Rebekah E. Allen, JD

Senior Policy Analyst

VA Department of Health

9960 Mayland Drive

Suite 401

Henrico, VA 23233

RE: VACEP Public Comment on 12VAC5-410-10 et seq Draft Regulations for the Implementation of SB 827

Dear Ms. Allen: 

On behalf of the Virginia College of Emergency Physicians (VACEP), we are writing to support the draft regulations as presented by VDH. The need and urgency for this legislation and accompanying regulations cannot be understated. An August 2022 survey of emergency physicians from the American College of Emergency Physicians (ACEP) shows that violence in ERs is increasing dramatically. Instances of patient and family member violence on emergency physicians and nurses not only harm the caregivers, but also impacts the care that can provided to others waiting for lifesaving care.  

During the 2023 legislative session, VACEP worked in conjunction with the VA Nurses Association and the Medical Society of VA to negotiate the compromise with the VA Hospital and Healthcare Association (VHHA) that passed both houses of the General Assembly unanimously.  As in most instances of compromise, both sides didn’t get exactly the outcome they wanted, but we believe the final bill allowed for the requested flexibility by hospitals for the varying needs of different communities by including a waiver option. 

It is therefore with great surprise and disappointment that we have to firmly and wholeheartedly disagree with the VHHA’s subsequent “interpretation” of the language in the bill in their posted public comment.  It was very clear from our numerous discussions, including with the patron Senator Favola, that the security risk assessment would certainly guide the creation of a security plan. However, it was never the intent- nor do we believe the plain reading of the law- that would lead to hospitals: 1.) Not needing any security in their ER ever or; 2). that if there was a different need shown other than security present in the ER 365 days a year, seven days a week and 24 hours a day, that they would be exempt from even having to apply for a waiver from that legal requirement.  

The clear purpose of the waiver was to acknowledge that some emergency departments might need security on one or two shifts a day, not the entire day.  We disagree vehemently with the notion that there are ERs in the Commonwealth that have no need for any security personnel to be present in the emergency department.  Not only are we backed up by national trends, but we hear stories every day from our members about not feeling safe in their ERs and about the violence they experience not being taken seriously. These emergency physicians work tirelessly in already difficult conditions, lately with patients boarded up and down their hallways, and they deserve to be supported and protected by their hospitals, as outlined in SB 827, which was supported by the legislature and signed by the Governor.  

We urge VDH to adopt the regulations as drafted, including the process outlined for waivers, and we look forward to working with our nursing colleagues and with hospital administrators across Virginia to complete timely security risk assessments and draft security plans together, as directed by law.  

We should not lose sight of the purpose of this bill- ensuring safe workplaces for doctors and nurses and safe places for patients to be cared for who are experiencing life threatening emergencies.  Cases of verbal assaults, serious threats of violence, hitting, slapping, spitting, kicking, and punching are becoming more and more common every day in ERs.  Legislators passed SB827 expecting hospitals to provide the necessary trained security to ensure safety- we hope you will adopt the regulations as drafted because they reflect the legislation and the underlying legislative intent of the parties involved.  

If you have any additional questions or concerns, do not hesitate to reach out.