Aug. 5—AUGUSTA — A task force of legislators, hospital and law enforcement officials and members of the judiciary held the first of four meetings Wednesday to lay the foundation for its monthslong study of the criminal process surrounding violence against health care workers.
The nearly full-day session covered a wide range of issues related to the topic and heard presentations from individuals representing the state's largest health care systems, district attorneys' offices, local law enforcement agencies and government agencies.
Through all the talk of data, regulations and policy, and the nuances of the prosecutorial system, at least one thing was clear: There are gaping holes in the matrix of Maine's health care, legal and judicial systems when it comes to balancing patient care, provider safety and criminal justice.
"I don't want to increase prosecutions in these cases. My goal is to reduce prosecutions because I don't want the violence to happen in the first place," said Frayla Tarpinian, a deputy district attorney for Kennebec and Somerset counties, in response to a question about how to increase convictions.
Tarpinian was appointed to the task force by Maine Supreme Judicial Court Chief Justice Valerie Stanfill, along with Brendan Trainor, a deputy district attorney for Penobscot and Piscataquis counties, and Maine District Court Judge Andrew Robinson.
The three judicial appointments joined the nine other members of the task force who were appointed by the Maine Senate president and the speaker of the House of Representatives.
When she looks upstream from the issues of violence against health care workers, Tarpinian said, "I see hospitals and jails very similarly positioned as the end of the line. We're the end of the line for folks who have mental health issues that are not adequately addressed and I think this is a statutory problem."
The judicial system, for one, is set up to be reactionary and not preventative, she said. And the only time the judiciary system is able to intervene in a person's life is "when they get so sick they are an imminent threat to themselves and others or they're so impacted they can't take care of themselves."
The chief of emergency medicine at Eastern Maine Medical Center in Bangor, Dr. Michael Melia, said this issue also comes down to a lack of resources.
"Emergency departments are often utilized to house aggressive individuals, both children and adults, that don't necessarily have any other (medical or behavioral health) issues," he said. "It's just that the state does not have another location for them. So those individuals are often with us because they are aggressive and assaultive and the state doesn't know where to put them."
Those individuals don't really belong in jail, "so they wind up being housed in the emergency department sometimes for as much as 100 days until a better location can be identified," Melia said.
He said he's seen patients have to go as far away as Tennessee or Ohio to get connected with an appropriate living situation, like a group home.
The longer those individuals sit in an emergency department, however, the more likely there is to be assaults. And because of that, it's harder to find a place that will accept those individuals.
"It feeds both ways," Melia said. "It's the aggression that also keeps them with us for a long period of time."
Jared Mills, Augusta's chief of police and the president of the Maine Chiefs of Police Association, said he heard anecdotally from some of his officers that if they are responding to an individual experiencing a mental health crisis, they are going to bring them to a hospital, not to a jail — even if they are acting violently.
"Because it's a mental health-type call, we don't charge. We look at that as this person doesn't belong in jail, they belong (in a hospital) receiving medical treatment. So we will bring them to the (emergency department)," Mills said.
He acknowledged, "This is the most flawed system" and "this is the number one problem that we need to look at."
Tarpinian said this system leaves a "huge chasm for folks," especially those who are unhoused and do not have access to the care and treatment they may need.
If an individual without any mental health considerations, "if such a thing exists," gets violent with a health care worker, "our system is 100% set up" to handle that person in a criminal sense.
"We struggle a whole lot with folks who are in that other category, which are what we largely see coming into the system. And we don't know how to treat them," she said.
Slapping those individuals with a fine or a few days in jail will do nothing to address the underlying issues and "that person is just going to boomerang right back around," Tarpinian said.
The task force will meet at 9 a.m. Tuesday, Sept. 13, in person at the State House and it will also be streamed online. For more information, visit the Maine Legislature's website.