Amended in Assembly September 3, 2013

Amended in Assembly June 20, 2013

Amended in Senate May 15, 2013

Amended in Senate April 4, 2013

Senate BillNo. 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 preventionbegin delete plan.end deletebegin insert plan.end insert

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.

Thisbegin delete 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. Theend delete bill would prohibit a hospitalbegin insert, as specified,end insert 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 post on its Internet Web site a report regarding violent incidents at hospitals, as specified, and to adopt 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:

P2    1

SECTION 1.  

Section 6401.8 is added to the Labor Code, to
2read:

begin delete
3

6401.8.  

(a) Except as provided in subdivision (n), as a part of
4its injury prevention program required pursuant to Section 6401.7,
5a hospital described in subdivision (a), (b), or (f) of Section 1250
6of the Health and Safety Code shall adopt a workplace violence
7prevention plan designed to protect health care workers, other
8facility personnel, patients, and visitors from aggressive or violent
9behavior. The plan shall include, but not be limited to, security
10considerations relating to all of the following:

P3    1(1) Physical layout.

2(2) Staffing, including staffing patterns and patient classification
3systems that contribute to the risk of violence or are insufficient
4to address the risk of violence.

5(3) The adequacy of facility security systems, protocols, and
6policies, including, but not limited to, security personnel
7availability and employee alarm systems.

8(4) Potential security risks associated with specific units or areas
9within the facility where there is a greater likelihood that a patient
10or other person may exhibit violent behavior.

11(5) Uncontrolled public access to any part of the facility.

12(6) Potential security risks related to working late night or early
13morning hours.

14(7) Employee security in areas surrounding the facility,
15including, but not limited to, employee parking areas.

16(8) The use of a trained response team that can assist employees
17in violent situations.

18(9) Policy and training related to appropriate responses to violent
19acts.

20(10) Efforts to cooperate with local law enforcement regarding
21violent acts in the facility.

22(b) As part of its workplace violence prevention plan, a hospital
23shall adopt safety and security policies, including, but not limited
24to, all of the following:

25(1) Personnel training policies designed to protect personnel,
26patients, and visitors from aggressive or violent behavior, including
27education on how to recognize the potential for violence, how and
28when to seek assistance to prevent or respond to violence, and how
29 to report violent incidents to the appropriate law enforcement
30officials.

31(2) A system for responding to violent incidents and situations
32involving violence or the risk of violence, including, but not limited
33to, procedures for rapid response by which an employee is provided
34with immediate assistance if the threat of violence against that
35employee appears to be imminent, or if a violent act has occurred
36or is occurring.

37(3) A system for investigating violent incidents and situations
38involving violence or the risk of violence. When investigating
39these incidents, the hospital shall interview any employee involved
40in the incident or situation.

P4    1(4) A system for reporting, monitoring, and recordkeeping of
2violent incidents and situations involving the risk of violence.

3(5) A system for reporting violent incidents to the division
4pursuant to subdivision (h).

5(6) Modifications to job design, staffing, security, equipment,
6or facilities as determined necessary to prevent or address violence
7against hospital employees.

8(c) The plan shall be developed in conjunction with affected
9employees, including their recognized collective bargaining agents,
10if any. Individuals or members of a hospital committee responsible
11for developing the security plan shall be familiar with hospital
12safety and security issues, as well as the identification of aggressive
13and violent predicting factors. In developing the workplace
14violence prevention plan, the hospital shall consider guidelines or
15standards on violence in health care facilities issued by the division,
16the federal Occupational Safety and Health Administration, and,
17if available, the State Department of Public Health.

18(d) All medical staff and health care workers who provide direct
19care to patients shall, at least annually, receive workplace violence
20prevention education and training that is designed in such a way
21as to provide an opportunity for interactive questions and answers
22with a person knowledgeable about the workplace violence
23prevention plan, and that includes, but is not limited to, the
24following topics:

25(1) General safety measures.

26(2) Personal safety measures.

27(3) The assault cycle.

28(4) Aggression and violence predicting factors.

29(5) Obtaining patient history from a patient with violent
30behavior.

31(6) Characteristics of aggressive and violent patients and victims.

32(7) Verbal and physical maneuvers to diffuse and avoid violent
33behavior.

34(8) Strategies to avoid physical harm.

35(9) Restraining techniques.

36(10) Appropriate use of medications as chemical restraints.

37(11) Any resources available to employees for coping with
38violent incidents, including, by way of example, critical incident
39stress debriefing or employee assistance programs.

