BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                AB 2399
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        ASSEMBLY THIRD READING
        AB 2399 (Allen)
        As Amended April 9, 2012
        Majority vote 

         HEALTH              10-0        LABOR & EMPLOYMENT       5-0     
         
         ----------------------------------------------------------------- 
        |Ayes:|Monning, Ammiano, Atkins, |Ayes:|Swanson, Alejo, Bonnie    |
        |     |Gordon, Mitchell,         |     |Lowenthal, Gorell, Yamada |
        |     |Nestande, Pan,            |     |                          |
        |     |V. Manuel Pérez, Silva,   |     |                          |
        |     |Williams                  |     |                          |
        |     |                          |     |                          |
         ----------------------------------------------------------------- 
         APPROPRIATIONS      12-0                                         
         
         -------------------------------- 
        |Ayes:|Fuentes, Blumenfield,     |
        |     |Bradford, Charles         |
        |     |Calderon, Campos, Davis,  |
        |     |Gatto, Hall, Hill, Lara,  |
        |     |Mitchell, Solorio         |
        |     |                          |
         -------------------------------- 
         SUMMARY  :  Requires each of the five state hospitals under the 
        jurisdiction of the Department of Mental Health (DMH) to update its 
        injury and illness prevention plan (IIPP) at least once a year, 
        establish an IIPP committee to provide recommendations for updates 
        to the plan, and develop an incident reporting system, as specified. 
         Specifically,  this bill  :  

        1)Requires each state hospital to update its IIPP at least once a 
          year to include necessary safeguards to prevent workplace safety 
          hazards related to workplace violence associated with patient 
          assaults on employees. 

        2)Requires updated plans to at least address all of the following:

           a)   Control of physical access throughout the hospital and 
             grounds;

           b)   Alarm systems;

           c)   Presence of security personnel;







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           d)   Training;

           e)   Buddy systems;

           f)   Communication; and, 

           g)   Emergency responses.

        3)Requires DMH to submit the updated plans to the Legislature every 
          two years.  Specifies that the requirement for submitting the 
          updated plans is inoperative four years after the date the first 
          report is due, as specified.  Indicates that the plans must comply 
          with existing reporting requirements.

        4)Directs each state hospital to establish an IIPP committee 
          comprised of hospital management and employees designated by the 
          hospital's director in consultation with the employee bargaining 
          units.  

        5)Makes the IIPP committee responsible for providing recommendations 
          to the hospital director for updates to the IIPP.  Requires the 
          committee to meet at least four times per year.

        6)Requires each state hospital to develop an incident reporting 
          system that can be used, at a minimum, to report patient assaults 
          on employees and report identified risks of patient assaults on 
          employees.  

        7)Provides that the reporting system must be widely accessible to 
          staff and be designed to provide hospital management with 
          immediate notification of reported incidents and identified risks.

        8)Requires each state hospital to provide for timely and efficient 
          responses and investigations to incident reports made under the 
          reporting system.  Requires the incident reports to be forwarded 
          to the IIPP committee. 

         FISCAL EFFECT  :  According to the Assembly Appropriations Committee:

        1)Based on variation among hospitals, it is unclear precisely what 
          modifications or upgrades would be required of the existing 
          incident reporting systems and related equipment, but potential 
          costs associated with the changes appear fairly minor given that 
          these systems already exist.  At least two of the five facilities 







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          have incident reporting systems that appear to meet this bill's 
          requirements.

        2)Costs related to IIPPs and reports should be minor and absorbable. 


         COMMENTS  :  The author asserts that an increasing forensic 
        population, insufficient staff levels, and facilities that were not 
        originally designed or maintained for forensic patients are the 
        major causes of increases in violent incidents at state hospitals.  
        The author maintains that creating a safer environment has a 
        significant impact on the well-being of both patients and staff and 
        can reap significant financial benefits associated with reductions 
        in overtime, fewer missed work days, and fewer workers' compensation 
        claims from staff injuries relating to patient aggression.  The 
        author states that this bill seeks to improve worker safety by 
        requiring state hospitals to update their IIPPs annually with 
        important safeguards against workplace hazards posed by patient 
        assaults and establishing a formal process, through an IIPP 
        committee, to enable employees to work with management to make 
        improvements.

        DMH reports that each hospital campus has its own individual IIPP.  
        DMH states that it is working with the Department of Industrial 
        Relations' Division of Occupational Safety and Health (Cal/OSHA), 
        and patient and employee groups to revise the IIPPs.  DMH has 
        reached an agreement with Cal/OSHA to establish workgroups, with 
        employee representation, to address identified deficiencies.  
        According to DMH, there has been discussion about an overarching 
        settlement agreement that would require DMH to adopt measures based 
        on these workgroup recommendations and other discussions between DMH 
        and Cal/OSHA relating to larger structural changes governing health 
        and safety at the hospitals.  Both sides believe a settlement 
        agreement is preferable to DMH litigating appeals of each hospital's 
        Cal/OSHA citations because the citations are similar and, as a 
        result, resolution and abatement would also be similar and more 
        effective if it encompassed system-wide changes.    


         Analysis Prepared by  :    Cassie Royce / HEALTH / (916) 319-2097      
                                                                    FN: 
        0003542










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