-October is Domestic Violence Awareness Month.

And here's a startling statistic for you: So far this year, Metro Police say they've responded to 25 domestic violence-related homicides, a 47% increase from the year before.

Here now to discuss that increase as well as new laws in Nevada meant to help survivors of domestic violence is Liz Ortenburger, CEO of SafeNest, Nevada's largest and most comprehensive charity dedicated solely to solving domestic violence issues.

Liz, welcome back to Nevada Week.

(Liz Ortenburger) Thank you for having me.

-Okay.

So what do you believe is behind this increase in domestic violence-related homicides?

-So when we had the recession 10 years ago, we became number one in the country for homicides per capita related to domestic violence.

We're seeing some of those similar stressors now.

That financial stress is an overlay.

If there's already violence in the household, these are the things that trigger it.

And now we're seeing that become lethal.

-And also it's a reason why people who are being abused don't leave their abusers.

Finances, correct?

-Absolutely.

In 2006, ACLU did a study.

50% of women who are homeless cite domestic violence as the root cause for that homelessness.

-How are you getting the message across at a time of such high cost of living to people who are being abused that they need to get out of the situation?

-Right.

So we communicate in two channels.

One is to survivors that, Here's the red flags.

And if these things are happening inside your relationship--strangulation, if there's a gun in the home, if there's recent job loss--those are indicators that we could be escalating a homicide.

Call and get support.

But we also talk to abusers in that if you're creating an environment in your home that's out of control or your kid is looking at you with fear, we have support and confidential resources for you as well.

-And that's a little bit controversial that you're working with the abusers, correct?

-Yeah.

SafeNest has been doing that for 30 years, but it is constantly sort of something that I have to defend, which is odd because the root cause of domestic violence is an abusers' behavior.

So while, yes, we want to have all the resources and support for survivors, because nobody should have to suffer inside a relationship, if we don't actually start working on the root causes of domestic violence, beginning in youth and working their way into adulthood, we will never have a solution for this epidemic.

-All right.

So you held a press conference recently to discuss the new legislation that was passed this past session.

And at it, Metro Undersheriff Andy Walsh said that Metro has seen a more than 50% increase in which the victims of these domestic violence-related homicides are Hispanic females.

-Yes.

-He had no answer as to what was behind that.

Do you have any idea?

-So when we look at-- when we look at wealth and wealth distribution, we know that our Hispanic communities in Nevada are some of our most low-income communities.

When we tie that with undocumented status and all of the other complications and the cultural elements within the Latin community, it can be very, very hard for a survivor to exit.

And so we make sure we're available at places like the Mexican consulate, on calls with Metro in the areas where domestic violence is high, in the Northeast Area Command, and some of the other hot spots for where those homicides are happening.

But it's really about making sure that undocumented survivors and survivors in the Latin community understand services are available for you.

They're available for you in a bilingual fashion.

But also leaving your abuser and getting the abuse to stop does not mean you have to leave your family.

And that's what becomes very complicated in that cultural context.

-All right.

So the key piece of legislation that you held that press conference to discuss, Governor Joe Lombardo was there, also Assemblywoman Shondra Summers-Armstrong, the bill sponsor, AB257, what does that do?

-So it basically creates a pathway for strangulation exams to be free of charge for a survivor.

So in the past, you would walk in and say, I need a strangulation exam.

The cost will be between $515 and $1,500.

That is no longer the case.

Any survivor would be able to walk into UMC and share that they've been a victim of domestic violence and get that exam for free.

-And why is that exam so important?

-For two reasons.

One is there is a lot of long-term health detriments tied to strangulation.

If you think about your airway being blocked, small bones can break off.

That can create scar tissue that can actually lead to your death 10 years down the road.

So the health of the survivor is one piece.

The other piece is absolutely for the forensic exams.

Strangulation is a felony offense in Nevada.

But without the strangulation exam, we have almost no luck, or just judicial process, in getting that felony charge to stick.

The other piece of this that's so critical, we don't talk enough about.

If mom's being strangled, 10% of the time, the kids are also being strangled.

And a strangulation exam gives us an opportunity to ask that question to the mom.

-To intervene.

Wow!

Prior to this law, I'm assuming victims were paying for this on their own.

And were they actually ending up getting them?

-Yeah.

Actually, I don't-- I have some anecdotal cases where people had gone to an emergency room.

Some of our survivors received a strangulation exam through their insurance, but because it wasn't done by forensic nurse, it doesn't hold up in Justice Court.

-Oh, I see.

-One of the problems in Clark County is that we have one forensic nurse for our 2.3 million residents.

And then we balloon up to 3 million on the weekends, especially, you know, as we have these great things coming to town.

We simply aren't resourced as a county in the way to deal with the needs of these survivors in any kind of a timely manner.

And a strangulation exam has to happen within three days of the incident.

You cannot eat, drink, change clothes, or shower.

So imagine you have been strangled, passed out, you've been unconscious, you may have defecated on yourself--that is a common occurrence--and you cannot do anything to clean yourself up until you have access to an exam.

-So, Liz, this is great legislation.

But if there is only one nurse you can go to in all of Clark County, how does this even work?

-So I am in favor of like, let's then figure this out.

Right?

So we've actually been talking with Commissioners Naft, Jones, and McCurdy to bring together a domestic violence advisory group at the county level to talk about the bottlenecks like this.

