H-1860.1

SUBSTITUTE HOUSE BILL 1931

ByHouse Labor & Workplace Standards (originally sponsored by Representatives Leavitt, Kilduff, Volz, Cody, Caldier, Jinkins, Rude, Sells, Lekanoff, and Riccelli)

AN ACT Relating to workplace violence in health care settings; amending RCW 49.19.020, 49.19.030, and 49.19.040; reenacting and amending RCW 49.19.010; and providing an effective date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1. RCW 49.19.010 and 2007 c 414 s 3 and 2007 c 375 s 10 are each reenacted and amended to read as follows:

For purposes of this chapter:

(1) "Health care setting" means:

(a) Hospitals as defined in RCW 70.41.020;

(b) Home health, hospice, and home care agencies under chapter 70.127 RCW, subject to RCW 49.19.070;

(c) Evaluation and treatment facilities as defined in RCW 71.05.020; ((and))

(d) ((Community mental))Behavioral health programs as defined in RCW 71.24.025; and

(e) Ambulatory surgical facilities as defined in RCW 70.230.010.

(2) "Department" means the department of labor and industries.

(3) "Employee" means an employee as defined in RCW 49.17.020.

(4) "Workplace violence," "violence," or "violent act" means any physical assault or verbal threat of physical assault against an employee of a health care setting on the property of the health care setting. "Workplace violence," "violence," or "violent act" includes any physical assault or verbal threat of physical assault involving the use of a weapon, including a firearm as defined in RCW 9.41.010, or a common object used as a weapon, regardless of whether the use of a weapon resulted in an injury.

Sec. 2. RCW 49.19.020 and 1999 c 377 s 3 are each amended to read as follows:

(1) ((By July 1, 2000))Every three years, each health care setting shall develop and implement a plan to ((reasonably)) prevent and protect employees from violence at the setting. In a health care setting with a safety committee established pursuant to RCW 49.17.050 and related rules, or workplace violence committee that is comprised of employee-elected and employer-selected members where the number of employee-elected members equal or exceed the number of employer-selected members, that committee shall develop, implement, and monitor progress on the plan.

(2) The plan developed under subsection (1) of this section shall ((address))outline strategies aimed at addressing security considerations ((related to the following items, as appropriate to the particular setting, based upon the hazards identified in the assessment required under subsection (2) of this section))and factors that may contribute to or prevent the risk of violence, including but not limited to the following:

(a) The physical attributes of the health care setting, including security systems, alarms, emergency response, and security personnel available;

(b) Staffing, including ((security)) staffing patterns, patient classifications, and procedures to mitigate employees time spent alone working in areas at high risk for workplace violence;

(c) ((Personnel policies;))Job design, equipment, and facilities;

(d) First aid and emergency procedures;

(e) The reporting of violent acts; ((and))

(f) Employee education and training requirements and implementation strategy;

(h) Processes and expected interventions to provide assistance to an employee directly affected by a violent act.

(2) ((Before the development of the plan required under subsection (1) of this section,))Each health care setting shall ((conduct a security and safety assessment to identify existing or potential hazards for violence and determine the appropriate preventive action to be taken. The assessment shall include, but is not limited to, a measure of))annually review the frequency of((, and an))incidents of workplace violence including identification of the causes for and consequences of, violent acts at the setting ((during at least the preceding five years or for the years records are available for assessments involving home health, hospice, and home care agencies))and any emerging issues that contribute to workplace violence. The health care setting shall adjust the plan developed under subsection (1) of this section as necessary based on this annual review.

(3) In developing the plan required by subsection (1) of this section, the health care setting ((may))shall consider any guidelines on violence in the workplace or in health care settings issued by the department of health, the department of social and health services, the department of labor and industries, the federal occupational safety and health administration, medicare, and health care setting accrediting organizations.

Sec. 3. RCW 49.19.030 and 1999 c 377 s 4 are each amended to read as follows:

(1) By July 1, ((2001))2020, and on a regular basis thereafter, as set forth in the plan developed under RCW 49.19.020, each health care setting shall provide violence prevention training to all ((its affected))applicable employees, volunteers, and contracted security personnel, as determined by the plan.

(2) The training shall occur within ninety days of the employee's initial hiring date unless he or she is a temporary employee. ((For temporary employees, training would take into account unique circumstances.))

(3) The method and frequency of training may vary ((by))according to the information and strategies identified in the plan ((and))developed under RCW 49.19.020. Trainings may include, but ((is))are not limited to, classes that provide an opportunity for interactive questions and answers, hands on training, video training, ((videotapes,)) brochures, verbal training, or other verbal or written training that is determined to be appropriate under the plan. ((The))Trainings((shall))must address the following topics, as appropriate to the particular setting and to the duties and responsibilities of the particular employee being trained, based upon the hazards identified in the ((assessment))plan required under RCW 49.19.020:

(((1)))(a) The health care setting's workplace violence prevention plan;

(b) General safety procedures;

(((2) Personal safety procedures;

))(c) Violence predicting behaviors and factors;

(d) The violence escalation cycle;

(((4) Violence-predicting factors;

))(e) De-escalation techniques to ((de-escalate and)) minimize violent behavior;

(((7)))(f) Strategies to ((avoid))prevent physical harm with hands-on practice or role play;

(((8) Restraining techniques;

))(g) Response team processes;

(h) Proper application and use of ((medications as))restraints, both physical and chemical restraints;

(((10) Documenting))(i) Documentation and reporting incidents;

(((11)))(j) The debrief process ((whereby))for affected employees ((affected by a))following violent acts((may debrief)); and

(((12) Any))(k) Resources available to employees for coping with the effects of violence((; and

)).

Sec. 4. RCW 49.19.040 and 1999 c 377 s 5 are each amended to read as follows:

((Beginning no later than July 1, 2000,))Each health care setting shall keep a record of any violent act against an employee, a patient, or a visitor occurring at the setting. Each record shall be kept for at least five years following the act reported, during which time it shall be available for inspection by the department upon request. At a minimum, the record shall include:

(1) The health care setting's name and address;

(2) The date, time, and specific location at the health care setting where the act occurred;

(3) The name, job title, department or ward assignment, and staff identification or social security number of the victim if an employee;

(4) A description of the person against whom the act was committed as:

(a) A patient;

(b) A visitor;

(c) An employee; or

(d) Other;

(5) A description of the person committing the act as:

(a) A patient;

(b) A visitor;

(c) An employee; or

(d) Other;

(6) A description of the type of violent act as a:

(a) Threat of assault with no physical contact;

(b) Physical assault with contact but no physical injury;

(c) Physical assault with mild soreness, surface abrasions, scratches, or small bruises;

(d) Physical assault with major soreness, cuts, or large bruises;

(e) Physical assault with severe lacerations, a bone fracture, or a head injury; or

(f) Physical assault with loss of limb or death;

(7) An identification of any body part injured;

(8) A description of any weapon used;

(9) The number of employees in the vicinity of the act when it occurred; and

(10) A description of actions taken by employees and the health care setting in response to the act. ((Each record shall be kept for at least five years following the act reported, during which time it shall be available for inspection by the department upon request.))

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