BILL ANALYSIS �
AB 2399
Page 1
Date of Hearing: May 9, 2012
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 2399 (Allen) - As Amended: April 9, 2012
Policy Committee: HealthVote:10-0
Labor and Employment Vote: 5-0
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill requires updates to injury prevention plans and
requires incident reporting systems in state hospitals to meet
certain specifications. Specifically, this bill:
1)Requires each state hospital under the jurisdiction of the
Department of Mental Health to include safeguards to prevent
workplace safety hazards in its injury and illness prevention
plan, and to update its plan at least annually.
2)Specifies quarterly committee meetings to provide recommended
plan updates.
3)Requires plans to be submitted to the Legislature.
4)Requires each hospital to develop an incident reporting system
to report patient assaults on employees and identified risks
of patient assaults on employees.
5)Requires the incident reporting system to be widely accessible
to staff, and to provide immediate notification to management
of reported incidents and identified risks.
6)Requires the hospitals to provide for timely and efficient
responses and investigations to incident reports made under
the reporting system.
FISCAL EFFECT
1)Based on variation among hospitals, it is unclear precisely
what modifications or upgrades would be required of the
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existing incident reporting systems and related equipment, but
potential costs associated with changes appear to be fairly
minor given that these systems already exist. At least two of
five state hospitals have incident reporting systems that
appear to meet this bill's requirements.
2)Costs related to injury prevention plans and reports should be
minor and absorbable.
COMMENTS
1)Rationale . According to the author, current Injury and Illness
Prevention Plans at each of the five state hospitals fail to
adequately protect patients from the inherent workplace
hazards related to patient assaults. The author argues this
bill will require state hospitals to update their current
Injury and Illness Prevent Plans in an effort to better
protect employees from workplace safety hazards associated
with patient assaults.
2)Background . State hospitals have come under increasing
scrutiny based on high levels of aggression and violence that
has put staff at risk of injury and death. The author points
to recent media reports that highlight by the tragic death of
an employee in October of 2010 at Napa State Hospital and the
brutal beating of another employee just six week later at the
same facility. Data provided by DMH at the request of various
media outlets, as well as the Assembly Select Committee on
State Hospital Safety, have also helped document the increases
in violence.
The Department of Industrial Relations, the Division of
Occupational Safety and Health, (Cal/OSHA) requires, by
regulation, every employer to establish, implement, and
maintain an effective injury and illness prevention program.
Cal/OSHA's requirements depend on the types of work activities
employees perform and the specific hazards they may be exposed
to. State hospitals have been fined for failure to protect
workers from injuries related to patient assaults.
The provisions of the bill related to injury and illness
prevention plans generally reflect current practice at state
hospitals, but specifies that the plans should address
workplace safety hazards related to violent patient assaults,
which is not currently required.
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3)Current Practice: Incident Reporting Systems . State hospitals
currently have a variety of different reporting systems in
place that would satisfy at least some of the provisions of
this bill. Some are databases that can be queried and others
appear to be management summaries that are used on a
day-to-day basis but not formally tracked. At least two
hospitals use a comprehensive Wellness and Recovery Model
Support (WaRMSS) data system, which appears to meet most of
the requirements of this bill. A legal review of the
capabilities each hospital's system against the incident
reporting requirements of this bill would be necessary in
order to evaluate actual costs. Other, non-WaRMSS systems
used at certain hospitals do not always appear to allow
collection and reporting of "identified risks." There appear
to be alternate mechanisms for handling identified risks in
these cases, such as immediate intervention at the treatment
team/provider level or other (not incident-based) types of
reporting systems.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081