SB 718, as amended, Yee. Hospitals: workplace violence prevention plan.
Existing law regulates the operation of health facilities, including hospitals.
Existing law, the California Occupational Safety and Health Act of 1973, imposes safety responsibilities on employers and employees, including the requirement that an employer establish, implement, and maintain an effective injury prevention program, and makes specified violation of these provisions a crime.
This bill would require a hospital, as specified, as a part of its injury prevention program and in conjunction with affected employees, to adopt a workplace violence prevention plan designed to protect health care workers, other facility personnel, patients, and visitors from aggressive or violent behavior. As part of that plan, the bill would require a hospital to adopt safety and security policies, including, among others, a system for the reporting to the Division of Occupational Safety and Health of any violent incident, as defined, against a hospital employee, as specified. The bill would further require all medical staff and health care workers who provide direct care to patients to receive, at least annually, workplace violence prevention education and training, as specified. The bill would prohibit a hospital from preventing an employee from, or taking punitive or retaliatory action against an employee for, seeking assistance and intervention from local emergency services or law enforcement for a violent incident. The bill would also require a hospital to provide evaluation and treatment, as specified, for an employee who is injured or is otherwise a victim of a violent incident.
The bill would require a hospital to document and keep for 5 years a written record of all violent incidents against a hospital employee, as defined, and to report to the division any violent incident, as specified. The bill would also authorize the division to assess a civil penalty against a hospital for failure to report a violent incident, as specified. The bill would further require the division to report to the relevant fiscal and policy committees of the Legislature information regarding violent incidents at hospitals, as specified, and to develop regulations implementing these provisions by January 1, 2015.
Because this bill would expand the scope of a crime, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.
The people of the State of California do enact as follows:
Section 6401.8 is added to the Labor Code, to
2read:
(a) begin deleteAs end deletebegin insertExcept as provided in subdivision (n), as end inserta part
4of its injury prevention program required pursuant to Section
56401.7, a hospitalbegin delete licensed pursuant to subdivisionsend deletebegin insert described in
6subdivisionend insert (a), (b), or (f) of Section 1250 of the Health and Safety
7Code shall adopt a workplace violence prevention plan designed
8to protect health care workers, other facility personnel, patients,
9and visitors
from aggressive or violent behavior. The plan shall
10include, but not be limited to, security considerations relating to
11all of the following:
12(1) Physical layout.
P3 1(2) Staffing, including staffing patterns and patient classification
2systems that contribute to the risk of violence or are insufficient
3to address the risk of violence.
4(3) The adequacy of facility security systems, protocols, and
5policies, including, but not limited to, security personnel
6availability and employee alarm systems.
7(4) Potential security risks associated with specific units or areas
8within the facility where there is a greater likelihood that a patient
9or other person may exhibit
violent behavior.
10(5) Uncontrolled public access to any part of the facility.
11(6) Potential security risks related to working late night or early
12morning hours.
13(7) Employee security in areas surrounding the facility,
14including, but not limited to, employee parking areas.
15(8) The use of a trained response team that can assist employees
16in violent situations.
17(9) Policy and training related to appropriate responses to violent
18acts.
19(10) Efforts to cooperate with local law enforcement regarding
20violent acts in the facility.
21(b) As part of its workplace violence prevention plan, a hospital
22shall adopt safety and security policies, including, but not limited
23to, all of the following:
24(1) Personnel training policies designed to protect personnel,
25patients, and visitors from aggressive or violent behavior, including
26education on how to recognize the potential for violence, how and
27when to seek assistance to prevent or respond to violence, and how
28
to report violent incidents to the appropriate law enforcement
29officials.
30(2) A system for responding to violent incidents and situations
31involving violence or the risk of violence, including, but not limited
32to, procedures for rapid response by which an employee is provided
33with immediate assistance if the threat of violence against that
34employee appears to be imminent, or if a violent act has occurred
35or is occurring.
36(3) A system for investigating violent incidents and situations
37involving violence or the risk of violence. When investigating
38these incidents, the hospital shall interview any employee involved
39in the incident or situation.
P4 1(4) A system for reporting, monitoring, and recordkeeping
of
2violent incidents and situations involving the risk of violence.
3(5) A system for reporting violent incidents to the division
4pursuant to subdivision (h).
5(6) Modifications to job design, staffing, security, equipment,
6or facilities as determined necessary to prevent or address violence
7against hospital employees.
8(c) The plan shall be developed in conjunction with affected
9employees, including their recognized collective bargaining agents,
10if any. Individuals or members of a hospital committee responsible
11for developing the security plan shall be familiar with hospital
12safety and security issues, as well as the identification of aggressive
13and violent predicting factors. In developing the workplace
14violence prevention
plan, the hospital shall consider guidelines or
15standards on violence in health care facilities issued by the division,
16the federal Occupational Safety and Health Administration, and,
17if available, the State Department of Public Health.
