approved the Patient Safety and Quality Improvement Act, which provided a framework for voluntary reporting of medical errors by hospitals to state data centers but also established strong confidentiality requirements.[1] Twenty-three states collected data on medical errors, but virtually all required that information remain confidential. An exception was Minnesota, which required in 2002 that medical errors be reported to the public, hospital by hospital.[2] Periodic audits suggested that even confidential reporting was often late or inaccurate.[3]
More-general quality-of-care rating systems fared better. By 2006, the federal Department of Health and Human Services as well as the Joint Commission on Accreditation of Healthcare Organizations had nascent systems that ranked hospitals on the basis of Medicaid and Medicare data and surveys.[4]
Disclosing Sex Offenders’ Residences to Improve Public Safety
In response to public outrage following the rape and murder of a seven-year-old girl named Megan Kanka by a released sex offender, New Jersey approved legislation in 1994 requiring disclosure of the places of residence of released sex offenders. Two years later, the federal Megan’s Law was enacted. It required that all states release information to the public about known convicted sex offenders. States were given considerable discretion in how information would be provided, how frequently it would be updated, and how detailed it would be. The federal law amended an earlier statute that required states to maintain registries of released sex offenders.[5]
By 2006, all fifty states and the District of Columbia had created some form of sex offender registry and had provided for community notification of offenders’ places of residence.[6] Notification methods varied widely from state to state, from active communication by police via door-to-door visits, mailings, and community meetings, to notice via hotlines or Web sites.[7] The constitutionality of state laws in Connecticut and Alaska was upheld by the Supreme Court in 2003 after lower courts struck them down as violations of due process and on other grounds.[8]
Washington State’s sex offender registration and notification system, the state system that we have analyzed for this book, predates both federal statutes. The state’s 1990 Community Protection Act was based on a finding that “sex offenders pose a high risk of engaging in sex offenses even after being released from incarceration”[9] and aimed to provide notice about the current residence of released sex offenders as a means of reducing risks to individuals and the community.[10]
In order to provide “necessary and relevant information” to the public, the law required that any adult or juvenile convicted of any sex or kidnapping offense register with the county sheriff’s department within twenty-four hours of release or thirty days of becoming a new state resident.[11] Offenders were required to provide their name, address, date and place of birth, place of employment, information about the crime, a photograph, and other personal data.[12] Those convicted of Class A felonies remained on the list throughout their lives, while those convicted of lesser crimes remained on the list for ten or fifteen years. Failure to register or provide accurate information was deemed a class C felony or gross misdemeanor, depending on the severity of the original crime.[13]
Community notification was provided through mailings, direct notification by the police, and the Internet. Washington was one of the first states to provide an Internet-based system for searching and locating individuals on the registry, which includes photographs of offenders.[14] Members of the public are given essentially unlimited access
