Legislature(2017 - 2018)BELTZ 105 (TSBldg)

03/02/2018 01:30 PM JUDICIARY

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Audio Topic
01:33:09 PM Start
01:35:34 PM SJR14
02:06:59 PM Confirmation Hearing
02:11:36 PM HB312
02:43:28 PM SB148
02:45:04 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Consideration of Appointee: TELECONFERENCED
Dennis "Skip" Cook, Select Committee on
Legislative Ethics
Heard & Held
Heard & Held
+ Bills Previously Heard/Scheduled: TELECONFERENCED
Moved SB 148 Out of Committee
          HB 312-CRIMES AGAINST MEDICAL PROFESSIONALS                                                                       
2:11:36 PM                                                                                                                    
CHAIR COGHILL announced the consideration of HB 312.                                                                            
2:12:01 PM                                                                                                                    
REPRESENTATIVE  CHUCK  KOPP,  Alaska  State  Legislature,  Juneau,                                                              
Alaska, sponsor  of HB 312,  explained that he and  Representative                                                              
Claman were each  contacted by the Alaska Nurses  Association, the                                                              
Alaska   Hospital   Nurses   Association,   and   emergency   room                                                              
physicians  with  requests  for  help  with  the  rising  tide  of                                                              
violence in health  care facilities. He and  Representative Claman                                                              
each  had legislation  drafted and  subsequently  decided to  work                                                              
2:13:27 PM                                                                                                                    
REPRESENTATIVE  MATT  CLAMAN, Alaska  State  Legislature,  Juneau,                                                              
Alaska, sponsor  of HB 312, said  he was in the Anchorage  LIO and                                                              
would let Representative Kopp take the lead introducing HB 312.                                                                 
REPRESENTATIVE  KOPP  said  things have  changed  dramatically  in                                                              
emergency  rooms and health  care facilities  generally since  the                                                              
opioid crisis hit.  They have become trauma zones  for staff. It's                                                              
not just from  people presenting for treatment,  but also visitors                                                              
and  family accompanying  them.  Some of  the  violence is  opioid                                                              
driven and  some is  behavioral health  issues. Regardless  of the                                                              
reason,  health  care  staff  are not  combat  medics  trained  to                                                              
survive  in   high-threat  environments.  They  are   health  care                                                              
professionals  who traditionally  treat  people in  very safe  and                                                              
secure environments.  It's come to  the point where the  law needs                                                              
to address the situation.                                                                                                       
House  Bill 312  addresses  the issue  by  allowing a  warrantless                                                              
arrest for  a fourth-degree misdemeanor  assault in a  health care                                                              
facility.  The perpetrator  can be  removed from  the facility  if                                                              
they are  stable for discharge.  If probable cause  is established                                                              
after interviewing  witnesses, the  responding officer can  make a                                                              
misdemeanor  arrest.  The bill  also  adds  an aggravator  to  the                                                              
felony assault statute  when the assault is  knowingly perpetrated                                                              
against a medical  professional who is working. He  noted that the                                                              
packets  contain   letters  of   endorsement  from   nearly  every                                                              
hospital in the state.                                                                                                          
2:21:01 PM                                                                                                                    
CHAIR COGHILL  asked for  confirmation that  a health  care worker                                                              
who witnesses  an assault could be  a party to a lawsuit  that may                                                              
REPRESENTATIVE  KOPP  said  that's  correct;  the  probable  cause                                                              
would  be based  on their  witness statement  so they  would be  a                                                              
party to any civil or criminal action.                                                                                          
CHAIR COGHILL  said he  brought it up  because the assault  occurs                                                              
within a health care facility and that becomes an issue.                                                                        
REPRESENTATIVE   KOPP  said  the   health  care  facility   is  an                                                              
important  issue because  it is  a sacred space  for every  worker                                                              
and patient.                                                                                                                    
2:23:33 PM                                                                                                                    
LIZZY  KUBITZ, Staff,  Representative  Matt  Claman, Alaska  State                                                              
Legislature  Juneau, Alaska, paraphrased  the following  sectional                                                              
analysis for HB 312:                                                                                                            
     Section 1                                                                                                              
        [Amends] AS 12.25.030(b) - Grounds for arrest by                                                                        
     private person or peace officer without a warrant.                                                                         
     Establishes  that a  peace officer  may arrest a  person                                                                   
     without a  warrant when the  peace officer has  probable                                                                   
     cause  for believing  that the person  has committed  an                                                                   
     assault in the  fourth degree at a health  care facility                                                                   
     and  the person  was not  seeking  medical treatment  at                                                                   
     the facility or was stable for discharge.                                                                                  
     The term "stable  for discharge" comes from  the federal                                                                   
     Emergency  Medical Treatment and  Labor Act, also  known                                                                   
