Medical Society of Virginia (MSV) Comment Regarding Draft Amendments for 12VAC5-410-10 et seq. to Implement SB 827

May 10, 2023

Ms. Rebekah E. Allen, J.D.

Senior Policy Analyst

Virginia Department of Health

Office of Licensure and Certification

9960 Mayland Drive, Suite 401

Henrico, Virginia 23233

RE:      Comment on Draft Amendments for 12VAC5-410-10 et seq. to Implement SB 827 from 2023 Regular Session

Dear Ms. Allen,

The Medical Society of Virginia (MSV) strongly supports efforts to assure the safety and wellness of Virginia’s healthcare providers. According to the Bureau of Labor Statistics, healthcare providers are 5 times more likely to experience workplace violence than employees in other industries. As representatives of Virginia’s physicians, the MSV knows the threat of violence in the workplace is a significant contributor to physician burnout and exhaustion.

SB 827 represents an ongoing effort by the General Assembly to help make the Commonwealth the best place to give and receive care. The MSV supports the drafted regulations, and we thank the Department of Health for their diligent work. As written, these regulations align with the legislative intent of SB 827—which is to make hospitals and emergency rooms more secure.

Regrettably, we were surprised to read the public comment from our colleagues at the Virginia Hospital and Healthcare Association (VHHA). VHHA was an active stakeholder in conversations regarding SB 827 throughout the 2023 General Assembly session. VHHA expressed no public opposition to the final version of SB 827, despite having ample opportunity to do so in subcommittees and committees in both the House and Senate.

VHHA’s newly expressed concern around SB 827’s requirement of “the presence of at least one off-duty law-enforcement officer or trained security personnel who is present in the emergency department at all times” is already assuaged by the legislative compromise VHHA agreed to three months ago with the bill patron, Senator Favola. SB 827 gives the Commissioner the ability to provide a waiver from the requirement, and the draft amendments for 12VAC5-410-10 et seq. give the Commissioner appropriate oversight to follow that provision. As such, the MSV supports the waiver amendment language as drafted by VDH and rejects VHHA’s efforts to avoid this important process.

Any effort to water down the intent of SB 827 is an effort to jeopardize patients and healthcare providers. For example, VHHA’s comment regarding L.5.c would make the Commonwealth less safe. As written, the draft amendments give the Commissioner the authority to modify or rescind a waiver where “results of the waiver jeopardize the health or safety of patients, employees, contractors, or the public.”  This is reasonable. If there is a fight or shooting in an ER, one would hope all security decisions in a hospital would be reconsidered.  VHHA’s suggestion—that “the commissioner can demonstrate that the waiver directly results in jeopardizing the health or safety of patients, employees, contractors, or the public”—must be rejected. This language is a needless legal hurdle placing the burden of proof on the Commissioner and the Commonwealth. Were VHHA’s suggestion adopted, the Commissioner would have to be able to prove the absence of a security guard led to (for example) a shooting in an ER. VHHA’s suggestion is proving a negative, with the sole intent of keeping the standard for security in Virginia’s hospitals low.

We must address the problem of violence in our healthcare system now. According to the Bureau of Labor Statistics, the rate of injuries from violent attacks against medical professionals grew by 63% from 2011 to 2020. In 2022, the country was shocked by an act of gun violence in Tulsa, Oklahoma when a disgruntled patient returned to St. Francis Health System and killed a surgeon, physician, receptionist, and visitor. Tragedies like those in Oklahoma are what sparked SB 827 and weakening SB 827’s intent while these tragedies and statistics continue to accumulate is irresponsible.

As such, the MSV asks VDH to adopt the regulations as drafted. Please let us know any questions. We look forward to seeing this important legislation implemented this summer.

Sincerely,

Clark Barrineau

Assistant Vice President of Government Affairs and Public Policy

Medical Society of Virginia