BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | SB 1299| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- 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 CONTINUED SB 1299 Page 2 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. CONTINUED SB 1299 Page 3 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 CONTINUED SB 1299 Page 4 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 CONTINUED SB 1299 Page 5 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. CONTINUED SB 1299 Page 6 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 CONTINUED SB 1299 Page 7 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 CONTINUED SB 1299 Page 8 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 CONTINUED SB 1299 Page 9 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 **** END **** CONTINUED