HB 1139: Allow Each Hospital Patient One “Unrestricted” Visitor

Representative Phil Jensen (R-33/Rapid City) has a lot of predictable right-wing horsehockey in his bucket of bills. But he also has a couple of bills that could move beyond the usual God-‘n’-Guns scorecard posing and invite some interesting discussion of policy and principle.

I mentioned Jensen’s House Bill 1133, the state park discount for residents, last night. Tonight, let’s turn to Jensen’s House Bill 1139, a proposal to create an “unrestricted privilege” (not a right!) for one special visitor for every hospital or nursing home patient.

House Bill 1139 would allow each hospital patient and each resident of a nursing home or assisted-living facility to designate one person (not a dog or cat or hamster) who can be with the patient at any time. HB 1139 prohibits terminating, suspending, or waiving that visitation privilege in the event of disaster or emergency declaration. HB 1139 allows the attending doctor or the nursing facility to “impose limitations” on when, how long, and how often the privileged visitor can be in the room and to require the special visitor to wear a mask or other personal protective equipment (“which must be provided, without charge, by the hospital”), but only if the doctor/facility determines that the visitor’s presence is bad for the patient or “otherwise inadvisable.” Hospitals and other covered facilities must inform their patients of this privilege and prominently post the policy somewhere in their buildings.

Jensen’s bill is clearly a response to the coronavirus pandemic, during which many Americans have been separated from their loved ones due to quarantine rules at health care facilities. Yet the language of HB 1139 does not seem quite clear enough guarantee the access Jensen appears to envision. “Otherwise inadvisable” leaves the door open for the doctor to say that allowing one visitor for each patient creates a whole herd of comers and goers who may carry the infection of their loved ones back out into the community and vice versa. Amidst the current pandemic, hospitals and nursing homes could still impose strict quarantine rules and tell the privileged visitors that their limitations include no visits until community infection rates drop to certain levels.

Having spent days in hospitals at loved ones’ bedsides, I understand exactly the desire and devotion Representative Jensen is trying to protect in law. I can only imagine the pain I would feel if I couldn’t support a family member in the hospital. Being sick should not abrogate one’s right to be at a spouse’s or child’s side. But, as usually happens when Republicans try to interfere in medical decisions, there’s just no good way for lawmakers to tell doctors how to practice medicine and protect all of their patients from harm. A similar bill proposed last June in North Carolina floundered under amendments intended to protect public health and avoid violations of federal law for health care facilities; those amendments tangled the “No Patient Left Behind” bill into meaninglessness. HB 1139 suffers its own contradictions already, referring to an “unrestricted privilege,” then allowing facility officials to “impose limitations.” Even Jensen appears to recognize that every privilege (like every right) has limits required by the balance of all interests.

The sentiment of HB 1139 is noble, but part-time legislators fiddling in Pierre can’t govern these situations with broad statutes. The doctors and nurses and other professionals taking care of our sick, injured, and elderly, especially in times like now of dire public health crisis, are far better informed about medicine and wellness and all of their patients’ specific needs to determine all of the elements of their support plans, including when and how often they can have visitors.

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Minor points:

1. House Bill 1139 does not limit whom a patient may designate as a privileged visitor. Representative Jensen thus would graciously ensure the same visitation rights for gay and straight spouses, couples living in sin, and just good friends.
2. Maybe HB 1139 would work better if Rep. Jensen amended it to allow one visitor who may quarantine in the hospital room with the patient.
3. Rep. Jensen includes that unfunded mandate of free masks, gloves, hazmat suits, what have you, for the privileged visitors. Would hospitals really eat that cost, or would they just fold that cost into the other labyrinthine expenses on the patient’s bill where it would likely never be noticed?