BUFFALO, N.Y. — Sexual assault takes its toll, whether physically, emotionally or otherwise.
For those who want to file criminal charges, a critical part is often rape kits. They collect vital information and evidence that can be used in a trial.
According to a Kaiser Family Foundation study, from 2016 to 2018, 66% of survivors faced out-of-pocket charges for rape kit-related procedures, paying an average of $347 — and that's just among those who are insured.
The issue: victims paying for rape kits is illegal under both state and federal law.
One Western New York woman says adding on to the trauma of her assault was the way she says she was treated at Erie County Medical Center (ECMC).
Maddie Crowley says she was raped the evening of July 7. In the hours after the alleged assault, she went to ECMC to get a rape kit done, but she said staff members told her she would need to pay $300 upfront for the rape kit.
“It's difficult enough to be a young woman fighting sexual assault and actually thinking about creating a case over it," Crowley said. "But what makes it even more difficult is when you're denied proper services and then that gets in the way of evidence collection.”
Crowley says nurses asked if she was insured. She said she wasn’t.
“And she said to me that the only way that they would be able to collect the evidence of my sexual assaults or conduct the rape kit was if I agree to be billed $300 or if I paid $300 to the facility right then and there. There is no other option,” Maddie recalled.
It's something Maddie says was repeated multiple times, by multiple staff members.
“The only way that I would be able to, like, fully prosecute my rapist is to get a rape kit done and then be told that unless I can pay money, I can’t have evidence collection done,” Maddie said. “In that moment, it was something very traumatizing and defeating.”
The federal Violence Against Women Act requires states to provide no-cost rape kits.
The state Office of Victims Services specified that, "providers must notify individuals – both verbally and in writing – that they can choose to have OVS pay for the services or use their private insurance. If an individual agrees that OVS should be billed, they should never receive a bill from the provider for this care. Allowing medical providers to directly bill OVS helps ensure a survivor’s privacy and confidentiality."
The New York State Department of Health added to that saying, "Every person in New York State has the right to a medical exam and forensic evidence collection in any hospital emergency department." They included a link to the sexual assault victim bill of rights here.
Maddie says she never got a notification.
“One of the nurses in particular even looked me dead in the eye and she said, 'sweetheart, nothing's free. You're at a hospital,'” Maddie recalled.
"[That's] certainly not the standard for ECMC," said Karen Beckman-Pilcher, who has overseen the Sexual Assault Nurse Examiner (SANE) program at ECMC since it started in 2003.
"One thing that will hurt every SANE nurse is that if someone’s coming here seeking services and they don't get what they come for or get the treatment they seek, it's something that we take to heart," said Beckman-Pilcher.
"It appears to me that the patient, the victim, received misinformation from a non-medical, non-nurse, non-doctor, staff member," Beckman-Pilcher explained.
Beckman-Pilcher couldn't comment much on this particular case because of potential future litigation, but says it usually takes a SANE nurse 60 minutes to get to ECMC.
Sources at ECMC confirm that the process to get a SANE nurse to Maddie was initiated, but they arrived shortly after Maddie left, without getting a rape kit.
Maddie says she contacted the advocacy center and went to the MAC Center hours later and got the rape kit done for free, but any evidence might be minimal.
“I threw my clothes away and I took a shower. I don't have anything. I had nothing," Maddie explained. "You can blame me for that, but in that situation, you don't want to...you don't want to sit in that. You don't want to sit there and think about it and you feel gross. You just want a clean slate.”
Beckman-Pilcher says this is an opportunity for better education for staff and hopes it doesn't dissuade other victims from coming forward.
"What happened to them, they have no control over. So once they walk into the door, they can dictate what they want, when they want it," she explained. "Once you gain control back of what's happening to you, you start to heal."
As for Maddie, she continues to take anti-STD medications and has other follow-ups scheduled.
“I didn't put myself in this situation for fun. I didn't do this...This wasn't something that I voluntarily did,” she said.
She's sharing her story so that others know their rights.
“I'm scared as Hell," Maddie added. "I don't want to put my face anywhere. I don't want to put my name anywhere. But it has to happen.”
She is doing this in the hopes that others don’t have the same experience.
“Every single person I know has been sexually assaulted or raped in some way, shape or form, myself included, before this incident, and I had never taken any action toward it," said Maddie. "You need to fight for yourself because nobody else is going to fight for you.
The one thing Maddie told Spectrum News 1 she was grateful for was the Buffalo community.
She posted her story anonymously on Reddit and was encouraged to speak out. That’s only grown as posts about her experience continue to be shared on social media.
She says she felt like the city of Buffalo truly had her back.
For anyone seeking sexual assault resources, you can find a list below: