BILL ANALYSIS �
AB 30
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Date of Hearing: May 4, 2011
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 30 (Hayashi) - As Amended: March 14, 2011
Policy Committee: HealthVote:13-4
Urgency: No State Mandated Local Program:
Yes Reimbursable: No
SUMMARY
This bill expands existing hospital safety and security
standards with respect to prevention of violence against health
care personnel. Specifically, this bill:
1)Increases the specificity of factors that must be considered
in hospital safety plans and included in security policies.
2)Requires hospitals to report all incidents of assault and
battery against a hospital employee or patient within certain
time frames, as specified.
3)Authorizes the Department of Public Health (DPH) to assess
civil penalties against hospitals if reports are not made
within specified time frames.
4)Requires annual security training for all employees providing
direct care in a hospital, and stipulates that medical staff
are required to receive the same training or, at a minimum,
training determined to be sufficient pursuant to a security
plan.
5)Requires each hospital to provide evaluation and treatment for
an employee who is injured or otherwise the victim of a
violent incident.
6)Requires minimum security standards for protection of health
care personnel in state and local correctional facilities to
be established by the Correctional Standards Authority.
7)Requires DPH to report to the Legislature on the incidence of
violence at hospitals.
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FISCAL EFFECT
1)Estimated costs to DPH of $500,000 to $800,000 (special fund)
annually to collect and evaluate newly reportable criminal
assaults, to conduct additional survey reviews to ensure
compliance with safety and training standards, and to compile
incidents and report to the Legislature. The increased costs
would be supported by corresponding increases in licensing
fees to hospitals.
2)Unknown, likely minor, new state revenue from civil penalties
against hospitals for failure to report incidents in a timely
manner.
3)Unknown, likely minor ongoing costs to the Department of
Mental Health to provide treatment and counseling for any
employees who are victims of violence at a state hospital
facility.
4)One-time costs, likely in the range of tens to hundreds of
thousands of dollars, to the Department of Developmental
Services to develop or expand safety and security plans at
state Developmental Centers, and unknown, likely minor ongoing
costs to report to DPH and to align training curriculum with
this bill's requirements.
5)One-time costs to the Correctional Standards Authority of
$60,000 to promulgate new regulations.
6)One-time costs to local correctional facilities of at least
$125,000 to update security plans.
7)One-time costs to the Office of the Receiver of $100,000 to
promulgate new regulations.
8)Unknown, potentially significant, conservatively in the
hundreds of thousands of dollars, ongoing training costs for
state and local direct care staff in the correctional
facilities, to the extent that new standards required to be
adopted pursuant to this bill would specify new training
requirements. In addition, possible significant one-time
costs if the new standards required modifications to treatment
facility space or capital improvements.
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9)Cost pressure to the University of California's five medical
centers of approximately $1 million associated with new
training requirements of direct care staff.
10)In addition to direct costs listed, this bill creates
indirect cost pressure to the state and other purchasers of
health care by raising the total cost of hospital care by a
sum, likely in the range of millions of dollars statewide, due
to new security training requirements of direct care staff who
are not currently required to receive this training.
COMMENTS
1)Rationale . According to the author and sponsor of this bill,
the California Nurses Association (CNA), 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.
CNA maintains that several recent incidences 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 health care workers throughout the state.
2)Concerns . The California Hospital Association (CHA) indicates
concern about the cost of compliance with this bill. In
addition, they assert that the bill's provisions regarding the
necessity to treat employees who suffer from violent incidents
conflict with existing worker's compensation law and
oversight. The CHA, as well as state facilities subject to
this bill's requirements, have also noted that the definition
of assault for the purposes of reporting to DPH lacks
specificity.
3)Related Legislation . AB 1083 (John. A. Perez), Chapter 506,
Statutes of 2009, required hospital security and safety
assessments and plans to be conducted and updated annually,
required hospitals to consult with affected employees and
members of the medical staff in developing their security
plans and assessments and provided that hospital security
plans could additionally include efforts to cooperate with
local law enforcement regarding violent acts at a hospital
facility.
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Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081