 Good afternoon and welcome to Vermont House Judiciary Committee. It is Friday, January 14. And we are continuing our deliberation of S 30. We have just one witness this afternoon. And that is Mr. Claudio for good afternoon and welcome. Thank you. I can't hear you. I'm not much of a tech person, but perhaps do you want to try to sign out and sign back in? See if that helps. Yeah, there we go. Back. Okay. You did it. Great. Wonderful. Welcome. I had to get another technical glitch. I'm sure you get this every single witness. So my apologies. But thanks for the opportunity, chair, chairperson grad and vice chair bird it and representative not and members of the House judiciary. Appreciate the opportunity. I'm Claudio Fort. I'm the president and CEO here at Rutland Regional Medical Center. And I'm going to speak a little bit from the hospital's perspective. And on this legislation of prohibit firearms by the public in Vermont hospitals. And my purpose for being here today is to express my support for this legislation and to provide you with some current firsthand information on what's happening at Rutland Regional that might be helpful to you and your deliberations on this matter. You know, as a hospital administrator, one of the things that keeps me awake at night is workplace violence. This was the case before the pandemic, and is even more of a concern today, and into the future. The hospital is a place that in the best of times, emotions run high. People arrive in our emergency rooms following heated domestic disputes. Families are under stress and at odds over who's in charge of end of life care decisions for the ailing parents. On our OB unit, there are frequently custody disputes between parents. And last year alone, we had 57 situations where the Vermont Department of Children and Families had to intervene to investigate abusive situations. And in some of those cases had to assume custody of newborns after delivery. These are some of the most challenging and emotionally charged and high risk situations that we deal with. And that was the situation before COVID. And as I'm sure you realize, the ongoing isolation and stress of this pandemic has exacerbated mental health conditions. Now, going into our third year of the COVID pandemic, healthcare workers are increasingly the targets of people's frustrations. So on are the parades and the posters and the food delivered to our staff. And in their place healthcare workers are now experiencing the same type of volatile and violent situations that you see happening on airplanes on the nightly news. These are occurring every day in our hospitals, but they don't get the same visibility with the public, because there are not 200 people with cell phones nearby to videotape these and send them to the media. Here at Rutland Regional, we are experiencing a concerning increase in security incidents involving disruptive visitors and patients. In calendar year 2021, we experienced a 48% increase in hospital security incidents involving disruptive visitors. We have taken a 21% increase in security incidents involving disruptive patients. We have taken numerous measures to respond to this concerning situation. We have added signage, we've consolidated hospital entrance access points. We have increased our security staffing by 25% over the past two years to deal with this. For us, as the second largest hospital in Vermont, Rutland Regional has the size and scale to warrant a dedicated in-house security force. But before I came to Rutland, I spent 10 years at North Country Hospital in the Northeast Kingdom. And I can also tell you firsthand that North Country and the majority of hospitals in our state do not have the ability to have a dedicated security staff. So in these cases, security incidents are managed by a team of other staff, primarily facilities and maintenance employees who get some additional training and include security as one of many duties they perform. In all our hospitals, the staff that perform security functions are some of the most dedicated and committed employees we have. They put their own safety at risk on a daily basis, and they're instrumental in deescalating and diffusing challenging situations. They are an essential part of our patient care team. But they and our nurses and our doctors and our frontline workers need your help. Our security staff do not carry weapons, not even non-lethal tasers or paper spray. And as you can imagine, because of the significant training and numerous other issues surrounding having access to this level of force. Our local and state police agencies have limited ability to intervene in patient management incidents unless the patient has committed a clear crime. Our hospital licensure regulations prohibit them from being involved in routine patient restraint and patient management functions in the hospital setting. So for all the reasons I just outlined, from the hospital perspective, there are no good reasons for members of the public to possess firearms in the hospital. And there's many reasons why this is a significant problem. I respectfully ask that you support our nurses and our doctors, our security officers, and our other essential frontline workers by supporting this proactive legislation. I want to thank you for the opportunity to speak with you today and for your help in keeping our hospitals safe. I'm happy to try to answer any questions that you might have. Thank you. Thank you very much. It's very helpful testimony. And can you tell me more please about, you mentioned that your licensure, that your licensing prohibits law enforcement involvement. If you could speak a little bit more about that, please. Yeah, we hospitals are required by federal regulations to take to have the staff to have the ability to manage patient incidents and patient restraint situations internally. Those in their viewpoint are healthcare part of the work that we do in healthcare on diffusing and the escalating and intervening, you know, how we restrain patients and, you know, we have an inpatient psyche dedicated psychiatric unit. There is a tremendous amount of training on how to manage patients and how to restrain patients and a lot of guidelines to protect patients in this situation. And I think what they find is, although certainly our law enforcement professionals are very well trained, they're not trained in the healthcare aspect of applying restraints. And in this setting so we've had numerous situations throughout the years where, you know, I think 10 years ago it was kind of the standard practice for hospitals to call on their local law enforcement if a patient got to the point and they needed to help them and they didn't have the in-house staff. But we very clearly heard from our licensing and regulations, these are significant violations of the regulations and the significant enforcement actions if we do that. But now if a patient has clearly committed a crime in the hospital, we can at that point the outside law enforcement agencies can come in and arrest the person or put them under police custody or so forth. But that's the only real situation. We're expected to manage those. Thank you. Thank you. Any other questions? Will, go ahead, Will. Thank you. I had one other thing that I