BILL NUMBER: AB 30 INTRODUCED
BILL TEXT
INTRODUCED BY Assembly Member Hayashi
DECEMBER 6, 2010
An act to amend Sections 1257.7 and 1257.8 of the Health and
Safety Code, and to amend Section 6030 of the Penal Code, relating to
health facilities.
LEGISLATIVE COUNSEL'S DIGEST
AB 30, as introduced, Hayashi. Health facilities: security plans.
Under existing law, the State Department of Public Health licenses
and regulates hospitals, as defined. Violation of these provisions
is a crime. Existing law requires hospitals, not less than annually,
to conduct a security and safety assessment and, using the
assessment, develop a security plan with measures to protect
personnel, patients, and visitors from aggressive or violent
behavior. Existing law provides that the plan may include, but is not
limited to, prescribed considerations.
This bill would, instead, require the plan to include these
considerations, as well as other considerations prescribed by the
bill. It would also require the hospital to adopt specified security
policies as part of the plan. The bill would also require the
hospital to evaluate and treat an employee who is involved in a
violent incident and to provide specified followup care. The bill
would prohibit a hospital from prohibiting an employee from, or
taking punitive or retaliatory action against an employee for,
seeking assistance from local emergency services or law enforcement
when a violent incident occurs.
Under existing law, an act of assault that results in injury or
involves the use of a firearm or other dangerous weapon against
on-duty hospital personnel is required to be reported to law
enforcement within 72 hours of the occurrence of the incident.
This bill would, instead, require reporting to law enforcement
within 24 hours.
This bill would also require a hospital to report incidents of
assault or battery to the department, as specified. The bill would
require the department to make an onsite inspection or investigation
when it receives a report from a hospital that indicates an ongoing,
urgent, or emergent threat of imminent danger of death or serious
bodily harm to patient, personnel, or visitors.
The bill would require the department to report to the
Legislature, as prescribed, beginning on January 1, 2014, and
annually thereafter until January 1, 2018, certain information
regarding incidents of violence at hospitals.
Under existing law, all hospital employees who are regularly
assigned to the emergency department are required to receive, on a
continuing basis as provided by the security plan, specified
training.
This bill would require training to be provided annually, and
would include in the required training hospital employees regularly
assigned to a psychiatric unit.
This bill would allow the imposition of an administrative penalty
for violation of the provisions relating to the safety plan. Because
this bill expands the definition of a crime, it would impose a
state-mandated local program.
Under existing law, the Corrections Standards Authority is
required to establish minimum standards for state and local
correctional facilities.
This bill would require the standards to include a safety and
security plan to protect health care personnel who provide care to
persons confined in state and local correctional facilities, as
specified.
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 1. Section 1257.7 of the Health and Safety Code is amended
to read:
1257.7. (a) After July 1, 2010, all All
hospitals licensed pursuant to subdivisions (a), (b), and (f)
of Section 1250 shall conduct, not less than annually, a security and
safety assessment and, using the assessment, develop, and annually
update based on the assessment, a security plan with measures to
protect personnel, patients, and visitors from aggressive or violent
behavior. The security and safety assessment shall examine trends of
aggressive or violent behavior at the facility. These hospitals shall
track incidents of aggressive or violent behavior , as well as
the hospital's response to those incidents, as part
of the quality assessment and improvement program and for the
purposes of developing a security plan to deter and manage further
aggressive or violent acts of a similar nature. The plan may
shall include, but shall not be limited to,
security considerations relating to all of the following:
(1) Physical layout.
(2) Staffing , including staffing patterns and patient
classification systems that contribute to the risk of violence or are
insufficient to address the risk of violence .
(3) Security The adequacy of facility
security systems, protocols, and policies, inclu ding, but
not limited to, security personnel availability.
(4) Potential security risks associated with specific units or
areas within the facility where there is a greater likelihood that a
patient or other person may exhibit violent behavior.
(5) Uncontrolled public access to any part of the facility.