18(d) All medical staff and health care workers who provide direct
19care to patients shall, at least annually, receive workplace violence
20prevention education and training that is designed in such a way
21as to provide an opportunity for interactive questions and answers
22with a person knowledgeable about the workplace violence
23prevention plan, and that includes, but is not limited to, the
24following topics:
25(1) General safety measures.
26(2) Personal safety measures.
27(3) The assault cycle.
28(4) Aggression and violence predicting factors.
29(5) Obtaining patient history from a patient with violent
30behavior.
31(6) Characteristics of aggressive and violent patients and victims.
32(7) Verbal and physical maneuvers to diffuse and avoid violent
33behavior.
34(8) Strategies to avoid physical harm.
35(9) Restraining techniques.
36(10) Appropriate use of medications as chemical restraints.
37(11) Any resources available to employees for coping with
38violent incidents, including, by way of example, critical incident
39stress debriefing or employee assistance programs.
P5 1(e) All temporary personnel shall be oriented to the workplace
2violence prevention plan.
3(f) A hospital shall provide evaluation and treatment for an
4employee who is injured or is otherwise a victim of a violent
5incident and shall, upon the request of the employee, provide access
6to followup counseling to address trauma or distress experienced
7by the employee, including, but not limited to, individual crisis
8counseling, support group counseling, peer assistance, and
9professional referrals.
10(g) A hospital shall not prohibit an employee from, or take
11punitive or retaliatory action against an employee for, seeking
12assistance and intervention from local emergency services or law
13enforcement when a violent incident occurs.
14(h) (1) In addition to the reports required by Section 6409.1, a
15hospital shall
document and keep for a period of five years a written
16record of any violent incident against a hospital employee
17immediately after the incident is reported by that employee or any
18other employee to a manager, supervisor, or other hospital
19administrator. The hospital shall document and keep a written
20record of all violent incidents, regardless of whether the employee
21sustains an injury. This record shall include, but not be limited to,
22the date and time of the incident, the unit in which the incident
23occurred, a description of the circumstances surrounding the
24incident, and the hospital’s response to the incident.
25(2) A hospital shall report to the division within 72 hours the
26information recorded pursuant to paragraph (1) regarding a violent
27incident. If the incident results in physical injury,
involves the use
28of a firearm or other dangerous weapon, or presents an urgent or
29emergent threat to the welfare, health, or safety of hospital
30personnel, the hospital shall report the incident to the division
31within 24 hours.
32(3) If a hospital fails to report a violent incident pursuant to
33paragraph (2), the division may assess a civil penalty against the
34hospital in an amount not to exceed one hundred dollars ($100)
35per day for each day that the incident is not reported following the
36initial 72-hour or 24-hour period, as applicable pursuant to
37paragraph (2).
38(i) The division may, at its discretion, conduct an inspection for
39any violent incident reported pursuant to subdivision (h).
P6 1(j) Nothing in this section
requiring recordkeeping and reporting
2by an employer relieves the employer of the requirements of
3Section 6410.
4(k) (1) By January 1, 2015, and annually thereafter, the division
5shall report to the relevant fiscal and policy committees of the
6Legislature, in a manner that protects patient and employee
7confidentiality, information regarding violent incidents
at hospitals,
8that includes, but is not limited to, the total number of reports and
9which specific hospitals filed reports pursuant to subdivision (h),
10the outcome of any related inspection or investigation, citations
11levied against a hospital based on a violent incident, and
12recommendations on how to prevent violent incidents at hospitals.
13(2) The requirement for submitting a report imposed pursuant
14to this subdivision is inoperative on January 1, 2019, pursuant to
15Section 10231.5 of the Government Code.
16(3) A report to be submitted pursuant to this subdivision shall
17be submitted in compliance with Section 9795 of the Government
18Code.
19(l) By January 1, 2015, the division shall adopt regulations to
20
implement the provisions of this section.
21(m) For purposes of this section, “violent incident” shall include,
22but not be limited to, the following:
23(1) The use of physical force against a hospital employee by a
24patient or a person accompanying a patient that results in or has a
25high likelihood of resulting in injury, psychological trauma, or
26stress, regardless of whether the employee sustains an injury.
27(2) An incident involving the use of a firearm or other dangerous
28weapon, regardless of whether the employee sustains an injury.
29(n) This section shall not apply to a hospital operated by the
30State
Department of State Hospitals, the State Department of
31Developmental Services, or the Department of Corrections and
32Rehabilitation.
No reimbursement is required by this act pursuant to
34Section 6 of Article XIII B of the California Constitution because
35the only costs that may be incurred by a local agency or school
36district will be incurred because this act creates a new crime or
37infraction, eliminates a crime or infraction, or changes the penalty
38for a crime or infraction, within the meaning of Section 17556 of
39the Government Code, or changes the definition of a crime within
P7 1the meaning of Section 6 of Article XIII B of the California
2Constitution.
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