Amended in Assembly June 20, 2013

Amended in Senate May 15, 2013

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

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) Except as provided in subdivision (n), as a part of
its injury prevention program required pursuant to Section 6401.7,
a hospital described in subdivision (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 and employee alarm systems.

(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 violent incidents to the appropriate law enforcement
officials.

(2) A system for responding to violent 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 violent incidents 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
violent incidents, 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) In addition to the reports required by Section 6409.1, a
hospital shall document and keep for a period of five years a written
record of any violent incident against a hospital employee
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. This record shall include, but not be limited to,
the date and time of the incident, 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 to the division within 72 hours the
information recorded pursuant to paragraph (1) regarding a violent
incident. If the incident results in physical 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 a violent incident pursuant to
paragraph (2), 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) The division may, at its discretion, conduct an inspection for
any violent incident reported pursuant to subdivision (h).

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

(k)  begin delete (1) end delete begin delete   end delete By January 1, 2015, and annually thereafter, the division
shall begin delete report to the relevant fiscal and policy committees of the
Legislature end delete , in a manner that protects patient and employee
confidentiality, begin insert post a report on its Internet Web site containing end insert
information regarding violent incidents 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 a violent incident, and recommendations on how
to prevent violent incidents at hospitals.

begin delete

(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.

end delete begin delete

(3) A report to be submitted pursuant to this subdivision shall
be submitted in compliance with Section 9795 of the Government
Code.

end delete

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

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

(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.

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

(n) This section shall not apply to a hospital operated by the
State Department of State Hospitals, the State Department of
Developmental Services, or the Department of Corrections and
Rehabilitation.

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.