AUGUSTA — Questions about the scope of its study and friction between health care professionals and district attorneys offices appear to be prominent challenges facing the task force studying the criminal process for handling violence in health care settings.
The 13-member panel met for the third time Tuesday to hear public testimony and review findings and discuss possible recommendations. Staff from the Legislature’s nonpartisan Office of Policy and Legal Analysis assigned to the task force were present at the meeting and will draft recommendations based on Tuesday’s discussion.
The question of the panel’s scope of study came up most prominently during a discussion on patients who are boarded in hospital emergency departments as they await placement in another department or facility. As officials from hospitals, long-term care facilities, group homes and mental health agencies discussed at length in prior meetings, there is a chronic lack of open beds for patients. This is especially an issue for those with psychiatric disorders who may be exhibiting aggressive behavior.
Dr. Michael Melia, chief of emergency medicine at Eastern Maine Medical Center in Bangor, said some patients are “abandoned” in emergency departments by their families or “quite frankly” by the state, which doesn’t know where to bring the patient next.
That leaves patients sitting in emergency departments — sometimes for months at a time — as they wait to be transferred to a more appropriate facility. Within these overcrowded settings, violent incidents often occur, several providers testified.
“That increases the level of violence across the department not just with that individual patient but because of overcrowding and boarding, that puts that patient and other patients at risk,” Melia said.
“This is a crucial topic and sort of the crux of my dilemma as part of this task force, which is the issue is kind of beyond the assignment to this task force but it’s crucial to the topic,” said Jim Bailinson, corporate counsel for MaineHealth.
Bailinson and others, including Melia, said that while they would like to address the issue of patients awaiting placement, they didn’t think that was within the task force’s purview.
According to the law that established the task force, LD 629, its duties are to “review the process by which criminal cases may be brought related to incidents of violence in hospitals and other health care facilities and settings, in particular, incidents of violence involving patients or individuals related to patients assaulting hospital or medical staff.”
Rep. Amanda Collamore, R-Pittsfield, said she believed consideration of this issue was within their charge.
“If the reason that the violence is coming — and I’m not saying that this is the only reason — but if a big part of the reason, and this is what we’re hearing, is because people are in the incorrect place for their treatment that is absolutely within the scope of what we are studying and we absolutely should be addressing this issue,” she said.
Later in the meeting, the discussion became tense when representatives of health care systems and prosecutors butted heads over district attorneys offices handling of cases.
Health care workers have expressed previously, both to the task force and in interviews with the Sun Journal, confusion and frustration with a lack of transparency with the prosecutorial process and with how a perpetrator’s mental state is considered by the prosecution.
Jeff Austin, Maine Hospital Association’s vice president of government affairs and communications, told the panel Tuesday that “this is the conversation that we’ve been waiting for two years to have.”
Austin is not a member of the task force but Rep. Anne Perry, D-Calais, allowed him to speak during the discussion on best practices.
“What makes a good case? What from us can help?” he asked, directing his questions at the two assistant district attorneys on the panel.
“We’re not saying ‘and therefore prosecute,'” but want district attorneys to reach the “right conclusion.”
Frayla Tarpinian, a deputy district attorney for Kennebec County, told Austin, “This is the second time that in these committee hearings that you’ve implied that we’re not doing our job.”
Tarpinian continued what Penobscot County Deputy District Attorney Brendan Trainor said earlier: Prosecutorial decisions by district attorneys’ offices can vary widely from jurisdiction to jurisdiction since every office may function differently.
“Every case that is presented to our office goes through an individualized determination by an individual prosecutor,” she said.
In response to Tarpinian’s comments, Melia, from EMMC, said, “Where we’re at now, certainly at least from the health care provider standpoint, we don’t feel like we’re being protected.”
He said providers do not feel there exists the proper communication between them and law enforcement and prosecutors and “what I kind of heard is you saying that we’re in the right place.”
The task force will meet at 9 a.m. Oct. 13. The hybrid meeting will be held in-person at the State House and streamed on the Maine Legislature’s website.
The task force must submit a final report 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 and Brendan Trainor. They are deputy district attorneys.
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