BILL ANALYSIS Ó AB 2399 Page 1 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; AB 2399 Page 2 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 AB 2399 Page 3 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 AB 2399 Page 4