BILL ANALYSIS Ó SB 1299 Page 1 Date of Hearing: August 6, 2014 ASSEMBLY COMMITTEE ON APPROPRIATIONS Mike Gatto, Chair SB 1299 (Padilla) - As Amended: June 5, 2014 Policy Committee: HealthVote:14-5 Labor Vote: 5-1 Urgency: No State Mandated Local Program: No Reimbursable: No SUMMARY This bill requires the Division of Occupational Safety and Health (Cal/OSHA) of the Department of Industrial Relations (DIR) to adopt standards, and 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 Cal/OSHA to adopt standards as follows: a) Requiring hospitals to adopt a workplace violence prevention plan. Prescribes its elements, as well as specified safety and security policies. b) Requiring 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 Cal/OSHA. c) Requiring all health care workers who provide direct care to patients to receive annual workplace violence prevention education and training. 1)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. 2)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 SB 1299 Page 2 1)One-time costs to Cal/OSHA of $350,000 over two years to develop regulations, and to establish a reporting system (Occupational Safety and Health (OSH) Fund). 2)Ongoing costs to Cal/OSHA of approximately $180,000 (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)Cost pressure to the University of California's five medical centers (special funds) in the hundreds of thousands of dollars annually associated with new training requirements of direct care staff. 4)Cost pressure to the state (GF/federal/special) and other purchasers of health care by raising the total cost of hospital care by millions of dollars statewide annually, due to new security training requirements of direct care staff not currently required to receive this training. Even using fairly conservative assumptions, overall statewide costs associated with the mandate for extra training could exceed $10 million annually, a portion of which the state would indirectly bear. COMMENTS 1)Purpose . According to the author, 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. The sponsor of this bill, the California Nurses Association (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. 2)Current Cal/OSHA Petitions . CNA and SEIU Local 121/RN/SEIU Nurse Alliance of California filed petitions in February of this year to the Cal/OSHA Standards Board, seeking the creation of workplace violence prevention standards for healthcare workers. Both petitions were granted in June. The Board's memo granting the petitions requests Cal/OSHA to SB 1299 Page 3 develop a consensus rulemaking proposal addressing workplace violence protection standards for consideration by the public and the Board, to convene an advisory committee for the rulemaking process, and to consider updating various guidelines they have developed on the issue of workplace safety. 3)Opposition . The California Hospital Association (CHA) opposes this bill unless substantial amendments are taken to align with existing law and remove the mandate to train all personnel, among other changes. CHA indicates this bill is inconsistent with existing law requiring hospitals to adopt a safety and security plan and it unreasonably usurps Cal/OSHA's stakeholder process for developing regulations, which is currently underway. Further, CHA contends the requirement that all direct patient care employees receive training is a significant unfunded mandate. The Department of Finance also opposes this bill. 4)Prior Legislation . SB 718 (Yee) of 2013 was substantially similar to this bill. SB 718 was amended to remove some of the bill's substantive provisions as the bill left the Suspense File of this committee, and was later placed on the Inactive File on the Assembly Floor. 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. 5)Staff Comment . The standards this bill requires the board to adopt appear quite prescriptive. Given the Cal/OSHA regulatory process is now underway to address the same concerns as this bill, the Committee may wish to consider how to reconcile this bill and the regulatory process in order to ensure cost-efficient administration of any health care workplace safety requirements. Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081