ve been equipped, but realistically, I don’t know if they could be.”