BILL NUMBER: SB 718	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 4, 2013

INTRODUCED BY   Senator Yee

                        FEBRUARY 22, 2013

   An act to add Section 6401.8 to the Labor Code, relating to
employment safety.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 718, as amended, Yee. Hospitals: workplace violence prevention
plan.
   Existing law regulates the operation of health facilities,
including hospitals.
   Existing law, the California Occupational Safety and Health Act of
1973, imposes safety responsibilities on employers and employees,
including the requirement that an employer establish, implement, and
maintain an effective injury prevention program, and makes specified
violation of these provisions a crime.
   This bill would require a hospital, as specified, as a part of its
injury prevention program and in conjunction with affected
employees, to adopt a workplace violence prevention plan designed to
protect health care workers, other facility personnel, patients, and
visitors from aggressive or violent behavior. As part of that plan,
the bill would require a hospital to adopt safety and security
policies, including, among others, a system for the reporting to the
Division of Occupational Safety and Health of any  violent 
incident  of assault, as defined, or battery  , as
defined, against a hospital employee  or patient  ,
as specified. The bill would further require all medical staff and
health care workers who provide direct care to patients to receive,
at least annually, workplace violence prevention education and
training, as specified. The bill would prohibit a hospital from
preventing an employee from, or taking punitive or retaliatory action
against an employee for, seeking assistance and intervention from
local emergency services or law enforcement for a violent incident.
The bill would also require a hospital to provide evaluation and
treatment, as specified, for an employee who is injured or is
otherwise a victim of a violent incident.
   The bill would require a hospital to  document and keep for 5
years a written record of all violent incidents against a hospital
employee, as defined, and to  report to the division any 
violent  incident  of assault, as defined, or battery,
as defined, against a hospital employee or patient , as
specified  , and   . The bill  would 
also  authorize the division to assess a civil penalty against a
hospital for failure to report  an   a violent
 incident, as specified. The bill would further require the
division to report to the relevant fiscal and policy committees of
the Legislature information regarding  violent  incidents
 of violence  at hospitals, as specified  , and
to develop regulations implementing these provisions by January 1,
2015  .
   Because this bill would expand the scope of a crime, the bill
would impose a state-mandated local program.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 6401.8 is added to the Labor Code, to read:
   6401.8.  (a) As a part of its injury prevention program required
pursuant to Section 6401.7, a hospital licensed pursuant to
subdivisions (a), (b), or (f) of Section 1250 of the Health and
Safety Code shall adopt a workplace violence prevention plan designed
to protect health care workers, other facility personnel, patients,
and visitors from aggressive or violent behavior. The plan shall
include, but not be limited to, security considerations relating to
all of the following:
   (1) Physical layout.
   (2) Staffing, including staffing patterns and patient
classification systems that contribute to the risk of violence or are
insufficient to address the risk of violence.
   (3) The adequacy of facility security systems, protocols, and
policies, including, but not limited to, security personnel
availability  and employee alarm systems  .
   (4) Potential security risks associated with specific units or
areas within the facility where there is a greater likelihood that a
patient or other person may exhibit violent behavior.
   (5) Uncontrolled public access to any part of the facility.
   (6) Potential security risks related to working late night or
early morning hours.
   (7) Employee security in areas surrounding the facility,
including, but not limited to, employee parking areas.
   (8) The use of a trained response team that can assist employees
in violent situations.
   (9) Policy and training related to appropriate responses to
violent acts.
   (10) Efforts to cooperate with local law enforcement regarding
violent acts in the facility.
   (b) As part of its workplace violence prevention plan, a hospital
shall adopt safety and security policies, including, but not limited
to, all of the following:
   (1) Personnel training policies designed to protect personnel,
patients, and visitors from aggressive or violent behavior, including
education on how to recognize the potential for violence, how and
when to seek assistance to prevent or respond to violence, and how to
report  violent  incidents  of violence 
to the appropriate law enforcement officials.
   (2) A system for responding to  violent  incidents and
situations involving violence or the risk of violence, including, but
not limited to, procedures for rapid response by which an employee
is provided with immediate assistance if the threat of violence
against that employee appears to be imminent, or if a violent act has
occurred or is occurring.
   (3) A system for investigating violent incidents and situations
involving violence or the risk of violence. When investigating these
incidents, the hospital shall interview any employee involved in the
incident or situation.
   (4) A system for reporting, monitoring, and recordkeeping of
violent incidents and situations involving the risk of violence.
   (5) A system for reporting  violent  incidents 
of violence  to the division pursuant to subdivision (h).
   (6) Modifications to job design, staffing, security, equipment, or
facilities as determined necessary to prevent or address violence
against hospital employees.
   (c) The plan shall be developed in conjunction with affected
employees, including their recognized collective bargaining agents,
if any. Individuals or members of a hospital committee responsible
for developing the security plan shall be familiar with hospital
safety and security issues, as well as the identification of
aggressive and violent predicting factors. In developing the
workplace violence prevention plan, the hospital shall consider
guidelines or standards on violence in health care facilities issued
by the division, the federal Occupational Safety and Health
Administration, and, if available, the State Department of Public
Health.
   (d) All medical staff and health care workers who provide direct
care to patients shall, at least annually, receive workplace violence
prevention education and training that is designed in such a way as
to provide an opportunity for interactive questions and answers with
a person knowledgeable about the workplace violence prevention plan,
and that includes, but is not limited to, the following topics:
   (1) General safety measures.
   (2) Personal safety measures.
   (3) The assault cycle.
   (4) Aggression and violence predicting factors.
   (5) Obtaining patient history from a patient with violent
behavior.
   (6) Characteristics of aggressive and violent patients and
victims.
   (7) Verbal and physical maneuvers to diffuse and avoid violent
behavior.
   (8) Strategies to avoid physical harm.
   (9) Restraining techniques.
   (10) Appropriate use of medications as chemical restraints.
   (11) Any resources available to employees for coping with 
violent  incidents  of violence  , including,
by way of example, critical incident stress debriefing or employee
assistance programs.
   (e) All temporary personnel shall be oriented to the workplace
violence prevention plan.
   (f) A hospital shall provide evaluation and treatment for an
employee who is injured or is otherwise a victim of a violent
incident and shall, upon the request of the employee, provide access
to followup counseling to address trauma or distress experienced by
the employee, including, but not limited to, individual crisis
counseling, support group counseling, peer assistance, and
professional referrals.
   (g) A hospital shall not prohibit an employee from, or take
punitive or retaliatory action against an employee for, seeking
assistance and intervention from local emergency services or law
enforcement when a violent incident occurs.
   (h) (1)  A   In addition to the reports
required by Section 6409.1, a  hospital shall  report to
the division any incident of assault, as defined in Section 240 of
the Penal Code, or battery, as defined in Section 242 of the Penal
Code,   document and keep for a period of five years a
written record of any violent incident  against a hospital
employee  or patient that is committed by a patient or a
person accompanying a patient   immediately after the
incident is reported by that employee or any other employee to a
manager, supervisor, or other hospital administrator. The hospital
shall document and keep a written record of all violent incidents,
regardless of whether the employee sustains an injury  . This
 report   record  shall include, but not be
limited to, the date and time of the incident  , whether the
victim was a hospital employee or a patient  , the unit in
which the incident occurred, a description of the circumstances
surrounding the incident, and the hospital's response to the
incident.
   (2) A hospital shall report  an incident to which
paragraph (1) applies  to the division within 72 hours 
the information recorded pursuant to paragraph (1) regarding a
violent incident  . If the incident results in  physical
 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 the division within 24 hours.
   (3) If a hospital fails to report  an   a
violent incident  of assault or battery 
pursuant to  subdivision (f)   paragraph (2)
 , the division may assess a civil penalty against the hospital
in an amount not to exceed one hundred dollars ($100) per day for
each day that the incident is not reported following the initial
72-hour or 24-hour period, as applicable pursuant to paragraph (2).