     as  EMTALA.   EMTALA  requires   anyone  coming   to  an                                                                   
     emergency   department   be  stabilized   and   treated,                                                                   
     regardless  of  their  insurance status  or  ability  to                                                                   
     pay.  The federal  government  has published  guidelines                                                                   
     that  describes  the responsibilities  of  hospitals  in                                                                   
     emergency cases.                                                                                                           
     The  guidelines   provide:  "a  patient   is  considered                                                                   
     stable  for discharge…when,  within reasonable  clinical                                                                   
     confidence,  it  is  determined  that  the  patient  has                                                                   
     reached   the  point  where   his/her  continued   care,                                                                   
     including  diagnostic  work-up and/or  treatment,  could                                                                   
     be reasonably  performed  as an outpatient  or later  as                                                                   
     an inpatient,  provided the patient is given  a plan for                                                                   
     appropriate   follow-up   care    with   the   discharge                                                                   
     instructions."  In addition,  "… 'Stable for  discharge'                                                                   
     does not require  the final resolution of  the emergency                                                                   
     medical condition."                                                                                                        
     Section 2                                                                                                              
     [Amends] AS  12.25.030 - Grounds  for arrest  by private                                                                   
     person or peace officer without a warrant.                                                                                 
     Establishes  that   the  definition  for   "health  care                                                                   
     facility" has the meaning given in AS 18.07.111.                                                                           
     Section 3                                                                                                              
     [Amends]  AS 12.55.155(c) -  Factors in aggravation  and                                                                   
     Adds an  aggravator to  Alaska's felony assault  statute                                                                   
     when  a defendant  committed  the  offense at  a  health                                                                   
     care  facility   and  knowingly  directed   the  conduct                                                                   
     constituting  the  offense  at  a  medical  professional                                                                   
     during   or  because  of   the  medical   professional's                                                                   
     exercise of professional duties.                                                                                           
     Section 4                                                                                                              
     Uncodified law                                                                                                             
     This section contains applicability provisions.                                                                            
CHAIR COGHILL asked for the definition of health care facility.                                                                 
REPRESENTATIVE  KOPP read  the  definition  in AS  18.07.111(8)(A)                                                              
and (B).                                                                                                                        
CHAIR COGHILL  said he wanted  that exact definition  brought into                                                              
the open.                                                                                                                       
SENATOR   COSTELLO    asked   if    a   warrantless    arrest   is                                                              
REPRESENTATIVE  KOPP said  the legislature  has  the authority  to                                                              
place exceptions  in the  law. The  arrest warrant requirement  in                                                              
the Fourth  Amendment is the law  of the land but the  courts have                                                              
given  state legislatures  the authority  to implement  that in  a                                                              
reasonable manner.  The current exceptions are crimes  relating to                                                              
domestic violence.                                                                                                              
CHAIR  COGHILL  advised  that  Title   47  holds  are  allowed  in                                                              
circumstances of life and safety.                                                                                               
REPRESENTATIVE  CLAMAN added  that both the  Alaska Supreme  Court                                                              
and  the   U.S.  Supreme  Court   have  addressed  the   topic  of                                                              
exceptions  to   the  warrant  requirement   in  the   context  of                                                              
misdemeanors.   The  courts   have   typically   found  that   the                                                              
legislature  has the  authority  to craft  narrow exceptions  when                                                              
there  are good  legislative  findings. HB  312  was crafted  with                                                              
that case law in mind; the exception is narrow.                                                                                 
2:31:34 PM                                                                                                                    
BECKY HULTBERG,  President/CEO, Alaska State Hospital  and Nursing                                                              
Home Association,  Anchorage, Alaska,  said she was  testifying on                                                              
behalf of  Alaska's hospitals  and skilled  nursing facilities  to                                                              
express  strong  support for  HB  312.  It  gives police  and  the                                                              
judicial  system new  tools  to address  violence  in health  care                                                              
facilities. She said  hospitals are sacred places  and they should                                                              
also be safe  places. Unfortunately, as violence  has increased in                                                              
some  communities, it  has  spilled over  into  hospitals. In  the                                                              
last  year  hospitals  have  reported  an  increase  in  workplace                                                              
violence  and  staff  report  feeling  unsafe  in  the  workplace.                                                              
Violence  should not  be an  acceptable workplace  hazard but  for                                                              
