BILL NUMBER: SB 718	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  SEPTEMBER 3, 2013
	AMENDED IN ASSEMBLY  JUNE 20, 2013
	AMENDED IN SENATE  MAY 15, 2013
	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.   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, as defined, against a hospital employee, 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
 , as specified,  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, as specified. The bill would also authorize the division to
assess a civil penalty against a hospital for failure to report a
violent incident, as specified. The bill would further require the
division to post on its Internet Web site a report regarding violent
incidents at hospitals, as specified, and to adopt 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) Except as provided in subdivision (n), as a part of
its injury prevention program required pursuant to Section 6401.7, a
hospital described in subdivision (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 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 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, 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) 
    6401.8.    (a)  A hospital  described in
subdivision (a), (b), or (f) of Section 1250 of the Health and Safety
Code  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) 
    (b)  (1) In addition to the reports required by Section
6409.1, a hospital shall document and keep for a period of five years
a written record of any violent incident against a hospital employee
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 record shall include, but not be limited to, the
date and time of the incident, 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 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 a violent incident pursuant to
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) 
    (c)  The division may, at its discretion, conduct an
inspection for any violent incident reported pursuant to subdivision
 (h)   (b)  . 
   (j) 
    (d)  Nothing in this section requiring recordkeeping and
reporting by an employer relieves the employer of the requirements
of Section 6410. 
   (k) 
    (e)  By January 1, 2015, and annually thereafter, the
division shall, in a manner that protects patient and employee
confidentiality, 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 pursuant to subdivision  (h),
  (b),  the outcome of any related inspection or
investigation, citations levied against a hospital based on a violent
incident, and recommendations on how to prevent violent incidents at
hospitals. 
   (  l  )
    (f)  By January 1, 2015, the division shall adopt
regulations to implement the provisions of this section. 
   (m) 
    (g)  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.

   (n) 
    (h)  This section shall 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.
  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.