(6) Potential security risks related to working late-night or
early morning hours.
(7) Employee security in areas surrounding the facility,
including, but not limited to, employee parking areas.
(8) The use of a trained response team that can assist employees
in violent situations.
(4)
(9) Policy and training related to appropriate
responses to violent acts.
(5)
(10) Efforts to cooperate with local law enforcement
regarding violent acts in the facility.
In
(b) In developing this
the plan, specified in subdivision (a)
, the hospital shall consider guidelines or standards on
violence in health care facilities issued by the department, the
Division of Occupational Safety and Health, and the federal
Occupational Safety and Health Administration. As part of the
security plan, a hospital shall adopt security policies ,
including, but not limited to, personnel all
of the following:
(1) Personnel training policies
designed to protect personnel, patients, and visitors from aggressive
or violent behavior . In , including
education on how to recognize the potential for violence, how and
when to seek assistance to prevent or respond to violence,
and how to report incidents of violence to the appropriate law
enforcement officials.
(2) A system for responding to incidents and situations involving
violence or the risk of violence, including, but not limited to,
procedures for rapid response by which an employee is provided with
immediate assistance if the threat of violence against that employee
appears to be imminent, or if a violent act has occurred or is
occurring.
(3) A system for investigating violent incidents and situations
involving violence or the risk of violence. When investigating these
incidents, the employer shall interview any employee who was involved
in the incident or situation.
(4) A system for reporting, monitoring, and record keeping of
violent incidents and situations involving the risk of violence.
(5) A system for reporting incidents of violence to the department
pursuant to subdivision (i).
(6) Modifications to job design, staffing, security, equipment, or
facilities as determined necessary to prevent or address violence
against hospital employees.
(c) In developing the plan and
the assessment, the hospital shall consult with affected employees,
including the recognized collective bargaining agent or agents, if
any, and members of the hospital medical staff organized pursuant to
Section 2282 of the Business and Professions Code. This consultation
may occur through hospital committees.
(b)
(d) The individual or members of a hospital committee
responsible for developing the security plan shall be familiar with
all of the following:
(1) The role of security in hospital operations.
(2) Hospital organization.
(3) Protective measures, including alarms and access control.
(4) The handling of disturbed patients, visitors, and employees.
(5) Identification of aggressive and violent predicting factors.
(6) Hospital safety and emergency preparedness.
(7) The rudiments of documenting and reporting crimes, including,
by way of example, not disturbing a crime scene.
(c)
(e) The hospital shall have sufficient personnel to
provide security pursuant to the security plan developed pursuant to
subdivision (a). Persons regularly assigned to provide security in a
hospital setting shall be trained regarding the role of security in
hospital operations, including the identification of aggressive and
violent predicting factors and management of violent disturbances.
(d)
(f) Any act of assault, as defined in Section 240 of
the Penal Code, or battery, as defined in Section 242 of the Penal
Code, that results in injury or involves the use of a firearm or
other dangerous weapon, against any on-duty hospital personnel shall
be reported to the local law enforcement agency within 72
24 hours of the incident. Any other act of
assault, as defined in Section 240 of the Penal Code, or battery, as
defined in Section 242 of the Penal Code, against any on-duty
hospital personnel may be reported to the local law enforcement
agency within 72 hours of the incident. No health facility or
employee of a health facility who reports a known or suspected
instance of assault or battery pursuant to this section shall be
civilly or criminally liable for any report required by this section.
No health facility or employee of a health facility who reports a
known or suspected instance of assault or battery that is authorized,
but not required, by this section, shall be civilly or criminally
liable for the report authorized by this section unless it can be
proven that a false report was made and the health facility or its
employee knew that the report was false or was made with reckless
disregard of the truth or falsity of the report, and any health
facility or employee of a health facility who makes a report known to
be false or with reckless disregard of the truth or falsity of the
report shall be liable for any damages caused. Any individual
knowingly interfering with or obstructing the lawful reporting
process shall be guilty of a misdemeanor. "Dangerous weapon," as used
in this section, means any weapon the possession or concealed
carrying of which is prohibited by any provision listed in Section
16590 of the Penal Code.
