Legislature(2017 - 2018)BELTZ 105 (TSBldg)
03/19/2018 01:30 PM Senate JUDICIARY
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| Audio | Topic |
|---|---|
| Start | |
| SB122 | |
| HB312 | |
| SB214 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 122 | TELECONFERENCED | |
| += | HB 312 | TELECONFERENCED | |
| *+ | SB 214 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 312-CRIMES AGAINST MEDICAL PROFESSIONALS
1:49:51 PM
CHAIR COGHILL reconvened the meeting and announced the
consideration of HB 312. He opened public testimony.
1:50:47 PM
DAWN ELLIOTT, Emergency Room Nurse, Providence Medical Center,
Anchorage, Alaska, testified in support of HB 312. She said the
emergency room at Providence sees about 70,000 patients each
year. Health care workers seldom hear thank you but physical
violence, verbal abuse, and being treated like garbage is the
norm. Every day she fears another assault. She described the
last assault she experienced to demonstrate the lack of
accountability. She opined that there needs to be immediate and
lifelong consequences for individuals who assault health care
workers.
1:52:22 PM
CHUCK BILL, CEO, Bartlett Regional Hospital, Juneau, Alaska,
testified in support of HB 312. He described the legislation as
an important component to protect staff from workplace violence.
The violence in hospitals has increased 50 percent the last
couple of years. He described an incident this past weekend when
three security guards and one nurse were assaulted. The hospital
has implemented several safety measures such as doubling the
security workforce and extensive training on deescalating and
avoiding these situations. HB 312 will help the police
department to better partner with staff when needed. He urged
passage of the bill without amendment.
1:54:35 PM
AMBER MICHAEL, Legislative Chair, Alaska Nurses Association and
registered nurse, Fairbanks, Alaska, testified in support of HB
312. She said the threat of violence on health care workers and
other staff occurs in all areas of the hospital on a daily
basis. It ranges from hitting and spitting to gun violence. The
lack of power that the police have in these situations is
unacceptable. Health care facilities are a magnifier of emotions
and can explode in stressful situations and anyone in the
vicinity can become a target. However, health care workers and
other personnel are limited in how they can protect themselves
while giving care. She said the added aggravator when assaulting
a health care worker in a health care facility is a positive
move and hopefully will reduce assaults. She urged the committee
to support HB 312.
1:56:22 PM
DANNY ROBINETTE, Chief Medical Officer, Fairbanks Memorial
Hospital, Fairbanks, Alaska, testified in support of HB 312. He
reported that in the past 18 months they have experienced about
182 incidents with violence or a significant threat of violence
to hospital staff. Some estimates show that just one-third of
incidents are reported, which suggests they have had over 500
incidents in that timeframe. Violence is increasing
significantly both at Fairbanks Memorial and statewide. This is
not acceptable. HB 312 will be a significant help, but it isn't
the only solution. Fairbanks Memorial is taking steps such as
nonviolent crisis intervention training for clinical staff,
expanding security presence, and developing processes to
identify patients that are high risk for violence. He urged the
committee to support HB 312.
1:58:18 PM
BRUCE RICHARDS, Director of Government Affairs, Central
Peninsula Hospital, Soldotna, Alaska, testified in support of HB
312. He described the incident in 2008 when a former employee
entered the hospital and shot and killed a supervisor and
injured another before taking his own life. Employees have not
forgotten that event. Employees at the hospital, nursing home,
and hospital-based clinics experience workplace violence more
frequently than in the past. It originates from patients, family
members, domestic disputes and even people who have no official
business at the hospital. The National Institute for
Occupational Safety and Health defines workplace violence as
"any physical assault, threatening behavior, or verbal abuse
occurring in the work place." He cited data points from the
agency that accredits and certifies 21,000 health care
organizations nationwide. From a sample of 3,700 nurses, 21
percent report being physically assaulted and over 50 percent
were verbally abused in a 12-month period; 12 percent of
emergency room nurses experienced physical violence and 59
percent experienced verbal abuse in the last 7-day period. He
agreed with previous testimony that violence in hospitals is
increasing. Central Peninsula Hospital has a code for a
situation involving violence that anyone can initiate over the
paging system. He described some of the things he's seen when he
responded to the call for help. Their staff support allowing law
enforcement to arrest someone for misdemeanor assault without a
warrant in these situations. This will take care of the existing
issue where the perpetrator remains in the facility after the
police have left. He urged the committee to pass HB 312.