many health  care workers  it has  become normal.  There are  many                                                              
contributing factors  to the increase  in violence,  including the                                                              
opioid crisis  and a  shortage of psychiatric  and detox  beds. As                                                              
employers,  hospitals  have  an obligation  to  address  workplace                                                              
violence and  they are working to  ensure that plans are  in place                                                              
to prevent, identify,  and de-escalate violence before  the police                                                              
need  to be  involved.  Because workplace  violence  is a  complex                                                              
problem with  many causes, it  will require multiple  solutions to                                                              
address. HB 312 is one of those tools.                                                                                          
MS.  HULTBERG  said  hospitals  clearly  understand  the  need  to                                                              
differentiate  between an intentional  and unintentional  assault.                                                              
Reporting an assault  by a patient is not something  caregivers do                                                              
lightly. But  hospitals do  report that  when health care  workers                                                              
call the police  to report an assault, the police  sometimes leave                                                              
the  individual at  the hospital  rather than  arresting them.  HB                                                              
312 gives  police new  tools to arrest  for fourth degree  assault                                                              
without   a  warrant.   Hospitals  address   violence  daily   and                                                              
understand the needs  of vulnerable populations. The  intent of HB                                                              
312  is  not to  penalize  those  who need  behavioral  health  or                                                              
substance abuse treatment.  In fact, it is carefully  designed not                                                              
to  do that.  It  is  intended to  give  police and  the  judicial                                                              
system  additional   tools  in   dealing  with  serious   physical                                                              
violence   when  it  is   creating  an   unsafe  environment   for                                                              
caregivers  and  patients.  The  legislation is  also  clear  that                                                              
patients  that need  medical  treatment  belong in  the  hospital.                                                              
Hospitals understand that obligation.                                                                                           
MS. HULTBERG  stressed that  hospitals cannot  bear the  burden of                                                              
community violence  much longer. Caregivers need  help and passing                                                              
HB 312 tells  everyone that violence in health  care facilities is                                                              
not acceptable. She  encouraged the committee to  act favorably on                                                              
the legislation.                                                                                                                
CHAIR  COGHILL  asked which  hospital  departments  are  primarily                                                              
affected by workplace violence.                                                                                                 
MS.  HULTBERG said  a  significant amount  of  the violence  takes                                                              
place  in the  emergency  room,  but labor  and  delivery and  the                                                              
general medical floors can also be very volatile.                                                                               
2:38:47 PM                                                                                                                    
CHAIR  COGHILL  found  no  questions.  He  asked  if  Pioneer  and                                                              
Veteran Homes have been part of the discussion.                                                                                 
REPRESENTATIVE  KOPP said  those  are primarily  residential,  not                                                              
health care  facilities. They  weren't intentionally  excluded but                                                              
staff haven't  reported problems  in those facilities.  Similarly,                                                              
private physician  offices didn't seem  to have the same  level of                                                              
problem  as in hospitals,  but there  wasn't  an overt attempt  to                                                              
exclude them.                                                                                                                   
SENATOR WIELECHOWSKI  directed  attention to  the new language  on                                                              
page 2,  lines 16-17, regarding  violating AS 11.41.230.  He asked                                                              
if  this  includes  the  sidewalk  and  parking  lot  outside  the                                                              
REPRESENTATIVE  KOPP said he  would defer  to the definition,  but                                                              
his guess  is it  may apply  to the  campus, not  just within  any                                                              
four walls on the campus.                                                                                                       
REPRESENTATIVE   CLAMAN    said   he   agrees    with   everything                                                              
Representative Kopp said.                                                                                                       
SENATOR WIELECHOWSKI  stated that he would interpret  this to mean                                                              
within the four  walls the health care facility  plus the sidewalk                                                              
and  the   parking  lot.  "That's   my  intent  in   passing  this                                                              
CHAIR COGHILL  said he  didn't know that  anyone on  the committee                                                              
would disagree.                                                                                                                 
REPRESENTATIVE KOPP thanked the committee for hearing the bill.                                                                 
2:43:10 PM                                                                                                                    
CHAIR COGHILL held HB 312 in committee for future consideration.                                                                

Document Name Date/Time Subjects
HB 312 - Sectional Summary (ver. O).pdf SJUD 3/2/2018 1:30:00 PM
HB 312
HB 312 - Letters of Support #1.pdf SJUD 3/2/2018 1:30:00 PM
HB 312
HB 312 - Letters of Support #2.pdf SJUD 3/2/2018 1:30:00 PM
HB 312
HB 312 - Sponsor Statement.pdf SJUD 3/2/2018 1:30:00 PM
HB 312
HB 312 - Supporting Document - Stable for Discharge Definition.pdf SJUD 3/2/2018 1:30:00 PM
HB 312
HB 312 - Letter of Opposition.pdf SJUD 3/2/2018 1:30:00 PM
HB 312
SJR 14 - Sponsor Statement.pdf SJUD 3/2/2018 1:30:00 PM
SJR 14
SJR 14 - Version A.PDF SJUD 3/2/2018 1:30:00 PM
SJR 14
Skip Cook Resume.pdf SJUD 3/2/2018 1:30:00 PM