BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 1299|
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THIRD READING
Bill No: SB 1299
Author: Padilla (D)
Amended: 5/27/14
Vote: 21
SENATE LABOR & INDUSTRIAL RELATIONS COMMITTEE : 4-1, 4/24/14
AYES: Hueso, Leno, Padilla, Mitchell
NOES: Wyland
SENATE HEALTH COMMITTEE : 5-1, 4/30/14
AYES: Hernandez, De León, DeSaulnier, Evans, Monning
NOES: Morrell
NO VOTE RECORDED: Beall, Nielsen, Wolk
SENATE APPROPRIATIONS COMMITTEE : 5-2, 5/23/14
AYES: De León, Hill, Lara, Padilla, Steinberg
NOES: Walters, Gaines
SUBJECT : Workplace violence prevention plans
SOURCE : California Nurses Association
DIGEST : This bill requires the Occupational Safety and Health
Standards Board (Cal/OSHA), no later than July 1, 2015, to adopt
standards that require specified hospitals to adopt a workplace
violence prevention plan as part of their injury and illness
prevention plan to protect health care workers and other
facility personnel from aggressive and violent behavior.
ANALYSIS : Existing law provides a framework for the
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protection of the occupational safety and health of employees
through Cal/OSHA, in the Department of Industrial Relations.
The California Occupational Safety and Health Act of 1973,
establishes certain safety and other responsibilities of
employers and employees necessary to render the employment safe.
Under existing law, California employers are required to
establish, implement and maintain an effective written,
industry-specific Illness and Injury Prevention Program (IIPP)
that contains certain mandatory provisions as part of an effort
to reduce workplace injuries. The IIPP shall include, among
other things, the employer's:
1. System for identifying and evaluating workplace hazards,
including scheduled periodic inspections.
2. Methods and procedures for correcting unsafe or unhealthy
conditions and work practices in a timely manner.
3. Training program designed to provide instruction with
respect to hazards specific to each employee's job
assignment.
4. System for communicating with employees on health and safety
matters, including provisions designed to encourage employees
to inform the employer of hazards at the worksite without
fear of reprisal.
Existing law requires every employer to file a complete report
with Cal/OSHA of every occupational injury or occupational
illness which results in lost time beyond the date of the injury
or illness, or which requires medical treatment beyond first
aid. In addition to this report, in every case involving a
serious injury or illness, or death, the employer is required to
make an immediate report to Cal/OSHA by telephone. Failure to
file this report as required deems an employer guilty of a
misdemeanor punishable by up to six months in a county jail
and/or a $5,000 fine.
Existing law, under Health and Safety Code, requires hospitals
to conduct an annual security and safety assessment, and using
that assessment, develop and annually update a security plan
with measures to protect personnel, patients, and visitors from
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aggressive or violent behavior. Additionally, existing law
requires hospitals to include in the plan:
1. Specified security considerations, including those relating
to staffing, security personnel availability, education and
training related to appropriate responses to violent acts.
2. Efforts to cooperate with local law enforcement when
incidents occur.
3. A consultation process with affected employees, including
the recognized collective bargaining agent, if any.
4. A report to local law enforcement within 72 hours, any act
of assault or battery, as defined, which results in injury or
involves the use of a firearm or other dangerous weapon
against any on-duty hospital personnel.
Existing law establishes a structure under which the Department
of Public Health (DPH) is permitted to assess administrative
fines to hospitals for violation of any of their licensing laws
and regulations.
This bill requires Cal/OSHA no later than July 1, 2015, to adopt
standards developed by Cal/OSHA that require specified hospitals
to adopt a workplace violence prevention plan as part of their
injury and illness prevention plan to protect health care
workers and other facility personnel from aggressive and violent
behavior.
This bill exempts state-run hospitals from provisions of this
bill.
This bill requires that the standards adopted include provisions
requiring:
1. A definition of workplace violence, as specified.
2. A workplace violence prevention plan that includes, but not
be limited to, the following:
A. Personnel education and training policies, to be
conducted at least annually, that require all health
care workers who provide direct care to patients to
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learn how to recognize potential for violence, how to
seek assistance and report violent incidents to law
enforcement, and information on resources available for
coping with incidents of violence.
B. A system for responding to, and investigating violent
incidents and situations.
C. A system to, at least annually, assess and improve
upon factors that may contribute to, or help prevent,
workplace violence including, but not limited to:
(1) Staffing;
(2) Sufficiency of security systems, including
security personnel availability;
(3) Job design, equipment and facilities; and
(4) Security risks associated with specific units,
areas of the facility with uncontrolled access,
late-night or early morning shifts, and employee
security in areas surrounding the facility.
3. That workplace violence prevention plans be in effect at all
times in all patient care units.
4. That all workplace violence prevention plans be developed in
conjunction with affected employees, including their
recognized collective bargaining agents, if any.