2:01:32 PM
REGENA DECK, representing self, Juneau, Alaska, testified in
support of HB 312. She said she is an emergency department
nurse, the professor of nursing for UAA in Juneau, and a victim
of violence as a direct result of her job. She described the
physical assault she experienced by a patient. Her assailant was
charged with misdemeanors and felonious assault, including
assault with a deadly weapon. He had been reported to the police
before and they said their hands were tied. Some nurses didn't
bother to report him because nothing would be done. Other nurses
view this as part of the job. It makes her sad and angry that
her injury and trauma could have been prevented if the police
had stronger tools available. HB 312 will make it so that
nurses' reports of violence will be taken seriously and
hopefully prevent further acts of violence. It will also send a
message to the public that there is zero tolerance for violent
behavior. She encouraged the committee to support HB 312.
2:04:15 PM
JENNIFER MOORE, Chief Quality Officer, MatSu Regional Medical
Center, Palmer, Alaska, testified in support of HB 312. She said
that as a nurse of over 20 years she has experienced assaults
while attempting to treat patients. All units in the hospital
are affected. Some nurses are afraid to go to work because they
fear assault. Health care workers need to know they are
supported in their time of need just as they help others in
their time of need. Violence should not be an acceptable
workplace hazard, but for many this is the new norm.
Legislation is not the only solution to this complex problem.
Every facility needs to implement a comprehensive strategy using
evidence-based practices. MatSu Regional is working on a
comprehensive workplace violence preventative program to teach
staff how to deescalate a situation, use specialized safety
techniques, and how to escort an aggressive person. It also
teaches staff how to recognize their tension triggers and how to
reduce personal tension. She urged the committee to pass HB 312
and send a strong message to health care providers that Alaska
takes this issue very seriously.
2:06:40 PM
JOANNA CAHOON, Member, Alaska Mental Health Board and Advisory
Board on Alcoholism and Drug Abuse and Staff Attorney,
Disability Law Center, Anchorage, Alaska, discussed unintended
consequences related to HB 312. She said the boards believe the
violence that HB 312 seeks to address is egregious. Her comments
are areas of drafting that may lead to unintended consequences
beyond the targeted violence the bill tries to address. There
are two ways that the current language could unintentionally
criminalize the actions of persons in need of psychiatric care.
First, people that are transported to a psychiatric facility
often refuse treatment. They can appear belligerent, yelling,
and demanding to leave. They may not be deemed to be seeking
medical treatment, but the boards' experience is that it's not
always a straightforward call. The second issue relates to the
idea that being deemed stable for discharge is straightforward.
There are certain populations that show up to ERs that may not
be admitted because they need support but not necessarily
medical treatment. Examples include a person with an
intellectual disability that is co-occurring with a mental
illness or an adult child that experiences autism and is in a
meltdown and is violent. Those individuals are in crisis, but
they may not be admitted. The bill may capture those
individuals, perhaps unintentionally.
In the boards' experience, difficult psychiatric patients have
sometimes been inappropriately deemed stable for discharge. On
occasion they have seen Emergency Medical Treatment and Labor
Act (EMTALA) violations. That is the law that requires anyone
going to an emergency department to be deemed stable before they
are discharged.
MS. CAHOON advised that a similar bill was adopted in Idaho and
patients with the conditions she described were caught up in the
criminal justice system, although that was not the intent of the
bill. She thanked the committee for the opportunity to point out
the potential for unintended consequences.
