A special legislative ad hoc committee put together in response to the hepatitis C outbreak at Exeter Hospital is prepared to move forward with two pieces of legislation.
While the bills will be formally filed in September, no action can be taken on them until next year. Even then, committee members expect a long battle with fellow legislators and the New Hampshire Hospital Association.
The first proposed bill calls for the creation of a "Health Care Worker Board of Registration." The second seeks the establishment of a statewide mandatory drug policy for health care workers.
The creation of a "Health Care Worker Board of Registration" is considered the most important bill. Such a board would be responsible for tracking individual health care workers in the state and to maintain a database of those workers not otherwise licensed or registered by the state. That online database would keep the registrants' information for 15 years, along with designation of "active, inactive, suspended, revoked or retired."
State Rep. Lee Quandt, R-Exeter, who chaired the special ad hoc committee, said the creation of such a board is a direct response to the work history of accused infector David Kwiatkowski.
Kwiatkowski, a former traveling medical technician hired by Exeter Hospital, was fired from two previous hospital jobs in Pennsylvania and Arizona, the latter of which involved him allegedly being found unresponsive in a locker room with syringes and needles in 2010. Tests allegedly later showed he had cocaine and marijuana in his system.
After Kwiatkowski was fired in Arizona, the incident was reported to the American Registry of Radiologic Technologists, but police charges were never filed and Arizona dropped its investigation once Kwiatkowski moved out of state, meaning the incident didn't appear on a criminal background check.
The board being proposed would investigate complaints brought to it by hospitals and then determine the appropriate action, which could include involving law enforcement. The board would also be responsible for sharing information with other registration boards in New Hampshire and other states.
"This is only the first step," Quandt said. "We hope we can push this through and hopefully other states will say 'hey, it's not that complicated, New Hampshire did it,' and take it from there."
To be safe, the committee has put together a broad definition for the term "health care worker." The position is defined as "Anyone working under the supervision of a licensed health care provider or anyone directed to supervise the worker, within a health care agency. A health care worker has direct contact with patients as a course of their natural day's work."
Anyone fitting that definition would be required to register with the board within five working days of employment. Quandt said the board would be made up of nine people from the health care industry — three appointed by the state Senate, three appointed by the House and three appointed by the governor.
Quandt expects the bill to be debated in multiple House committees, including Health and Human Services, Finance, Ways and Means and Criminal Justice. "This bill is going to get frequent flyer miles," he said,
While the committee is expected to push for some type of mandatory drug testing policy, what that policy would look like remains in question.
Committee member and former state Sen. Robert Clegg Jr., of Hudson, said he believes the health care registration board is the most important bill to get out there and suggested that the committee perhaps wait on a drug testing policy.
"It would be great to get the registration board law out there and see if the hospitals crack down," he said. "Maybe do drug testing."
However, Quandt decided it was best to submit something to get a conversation going. "I don't want to let it sit," he said. "I think we owe it to the people of the area to know that we're doing the best we can to put something in place."
One policy the committee is looking into would mirror that of the state Department of Transportation in which employees are screened at the beginning of their employment, and then once a month 5 percent of the employee base is tested at random.
Additional research is being done on drug policies in other states.
Quandt said he expects some opposition from the N.H. Hospital Association regarding both bills.
There's also the chance that the representatives supporting the bill won't be re-elected in the upcoming election. Other legislators supporting the bill are Rep. Matt Quandt, R-Exeter; Rep. Tim Copeland, R-Stratham; and Rich DiPentima, D-Portsmouth. Quandt said if that happened, he would reach out to other lawmakers in hopes that someone would take it on.
N.H. Hospital Association President Steve Ahnen said he's keeping an open mind about any potential legislation. "There's clearly a need for this conversation to go forward," he said.
Ahnen said the NHHA is willing to work with the Legislature to discuss the right set of policies that could prevent such an outbreak from happening again, but he stressed it is an issue that needs to be discussed on the federal level.
"I think there are a number of things to look at, but we also need to understand the national implications of what has happened and how this issue goes beyond New Hampshire," he said.
Quandt said he would also like the federal government to get involved, but added the conversation needs to start locally.