A bill that would expand Maine’s criminal code for assault on emergency care providers passed easily in both houses of the state legislature this week — but advocates say there’s still more work to do to protect health care workers.
Maine law currently makes assault on an “emergency medical provider” while the provider is providing emergency medical services a Class C felony and punishable by up to five years in prison and a $5,000 fine.
While the crime carries harsher penalties than assault on another person, a legislative task force studying violence against health care workers said in its final report in December that the scope of the law is “too limited to effectively prevent violence against health care workers.” “
LD 1119 amends the Maine Emergency Medical Services Act of 1982 to make it illegal for anyone licensed under the Maine Emergency Medical Services Act to “commit an assault on an emergency medical service person.” where emergency medical services are provided”
The bill would add a new section to the bill that would make it a Class C felony — a felony — to assault “a person employed or detained by a hospital … if the injury occurs in the hospital’s designated emergency room.”
Expanding the scope of the law would solve a problem with the current law, the task force said, noting that the report does not criminalize an emergency room worker who injures someone who is not directly caring for the person. and/or are not in a medical emergency.
The broad law, for example, makes it a crime to injure a nurse working in an emergency room, even if the nurse did not provide direct care to the person who committed the assault. It makes it a felony to harm any medical staff in the emergency room, such as caregivers, security or administrative staff.
The bill’s sponsor, Sen. Richard Bennett, R-Oxford, served on the task force.
After a 105-38 vote in favor of the House, the bill was tabled on special measures by Sen. Peggy Rotundo, D-Lewiston.
Since there is a fiscal note attached to LD 1119, it will have to go through the Special Response Table to get funding from the Revenue and Financial Affairs Committee.
Bennett said Friday afternoon that he believes the bill should be taken off the table because there is no funding request, especially since “there seems to be a practice now of letting bills die.”
Fiscal notes are preliminary estimates of the financial impact on the level budget. The memorandum accompanying this legislation does not request funding but anticipates a small increase in revenues due to the higher penalties associated with Class C felonies.
However, the memo states that the current average cost of incarcerating an individual for one year is $55,203.
As of Friday afternoon, there were more than 250 bills, including LD 1119, still on the table.
If the bill clears the appropriations committee and is submitted to Gov. Janet Mills’ desk for her signature, she said, “It’s a small step.” It absolutely should be done,” said the Maine Hospital Association’s vice president of government affairs and communications.
“But it’s not a solution,” Jeff Austin said in an email.
While the bill is a “very important clarification” to the current law, it is limited to emergency care, MaineHealth chief government affairs officer Katie Fulham Harris said Wednesday.
Harris said she and others have supported expanding the law to all health care workers, regardless of the unit where the assault occurred, but “they have not been successful in that effort.”
From January 2021 through May 2021, there were a total of 6,305 violent incidents across all departments at Maine Health’s main hospital, Maine Medical Center in Portland, according to data provided by the health system.
In the Northern Light Health network, which includes Eastern Maine Medical Center in Bangor, the “current average” is 88 “serious patient events” per month, a spokeswoman said.
According to Lisa Harvey-McPherson, Northern Light’s vice president of government, one of the primary challenges in the past few years has been the “long-term boarding of behavioral health patients in the emergency room,” where these incidents tend to be concentrated in hospital emergency rooms. relationships.
These patients are often stuck in the emergency room and waiting for a bed in an inpatient psychiatric unit or residential care facility for weeks or months. Harris and Harvey-McPherson said the situation is particularly concerning when it comes to children who end up in emergency rooms while waiting for behavioral health services.
In May, 623 children or youth in Maine were on waiting lists for home and community-based treatment. These services “provide strategies to help children and families manage mental health symptoms, function better at home, school and in the community, and prevent hospitalization,” according to DHHS. Together, these children were on the waiting list for an average of 194 days.
“It’s stressful in the emergency room and they’re there for days and some of these kids have been there for weeks and months,” Harvey-McPherson said. “And then that stressor, you know, challenges everybody in the emergency room.”
“Violence is not usually the result of mental illness. It is the result of an uncontrolled and misguided invasion,” she said.
Some mental health advocates and criminal defense attorneys have warned lawmakers that expanding the criminal code could have a disproportionate impact on people with mental illness.
“Emergency rooms are places where people go because they have an emergency medical or psychological condition that requires immediate care,” said Augusta attorney Walter McKee, who testified on behalf of the Maine Association of Criminal Defense Lawyers in opposition to LD 1119.
“You’re never in the best state of mind and your behavior sometimes manifests itself in ways you don’t expect. It’s a terrible idea to make someone’s actions that day a criminal forever,” he said.
Harris said it is “absolutely not our intention” to arrest and prosecute someone who has a psychiatric episode or whose behavior is a behavioral health problem.
“We only ask for situations where a patient or visitor knowingly and intentionally decides to harm us,” said Nancy Jean Gowdey, director of emergency services at MMC, in testimony in support of LD 1119.
Miranda Chadbourn, MMC’s workplace violence prevention program manager, told lawmakers in April that a study of 277 incidents at MMC’s emergency department in the first three months of the year found that “only 18 incidents were by individuals.” He had no medical capacity.”
Still, Harris, Harvey-McPherson and Austin agree there’s more work to be done on the defensive end.
“I can’t emphatically say that the single most important thing we can do in terms of public policy is to build a comprehensive behavioral health system that meets the needs of individuals with mental health and substance abuse issues or developmental disabilities. It gives them the right level of care in the right place at the right time,” Harris said.