BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  SB 1299
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          SENATE THIRD READING
          SB 1299 (Padilla)
          As Amended  June 5, 2014
          Majority vote 

           SENATE VOTE  :22-13  
           
           LABOR AND EMPLOYMENT     5-1    HEALTH              14-5        
           
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          |Ayes:|Roger Hernández, Alejo,   |Ayes:|Pan, Ammiano, Bonilla,    |
          |     |Chau, Holden,             |     |Bonta, Chesbro, Gomez,    |
          |     |Ridley-Thomas             |     |Gonzalez,                 |
          |     |                          |     |Roger Hernández,          |
          |     |                          |     |Lowenthal, Nazarian,      |
          |     |                          |     |Nestande, Ridley-Thomas,  |
          |     |                          |     |Rodriguez, Wieckowski     |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Grove                     |Nays:|Maienschein, Chávez,      |
          |     |                          |     |Mansoor, Patterson,       |
          |     |                          |     |Wagner                    |
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           APPROPRIATIONS      12-5                                        
           
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          |Ayes:|Gatto, Bocanegra,         |     |                          |
          |     |Bradford, Ian Calderon,   |     |                          |
          |     |Campos, Eggman, Gomez,    |     |                          |
          |     |Holden, Pan, Quirk,       |     |                          |
          |     |Ridley-Thomas, Weber      |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Bigelow, Donnelly, Jones, |     |                          |
          |     |Linder, Wagner            |     |                          |
          |     |                          |     |                          |
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           SUMMARY  :  Enacts various requirements related to workplace  
          violence prevention plans for hospitals.  Specifically,  this  
          bill  :

          1)Requires the Occupational Safety and Health Administration  
            (OSHA) Standards Board, no later than July 1, 2016, to adopt  








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            standards that require specified hospitals to adopt a  
            workplace violence prevention plan as a part of their injury  
            and illness prevention plans to protect health care workers  
            and other facility personnel from aggressive and violent  
            behavior.

          2)Specifies that this bill does not apply to a hospital operated  
            by the State Department of State Hospitals, the State  
            Department of Developmental Services, or the Department of  
            Corrections and Rehabilitation.

          3)Specifies that the standards shall include all of the  
            following:

             a)   A requirement that the workplace violence prevention  
               plan be in effect at all times in all patient care units,  
               including inpatient and outpatient settings and clinics on  
               the hospital's license.

             b)   A definition of workplace violence that includes, but is  
               not limited to, both of the following:

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

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

             c)   A requirement that a workplace violence prevention plan  
               include, but not be limited to, all of the following:

               i)     Personnel education and training policies that  
                 require all health care workers who provide direct care  
                 to patients to, at least annually, receive specified  
                 education and training that is designed to provide an  
                 opportunity for interactive questions and answers with a  
                 person knowledgeable about the workplace violence  
                 prevention plan.

               ii)    A system for responding to, and investigating,  








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                 violent incidents and situations involving violence or  
                 the risk of violence.

               iii)   A system to, at least annually, assess and improve  
                 upon factors that may contribute to, or help prevent  
                 workplace violence, as specified.

             d)   A requirement that all workplace violence prevention  
               plans be developed in conjunction with affected employees,  
               including their recognized collective bargaining agents, if  
               any.

             e)   A requirement that all temporary personnel to be  
               oriented to the workplace violence prevention plan.

             f)   Provisions prohibiting hospitals from disallowing an  
               employee from, or taking punitive or retaliatory action  
               against an employee for, seeking assistance and  
               intervention from local emergency services or law  
               enforcement when a violent incident occurs.

             g)   A requirement that hospitals document, and retain for a  
               period of five years, a written record of any violent  
               incident against a hospital employee, regardless of whether  
               the employee sustains an injury, and regardless of whether  
               the report is made by the employee who is the subject of  
               the violent incident or any other employee.

             h)   A requirement that a hospital report violent incidents  
               to the division.  If the incident results in injury,  
               involves the use of a firearm or other dangerous weapon, or  
               presents an urgent or emergent threat to the welfare,  
               health, or safety of hospital personnel, the hospital shall  
               report the incident to the Division of Occupational Safety  
               and Health (DOSH) within 24 hours.  All other incidents of  
               violence shall be reported to DOSH within 72 hours.

          4)Requires DOSH, by January 1, 2017, and annually thereafter, in  
            a manner that protects patient and employee confidentiality,  
            to post a report on its Internet Web site containing  
            information regarding violent incidents at hospitals, that  
            includes, but is not limited to, the total number of reports,  
            and which specific hospitals filed reports, the outcome of any  
            related inspection or investigation, the citations levied  








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            against a hospital based on a violent incident, and  
            recommendations of DOSH on the prevention of violent incidents  
            at hospitals.

          5)Specifies that this bill does not limit the authority of the  
            OSHA Standards Board to adopt standards to protect employees  
            from workplace violence and shall not be interpreted to  
            preclude it from adopting standards that require other  
            employers, including those exempted from this bill, to adopt  
            plans to protect employees from workplace violence.

          6)Specifies that this bill shall not be interpreted to preclude  
            the OSHA Standards Board from adopting standards that require  
            an employer covered by this bill, or any other employers, to  
            adopt a workplace violence prevention plan that includes  
            elements or requirements additional to, or broader in scope,  
            than those described in this bill.

           EXISTING LAW  under the 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  
          aggressive or violent behavior.  (Health and Safety Code Section  
          1257.7).  Existing law also establishes a mechanism 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.  

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, this bill will result in:

          1)One-time costs to DOSH of $350,000 over two years, and ongoing  
            costs of approximately $180,000.

          2)Cost pressure to the University of California's five medical  
            centers in the hundreds of thousands of dollars annually  
            associated with new training requirements of direct care  
            staff.

          3)Cost pressure to the state and other purchaser of health care  
            by raising the total cost of hospital care by several million  
            dollars statewide annually, due to new security training  
            requirements of direct care staff not currently required to  
            receive this training.








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           COMMENTS  :  This bill would require the OSHA Standards Board, no  
          later than July 1, 2016, to adopt standards developed by DOSH  
          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.  

          According to the author, violence in healthcare settings is a  
          continuing national problem, and the risk of workplace violence  
          is a serious occupational hazard for health care workers.  The  
          author cites a finding from the United States Bureau of Labor  
          Statistics, which states that a worker in health care and social  
          assistance 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.

          The author and proponents believe that by requiring the OSHA  
          Standards Board to adopt standards addressing workplace violence  
          in hospitals, this bill would put forth reasonable provisions  
          that would enhance safety and security protections for the  
          healthcare labor force. Additionally, the author 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.

          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) current law requires  
          hospitals to adopt and implement a comprehensive workplace  
          violence prevention plan, 2) DOSH 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 the OSHA  
          Standards Board.  Additionally, they argue that the DPH already  
          reviews the adequacy of these workplace violence prevention  








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          plans and evaluates compliance.  If problems are found, then  
          hospitals would be subject to administrative penalties. 

          Finally, opponents believe that this bill is duplicative of  
          current efforts already underway at the OSHA Standards Board,  
          where two petitions have been filed requesting that regulations  
          be developed pertaining to workplace violence in healthcare.


           Analysis Prepared by  :    Ben Ebbink / L. & E. / (916) 319-2091 


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