   (i) The division may, at its discretion, conduct an inspection for
any violent incident reported pursuant to subdivision (h). 

   (j) Nothing in this section requiring recordkeeping and reporting
by an employer relieves the employer of the requirements of Section
6410.  
   (i) 
    (k)  (1) By January 1, 2015, and annually thereafter,
the division shall report to the relevant fiscal and policy
committees of the Legislature, in a manner that protects patient and
employee confidentiality, information regarding  violent 
incidents  of violence  at hospitals, that includes,
but is not limited to, the total number of reports and which
specific hospitals filed reports pursuant to subdivision (h), the
outcome of any related inspection or investigation, citations levied
against a hospital based on  an   a violen 
 t  incident  of workplace violence  , and
recommendations on how to prevent  violent  incidents
 of workplace violence  at hospitals.
   (2) The requirement for submitting a report imposed pursuant to
this subdivision is inoperative on January 1, 2019, pursuant to
Section 10231.5 of the Government Code.
   (3) A report to be submitted pursuant to this subdivision shall be
submitted in compliance with Section 9795 of the Government Code.

   (l  ) By January 1, 2015, the division shall adopt
regulations to implement the provisions of this section. 
   (m) For purposes of this section, "violent incident" shall
include, but not be limited to, the following:  
   (1) 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. 

   (2) An incident involving the use of a firearm or other dangerous
weapon, regardless of whether the employee sustains an injury. 
  SEC. 2.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.