Choosing to Seek Medical Care

Getting medical care after a sexual assault is a personal choice. As you decide, keep in mind that medical treatment is critical if you want to document and treat injuries, get emergency contraception, or receive preventative medicine for sexually transmitted infections (STIs). You can go to the doctor of your choice or an emergency room (ER) for these services. However, in Illinois, an ER is the only place* that can complete a forensic medical exam—commonly known as a rape kit—and get a voucher to cover related medical bills after an assault. 

So, what can you expect at the ER after a sexual assault? What are the steps for getting a rape kit? The following information will help you understand the process based on our familiarity with the experiences of adult survivors and with the laws in Chicago, Illinois. You can always reach out to a rape crisis center if you have questions or need support.

The Process at the Emergency Room

An ER can complete a forensic medical exam within seven days of the assault. If you decide to seek care at an ER, it could be beneficial to go as soon as possible and try not to eat, drink, brush your teeth, bathe, or wash the clothing you were wearing to maximize the chances that they can recover evidence on your body or clothing. Because the clothing could be helpful as evidence, you may also want to bring a spare set with you, or the hospital can provide you with a new set.

Arrival

When you get to the ER, inform reception that you are there for treatment after a sexual assault. Staff will give you forms to get your info and permission for medical professionals to examine you, treat injuries, and provide medication. You’ll also get paperwork that asks if you want to release information to the police. You don’t have to make these decisions without help because you have a right to a rape crisis center advocate. Hospital staff will call them to the ER to support you through the process and explain the different steps. But, you do not have to talk to the advocate if you don’t want to. 

Getting Care

A medical professional will take you to a private room to ask you questions that help them understand the best way to assist you. With your permission, they may examine you, test you for pregnancy, and prescribe medications that can prevent infections like gonorrhea, trichomoniasis, chlamydia, and HIV.

Medical Forensic Exam

Staff will offer you a sexual assault medical forensic exam, also known as a “rape kit.” If you consent to it, the hospital will use the Illinois State Police Evidence Collection Kit to conduct the exam and gather evidence. Staff will explain each step, and you have the option to decline any portion of the exam that you do not want. 

Evidence can be collected even if you don’t want to file a police report. It could be helpful later on if you decide to involve law enforcement because any material and information collected during this exam will be stored and could support a future criminal case. 

Collecting Evidence 

The information you tell medical staff helps them decide where to collect samples. For example, they may use cotton swabs to swipe the genitals, rectum, and mouth in an effort to collect any DNA from your perpetrator that may be on your body. Staff may also perform combings of head and pubic hair, collect material from underneath your fingernails, and look for any other spots to swab, such as bite marks for saliva. With your consent, they might also photograph your injuries. They may ask you to submit your clothes to the crime lab, too.

These collections, especially photographs of injuries and DNA swabs, may contain valuable evidence that would otherwise degrade over time. Obtaining them can improve the strength of a criminal case. That said, you can decline any portion of the exam and do not have to submit the kit for testing if you don’t want to. You can even make that decision later on. 

Police at the ER

Illinois hospitals are required to notify the local police when they treat someone for sexual assault. An officer will typically arrive at the ER while the survivor is still there and ask if they want to give information for a report. Know that you don’t have to talk to them, release identifying information, or agree to submit your kit for testing if you don’t want to. 

If and when you report to the police is up to you. If you decide to move forward with involving law enforcement, it may be helpful to know that the sooner a report is made, the sooner the police can start investigating and gathering other evidence, which may improve the strength of a criminal case. 

At the ER, you have three main options regarding the police and a decision to make about testing your kit:

1. You can choose to talk to the police at the ER and be named in the police report. You will be interviewed by police while still at the hospital, but you can stop the interview at any time if you feel you can’t continue. You will get a sexual assault incident notice or a victim’s information notice with a number on it to reference the police report. This option is likely to result in the fastest law enforcement investigation. 

2. You can choose not to talk with the police during the ER visit but allow medical staff to share your name and whatever information you want them to give to law enforcement. You will receive a sexual assault incident notice or a victim’s information notice with a number on it to reference the police report. You can expect a detective to reach out to you. If you do not hear from them within a week and you want to be engaged in the case or provide further information, you can use the contact details on your notice to follow up with the police. 

