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Lawmakers consider first-in-the-nation registry to shine light on medical technicians

 Kwiatkowski

Kwiatkowski

New Hampshire could become the first state in the country to maintain a registry of licensed medical technicians, partly in hopes of encouraging a national registry, which some officials say could have prevented a technician at Exeter Hospital from allegedly infecting dozens of people with hepatitis C.

The idea is contained in one of two bills related to the Exeter case that legislators are reviewing this summer. Both bills were sponsored in the last session by Exeter Democratic Rep. Tim Copeland in response to the hepatitis C virus outbreak at Exeter Hospital, allegedly spread by David Kwiatkowski, a technician who had previously worked – and allegedly had drug problems on the job – in hospitals in six other states before working in New Hampshire.

More than 40 cases of hepatitis nationwide have been attributed to Kwiatkowski. He is due to stand trial in federal court next year on drug charges stemming from the allegations.

One of the bills under consideration would require health care facilities to randomly test employees for drug use at least four times annually.

A proposed amendment, supported by the state Department of Health and Human Services and health care providers, removes the random testing provision and instead requires providers to institute a policy outlining procedures for drug testing and educating workers about drug addiction and proper monitoring and storage of controlled substances.

Copeland, a retired law enforcement officer, said the threat of random drug testing works in that field and could work in health care as well, but members of subcommittees of the Executive Departments and Administration committee and the Health, Human Services and Elderly Affairs committee disagreed.

Random testing has been shown to be an ineffective method of catching workers who may be abusing drugs, and raised concerns for the committee about expense for employers and due process for employees when a positive result is found, said Rep. Tom Sherman, a Rye Democrat and a gastroenterologist at Exeter Hospital.

Though the amendments discussed yesterday would have narrowed the scope of his bill, Copeland said he is still optimistic.

“I’ve learned to pick my battles,” he said. “I’ve learned that you take baby steps, and the intent of the law is still there and is still viable, to improve patient safety.”

The other bill under consideration would create a state board to oversee the licenses of medical technicians, and a registry of the status of those licenses. The information would then be available on a national database of health care worker licenses.

Some states require certain subsets of medical technicians to receive licenses, but not all do, and not all types of technicians fall under those boards’ jurisdictions. New Hampshire is one of many states that do not require medical technicians to be licensed.

The bill defines a medical technician as “an individual working under the supervision of a licensed health care provider, whether employed by a health care facility or acting independently, who provides preventive, curative, promotional or rehabilitative health care services in a systemic way to individuals, families or communities.”

In applications for jobs or licenses in the states that do license medical technicians, Kwiatkowski omitted on his applications employers with whom he had trouble or had been fired from. A national registry of licenses would track that information independently.

Providers here might not see much benefit immediately, because it would only contain information about technicians who have already worked in New Hampshire, but legislators said yesterday they hope other states would eventually maintain similar databases in similarly searchable formats.

“As I understand it, right now there is only a national registry for doctors and nurses. There is a hole there, and there’s no checks and balances. Human resources can’t always divulge that information, but they wouldn’t have to if we had a national registry,” Copeland said.

“If (a registry) had been in place nationally, there’s no way he could have gone to 17 hospitals. So many of the things he did were reportable,” Sherman said.

And yet in many instances, Kwiatkowski’s behavior was not reported.

A report by the New Hampshire Division of Public Health released in June concluded a large part of the reason Kwiatkowski allegedly was able to continue diverting pain medication for his personal use was because peers did not report his suspicious behavior, or if they did, their supervisors did not pursue an investigation.

“A culture of accountability is the center hub of it all. If you don’t have that, you don’t have anything,” Copeland said. “I hope the laws can bring about a change in the culture. I hope that employees will feel protected and supported in reporting strong suspicions they may have.”

Sherman agreed with Copeland that a culture of accountability is “much more effective than any law.

“The problem is, it’s not universal. Laws and regulations are designed to bring up the bar at all facilities, even those who don’t bring up that culture of accountability for themselves.”

Both subcommittees are scheduled to meet again Sept. 10 to finalize their potential amendments for the bills.

(Sarah Palermo can be reached at 369-3322 or
spalermo@cmonitor.com or on Twitter @SPalermoNews.)

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