5. That all temporary personnel be oriented to the plan.
6. Provisions prohibiting hospitals from disallowing an employee
from (or taking punitive or retaliatory action against)
seeking assistance and intervention from local emergency
services or law enforcement when a violent incident occurs.
7. A requirement that hospitals document, and retain for a
five-year period, a written record of any violent incident
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against an employee.
8. Hospital to report violent incidents to Cal/OSHA:
A. Within 24 hours if it resulted in injury due to the use
of a firearm or other dangerous weapon or if the incident
presents an urgent/emergent threat; or
B. Within 72 hours for all other incidents of violence.
9. By January 1, 2017, and annually thereafter, Cal/OSHA must
post a report on its web site containing information
regarding violent incidents at hospitals, including any
reports filed and the citations levied against the hospital
for any violent incidents.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee, the Department
of Industrial Relations will incur costs of $375,000 in the
first year and $268,000 ongoing (Occupational Safety and Health
Fund), related to (1) information technology costs for the
internet-based portal reporting requirement, and (2) additional
rulemaking.
SUPPORT : (Verified 5/27/14)
California Nurses Association (source)
California Industrial Hygiene Council
Consumer Attorneys of California
LIUNA Locals 777 & 792
OPPOSITION : (Verified 5/27/14)
Association of California Healthcare Districts
California Hospital Association
ARGUMENTS IN SUPPORT : According to the author's office,
violence in health care settings is a continuing national
problem, and the risk of workplace violence is a serious
occupational hazard for health care workers. The author's
office cites a finding from the U.S. Bureau of Labor Statistics,
which states that a worker in health care and social assistance
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is nearly five times more likely to be the victim of a nonfatal
assault or violent act by another person than the average worker
in all other major industries combined. In 2007, nearly 60% of
all nonfatal assaults and violent acts by persons occurred in
the health care and social assistance industry. The fatal
injury rate between 2003 and 2007 was twice the average rate for
workers in all industries combined.
According to the sponsor, the California Nurses Association
(CNA), these findings are consistent with plentiful anecdotal
evidence from RNs and other health care workers throughout the
state who have expressed worry and frustration over inadequate
protections from violence in their workplace. Concerns that,
they argue, reached a fever pitch near the end of October 2010,
when Cynthia Palomata, an RN at Contra Costa County's Martinez
correctional facility was violently assaulted and killed by an
inmate while attempting to provide him care. CNA argues that
her death has sparked a public outcry over the safety of RNs and
other health care workers, and called into question the efforts
of employers to have in place standards and policies that ensure
the safety and security of its workers.
The author's office and proponents believe that by requiring
Cal/OSHA to adopt standards addressing workplace violence in
hospitals, this bill puts forth reasonable provisions that
enhance safety and security protections for the healthcare labor
force. Additionally, the author's office states that at least
16 states have enacted laws aimed at addressing workplace
violence against health care workers. The requirements among
these laws vary widely, ranging from requiring health facilities
to have safety and security plans, establishing fair leave
policies to employee victims, and increasing criminal penalties
for assaults against health care workers.
ARGUMENTS IN OPPOSITION : According to opponents, California
hospitals take very seriously the duty of providing a safe,
healthy environment for patients as well as staff and argue that
this bill is simply unnecessary as (1) existing law requires
hospitals to adopt and implement a comprehensive workplace
violence prevention plan; (2) Cal/OSHA already has jurisdiction
to investigate, remedy and enforce situations involving
workplace violence; and (3) the sponsor of this bill, the
California Nurses Association, has initiated the regulatory
process with Cal/OSHA. Additionally, they argue that DPH already
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reviews the adequacy of these workplace violence prevention
plans and evaluates compliance. If problems are found, then
hospitals would be subject to administrative penalties.
According to opponents, the training requirements in this bill
duplicate existing law and unreasonably expand the scope.
Currently, hospitals are required to provide annual training for
staff in the emergency department (ED) as well as any high risk
areas as identified in the security assessment. This bill
requires training for all direct patient care employees rather
than only those in high risk areas, a provision that, they
argue, creates a significant unfunded mandate without any
evidence of a corresponding benefit and does not allow hospitals
the ability to allocate training resources appropriately.
Additionally, opponents argue that the prohibition on a
hospital's ability to direct employees to contact internal
security staff rather than local emergency services or law
enforcement is not in the best interest of employee safety or
patient care because contacting internal security can provide
the assistance and support needed in a timelier manner. They
also argue that some in some units, such as a psychiatric unit,
the presence of uniformed officers can be detrimental to patient
care. Thus, they argue, it is not unreasonable to expect
employees to use a chain of command to ensure that the proper
resource is used and if law enforcement is called in, they know
where to go and can partner with the hospital security
personnel.
Lastly, opponents believe that this bill is duplicative of
current efforts already underway at the Cal/OSHA, where two
petitions have been filed requesting that regulations be
developed pertaining to workplace violence in healthcare.
PQ:AL:d 5/27/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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