3. You can choose not to talk to the police, not allow medical staff to provide identifying information, and not be named in a police report at the ER. Hospital staff will still need to provide very basic, non-identifying information to the police along with the rape kit for storage. You will likely receive a sexual assault incident notice or a victim’s information notice with a number on it for reference. An investigation is unlikely to start unless and until you reach out to law enforcement to add your name to the report. To do so, use the contact information on your notice to follow up with the police. If you need assistance understanding your options or contacting the police, reach out to a rape crisis center or CAASE.

Releasing Evidence for Testing 

If you undergo a forensic medical exam and decide to add your name to the police report, you can release the kit to the state crime lab for testing. You can give permission at the hospital, or you can decide to wait. If you don’t give permission for testing or are not named in the police report (and therefore your kit can’t be tested), the police will store your kit. It will be held for at least ten years or, if you were a minor at the time, until your 28th birthday (whichever is longer). This gives you time to think about what you want to do. You can contact law enforcement during the storage period if you decide you want the kit submitted for testing.

Cost of Visiting the ER 

SASETA is an Illinois law covering emergency room costs for sexual assault survivors, including any medications you receive. You should be given a voucher at the hospital to cover outpatient follow-up care related to the assault, too. You may qualify for additional assistance through other laws, and a rape crisis center advocate can help you understand and access options for coverage. An advocate will be at the hospital to support you, and you can contact them later on if you have questions or receive a bill. 

What Comes Next? 

When the police file a report, law enforcement may launch an investigation and pursue criminal legal action against the perpetrator. If you decide to participate, it may be a long and challenging process. Support can bolster your healing. You can stay in contact with a rape crisis center advocate for answers to your questions, resources including free counseling, and assistance understanding your rights in your workplace or at school—like taking time off. Getting your own victim’s attorney, who plays a separate role from a state’s attorney, can help you too. 

A state’s attorney may be assigned to your case. They represent the state in prosecuting crimes while often keeping the victim’s interests in mind. A victim’s attorney, on the other hand, represents a victim of a crime specifically. They would prioritize your interests and can help you understand and assert your rights as a victim of crime in the legal system. They can also assist you in seeking civil remedies against the perpetrator, such as a protective order or restitution, and provide support if you face discrimination at your workplace or school.

Getting Free Legal Help

Survivors in Cook County may qualify for free legal services through CAASE. Our clients receive individualized legal advice, consultation, and representation following and related to sexual harm, with special attention paid to their victim’s rights within the criminal legal system. 

To learn more or to schedule a consultation, please call Veronica at 773-244-2230, ext. 205 or email legal@caase.org. Even if CAASE can’t assist you, we will attempt to connect you to another attorney and support resources. 

NOTE: Due to the concerns about our staff and clients’ health, our offices are closed. We are working remotely, and email is the easiest way to contact our legal team. Please allow up to 72 hours for responses by email and phone.

Resources List

Here is a summary of the resources included in this piece:

• Rape crisis centers and advocates in Illinois – list and contact info
• Free legal services available from CAASE – general info
• Free victim’s rights representation from CAASE
• Free legal services for student survivors from CAASE
• Contact email for CAASE legal services: legal@caase.org
• Protective orders for Survivors – What they are and how to get one 
• Howard Brown Health In Power – Sexual assault medical forensic exams outside an ER setting during the COVID-19 pandemic 
• Sexual Assault Survivors Emergency Treatment Act (SASETA) – info about the law

Hayley Forrestal and KT Hawbaker authored this piece with support from Christine Crow of CAASE and generous input from Mariá Balata, Director of Advocacy Services at Resilience.

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*A temporary change to the Sexual Assault Survivors Emergency Treatment Act (SASETA) expanded places that can perform forensic medical exams. As of 3/1/21, two Howard Brown Health clinics in Chicago are options for survivors. This exception only applies during the COVID-19 public health crisis and is subject to change.

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This product was made possible through RISE. Specifically by a subgrant from the National Crime Victim Law Institute (NCVLI) pursuant to award number 2018-V3-GX-K018, awarded to NCVLI by the Office for Victims of Crime (OVC), Office of Justice Programs, U.S. Department of Justice. The opinions, findings, conclusions or recommendations expressed in this document are those of the author(s) and do not necessarily represent the official position or policies of the U.S. Department of Justice or NCVL.

*RISE is a national project of the National Crime Victim Law Institute made possible with funding from the Office for Victims of Crime, U.S. Department of Justice. Six legal clinics are funded through RISE, including CAASE. RISE aims to provide crime victims with access to no cost legal services to aid enforcement of their rights. For more information about this national rights enforcement initiative, visit https://law.lclark.edu/centers/national_crime_victim_law_institute/projects/RISE/overview/.