Calif. Hospital Violence Bill Sent to Governor

By Roy Maurer Sep 8, 2014
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Editor's Note: Gov. Brown signed Senate Bill 1299 Sept. 29, 2014.

California Senate Bill 1299 requiring hospitals to establish comprehensive workplace violence prevention programs was sent to the governor’s office for signature Aug. 28, 2014. According to the bill’s backers, “violent attacks at California hospitals underscore the need for more health care worker protections.”

Hospitals are some of the most hazardous places to work. According to the U.S. Bureau of Labor Statistics, hospital workers have an estimated rate of 8.3 assaults per 10,000 workers compared to an estimated two assaults per 10,000 workers in the overall work environment.

“Health care workers have long been recognized as having a high risk of work-related assault, and nurses are at particularly high risk with the highest rate of victimization among occupations in the health care industry,” said California Sen. Alex Padilla, D-Pacoima, and the sponsor of the bill.

The legislation was introduced after nurses were wounded in two separate stabbings at Los Angeles-area hospitals in April 2014. “Anyone who has worked in a hospital setting recognizes that you never know who is going to walk through the doors, and in what state of mind,” said Padilla. “These recent attacks demonstrate that we must do a better job of protecting patients, visitors and personnel from violence, and make California hospitals as safe as possible.”

The bill would require hospitals to establish workplace violence prevention plans that include:

Systems for investigating and responding to incidents of workplace violence.

Systems to assess and address factors that contribute to violence, including security and staffing levels, security risks associated with specific units, facility access, and security in areas surrounding the facility such as employee parking lots.

Education and training programs to help employees identify and respond to workplace violence, and resources available to employees who are victims of violence.

Requirements for hospitals to document and report incidents of violence to the California Division of Occupational Safety and Health (Cal/OSHA).

Provisions prohibiting retaliation against employees who seek help from law enforcement.

The bill would also require Cal/OSHA to post a report on its website detailing workplace violence at hospitals and make recommendations on how to prevent such incidents.

Padilla cited a 2007 report commissioned by the National Institute for Occupational Safety and Health that found that among California hospitals:

Hospital security was often uncoordinated and insufficient.

Employee training programs rarely included review of violence trends.

Few hospitals had effective systems to communicate about the presence of violent patients.

Security programs and training were often less complete in psychiatric units than in emergency departments. Current law only requires hospitals to establish workplace violence prevention plans for emergency room departments and areas which they deem high risk. Safety and security training is only required for the staff assigned to these departments and areas.

“This bill requires hospitals to establish such plans for all areas where patients are provided care and requires standards, like training for all staff providing care to patients,” Padilla said.

The California Hospital Association (CHA) opposes the bill as unnecessary, arguing that current law already requires hospitals to implement workplace violence prevention plans, Cal/OSHA already has jurisdiction to investigate, remedy and enforce situations involving workplace violence, and the California Department of Public Health already reviews the adequacy of these plans.

The CHA argues that requiring training for all direct patient care employees rather than only those in high risk areas, creates a “significant unfunded mandate without any evidence of a corresponding benefit.”

Finally, opponents believe that this bill is duplicative of current efforts already underway at Cal/OSHA, where workplace violence regulations are being developed.

Roy Maurer is an online editor/manager for SHRM.

Follow him @SHRMRoy

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