It seems counterintuitive: To help domestic violence victims, tell their doctors they no longer need to report injuries to the police.
But that's just what survivors and their advocates want to see happen. For decades now, Colorado has been one of just a handful of states where suspected domestic violence falls into the "mandatory reporting" category for medical professionals, and that's had some unintended consequences, according to advocates.
"What we've seen and heard from our shelters around the state was these stories of women coming into shelters who had not sought medical care because they did not want a law enforcement response," said Lydia Waligorski, public policy director of the Colorado Coalition Against Domestic Violence.
Marie -- she asked to use her middle name to protect her daughter's privacy -- still suffers problems with her ankle and wrist years later because she didn't seek medical attention when she was beaten and thrown to the ground by her live-in partner. One time she did go to the doctor, and the doctor suspected domestic violence. When she realized the doctor would call the police if she were honest, she swore up and down that her injuries were not as they appeared.
"He used to say, 'If I ever go to jail, I will get out, and I will find you and I will kill you and I will kill whoever you are with,'" Marie said. "I was really wanting to go seek medical attention for my injuries, but I knew if I called the cops without a safety plan, I would be either sleeping on the streets with my daughter or he would be there to kill me."
Many domestic violence suspects are able to get out of jail quickly on bond, so quickly that their victims may not have time to get into a shelter or another safe location. And victims may have dependent children and no source of income.
"I feel all those times I had to seek medical attention, I felt that should have been my decision, to do something when I had my safety plan in place and knew I wouldn't have my daughter out on the street. They don't know my life," Marie said.
The Coalition Against Domestic Violence has been on a multi-year campaign to address issues in Colorado law identified by the roughly 40 shelters and agencies under their umbrella. Last year, they successfully made nonfatal strangulation a felony and made it easier to charge repeat domestic violence offenders with felonies, even if each individual offense would only be a misdemeanor. This year, another bill working its way through the legislature would allow victims of domestic violence and stalking to break their leases. The issue of mandatory reporting is one of the last legislative fixes on the coalition's to-do list.
Under current Colorado law, doctors, physician's assistants and certain other medical professionals are required to call law enforcement when they encounter certain kinds of injuries. Those include serious bodily injury like shootings and stabbings and any injuries believed to be caused by domestic violence.
HB17-1322, sponsored by Rep. Lois Landgraf, a Colorado Springs Republican and Rep. Daneya Esgar, a Pueblo Democrat, would allow doctors to not report domestic violence to law enforcement if the patient is at least 18 years old and doesn't want to report it. Doctors would have to give patients a referral to an advocate who can help them make a safety plan and understand their options when they're ready to leave. The bill would allow injuries to be documented in medical records as domestic violence-related -- creating evidence for future court proceedings, whether criminal or family court proceedings.
Doctors would still have a mandatory reporting requirement in cases involving serious bodily injury, like gunshots and stabbings, in cases of child abuse, in cases of elder abuse and in cases of abuse against people with disabilities.
Prosecutors have come out against the bill.
Boulder County Deputy District Attorney Tim Johnson, a senior domestic violence prosecutor, testified Thursday before the House Judiciary Committee on behalf of the Colorado District Attorneys' Council. He said the bill would carve out an exception for domestic violence and treat it differently than other types of assault. There's a broader societal interest in knowing when crimes occur, he said. He also said the bill would be a step backwards toward treating domestic violence like a personal, private matter.
"This puts domestic violence back into the shadows," he said. "There will be a lot of talk about victims making decisions in their best interests. We know that domestic violence is a crime of power and control. We know that victims make decisions for their own self-preservation. And often times that self-preservation means they go back into that relationship, and they cannot get out. Mandatory reporting means you have intervention."
Johnson said it's not so easy to separate types of reporting requirements -- a domestic violence victim might have intellectual disabilities or the abuse might have taken place in front of children, which is itself a form of child abuse.
Adrian Van Nice, also a Boulder County deputy district attorney, described watching her father beat her mother with a 2x4 when she was a small child and described in vivid detail the types of injuries that might not get reported to police -- strangulation, cigarette burns, attacks with tire irons and crowbars.
"We know from research that when domestic violence is not reported, offenders tend to increase the severity of violence," she said. "We also know from research that when offenders know that people in authority will not report, they also tend to increase the severity of violence because they see that lack of reporting as tacit approval for their actions."
It's not clear how many domestic violence cases start with a doctor making a phone call. Johnson said a quarter of all cases start with a third party making a report, while Waligorksi said her organization monitored a week's worth of cases and found two out of 40 started with a medical professional. This reporting isn't tracked, and researchers found inconsistent practices and awareness of current law around the state.
The House Judiciary Committee voted 7-4 Thursday to advance the bill. The vote was bipartisan, but it wasn't easy. Some members were clearly torn about whether this was really a step forward in how we treat domestic violence cases.
Waligorski said her organization wants to hold offenders accountable -- she stressed that advocates were not seeking to do away with mandatory arrest policies or "no drop" policies that require that prosecution go forward once begun. But the first step to doing that is empowering victims to make their own decisions and helping them stay safe, she said. And the authorities cannot actually guarantee the safety of women whose domestic violence is reported without their consent.
"They're the guys in the white hats who think the system works and that reporting solves everything," she said of prosecutors. "But we have to come down on the side of supporting all victims, including those who aren't ready to report."
Douglas County Sheriff Tony Spurlock testified in support of the bill. There are higher values than making it easier for law enforcement to secure convictions, he said.
"They shouldn't have to be in danger for us to do our job," he said.
Doctors and nurse practitioners also described feeling torn between the requirement to report and their ethical obligations to do what was in their patient's best interest.
Marie said that law enforcement can't keep victims safe, and survivors need the chance to get to a safe place before they report.
"That's the knight-in-shining-armor syndrome," she said. "They're thinking, 'Oh, she's coming into the emergency room, she's got a busted knee, she's got a busted lip, and we're going to arrest him and take him to jail.' He'll only be in for 24 hours, and all her stuff is in the house. She has kids. She has money issues. ... That's where the misconception is. That she's able to be out there in the world because he's in jail for 24 hours."
