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  








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          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  








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            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