BILL ANALYSIS Ó
SB 718
Page 1
Date of Hearing: August 14, 2013
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
SB 718 (Yee) - As Amended: June 20, 2013
Policy Committee: HealthVote:13-6
Urgency: No State Mandated Local Program:
Yes Reimbursable: No
SUMMARY
This bill requires hospitals to take specific actions related to
assessing, reporting, training, and planning and policy
development to address violence and threats of violence against
employees and others. Specifically, this bill:
1)Requires hospitals to adopt a workplace violence prevention
plan and prescribes its elements, as well as specified safety
and security policies.
2)Requires hospitals to document and keep for five years a
written record of all violent incidents against a hospital
employee, and to report incidents to the Division of
Occupational Safety and Health (Cal/OSHA) of the Department of
Industrial Relations (DIR).
3)Requires all medical staff and health care workers who provide
direct care to patients to receive annual workplace violence
prevention education and training.
4)Provides hospitals may not prevent an employee from, or take
punitive or retaliatory action against an employee for,
seeking assistance and intervention from local emergency
services or law enforcement for a violent incident.
5)Requires hospitals to provide evaluation and treatment, as
specified, for an employee who is injured or is otherwise a
victim of a violent incident.
6)Authorizes Cal/OSHA to assess a civil penalty against a
hospital for failure to report a violent incident. Requires
Cal/OSHA to adopt regulations implementing these provisions by
SB 718
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January 1, 2015.
7)Exempts hospitals operated by the State Department of State
Hospitals, the State Department of Developmental Services, or
the Department of Corrections and Rehabilitation from the
bill's requirements.
FISCAL EFFECT
1)One-time costs to Cal/OSHA of $120,000 over two years to
develop regulations, and $50,000 to establish a reporting
system (Occupational Safety and Health (OSH) Fund).
2)Ongoing costs to Cal/OSHA of approximately $75,000 (OSH fund)
annually to collect and evaluate newly reportable criminal
assaults, to ensure compliance with safety and training
standards, and to compile incidents and report to the
Legislature.
3)Unknown, likely minor, new state GF revenue from civil
penalties against hospitals for failure to report incidents in
a timely manner.
4)Cost pressure to the University of California's five medical
centers of approximately $1 million total associated with new
training requirements of direct care staff.
5)Cost pressure to the state (GF/federal/special) and other
purchasers of health care by raising the total cost of
hospital care by at least $10 million statewide annually, due
to new security training requirements of direct care staff not
currently required to receive this training.
COMMENTS
1)Rationale . According to the author and sponsor of this bill,
the California Nurses Association (CNA), violence in health
care settings has been an area of concern for some time, as
risk of workplace violence is a serious occupational hazard
for Registered Nurses (RNs) and other health care workers.
CNA maintains the incidence of violence against RNs and other
health care workers calls into question the adequacy of
existing safety and security standards. According to CNA,
this bill will improve the safety and security of RNs and
other health care workers throughout the state.
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2)Opposition . The California Hospital Association (CHA)
indicates concern about the cost of compliance with this bill.
They indicate the requirement to train all direct patient
care staff annually is burdensome and unnecessary, as
hospitals are currently able to tailor training requirements
based on risk assessment. Furthermore, CHA indicates current
law already prescribes comprehensive requirements related to
safety and security assessment, planning, reporting, and
training. They believe the bill's reporting requirements are
duplicative. In addition, they assert requiring hospitals to
train medical staff is not reasonable given hospitals are
legally prohibited from employing physicians.
3)Prior Legislation . AB 30 (Hayashi) of 2011 was substantially
similar to this bill, but placed requirements in the Health
and Safety Code with the California Department of Public
Health responsible for enforcement. AB 30 was held on the
Suspense File of this committee.
AB 1083 (John. A. Perez), Chapter 506, Statutes of 2009,
required hospital security and safety assessments and plans to
be conducted and updated annually, required hospitals to
consult with affected employees and members of the medical
staff in developing their security plans and assessments and
provided that hospital security plans could additionally
include efforts to cooperate with local law enforcement
regarding violent acts at a hospital facility.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081