S-0019

AN ACT Relating to prevention of workplace violence in health care settings; adding a new chapter to Title 49 RCW; creating a new section; and prescribing penalties.

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

NEW SECTION. Sec. 1. The legislature finds that:

(1) Violence is an escalating problem in many health care settings in this state and across the nation;

(2) Based on an analysis of workers' compensation claims, the department of labor and industries reports that health care workers face the highest rate of workplace violence in Washington state;

(3) The actual incidence of workplace violence in health care settings is likely to be greater than documented because of failure to report or failure to maintain records of incidents that are reported;

(4) Patients, visitors, and health care personnel should be assured a reasonably safe and secure environment in health care settings; and

(5) Many health care settings have undertaken efforts to attempt to assure that patients and workers are safe from violence, but additional personnel training and appropriate safeguards may be needed to prevent workplace violence and minimize the risk and dangers affecting people in health care settings.

NEW SECTION. Sec. 2. This chapter applies to the following health care settings:

(1) Acute care hospitals under chapter 70.41 RCW;

(2) Residential care facilities under chapter 18.20 RCW;

(3) Skilled nursing care facilities under chapter 18.51 RCW;

(4) Mental health clinics;

(5) Facilities for the developmentally disabled;

(6) Psychiatric hospitals and residential treatment facilities under chapter 71.12 RCW; and

(7) Nursing and personal care.

NEW SECTION. Sec. 3. (1) Health care settings subject to this chapter shall conduct a security and safety assessment and, using the assessment, develop and implement by July 1, 1998, an appropriate workplace violence prevention plan with measures to reasonably protect personnel, patients, and visitors from acts of violent behavior. The security and safety assessment shall examine trends of disruptive or violent behavior in the health care setting. The health care setting must track incidents of disruptive or violent behavior for the purpose of developing a workplace violence prevention plan to deter and manage further disruptive or violent acts. The workplace violence prevention plan shall include, but not be limited to, security considerations relating to the following:

(a) Physical layout of the health care setting;

(b) Staffing of the health care setting and security personnel availability;

(c) Adoption of security policies including, but not limited to, personnel training policies designed to protect personnel, patients, and visitors from disruptive or violent behavior. Persons regularly assigned to security functions in related or similar health care settings shall be trained regarding the role of security in health care setting operations, including the identification of disruptive and violent predicting factors, management of disruptive or violent disturbances, and appropriate responses to disruptive or violent acts; and

(d) Education and training of employees as appropriate for the particular setting.

(2) In developing the workplace violence prevention plan required under this section, the health care setting shall consider any guidelines or standards on violence 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.

(3) The health care setting's committee responsible for developing the workplace violence prevention plan shall include where reasonable, based upon the outcome of the assessment process, persons with expertise or experience in the following:

(a) The role of security in health care setting operations;

(b) The organization of health care settings;

(d) The handling of disruptive or violent patients, visitors, and employees;

(e) Identification of disruptive and violent predicting factors;

(f) Health care setting safety and emergency preparedness; and

(g) The rudiments of documenting and reporting incidents.

NEW SECTION. Sec. 4. (1) By July 1, 1999, and thereafter on a continuing basis as provided for in the workplace violence prevention plan developed under section 3 of this act, with the exception of individuals not considered employees under RCW 49.17.020, for whom training shall be discretionary, any personnel working in the health care setting, whether or not directly employed by the health care setting, shall receive violence prevention education and training related to the following topics that are reasonable under the circumstances, or relevant to their workplace, based upon the outcome of the assessment process:

(a) General safety procedures;

(b) Personal safety procedures;

(d) Disruptive indicators and violence-predicting factors;

(e) Obtaining patient history from a patient with violent behavior;

(f) Characteristics of disruptive and violent patients and victims;

(g) Verbal and physical techniques to deescalate and minimize violent behavior;

(h) Strategies to avoid physical harm;

(i) Restraining techniques;

(j) Appropriate use of medications as chemical restraints;

(k) The rudiments of documenting and reporting incidents;

(l) An opportunity for affected employees to debrief;

(m) Any resources available to employees for coping with incidents of violence; and

(n) The health care setting's workplace violence prevention plan.

(2) Establishment of a workplace violence prevention plan under this chapter is a standard of licensure or certification for the specified health care setting.

(3) Incidents of violence occurring in health care settings shall be monitored by the health care setting, and the number and type of such incidents shall be reported to the department of health.

(4) The health care settings shall report data established by rule for their workplace violence prevention plans to the department of health by July 1, 1998, and by each July 1st thereafter. The department shall determine data reporting requirements designed to enable analysis of the type, extent, and frequency of reportable incidents in order to evaluate the trends in workplace violence in health care settings and the effectiveness of violence prevention plans. The department shall compile the information from the reports and transmit the information in a report to the appropriate committees of the legislature by January 1, 2000.

(5) The department of health and the department of labor and industries shall cooperate in the reporting, data collection, and enforcement required under this chapter, including enforcement action for failure to establish a plan, by interagency agreement.

(6) Failure of a specified health care setting to establish a workplace violence prevention plan makes the health care setting subject to notice or citation under chapter 49.17 RCW.

NEW SECTION. Sec. 5. Employers needing assistance in the workplace violence assessment or the development and establishment of their plan may contact the federal secretary of labor or the state department of labor and industries for assistance. The departments of labor and industries, social and health services, and health shall coordinate their assistance to employers.

NEW SECTION. Sec. 6. The legislature recognizes that not all professional health care occurs in formal settings, such as hospitals. Many health care services are provided by home health agencies licensed under chapter 70.127 RCW. The legislature finds that it is inappropriate and impractical to require home health agencies to address workplace violence prevention in the same manner as other, facility-based, health care settings.

The legislature intends to require home health agencies to assess their own particular specialized violence-prevention needs, which may vary among agencies, and to develop workplace violence prevention plans customized for those needs, that contain only those elements set forth in sections 3 and 4 of this act as may be relevant to the professional work of the particular home health agency.

To the extent that they are relevant, the requirements of this chapter regarding assessing the workplace, developing and reporting a workplace violence prevention plan, and reporting to the department of health apply to home health agencies.

NEW SECTION. Sec. 7. Sections 2 through 6 of this act constitute a new chapter in Title 49 RCW.