Now that Georgia's controversial gun-carry legislation has taken effect, hospitals across the state are trying to figure out how to respond to it.
The new law means different things for different hospitals. Generally speaking, hospitals that are considered government buildings have to comply with it, while those that are privately owned do not.
And there are other exceptions, including one that pertains to Grady Memorial Hospital in Atlanta.
Yet the ultimate effect of House Bill 60 on hospitals and even some nursing homes may not be clear until it plays out in practice - perhaps until someone with a weapon enters a facility and is confronted about his or her right to carry it.
It's possible that some facilities may even choose to ignore the law or test its limits.
"As is often the case with newly enacted laws, there are many unanswered questions regarding HB 60, and ultimately courts will interpret the law and apply it to specific facts,'' said a July 1 memo from Georgia Hospital Association attorney Temple Sellers to association members, which was obtained by Georgia Health News.
The bill was passed on the last day of the General Assembly session and was signed into law by Republican Gov. Nathan Deal, who said at the signing ceremony: "Our state has some of the best protections for gun owners in the United States. And today we strengthen those rights protected by our nation's most revered founding document."
State Sen. Jason Carter, a Democrat who is running for governor against Deal, was among the lawmakers voting for House Bill 60.
The legislation, which took effect July 1, allows gun owners with carry licenses in Georgia to bring a firearm into some bars, churches, school zones, and into government buildings that do not maintain security.
Many hospitals are operated by hospital authorities or have been restructured and are leased from authorities, and as such can be considered "government buildings."
The hospital association memo said House Bill 60 "impacts virtually all of Georgia's hospitals to some degree'' but that it is "most problematic" for authority or restructured hospitals. The "government" definition may include as many as one-third of Georgia's hospitals, the association said.
Some provisions unclear
Prior to the law, many hospitals simply confiscated weapons from people in their facilities, association Vice President Kevin Bloye said Wednesday in an email to Georgia Health News.
"Many hospitals are still trying to understand the law because a lot of the terms are undefined and it isn't clear what specific steps are required to keep guns out,'' said Bloye, who added that the hospital association did not take a position on the legislation. "Hospitals are concerned first and foremost with the safety of patients, staff and visitors and are concerned about the law's impact on their ability to continue to provide a safe environment, especially in emergency departments."
GeorgiaCarry.org, which lobbied for the bill, told Georgia Health News on Wednesday that the legislation was not designed with any specific focus on hospitals. But as with any government buildings, "we should be able to defend ourselves,'' said Jerry Henry of GeorgiaCarry.Org.
Under the new law, having security at all entrances can allow a government building to block guns from entering, Henry said.
But while some hospitals have security guards at emergency department entrances, "few, if any, employ security personnel to screen all public entrances,'' said the hospital association memo. "Instead, signs are often posted to inform the public that weapons are banned."
Many rural hospitals are struggling financially, so the idea of staffing all entrances with security is impractical from a fiscal point of view, said Jason Bring, a health care attorney with law firm Arnall Golden Gregory. In addition, he said, rural areas are more familiar with weapons being carried in public areas.
But even for many urban facilities, screening at all entrances "would be a challenge,'' Bring said.
Publicly owned hospitals may decide to set up a checkpoint at the ER, Bring said.
"It's a challenging issue but we need to see how it plays out in reality."
The law also could apply to nursing homes owned by a hospital authority, he added.
Sellers, of the hospital association, added that the law "includes a provision that may make it difficult, if not impossible, to determine whether an individual with a gun has a valid license."
Difficult decisions ahead
Many hospital officials are trying to understand what it all means.
A spokeswoman for the Medical Center of Central Georgia said the Macon facility "is currently reviewing the law in view of our overall obligation to maintain a safe environment for patients, visitors and employees."
Privately owned facilities, such as HCA hospitals, Piedmont Atlanta Hospital and East Georgia Regional Medical Center, which is owned by Franklin, Tenn.-based Community Health Systems, are exempt from the gun-carry legislation. If they wish to ban weapons, or continue an existing ban, they can do so.
Also exempt is any hospital that is a state mental health facility or that has an inpatient unit that is a state mental health facility.
That latter exception includes Grady Memorial Hospital.
"Because of our status as an emergency inpatient mental health facility, we are continuing our no weapons policy under the section of HB 60 that prohibits licensed gun owners from carrying weapons into a hospital, inpatient unit or other institution operated under contract with the Department of Behavioral Health and Developmental Disabilities,'' said Denise Simpson, a spokeswoman for Grady.
The hospital has posted new signs at entrances saying weapons are not allowed, Simpson added.
The Sellers memo says that the gun law includes no "specific penalties for noncompliance." But in the case of government buildings that come under the law, the memo says, "hospitals may be subject to lawsuits by licensed carriers for enforcing gun bans in violation of the law through such methods as confiscating weapons or attempting to effectuate arrests.
"However, given the compelling need to protect hospital staff, visitors and patients from gun violence, some hospitals may decide the safety risks associated with compliance outweigh such liability concerns,'' the memo says.