2:11:23 PM
BENJAMIN SHELTON, MD, President, Alaska Chapter American College
of Emergency Physicians, said he works at Providence in
Anchorage. He is testifying in support of HB 312 that helps
address workplace violence in health care facilities. This is
necessary. Violence in the emergency department seems to be
worsening. This should not be accepted as a workplace hazard,
but for many it has become the normal. Many of the assaults are
in the category of fourth degree assault for which an officer
must have a warrant to make an arrest. After a staff member is
assaulted, the police take a report and often leave the
individual on premises. This sends the unfortunate message to
the care giver that their safety is not important. The bill
gives police officers the same ability to remove the assailant
from the scene without a warrant. This is the same authority
that law enforcement has to remove an assailant from the scene
in domestic violence situations.
All emergency providers are responsible for EMTALA. Every
patient that comes in is cared for and stabilized. HB 312 does
not change that. If someone comes in with an acute mental health
crisis, they're psychotic, or high on methamphetamine, the
emergency department's responsibility is to treat them. He urged
the committee to pass HB 312 and send a strong message to those
providing health care that Alaska takes this issue seriously.
2:14:19 PM
KIM MCDOWELL, Emergency Room Director and registered nurse,
Bartlett Regional Hospital, Juneau, Alaska, testified in support
of HB 312. She reported that in the last six months they have
had 18 incidents of nurses being assaulted. This has become the
rule rather than the exception. This would not be acceptable in
any other place of business. She urged passage of HB 312, so
health care providers can do their jobs safely and without harm
to themselves or other people.
CHAIR COGHILL asked if she believes the bill, as currently
drafted, provides enough discretion to deal with behavioral
health issues.
MS. MCDOWELL said that as professionals they all have the
ability to make that discretionary decision. There is a
difference between an individual with autism who may not be able
to control their behavior as opposed to an individual who is
assaulting staff but does have the means to know the difference
between right and wrong.
CHAIR COGHILL asked Ms. Cahoon to address the same question.
2:17:08 PM
MS. CAHOON said she isn't questioning anybody's ability to make
an appropriate professional call. The boards' concern is based
on seeing the intention of what other states passed and what
happened. The law in Idaho intended to capture the actions of
patients or non-patients who could understand their actions but
were drunk or angry. It had an exemption for people experiencing
mental illness, but that provision was removed and patients with
mental illness or autism were caught up in the criminal justice
system. This may not be an issue most of the time, but there is
some vagueness between seeking medical treatment and stable for
discharge. She suggested that a definition or exemption might
make it clear in those situations that don't fall in the norm so
that situations like in Idaho and Washington are avoided.
CHAIR COGHILL commented that the bill appears broad enough for
the rule, but not the exception. He said he didn't know that he
was willing to slow the bill to find out how best to make an
exception when is seems that there is discretion with the
officer and health care provider.
2:19:31 PM
SENATOR WIELECHOWSKI asked if the sponsor was available to
respond to Ms. Cahoon's testimony.
CHAIR COGHILL said that was discussed in House Judiciary and the
sponsor is satisfied that the discretion given to the officers
and health care professionals is sufficient. He reiterated that
he believes there is enough discretion.
SENATOR WIELECHOWSKI said okay.
2:20:38 PM
SENATOR COSTELLO moved to report HB 312, version O, from
committee with individual recommendations and attached fiscal
note(s).
2:20:53 PM
CHAIR COGHILL announced that without objection, HB 312 moved
from the Senate Judiciary Standing Committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 214 - Version A.PDF |
SJUD 3/19/2018 1:30:00 PM |
SB 214 |
| SB 214 - Sponsor Statement.pdf |
SJUD 3/19/2018 1:30:00 PM |
SB 214 |
| SB 214 - Sectional Summary (ver. A).PDF |
SJUD 3/19/2018 1:30:00 PM |
SB 214 |
| SB 122 - Version O.pdf |
SJUD 3/19/2018 1:30:00 PM |
SB 122 |
| SB 122 - Summary of Changes (ver. J to ver. O).pdf |
SJUD 3/19/2018 1:30:00 PM |
SB 122 |