From the MHH

Victims of violence: Confidential preservation of evidence becomes a health insurance benefit

The state, the GKV and the MHH sign a contract to cover the costs of the ProBeweis network.

Prof. Dr. Anette S. Debertin, Minister Dr. Andreas Philippi, Professor Dr. Michael Manns and Hanno Kummer (from left) stand side by side.

The contract has been signed: Professor Dr. Anette S. Debertin, Minister Dr. Andreas Philippi, Professor Dr. Michael Manns and Hanno Kummer (from left). Copyright: Karin Kaiser/MHH

In cases of domestic violence or sexual assault, there is a high inhibition threshold for the victims to exercise their rights and file a complaint directly with the police. Many victims of violence can only bring themselves to file a complaint after some time has passed since the crime was committed. Any traces or findings that are relevant for the criminal investigation can then often no longer be secured and documented. Since 2012, the ProBeweis network, which is anchored at the MHH, has therefore been offering victims of domestic or sexual violence a confidential evidence recovery service that is independent of the proceedings. With 45 examination centres at 39 partner clinics, Lower Saxony now has a nationwide evidence collection service for victims of violence.

With today's signing, Lower Saxony is the first federal state to finally regulate the financing of these forensic medical services with the statutory health insurance funds and to transfer it into a contract. As a result, forensic evidence collection by the ProBeweis network will become a service financed by the health insurance funds in accordance with Social Code Book V as of 1 January 2024. In addition, the state's financial support for the ProBeweis network will also be significantly improved as of 1 January 2024. Since 2012, 1,707 confidential evidence recoveries have already been carried out. About every second case involves violence in a domestic context.About five per cent of the investigated cases are men.About 15 to 20 per cent resulted in charges - including final convictions."It is a great concern of the MHH that there is no gap in care for those affected," emphasised MHH President Professor Dr. Michael Manns, "The target group of the ProBeweis network are victims of domestic and sexual violence; the aim is to reduce inhibitions and shame when seeking help."

Lower Saxony's Minister for Social Affairs, Labour, Health and Equality, Dr Andreas Philippi, signed the contract in the presence of the MHH President and Hanno Kummer, Head of the Association of Substitute Health Insurance Funds (vdek) in Lower Saxony - representing the SHI.

"We have been promoting the ProBeweis network in our Flächenland for many years, and I am very pleased that we are now making the services of this important network a genuine SHI benefit," explained Minister Dr Andreas Philippi at the signing ceremony. "We have established a procedure in Lower Saxony that is based on the highest medical standards, that is legally secure and at the same time takes into account the psychological and physical stress of victims of violence. The fact that this concept has been implemented very convincingly for more than ten years - so far with state funds amounting to 310,000 euros annually - is the decisive point in its introduction as a statutory health insurance benefit. It is also an expression of the quality in securing traces and findings that we were able to reach this agreement."

Minister Philippi thanked the MHH and the statutory health insurers for the constructive cooperation in the interest of the victims of violence, mostly women. "Word has spread far and wide about the outstanding work of the ProBeweis network, so that more and more victims are taking advantage of this important service. I am therefore pleased that we can noticeably increase the previous state funding of 100,000 euros by about a third to 410,000 euros in 2024.This significantly larger pot can then also be used to finance the preservation of evidence of victims who are not or not privately insured, which unfortunately is not included in the federal law. "The Minister also thanked the statutory health insurance funds, namely the Allgemeine Ortkrankenkasse (AOK), Techniker Krankenkasse (TK), BARMER, DAK-Gesundheit, Kaufmännische Krankenkasse - KKH, Handelskrankenkasse (hkk), HEK - Hanseatische Krankenkasse, BKK Landesverband Mitte, IKK classic, Sozialversicherung für Landwirtschaft, Forsten und Gartenbau (SVLFG) and KNAPPSCHAFT Regionaldirektion Nord.

Professor Dr Anette S. Debertin, senior physician at the MHH Institute of Forensic Medicine and head of the ProBeweis network since 2012, emphasised the many years of support from the Ministry of Social Affairs: "We thank the Lower Saxony Ministry of Social Affairs, Labour, Health and Equality for its continuous support and see our preliminary work to improve the care of victims of violence confirmed. The recognition of confidential evidence recovery as a health insurance benefit represents a milestone in dealing with the issue of domestic and sexual violence.Lower Saxony benefits from the consolidation of the structures of the ProBeweis network, also for the nationwide implementation of the so-called Istanbul Convention."

 "It is with full conviction that we make our contribution as help for those affected," said Hanno Kummer, head of the vdek regional office, representing the GKV."To this end, we have agreed on a billing procedure for the assumption of costs that guarantees confidentiality: Personal data is not passed on to the health insurance funds.The SHI funds share the costs according to market share, not according to utilisation by their own insured persons."

The contractual agreement between the SHI, the MHH/Netzwerk ProBeweis and the state of Lower Saxony provides that 421 euros net will be reimbursed to the Netzwerk ProBeweis for each case treated or forensic evidence secured.

Of this, the network will transfer 200 euros net to the respective service-providing clinic from the network.

Up to now, the ProBeweis network has only been able to pay a flat rate of 50 euros net to the clinics from the funds of the Ministry of Health.For the documentation to be used in court, the victims are physically examined and samples are taken if necessary. Injuries are photographed. All findings are stored in a tamper-proof and access-proof manner and can be requested in the event of a report and release from confidentiality and brought into criminal proceedings.

Text: Lower Saxony Ministry of Social Affairs, Health and Gender Equality

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