BILL ANALYSIS
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THIRD READING
Bill No: AB 1083
Author: John A. Perez (D)
Amended: 6/17/09 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 10-0, 6/25/09
AYES: Alquist, Strickland, Aanestad, Cedillo, Cox,
DeSaulnier, Leno, Maldonado, Negrete McLeod, Pavley
NO VOTE RECORDED: Wolk
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 76-0, 5/28/09 - See last page for vote
SUBJECT : Health facilities: security plans
SOURCE : Service Employees International Union
DIGEST : This bill requires hospital security and safety
assessments to be conducted not less than annually, and
requires hospital security plans to be updated annually,
provides that hospital security plans may additionally
include efforts to cooperate with local law enforcement
regarding violent acts at the facility, and requires
hospitals to consult with affected employees and members of
the medical staff in developing their security plans and
assessments.
ANALYSIS :
CONTINUED
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Existing law:
1. Requires all general acute care, acute psychiatric, and
special hospitals to conduct a security and safety
assessment and develop a security plan with measures to
protect personnel, patients, and visitors from
aggressive and violent behavior.
2. Requires the assessment to examine trends of aggressive
or violent behavior at the facility.
3. Requires hospitals to track incidents of aggressive or
violent behavior for purposes of developing a security
plan, which may include security considerations relating
to physical layout, staffing, security personnel
availability, and policy and training related to
responses to violent acts.
4. Requires hospitals, in developing the security plan, to
consider guidelines or standards issued by the
Department of Public Health (DPH), the Division of
Occupational Safety and Health, and the federal
Occupational Safety and Health Administration, and to
adopt policies including but not limited to, policies
regarding personnel training designed to protect
personnel, patients, and visitors from aggressive or
violent behavior.
5. Requires the members of a hospital committee responsible
for developing the security plan to be familiar with
several things, including the role of security in
hospital operations, hospital organization, protective
measures, handling of disturbed patients, visitors, and
employees, and identification of aggressive and violent
predictive factors.
6. Requires a hospital to have sufficient personnel to
provide security pursuant to the plan.
7. Requires certain acts of assault, as defined, to be
reported to the local law enforcement agency within 72
hours.
8. Gives DPH authority to assess administrative penalties
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against hospitals for licensing deficiencies, including
up to $100,000 for a deficiency that constitutes
immediate jeopardy to the health or safety of a patient,
and up to $25,000 for a deficiency that does not
constitute immediate jeopardy to the health or safety of
a patient.
This bill:
1. Requires hospitals to conduct security and safety
assessments not less than annually and to annually
update their security plans.
2. Provides that security plans may additionally include
efforts to cooperate with local law enforcement
regarding violent acts at the facility.
3. Requires hospitals, in developing their plans and
assessments, to consult with affected employees,
including the recognized collective bargaining agents
and members of the medical staff.
4. Provides that the consultation may occur through
hospital committees.
Background
Recent data developed by the Bureau of Labor Statistics
indicates that hospital workers are at high risk for
violence in the workplace. The Bureau of Labor Statistics
estimates that in a typical year 2,637 nonfatal assaults
are made on hospital workers in this country, a rate of 8.3
assaults per 10,000 workers. This rate is much higher than
the same rate for all other private sector industries which
is only two nonfatal assaults per 10,000 workers. Nurses
and aides with direct patient contact are at higher risk
for violence as are emergency response personnel, hospital
security officers, and other providers.
Violence in health care work settings has been the focus of
several policy initiatives in California since the early
1990s. In 1990, a survey of emergency departments was
conducted by the California Emergency Nurses Association to
determine the magnitude of violence against emergency
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nurses and the security practices in place at the time.
This survey precipitated the passage of AB 508 (Speier),
Chapter 936, Statutes of 1993, which required hospitals to
conduct security assessments and develop security plans by
July 1, 1995. A follow-up survey, in 2002, found that
security measures had increased since passage of AB 508,
but that substantial gaps still exist. In 1993, Cal-OSHA
issued guidelines for safety and security of health care
and community service workers.
According to an evaluation of safety and security programs
that was completed in 2007, which looked at safety and
security in California and New Jersey hospitals, health
care workers, particularly those who work in emergency
departments and in psychiatric care units, have a high risk
of work-related assault. Among the factors that place such
workers at heightened risk are dealing with the public on
demand in a highly publicly accessible place and working
with potentially hostile clients.
The survey found that 93.1 percent of California hospitals
provided workplace violence training for emergency
department employees, and that 94.8 percent had written
policies regarding violence in the workplace, but found
that many emergency department employees in general acute
care and employees in psychiatric hospitals do not receive
training. The survey found wide variation in the specific
types of security measures in place in hospitals, but also
documented a decline in the rate of violent events in
emergency departments and in psychiatric care units after
the passage of AB 508. The survey also found that nurses,
medical technicians, and mental health workers were the
most frequently assaulted employees.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
SUPPORT : (Verified 7/15/09)
Service Employees International Union (source)
California Labor Federation
California Medical Association
Kaiser Permanente
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ARGUMENTS IN SUPPORT : The bill's sponsor, Service
Employees International Union (SEIU), states that this bill
is a modest measure that will address gaps in existing law
by requiring hospitals to annually review and update
security and safety assessment plans and to consult with
their employees in the development of the plans. SEIU
states that violence and aggression do not stop at the
hospital door and the reality is that doctors, nurses,
hospital workers, and patients face acts of aggression and
violence on a daily basis. SEIU states that while many
hospitals undertake periodic reviews of their plans,
unfortunately, not all do.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,
Brownley, Buchanan, Caballero, Carter, Chesbro, Conway,
Cook, Coto, Davis, De La Torre, De Leon, DeVore,
Emmerson, Eng, Feuer, Fletcher, Fong, Fuentes, Fuller,
Furutani, Gaines, Galgiani, Garrick, Gilmore, Hagman,
Hall, Harkey, Hayashi, Hernandez, Hill, Huber, Huffman,
Jeffries, Jones, Knight, Krekorian, Lieu, Logue, Bonnie
Lowenthal, Ma, Mendoza, Miller, Monning, Nava, Niello,
Nielsen, John A. Perez, V. Manuel Perez, Portantino,
Price, Ruskin, Salas, Saldana, Silva, Skinner, Smyth,
Solorio, Audra Strickland, Swanson, Torlakson, Torres,
Torrico, Tran, Villines, Yamada, Bass
NO VOTE RECORDED: Charles Calderon, Duvall, Evans,
Nestande
CTW:mw 7/15/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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