Amended in Senate April 4, 2013

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 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 begin insert violent end insert incident begin delete of assault, as defined, or battery end delete , as defined, against a hospital employee begin delete or patient end delete , 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 begin insert document and keep for 5 years a written record of all violent incidents against a hospital employee, as defined, and to end insert report to the division any begin insert violent end insert incident begin delete of assault, as defined, or battery, as defined, against a hospital employee or patient end delete , as specified begin delete , and end delete begin insert . The bill end insert would begin insert also end insert authorize the division to assess a civil penalty against a hospital for failure to report begin delete an end delete begin insert a violent end insert incident, as specified. The bill would further require the division to report to the relevant fiscal and policy committees of the Legislature information regarding begin insert violent end insert incidents begin delete of violence end delete at hospitals, as specified begin insert , and to develop regulations implementing these provisions by January 1, 2015 end insert .

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 begin insert and employee alarm systems end insert .

(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 begin insert violent end insert incidents begin delete of violence end delete to the appropriate law
enforcement officials.

(2) A system for responding to begin insert violent end insert 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 begin insert violent end insert incidents begin delete of violence end delete 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
begin insert violent end insert incidents begin delete of violence end delete , 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)  begin delete A end delete begin insert In addition to the reports required by Section 6409.1,
a end insert hospital shall begin delete 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, end delete begin insert document and keep for a period
of five years a written record of any violent incident end insert against a
hospital employee begin delete or patient that is committed by a patient or a
person accompanying a patient end delete begin insert immediately after the incident is
reported by that employee or any other employee to a manager,
supervisor, or other hospital administrator. The hospital shall
document and keep a written record of all violent incidents,
regardless of whether the employee sustains an injury end insert . This begin delete report end delete
begin insert record end insert shall include, but not be limited to, the date and time of the
incident begin delete , whether the victim was a hospital employee or a patient end delete ,
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 begin delete an incident to which paragraph (1)
applies end delete to the division within 72 hours begin insert the information recorded
pursuant to paragraph (1) regarding a violent incident end insert . If the
incident results in begin insert physical end insert 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 begin delete an end delete begin insert a violent end insert incident begin delete of assault
or battery end delete pursuant to begin delete subdivision (f) end delete begin insert paragraph (2) end insert , 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).

begin insert

(i) The division may, at its discretion, conduct an inspection for
any violent incident reported pursuant to subdivision (h).

end insert begin insert

(j) Nothing in this section requiring recordkeeping and reporting
by an employer relieves the employer of the requirements of Section
6410.

end insert begin delete

(i)

end delete

begin insert (k) end insert  (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 begin insert violent end insert incidents begin delete of violence end delete
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 begin delete an end delete begin insert a
violen end insert begin insert t end insert incident begin delete of workplace violence end delete , and recommendations on
how to prevent begin insert violent end insert incidents begin delete of workplace violence end delete 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.

begin insert

(l) By January 1, 2015, the division shall adopt regulations to
implement the provisions of this section.

end insert begin insert

(m) For purposes of this section, “violent incident” shall
include, but not be limited to, the following:

end insert begin insert

(1) The use of physical force against a hospital employee by a
patient or a person accompanying a patient that results in or has
a high likelihood of resulting in injury, psychological trauma, or
stress, regardless of whether the employee sustains an injury.

end insert begin insert

(2) An incident involving the use of a firearm or other dangerous
weapon, regardless of whether the employee sustains an injury.

end insert

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.