BEXAR COUNTY, Texas – It's estimated 68 percent of rape victims never report the crime. A 2013 Texas law was meant to take away one barrier to reporting sexual assault.
Senate Bill 1191 required all hospital ERs to have a nurse or doctor on-hand who could collect evidence for rape kits so victims could go to a hospital close to home.
But experts in the field are concerned nurses and doctors aren't getting enough training to handle forensic evidence.
Patricia Stich Langford is a rape survivor. She reported her attacker to police and went to the hospital for an exam.
"People have to be strong and brave and courageous and want to come forth," said Langford. "At the hospital they do the DNA, they take your clothes and anything that they have to have for evidence."
DNA evidence from a rape kit linked Langford's attacker to her and other victims. He's now serving two life terms because in those cases, the system worked.
Shelley Botello has performed more than 1,300 examinations as a sexual assault nurse examiner or SANE. She's the program coordinator at Methodist Specialty and Transplant, one of only two hospitals in Bexar County that have a SANE program.
The job she does is so important, she said, it could change the outcome of a trial.
"We don't do our role as medical forensic examiners, a case could be lost, and there is the possibility of a perpetrator walking free among us," said Botello.
That's why Botello trained the 10 nurses in her program for 4 to 6 months before they ever handled a rape kit on their own.
Yet, other nurses now required by law to collect the exact same forensic evidence are only required to take a two-hour course.
"There is definitely more training needed just because of the subject matter," Langford said.
Which in most cases is the strongest evidence in a rape trial, "they're scared of court," Langford said.
Botello said some nurses fear their lack of training could lead to evidence not holding up in court.
"That's the first thing I hear when I do outreach is like, 'Oh, I won't do those, because I'm scared of going to court,'" said Botello.
For now victim advocates at the Rape Crisis Center and police are still encouraging survivors to go to hospitals with SANE programs. In San Antonio that's Methodist Specialty and Transplant, and Children's Hospital of San Antonio.
The team at Methodist performed 469 victim exams last year, a number that hasn't gone down since the law changed.