P5    1(e) All temporary personnel shall be oriented to the workplace
2violence prevention plan.

3(f) A hospital shall provide evaluation and treatment for an
4employee who is injured or is otherwise a victim of a violent
5incident and shall, upon the request of the employee, provide access
6to followup counseling to address trauma or distress experienced
7by the employee, including, but not limited to, individual crisis
8counseling, support group counseling, peer assistance, and
9professional referrals.

10 10(g)

end delete
11begin insert

begin insert6401.8.end insert  

end insert

begin insert(a)end insert A hospitalbegin insert described in subdivision (a), (b), or (f)
12of Section 1250 of the Health and Safety Codeend insert
shall not prohibit
13an employee from, or take punitive or retaliatory action against an
14employee for, seeking assistance and intervention from local
15emergency services or law enforcement when a violent incident
16occurs.

begin delete

14 17(h)

end delete

18begin insert(b)end insert (1) In addition to the reports required by Section 6409.1, a
19hospital shall document and keep for a period of five years a written
20record of any violent incident against a hospital employee
21immediately after the incident is reported by that employee or any
22other employee to a manager, supervisor, or other hospital
23administrator. The hospital shall document and keep a written
24record of all violent incidents, regardless of whether the employee
25sustains an injury. This record shall include, but not be limited to,
26the date and time of the incident, the unit in which the incident
27occurred, a description of the circumstances surrounding the
28incident, and the hospital’s response to the incident.

29(2) A hospital shall report to the division within 72 hours the
30information recorded pursuant to paragraph (1) regarding a violent
31incident. If the incident results in physical injury, involves the use
32of a firearm or other dangerous weapon, or presents an urgent or
33emergent threat to the welfare, health, or safety of hospital
34personnel, the hospital shall report the incident to the division
35within 24 hours.

36(3) If a hospital fails to report a violent incident pursuant to
37paragraph (2), the division may assess a civil penalty against the
38hospital in an amount not to exceed one hundred dollars ($100)
39per day for each day that the incident is not reported following the
P6    1initial 72-hour or 24-hour period, as applicable pursuant to
2paragraph (2).

begin delete

38 3(i)

end delete

4begin insert(c)end insert The division may, at its discretion, conduct an inspection
5for any violent incident reported pursuant to subdivisionbegin delete (h)end deletebegin insert (b)end insert.

begin delete

P6   1 6(j)

end delete

7begin insert(d)end insert Nothing in this section requiring recordkeeping and reporting
8by an employer relieves the employer of the requirements of
9Section 6410.

begin delete

4 10(k)

end delete

11begin insert(e)end insert By January 1, 2015, and annually thereafter, the division
12shall, in a manner that protects patient and employee
13confidentiality, post a report on its Internet Web site containing
14information regarding violent incidents at hospitals, that includes,
15but is not limited to, the total number of reports and which specific
16hospitals filed reports pursuant to subdivisionbegin delete (h),end deletebegin insert (b),end insert the outcome
17of any related inspection or investigation, citations levied against
18a hospital based on a violent incident, and recommendations on
19how to prevent violent incidents at hospitals.

begin delete

20(l)

end delete

21begin insert(f)end insert By January 1, 2015, the division shall adopt regulations to
22implement the provisions of this section.

begin delete

22 23(m)

end delete

24begin insert(g)end insert For purposes of this section, “violent incident” shall include,
25but not be limited to, the following:

26(1) The use of physical force against a hospital employee by a
27patient or a person accompanying a patient that results in or has a
28high likelihood of resulting in injury, psychological trauma, or
29stress, regardless of whether the employee sustains an injury.

30(2) An incident involving the use of a firearm or other dangerous
31weapon, regardless of whether the employee sustains an injury.

begin delete

30 32(n)

end delete

33begin insert(h)end insert This section shall not apply to a hospital operated by the
34State Department of State Hospitals, the State Department of
35Developmental Services, or the Department of Corrections and
36Rehabilitation.

37

SEC. 2.  

No reimbursement is required by this act pursuant to
38Section 6 of Article XIII B of the California Constitution because
39the only costs that may be incurred by a local agency or school
40district will be incurred because this act creates a new crime or
P7    1infraction, eliminates a crime or infraction, or changes the penalty
2for a crime or infraction, within the meaning of Section 17556 of
3the Government Code, or changes the definition of a crime within
4the meaning of Section 6 of Article XIII B of the California
5Constitution.



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