believe came up at a legislative breakfast with RMC some time ago in regards to guns in the hospitals because we've heard about a lot of high emotional points where we best if someone did not have a gun with them in the hospital. And I believe and I believe it was at RMC breakfast that I heard about this and if I'm wrong, I apologize. But I'd also heard another concern was occasionally there are patients who bring a gun into the hospital with them, maybe it's like they're more secure whatnot, and people who are doing cleaning in the rooms might potentially find a firearm like tucked under a cushion or hidden under a blanket. And that so in addition to, you know, very highly charged events, you know, there's also the possibility of, you know, a terrible accident happening just through, you know, housekeeping, trying to clean up possible rooms and I wonder if that's something that I'm remembering correctly or if that's something that hasn't been a concern at RMC. Thank you. Yeah, I can't recall the specific situation you're referring to and I don't know I can't recall the specific situation. You know, I, I, we've had some instances where people do attempt to bring a firearm and we discover that in the hospital and we asked them to go to their cars to secure it. And in large part, and I think in all those cases they have been compliant with that. And, you know, certainly we're concerned about the people who are concealing weapons coming into the hospital that we don't know we don't. You know, we've increased our security and our access control for patients, initially because of the COVID pandemic. But those are not going to go away post COVID I think because of some of the security issues will keep those, but we don't have metal detectors we don't search people. So we have no way of knowing unless they're coming in for, you know, a mental health situation, where we will, we do have the ability to protect them to take and to walk away items that could be a threat to them or others. So, you know, that might have happened I've never, I don't recall like such a significant situation where we've had that or that's happening a lot. But it is very concerning about the increase in the increase. And we're hearing it every day from our staff and if you talk I think I'm not alone if you talk to any hospital administrator, or probably any emergency department nurse, or even the people who are out there on the outpatient clinics manning the testing and those things. This pandemic has brain people's nerves and people are not, and we're stretched. We're, we're doing heroic. We are frontline people are doing heroic work, just keeping the lights on and taking care of patients through this through this. And so people have longer wait times and those type of things that they're not accustomed to in our Vermont hospitals. And this isn't going to be resolved soon these workforce and these other issues that are driving this, there's going to be a long tail to this so if there was ever a time to, to look at a proactive bill to do this. I think, I think this would be now. Thank you. Barbara. Thank you. Yesterday, we had a chance to hear an array of testimony. And one thing that we heard from some people that don't like this bill is that it doesn't add anything new that basically so I'm wondering if you can speak to two concerns that we kept hearing that we don't need the spell and that and that part. It would be great to kind of hear more of the second part I sympathetic with but I think there are still reasons to consider it which is putting having signs up won't necessarily stop people. I mean, I think there are other reasons to have signage. But if and I don't know if you had a chance to hear the testimony yesterday. But I just wonder if you can talk to what this bill would do that you can't do now. Yeah, thank you. So now if we had someone who would refuse to relinquish their firearm, as they came to the hospital we could. I understand we could have them. And they, there was a standoff we could call the police and have them removed under the trespassing statute, because we, it is our policy not to have weapons firearms in the hospital. But that requires our staff to be the people to initiate that and to have to do that. If it's the law of the state. I think it kind of takes the monkey, I think it takes the burden off that security officer that has to intervene in that situation or that nurse or that doctor or the psychiatric technician, the people who are doing the intake with that patient, or that family or that visitor that we can say hey it's this month, you know this isn't the hospital don't take it out on us. And that's where we, when I say we need your help, then we can say it's the law of the state of Vermont, and it's so it kind of helps us deescalate the situation and depersonalize it. You know, and, and I get why people are upset, you know we're telling them you got to wear masks and now you can't wear a clock mask you got to wear this specific mask that we give you and know you can't come and visit your mom unless there's, you know, there's a lot of stuff going on. And this is one less point that can potentially inflame folks we're already under a lot of stress so I think that's the difference it's a more proactive thing. And just like, you know, you know it's a lot of land and it doesn't have to be us being the bad guy to initiate it which we do now if we have to take that action. Can I ask a follow up question. So, the other thing that we heard yesterday, I think I want to know want to mischaracterize it. But at one point we had a witness talk about. They wouldn't refer somebody a patient or someone in crisis to a. The law passed, they would make the referral to a pastor who wouldn't have to follow this law. So I guess I'm wondering if you think if you have any information on. If you think people would not seek services at your hospital because if this would be came a lot. Yeah, and you know I came. I think part of those are in representative knots amendment, where there's some language about the, you know, the ability for healthcare professionals in certain situations to warn and not have liability if they see a potential threat. My real deal is, I don't see any good reason to have guns and hospital and I see more potential problems down the road with workplace violence that we're doing a lot of stuff and we're spending a lot of resource to try to deescalate and address. So a little beyond kind of my understanding and scope. My understanding is though that amendment or that language does not require healthcare professionals to do that. It absolves them of liability if they choose to do that. And they're not, you know, there's hippo laws or so forth. I think I'm getting that correct. I don't see that we already have a duty to warn that is in place has been in place for a decade now on some mental health issues. I don't see that. And from my perspective, and from my interface with our frontline clinicians of preventing people from going to the hospital seek treatment. I don't see where that would be a factor. Thank you. Any other questions. Let's see any again thank you thank you very much for your for your flexibility. Take care, thank you. Thanks for the opportunity. Thank you. And with