This is one bottleneck on a victim's path to justice, but there are others in the system.

If we get all of the stakeholders at the table: How does UMC get more forensic nurses?

Can Roseman University help?

Can Dignity Health help?

How do we create a solution that's survivor-centered and meets the economic needs of our county in a way that is efficient?

-So you still have work to do?

-Absolutely.

-So the County can be reimbursed for these tests via the State.

The State set aside a million dollars for this fiscal year and a million for next fiscal year, but they have to actually bill the State.

And have you found that they are billing the State?

Because right now, rape kits can be reimbursed.

-Right.

So we've heard from the State that the County has not been billing for rape kits, which does not mean rape kits aren't happening, it just means the County is covering that cost themselves.

So part of figuring out how to get this to work seamlessly is, what is the billing mechanism, and who can bill a county?

Is it only UMC?

Or can other providers if they are to hire a forensic nurse and have the equipment to do the exam, can other providers also bill the County?

So that's all the work that has to be figured out to make sure we clear this pathway.

-And as you explained to me, if the County does not bill the State, the State does not have the data that you need to support getting more funding for these strangulation tests in the future.

-Yeah, absolutely.

So we're the fourth state in the country to allow for strangulation exams to be free of charge.

We're the first state to do it with a line item in our budget.

So I'm very proud of Nevada for that, but that line item will go away if we do not see the data to support the expense.

So now it's clear all the bottlenecks, make sure survivors have access, and then let's collect the relevant data and adjust as needed.

-How are other states paying for this?

-ARPA funding.

-Oh.

-Yes.

-Which will run out, as well?

-Yes, it will.

-Other domestic violence legislation signed into law this past session was AB51.

What does it do?

Why was it needed?

-Yeah, so AB51 did two important things.

The first was if you are an abuser and you fled the scene, you really had to hide for 24 hours and then there was no consequence.

The police couldn't arrest you after 24 hours.

So it added seven days to that.

We had asked for two weeks.

It got cut down to seven days.

So that should help police.

Right now about 50% of domestic violence incidences that don't result in an arrest is because the abuser fled.

So this will help police follow up shift-to-shift and find these abusers.

It's harder to hide for seven days than it is to hide for 24 hours.

-Why on earth was 24 hours ever deemed sufficient?

-You know, you have to think about-- we have such a great working relationship with LVMPD, but they are really busy.

And so it felt like holding it over was probably where we started, and then no one had really looked at it.

And so as we started working with the AG's office and others, it's like, This is a barrier for LVMPD.

Let's fix this.

Let's get this to change to seven days.

So I think it was just probably put there as a placeholder to start, and now we improve.

-So do abusers, do you find that they're going to get up to date on these new laws and try to start hiding for seven days?

-You know, I will never underestimate the savviness of an abuser to know the criminal justice system and to manipulate it to their will, which is absolutely what we see all the time at court.

And so, you know, it will be interesting to see what happens and how many of these that flee the scene we're able to actually get now on the seven-day.

And that information is all tracked publicly, which is another great thing about Nevada.

We can see the data and see where the adjustments are working or not working.

-I want to go back to strangulation.

What do we know about people who strangle other people?

-Yeah.

So this is a terrifying statistic.

So a survivor strangled once is 750% more likely to be murdered than her peer who is also being abused but not strangled.

And that's on the first strangulation.

When it escalates, that percentage goes up each time.

On average, women do not call 911 until they've been strangled five times.

So there's that element.

But we also know there's an incredible tie between mass shootings and domestic violence.

So 68% of mass shooters have a known domestic violence on their record.

It is believed of that 68%, 100% have strangulation.

And then there's also a terrifying link between those that strangle and killing police.

We know domestic violence is the most dangerous call that police will go on.

But when we look from a different lens and say, Who are cop killers, we find very often 80% of the time, there's domestic violence.

And it is believed that 100% of that 80% has got a strangulation on their record.

So this is a terrifying red flag.

We need to not only catch it for the safety of the survivor and the family unit, but the safety of our community as well.

-And one more thing I do want to bring up, when you are trying to talk to survivors or people who still need to leave the domestic violence situation, do you make a plea about their children?

Because if there is violence in the home, it can severely impact a child, correct?

-So here's how all domestic violence agencies need to work: We do not tell survivors what to do.

Because the minute we tell somebody what to do or they feel like they're being told what to do, our behavior, while our intentions are different, is exactly the same as the abuser.

So what we do when we safety plan is we lay out all of the options and we talk about all those options.

We have some tremendously brave survivors that choose to stay inside that relationship for reasons that makes sense for them.

But what we want to do is make sure there are always the resources available in Clark County for a survivor to find safety when they need it.

And I will tell you, last month we had 432 survivors who called our hotline who because they were not in lethal enough danger, they could not find a bed.

And Shade Tree is full, and Safe House is full.

And so our county is under-resourced in the-- in the places for lethal survivors to find safety.

-Lastly, Nevada, where do we rank in terms of domestic violence compared to the rest of the country?

-Yeah.

So we're the seventh most dangerous place in the country on a 10-year average for women being murdered by men, which is the most common domestic violence homicide statistic.

And then we rank about fifth for the numbers of domestic violence that don't result in homicide, necessarily.

So we have an epidemic here.

-Yeah.

A lot to work on.

Liz Ortenburger, CEO of SafeNest, thank you for joining Nevada Week.

-Thank you for having me.