BILL ANALYSIS Ó
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UNFINISHED BUSINESS
Bill No: SB 1299
Author: Padilla (D)
Amended: 6/5/14
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
SENATE FLOOR : 22-13, 5/29/14
AYES: Beall, Block, Corbett, De León, DeSaulnier, Evans,
Galgiani, Hancock, Hernandez, Hill, Hueso, Jackson, Lara,
Leno, Lieu, Liu, Mitchell, Padilla, Pavley, Steinberg, Torres,
Wolk
NOES: Anderson, Berryhill, Cannella, Correa, Fuller, Gaines,
Huff, Knight, Morrell, Nielsen, Vidak, Walters, Wyland
NO VOTE RECORDED: Calderon, Monning, Roth, Wright, Yee
ASSEMBLY FLOOR : 54-21, 8/20/14 - See last page for vote
SUBJECT : Workplace violence prevention plans: hospitals
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SOURCE : California Nurses Association
DIGEST : This bill requires the Occupational Safety and Health
Administration Standards Board (OSHA), no later than July 1,
2016, 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.
Assembly Amendments stipulate that the OSHA authority is not
limited to adopt standards to protect employees from workplace
violence as specified; stipulate OSHA shall not be precluded
from adopting standards that require an employee covered, as
specified, or any employers, to adopt a workplace violence
prevention plan that includes element or requirements additional
to, broader in scope, as specified; change the date from no
later than July 1, 2015, to not later than July 1, 2016, for
OSHA to adopt standards developed by the Division of
Occupational Safety and Health (DOSH); and make technical
changes.
ANALYSIS : Existing law provides a framework for the
protection of the occupational safety and health of employees
through 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.
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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 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 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
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
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fines to hospitals for violation of any of their licensing laws
and regulations.
This bill enacts various requirements related to workplace
violence prevention plans for hospitals. Specifically, this
bill:
1.Requires OSHA, no later than July 1, 2016, to adopt 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:
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.
An incident involving the use of a firearm or
other dangerous weapon, regardless of whether the
employee sustains an injury.
A. A requirement that a workplace violence prevention plan
include, but not be limited to, all of the following:
Personnel education and training policies that
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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.
A system for responding to, and investigating,
violent incidents and situations involving violence or
the risk of violence.
A system to, at least annually, assess and
improve upon factors that may contribute to, or help
prevent workplace violence, as specified.
A. A requirement that all workplace violence prevention
plans be developed in conjunction with affected employees,
including their recognized collective bargaining agents, if
any.
B. A requirement that all temporary personnel to be
oriented to the workplace violence prevention plan.
C. 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.
D. 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.
E. 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 DOSH within 24 hours. All other
incidents of violence shall be reported to DOSH within 72
hours.
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1.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
against a hospital based on a violent incident, and
recommendations of DOSH on the prevention of violent incidents
at hospitals.
2.Specifies that this bill does not limit the authority of the
OSHA 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.
3.Specifies that this bill shall not be interpreted to preclude
the OSHA 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.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Assembly Appropriations Committee, this bill
will result in:
One-time costs to DOSH of $350,000 over two years, and ongoing
costs of approximately $180,000.
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.
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
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receive this training.
SUPPORT : (Verified 8/20/14)
California Nurses Association (source)
American Nurses Association/ California
California Industrial Hygiene Council
Consumer Attorneys of California
Laborers' International Union of North America Locals 777 & 792
SEIU - California
United Nurses Associations of California/ Union of Health Care
Professionals
OPPOSITION : (Verified 8/20/14)
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
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
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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
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
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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.
ASSEMBLY FLOOR : 54-21, 8/20/14
AYES: Alejo, Ammiano, Bloom, Bocanegra, Bonilla, Bonta,
Bradford, Buchanan, Ian Calderon, Campos, Chau, Chesbro,
Cooley, Dababneh, Daly, Dickinson, Eggman, Fong, Fox, Frazier,
Garcia, Gatto, Gomez, Gonzalez, Gordon, Gray, Hall, Roger
Hernández, Holden, Jones-Sawyer, Levine, Lowenthal, Medina,
Mullin, Muratsuchi, Nazarian, Pan, Perea, John A. Pérez, V.
Manuel Pérez, Quirk, Quirk-Silva, Rendon, Ridley-Thomas,
Rodriguez, Salas, Skinner, Stone, Ting, Weber, Wieckowski,
Wilk, Williams, Atkins
NOES: Achadjian, Allen, Bigelow, Chávez, Conway, Dahle,
Donnelly, Beth Gaines, Hagman, Harkey, Jones, Linder, Logue,
Maienschein, Mansoor, Melendez, Nestande, Olsen, Patterson,
Wagner, Waldron
NO VOTE RECORDED: Brown, Gorell, Grove, Yamada, Vacancy
PQ:AL:d:n 8/20/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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