University Hospital, the area's center for sexual-assault treatment, will no longer pick up the tab for rape exams.
Victims won't have to pay, but by January, local law-enforcement agencies will have to spend up to $800 per rape for the collection of semen, hair and fiber samples used to prosecute suspected rapists.
State law allows hospitals to charge the county or municipality where an alleged sexual assault occurred for the collection of forensic evidence. Until now, University Hospital and other area hospitals have absorbed the cost.
At University, the cost will be a flat rate between $400 to $800, said Karen Bankston, a nurse and administrator of patient care services. The exact price that will be charged has not yet been determined.
''It's certainly not an intention to pull anything over anyone's eyes,'' she said. ''But like anybody else, we need to recover our costs.''
That leaves Cincinnati rape investigators worried, because while the police budget pays for the forensic evidence collection in other crimes, the cost in rape cases would be enormous. The city investigates about 300 adult rapes a year, which could cost up to $240,000 annually.
It's too soon to tell whose budget would pay in rape cases in Cincinnati and across Hamilton County and what the exact cost would be, but the issue has people talking.
''We don't want to turn away a person from getting an exam when they have a legitimate rape,'' said Cincinnati police Lt. David Ratliff, commander of the personal crimes unit. ''We will do the rape exams in spite of the cost. However, this is something that will have to be carefully thought out, and we'll have to establish criteria for which rape exams will be done.''
University, which is the hospital city police refer rape victims to, is the first Cincinnati hospital to prepare to charge for the exams.
Children's Hospital Medical Center, which collects evidence in most cases involving children, does not plan to begin charging for rape kits, spokesman Jim Feuer said.
Across the state, a handful of hospitals already charge for rape kits. The kits include evidence-gathering material, antibiotics and clothes for victims.
Some hospitals are just discovering that the law allows them to charge for the kits, and prices being charged around the state range from $50 to more than $800, said Judi Moseley, program administrator for the women's health section at the Ohio Department of Health.
Summit Health Systems in Akron charges a flat rate of $710.
''We've never had a problem in regard to our municipalities paying for this,'' said Renee Collette, a nurse and trauma coordinator for Summit. ''The issue here is looking at it as a crime being committed and being investigated.''
In Cleveland, where the city investigates about twice as many rapes as Cincinnati, the city pays for rape kits as long as a victim files a police report. If the victim refuses to report the rape, their health insurance can be charged for hospital treatment, said Lt. Valarie Wilson, commander of the Cleveland police sex crimes unit.
''Money is always an issue,'' she said. ''But the quality of the investigation is our main concern.''
Linda Hutson, a University Hospital emergency room nurse, sees traumatized rape victims almost every day. The hospital conducts about 30 rape exams a month.
As the sexual assault nurse examiner, she draws tubes of blood, takes saliva specimens, checks to see whether the victim is pregnant, swabs body fluids - and all the while tries to preserve the victim's dignity.
''If I do a good kit, maybe a year from now when she goes to court, I will have done something,'' she said. ''I'd love to see higher convictions.''
Kendall Fisher, associate director at Women Helping Women, a non-profit group that provides crisis intervention to rape victims, said she also understands that someone must pay in rape cases.
''Our primary focus is on the victim's needs,'' she said. ''I don't really care who pays for the exam as long as it's not absorbed by a victim and as long as the victim's choices are not restricted.''
Those who work with rape survivors say they hope the victims don't get lost in the discussion of money.
''We have to work this out for the main reason we're even doing this,'' Ms. Moseley said. ''And that's to help the survivors.''
