AUGUSTA — At its final meeting Thursday, the task force studying violence in health care settings recommended that the Legislature expand some elements of Maine’s criminal code but by no means suggested an exhaustive overhaul of the criminal process.
In testimony to the 13-member task force last month, health care providers told members that the escalating frequency and severity of the physical and verbal abuse they face in the workplace is “unsustainable.” Already facing a massive worker shortage in Maine and nationwide, some suggested that this violence is likely driving many people out of the profession.
“We tolerate a level of abuse that is unlike any level of abuse that’s tolerated in any other setting,” Andrea Patstone, president of Stephens Memorial Hospital in Norway, told the Sun Journal in June.
Much of this abuse is occurring in hospital emergency departments, where some patients end up “stuck” for days and sometimes for more than year while they wait for a more appropriate placement. It’s often in these situations where people — mostly patients and some, though not all, with a diagnosed mental or psychiatric disability — can get violent, providers testified.
When violence does occur, representatives from law enforcement and district attorneys’ offices said there are several factors, such as a person’s mental state, that can impede or complicate their ability to charge or prosecute.
“I would really like to fight with the idea that if we prosecute these folks more, that we’re going to stop the violence,” Kennebec County Deputy District Attorney Frayla Tarpinian, who is on the task force, said during a September meeting.
The most significant change the task force recommended is to assign a higher-class crime for assaults against all emergency department personnel, not only “an emergency care provider while the emergency care provider is providing emergency medical care.”
In most cases under current statute, a person found guilty of assault is charged with a misdemeanor-level crime, which is generally considered less serious than a felony charge and carries a maximum prison sentence of 364 days.
Assault on an emergency care provider, however, carries a felony-level charge, which is considered a serious crime that typically carries a minimum one-year prison sentence.
Maine no longer uses the categories “misdemeanor” or “felony” but some task force members used these terms when referring to the severity of a charge or punishment.
While some members wanted to expand the statute to include any violence that occurs on hospital grounds, or even extend it beyond hospitals, to include group homes and other private nonmedical institutions, Reps. Anne Perry, D-Calais, and Amanda Collamore, R-Pittsfield, pushed back and said that could be a slippery slope.
“I think we need to do this with good information and not broaden it just because it seems like it’s something we should do,” Perry said, adding that among its other recommendations is standardized data collection from hospitals and private non-medical institutions that would document incidents.
“I don’t feel like we can fully understand what broadening this could have (in terms of) implications in other areas of the law,” Collamore said.
Collamore said she used to work in group homes and would not want children “to be felons because they had a bad day” and lashed out.
The deputy district attorneys on the task force also said that expanding the definition to include various facilities beyond emergency departments could muddle the law in some cases and exponentially increase the number of felonies going through offices.
“If you want to expand to (private non-medical institutions), that would have a tremendous impact,” Tarpinian said.
“There are a lot of unintended consequences by broadening this. … If you wanted to prosecute (assaults committed in) PNMIs, that would tremendously increase the number of felonies going through my office,” the Kennebec County assistant district attorney said.
Instead, the task force landed on a very narrow expansion of the statute, choosing to add a provision to the law that would include all staff in an emergency department, not just providers actively giving care.
In addition to statutory changes, the task force also made several recommendations for “best practices” across health care systems, law enforcement agencies and district attorneys’ offices, including the data collection and terminology standardization.
The group also suggested that health care systems get to know their district attorney’s office better through more communication so they can better understand their prosecutorial decisions.
The task force’s full report with its recommendations is due to the Legislature’s Criminal Justice and Public Safety Committee no later than Nov. 2.
This story was updated to reflect the correct title for Frayla Tarpinian. She is a deputy district attorney.
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