In light of high rates of workplace violence and the murder of a nurse in 2023, Connecticut lawmakers are considering legislation establishing an alert within the state health information exchange system to notify health care providers when a patient has a reported history of combative behavior or violence toward a health care worker.
The Connecticut Nurses Association, AFT, the Office of the Victim Advocate, among other health organizations say the bill is critically needed in what has become a dangerous work environment. The American Nurses Association found that one in four nurses reported being physically assaulted on the job.
However, the Connecticut Hospital Association, Connecticut State Medical Society, the state Department of Mental Health and Addiction Services, and Mental Health Connecticut submitted testimony raising concerns about the bill, including that the language is too vague leading to inconsistent reporting practices and whether HIPAA continues to apply. There are also fears a patient flagged may be discriminated against and denied care.
The Public Health Committee voted favorably for HB 5169, mainly along party lines, with 20 Democrats and one Republican voting in favor and 10 Republicans in opposition to the measure.
‘She went to see a patient and did not make it out’
Rep. Rebecca Martinez, a Plainville Democrat and health care worker for 26 years, said in an email she has personally been hit multiple times over the years and has seen an increase in assaults against health care workers.
Martinez, a strong proponent of the bill, said currently while violent behavior may be documented, “critical safety information does not reliably follow the patient.
“It is important that providers have access to critical information that helps them plan and prepare for potentially dangerous situations,” Martinez said.
The legislation would establish an alert with the state’s Statewide Health Information Exchange — which allows health care providers to access and share a patient’s medical records through a secure system — when a patient has a history of violence toward a health care worker.
Martinez said that having such information allows health care workers to take appropriate precautions and protects both the patient and the health care provider while care is provided.
Martinez said her coworker, Joyce Grayson, was murdered while doing her job as a home care nurse in 2023.
“She went to see a patient and did not make it out,” Martinez said.
A mother of six, Grayson worked as a nurse for 36 years and went to a halfway house to administer medication to Michael Reese on Oct. 28, 2023. Reese was living there while on probation after serving more than 14 years in prison for stabbing and sexually assaulting a woman in New Haven in 2006. State records show he was released from prison in late 2020 and was sent back to detention two times for violating probation.
Police responded to the halfway house after Grayson missed multiple appointments later in the day and found that she had been strangled. After pleading guilty to murder, Reese in August of last year was sentenced to 50 years in prison without the possibility of early release or parole.
“This proposal also builds on the work that was done in 2024 through SB 1 to strengthen protections for health care workers,” Martinez said.
Heather Brauth, a recovery nurse at Backus Hospital, told the Courant that especially since COVID she has seen an uptick in violence against health care workers and that it is “creating a struggle for people to come to work for fear of their own personal harm or welfare.”
Brauth said it is hard to get people to work in the profession.
“We had a nurse who got kicked in the chest and received cracked ribs,” she said, also sharing that she was kicked in the wrist and out for six months.
During COVID, Brauth said many patients were afraid to get care for some conditions which have now become worse.
“Now we are seeing patients that are in acute crisis,” she said. “We are seeing a population of people who are irritated, frustrated and despondent.”
Lisa Capitani, a nurse, wrote in her testimony that “I have been impacted by aggressive, abusive and threatening behavior from patients or visits/family members many times throughout my career.
“In my current role as a home health nurse, safety and violence are especially concerning as I’m entering patients’ homes, often as the first staff member to visit,” Capitani said.
Tracy Wodatch, president and CEO of the Connecticut Association for Healthcare at Home, wrote in support of the bill in her testimony that “unlike hospitals or nursing facilities, health care workers are often entering homes alone, without immediate security or coworkers nearby.
“They do this work every day with compassion and professionalism — but they should not be expected to do it without the information necessary to protect themselves,” Wodatch wrote in her testimony.
Kimberly Sandor, executive director of the Connecticut Nurses Association, wrote in her testimony that the “bill does not deny care.
“It does not criminalize illness,” Sandor wrote. “It strengthens situational awareness.”
Sandor also wrote in her testimony that “implementation must be deliberate, balanced, and equitable.”
‘It’s not that simple to say someone is combative’
Sen. Jeff Gordon, a Woodstock Republican, who voted against the bill, said the problem with the bill is “the way it is being set up is cumbersome” and may violate federal HIPAA laws.
“It’s not that simple to say that someone is combative,” he told the Courant. “Maybe someone’s combative because, you know, they were drunk. Maybe they’re combative because that’s just the way they are. But what about an elderly woman who has dementia and flails her arms around but doesn’t know what she’s doing. That’s not combative. That’s something different.”
Gordon said he is “concerned if we rush something this big and don’t understand all the legal ramifications with HIPAA then something bad will be created and we could violate HIPAA.”
Sen. Heather Somers, a Groton Republican and a ranking member on the Public Health Committee, said she voted against the bill to flag it.
“I’m very uncomfortable seeing as the major agencies, the Department of Public Health, Department of Mental Health & Addiction Services, and the Connecticut Hospital Association are against the bill.”
The Connecticut Hospital Association wrote in its testimony that “HB 5169 is a unique approach to addressing patient-on-worker violence that, while certainly well-intentioned, is likely unworkable in practice unless a variety of legal and operational challenges are addressed.”
DMHAS states in its testimony: “Without safeguards, there is potential that such a system could unintentionally contribute to stigma, care avoidance, or barriers to community-based services, particularly for individuals with behavioral health conditions who are otherwise stable.”
Martinez said in an email that DMHAS “raises an important point about the need for safeguards.
“Any information included in such a system should be objective and factual so that it does not unintentionally create stigma or discourage individuals from seeking care,” Martinez said. “If a violent episode is noted in a chart or system, health care providers understand there can be many reasons why it occurred.”
State Sen. Saud Anwar, a South Windsor Democrat and co-chair of the Public Health Committee, said while the bill has passed out of committee “we were very clear that this is not the final product” and that there needs to be clarification on the definitions in the bill.
“The proponents have been very clear that this is just a risk stratification of the nursing staff and all the other health care workers so that they are better prepared to take care of that patient,” he said. “But it is in no way to try and restrict anybody’s right to get care.”
Reporting from Courant reporter Justin Muszynski is contained in this article.