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(s): Select Committee on Legislative Ethics
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
*+ SJR 14 CONST. AM: PARENTAL CONSENT TO ABORTION TELECONFERENCED
Heard & Held
+ HB 312 CRIMES AGAINST MEDICAL PROFESSIONALS TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled: TELECONFERENCED
+= SB 148 BACKGROUND CHECKS FOR POLICE & TRAINING 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                                                               
together.                                                                                                                       
                                                                                                                                
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                                                               
arise.                                                                                                                          
                                                                                                                                
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                                                                    
     mitigation.                                                                                                                
                                                                                                                                
     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                                                               
constitutional.                                                                                                                 
                                                                                                                                
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                                                               
facility.                                                                                                                       
                                                                                                                                
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                                                               
legislation."                                                                                                                   
                                                                                                                                
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