Susan Senator’s son Nat Batchelder thrives on routine. Batchelder is 36 and has profound autism, meaning he requires round-the-clock support and struggles to communicate when he is stressed.
Batchelder lives in a group home in Boston. Like many parents of children with autism and other intellectual disabilities, Senator worries his behavior could be misinterpreted when he’s in environments with people who haven’t been specifically trained to support him.
“If there’s a change, or if there’s something in the environment that is confusing or destabilizing to him, he or others with a similar diagnosis could act out — maybe self-injurious behavior, or biting himself,” she said.
That’s why Senator is worried about some parts of a bill currently being negotiated on Beacon Hill. The legislation is designed to address violence against health care workers.
It would make it easier for police to arrest people who assault health care workers, and require health care facilities to improve safety measures including increased reporting, more data collection, special training and giving employees time off to recover from assaults. According to a survey from Massachusetts Nursing Association, seven out of 10 nurses have been experienced abuse or violence at work in the last two years.
While the bill has attracted widespread support among lawmakers and health care worker groups, some disability advocates are pushing back. While they support the bill overall, they argue that its too-broad definition of health care facilities to include group homes could have unintentional consequences, and it could criminalize behavior that is common among people with intellectual disabilities who have communication barriers.
“There’s all this potential for misunderstanding and tragedy,” Senator said.
Both the House and Senate have passed the bill, and the conference committee is currently debating the final version to reconcile the two. The House version of the bill would allow assaults against health care workers to be elevated from a misdemeanor to a felony. The Senate version allows for a police officer to arrest and detain someone without a warrant if the officer has probable cause that they committed a misdemeanor against a health care worker.
“This really is a nuanced matter,” state Sen. Robyn Kennedy told GBH News. Kennedy, a Worcester Democrat, introduced an amendment that would put a one-year pause on the arrest provision for group homes so that alternatives could be explored.
“We still want to get employees in group homes to have the access to the same supports that the bill overall includes,” Kennedy said. “But I share the concerns that the advocates referenced when it comes specifically to what it would mean for this new warrantless arrest in a group home setting and how that is different.”
Disability groups including the Arc of Massachusetts support the bill, especially the parts that require facilities to do risk and safety evaluations and create specific violence prevention plans.
“That’s so important. All of that is key, and we know that violence against healthcare workers is such a serious problem,” CEO Maura Sullivan told GBH News. However, she continued, “I think the language of the bill unintentionally harms our community.”
As lawmakers negotiate the final bill language, Sullivan is urging them to exclude Department of Developmental Services group homes from some provisions. She says that, for many people with profound autism and other conditions, group homes are the safest place for them.
“A lot of what we’re trying to help people understand is these behaviors, assaultive or aggressive behavior, they’re communication. These are people who have no other ways of communicating at times,” she said.
Sullivan is also worried that the legislation could lead to an individual being removed from their group home, which could escalate their behavior.
“There is no other place for them to go,” she said.
Among the proponents of the bill is the Massachusetts Nurses Association. Board member Karen Coughlin worked as a psychiatric nurse for 34 years, and says that she was personally assaulted six to 10 times a year. She retired early because of the risks.
“I had weapons pulled on me, punched, kicked, bitten, spit at, cursed at, threatened with my life, sexually assaulted,” she said.
Coughlin says that she believes the bill’s focus should stay on health care workers. She thinks some measures, like increased reporting on assaults, could help facilities figure out where’s safest for some individuals to go for care — or where more training should be provided.
“As a nurse, as a health care advocate, no one wants to see anybody penalized or hurt in any way from any aspects of this bill. And that is not something that I think this bill does,” she said. “There are some patients that we had who I don’t think a nurse would even think of attempting to file charges unless they felt that it was a volitional purposeful assault.”
As a mother of two sons with autism, Sullivan says she admires health care workers and has seen the challenge up close.
“We have been in a situation in the hospital so many times where he’s [my son] in pain, and all I’m doing is trying to protect the nurses, the doctors, and protect him from himself,” she said, “because he is fully out of control and he really has no understanding of the consequences of any of his behavior. He just wants his pain to end.”