(g) Each hospital shall provide evaluation and treatment for an
employee who is injured or is otherwise a victim of a violent
incident and shall, upon the request of the employee, provide access
to followup counseling to address trauma or distress experienced by
the employee, including, but not limited to, individual crisis
counseling, support group counseling, peer assistance, and
professional referrals.
(h) A hospital shall not prohibit an employee from, or take
punitive or retaliatory action against an employee for, seeking
assistance and intervention from local emergency services or law
enforcement when a violent incident occurs, or from filing a police
report or criminal charges against the individual who committed the
violence.
(i) (1) A hospital shall report to the department any incident of
assault, as defined in Section 240 of the Penal Code, or battery, as
defined in Section 242 of the Penal Code, against a hospital employee
or patient that is committed by a patient or a person accompanying a
patient. This report shall include the date and time of the
incident, whether the victim was a hospital employee or a patient,
the unit in which the incident occurred, a description of the
circumstances surrounding the incident, and the hospital's response
to the incident.
(2) (A) Except as provided in subparagraph (B), a hospital shall
report an incident to which paragraph (1) applies to the department
within 72 hours.
(B) A hospital shall report to the department within 24 hours any
incident to which paragraph (1) applies that results in injury,
involves the use of a firearm or other dangerous weapon, or presents
an urgent or emergent threat to the welfare, health, or safety of
patients, personnel, or visitors.
(j) The department shall make an onsite inspection or
investigation within 48 hours, or two business days, whichever is
greater, of the receipt of a report from a hospital pursuant to
subdivision (i) that indicates an ongoing, urgent, or emergent threat
of imminent danger of death or serious bodily harm to patients,
personnel, or visitors.
(k) The department may assess an administrative penalty against a
hospital for violation of this section or Section 1257.8. Pursuant to
Section 1280.1, an additional administrative penalty may be assessed
for a violation of this section or Section 1257.8 that results in
immediate jeopardy to the health or safety of a patient.
(l) (1) Beginning on January 1, 2014, and annually thereafter, the
department shall report to the relevant fiscal and policy committees
of the Legislature information, in a manner that protects patient
and employee confidentiality, regarding incidents of violence at
hospitals, that includes, but is not limited to, the total number of
reports and what specific hospitals filed reports pursuant to
subdivision (i), the outcome of any inspection or investigation
initiated pursuant to subdivision (j), the amount of any
administrative penalty levied against a hospital pursuant to
subdivision (k), and recommendations on how to prevent incidents of
violence at hospitals.
(2) The requirement for submitting a report imposed pursuant to
this subdivision is inoperative on January 1, 2018, pursuant to
Section 10231.5 of the Government Code.
(3) A report to be submitted pursuant to this subdivision shall be
submitted in compliance with Section 9795 of the Government Code.
SEC. 2. Section 1257.8 of the Health and Safety Code is amended to
read:
1257.8. (a) All hospital employees regularly assigned to the
emergency department or psychiatric unit shall at
least annually receive , by July 1, 1995, and
thereafter, on a continuing basis as provided for in the security
plan developed pursuant to Section 1257.7, security
education and training relating to the following topics:
(1) General safety measures.
(2) Personal safety measures.
(3) The assault cycle.
(4) Aggression and violence predicting factors.
(5) Obtaining patient history from a patient with violent
behavior.
(6) Characteristics of aggressive and violent patients and
victims.
(7) Verbal and physical maneuvers to diffuse and avoid violent
behavior.
(8) Strategies to avoid physical harm.
(9) Restraining techniques.
(10) Appropriate use of medications as chemical restraints.
(11) Any resources available to employees for coping with
incidents of violence, including, by way of example, critical
incident stress debriefing or employee assistance programs.
