Senate Bill No. 718

Introduced by Senator Yee

February 22, 2013

An act to add Section 6401.8 to the Labor Code, relating to employment safety.

LEGISLATIVE COUNSEL’S DIGEST

SB 718, as introduced, 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 incident of assault, as defined, or battery, as defined, against a hospital employee or patient, 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 report to the division any incident of assault, as defined, or battery, as defined, against a hospital employee or patient, as specified, and would authorize the division to assess a civil penalty against a hospital for failure to report an incident, as specified. The bill would further require the division to report to the relevant fiscal and policy committees of the Legislature information regarding incidents of violence at hospitals, as specified.

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 1.  

Section 6401.8 is added to the Labor Code, to
read:

6401.8.  

(a) As a part of its injury prevention program required
pursuant to Section 6401.7, a hospital licensed pursuant to
subdivisions (a), (b), or (f) of Section 1250 of the Health and Safety
Code shall adopt a workplace violence prevention plan designed
to protect health care workers, other facility personnel, patients,
and visitors from aggressive or violent behavior. The plan shall
include, but 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) The adequacy of facility security systems, protocols, and
policies, including, 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.

(9) Policy and training related to appropriate responses to violent
acts.

(10) Efforts to cooperate with local law enforcement regarding
violent acts in the facility.

(b) As part of its workplace violence prevention plan, a hospital
shall adopt safety and security policies, including, but not limited
to, all of the following:

(1) Personnel training policies designed to protect personnel,
patients, and visitors from aggressive or violent behavior, 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 hospital shall interview any employee involved
in the incident or situation.

(4) A system for reporting, monitoring, and recordkeeping of
violent incidents and situations involving the risk of violence.

(5) A system for reporting incidents of violence to the division
pursuant to subdivision (h).

(6) Modifications to job design, staffing, security, equipment,
or facilities as determined necessary to prevent or address violence
against hospital employees.

(c) The plan shall be developed in conjunction with affected
employees, including their recognized collective bargaining agents,
if any. Individuals or members of a hospital committee responsible
for developing the security plan shall be familiar with hospital
safety and security issues, as well as the identification of aggressive
and violent predicting factors. In developing the workplace
violence prevention plan, the hospital shall consider guidelines or
standards on violence in health care facilities issued by the division,
the federal Occupational Safety and Health Administration, and,
if available, the State Department of Public Health.

(d) All medical staff and health care workers who provide direct
care to patients shall, at least annually, receive workplace violence
prevention education and training that is designed in such a way
as to provide an opportunity for interactive questions and answers
with a person knowledgeable about the workplace violence
prevention plan, and that includes, but is not limited 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.

(e) All temporary personnel shall be oriented to the workplace
violence prevention plan.

(f) A 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.

(g) 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.

(h) (1) A hospital shall report to the division 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, but not be
limited to, 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 hospital shall report an incident to which paragraph (1)
applies to the division within 72 hours. If the incident 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 hospital personnel, the hospital shall report the incident
to the division within 24 hours.

(3) If a hospital fails to report an incident of assault or battery
pursuant to subdivision (f), the division may assess a civil penalty
against the hospital in an amount not to exceed one hundred dollars
($100) per day for each day that the incident is not reported
following the initial 72-hour or 24-hour period, as applicable
pursuant to paragraph (2).

(i) (1) By January 1, 2015, and annually thereafter, the division
shall report to the relevant fiscal and policy committees of the
Legislature, in a manner that protects patient and employee
confidentiality, information regarding incidents of violence at
hospitals, that includes, but is not limited to, the total number of
reports and which specific hospitals filed reports pursuant to
subdivision (h), the outcome of any related inspection or
investigation, citations levied against a hospital based on an
incident of workplace violence, and recommendations on how to
prevent incidents of workplace violence at hospitals.

(2) The requirement for submitting a report imposed pursuant
to this subdivision is inoperative on January 1, 2019, 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.  

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.