(b) As provided in the security plan developed pursuant to
subdivision (a) of Section 1257.7, members of the medical staff
of each hospital and all other practitioners, including, but not
limited to, nurse practitioners, physician assistants, and other
personnel, who are regularly assigned to the emergency
department department, psychiatric units, or
other departments identified in the security plan shall receive the
same training as that provided to hospital employees or, at a
minimum, training determined to be sufficient pursuant to the
security plan.
(c) Temporary personnel shall be oriented as required pursuant to
the security plan. This section shall not be construed to preempt
state law or regulations generally affecting temporary personnel in
hospitals.
SEC. 3. Section 6030 of the Penal Code is amended to read:
6030. (a) The Corrections Standards Authority shall establish
minimum standards for state and local correctional facilities. The
standards for state correctional facilities shall be established by
January 1, 2007. The authority shall review those standards
biennially and make any appropriate revisions.
(b) The standards shall include, but not be limited to, the
following: health and sanitary conditions, fire and life safety,
security, rehabilitation programs, recreation, treatment of persons
confined in state and local correctional facilities, and personnel
training.
(c) The standards shall require that at least one person on duty
at the facility is knowledgeable in the area of fire and life safety
procedures.
(d) The standards shall also include requirements relating to the
acquisition, storage, labeling, packaging, and dispensing of drugs.
(e) The standards shall include requirements for a safety and
security plan designed to prevent and protect, from aggression and
violence, health care personnel who provide care to persons confined
in state and local correctional facilities, including, but not
limited to, correctional treatment centers licensed pursuant to
subdivision (j) of Section 1250 of the Health and Safety Code. The
safety and security plan shall include, but not be limited to,
security considerations of all of the following:
(1) Physical layout, including, but not limited to, the physical
layout of intake areas.
(2) Security, placement, and storage of equipment, supplies, or
other items that may be used in a manner that would pose a risk to
the physical safety of health care personnel.
(3) Staffing, including, but not limited to, the adequacy of
health care personnel staffing during the processing and intake of
detainees.
(4) The adequacy of facility security systems, protocols, and
policies, including, but not limited to, the availability of security
personnel during the provision of health care services to detainees
by health care personnel.
(5) Training for health care personnel, including, but not limited
to, education on how to recognize the potential for violence, and
how and when to seek assistance to prevent or respond to violence.
(e)
(f) The standards shall require that inmates who are
received by the facility while they are pregnant are provided all of
the following:
(1) A balanced, nutritious diet approved by a doctor.
(2) Prenatal and postpartum information and health care,
including, but not limited to, access to necessary vitamins as
recommended by a doctor.
(3) Information pertaining to childbirth education and infant
care.
(4) A dental cleaning while in a state facility.
(f)
(g) The standards shall provide that at no time shall a
woman who is in labor be shackled by the wrists, ankles, or both
including during transport to a hospital, during delivery, and while
in recovery after giving birth, except as provided in Section 5007.7.
(g)
(h) In establishing minimum standards, the authority
shall seek the advice of the following:
(1) For health and sanitary conditions:
The State Department of Health Services
State Department of Public Health , physicians, psychiatrists,
local public health officials, and other interested persons.
(2) For fire and life safety:
The State Fire Marshal, local fire officials, and other interested
persons.
(3) For security, rehabilitation programs, recreation, and
treatment of persons confined in correctional facilities:
The Department of Corrections and Rehabilitation, state and local
juvenile justice commissions, state and local correctional officials,
experts in criminology and penology, and other interested persons.
(4) For personnel training:
The Commission on Peace Officer Standards and Training,
psychiatrists, experts in criminology and penology, the Department of
Corrections and Rehabilitation, state and local correctional
officials, and other interested persons.
(5) For female inmates and pregnant inmates in local adult and
juvenile facilities:
The California State Sheriffs' Association and Chief Probation
Officers' Association of California, and other interested persons.
(6) For safety and security plans for health care personnel:
The State Department of Public Health, the Division of
Occupational Safety and Health, registered nurses, other relevant
health care personnel, and other interested persons.
SEC. 4. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.