[atlas:bill]

AN ACT Relating to prevention of workplace violence in health care settings; adding a new section to chapter 70.41 RCW; adding a new section to chapter 5.40 RCW; 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 employees 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 employees should be assured a reasonably safe and secure environment in health care settings; and

(5) Many health care settings have undertaken efforts to assure that patients, visitors, and employees 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. 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 section 8 of this act;

(d) Community mental health programs as defined in RCW 71.24.025(8).

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

(3) "Employee" means an individual who is regularly employed in a health care setting whether by way of manual labor or otherwise, but does not include an individual who is employed sporadically or temporarily.

(4) "Violence" or "violent act" means any physical assault or verbal threat of physical assault against an employee of a health care setting.

NEW SECTION. Sec. 3. (1) By July 1, 2000, each health care setting shall develop and implement a plan to reasonably prevent and protect employees from violence at the setting. The plan shall address 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:

(a) The physical attributes of the health care setting, including design and engineering features;

(b) Staffing, including security staffing;

(d) First aid and emergency procedures;

(e) The reporting of violent acts; and

(f) Employee education and training.

(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 the frequency of, and an 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.

(3) In developing the plan required by subsection (1) of this section, the health care setting 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.

NEW SECTION. Sec. 4. By July 1, 2001, and on a regular basis thereafter, as set forth in the plan developed under section 3 of this act, each health care setting shall provide violence prevention training to all its employees. The training shall 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 required under section 3 of this act:

(1) General safety procedures;

(2) Personal safety procedures;

(3) The violence escalation cycle;

(4) Violence-predicting factors;

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

(6) Verbal and physical techniques to de-escalate and minimize violent behavior;

(7) Strategies to avoid physical harm;

(8) Restraining techniques;

(9) Appropriate use of medications as chemical restraints;

(10) Documenting and reporting incidents;

(11) The process whereby employees affected by a violent act may debrief;

(12) Any resources available to employees for coping with violence; and

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

NEW SECTION. Sec. 5. 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. 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;

(d) Other;

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

(a) A patient;

(b) A visitor;

(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;

(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.

NEW SECTION. Sec. 6. Failure of a health care setting to comply with this chapter shall subject the setting to citation under chapter 49.17 RCW. The department of health and the department of social and health services shall cooperate with the department in the enforcement of this chapter.

NEW SECTION. Sec. 7. A health care setting needing assistance to comply with this act may contact the federal department of labor or the state department of labor and industries for assistance. The state departments of labor and industries, social and health services, and health shall coordinate their assistance to health care settings.

NEW SECTION. Sec. 8. It is the intent of the legislature that any violence protection and prevention plan developed under this chapter be appropriate to the setting in which it is to be implemented. To that end, the legislature recognizes that not all professional health care is provided in a facility or other formal setting, such as a hospital. Many services are provided by home health, hospice, and home care agencies. The legislature finds that it is inappropriate and impractical for these agencies to address workplace violence in the same manner as other, facility-based, health care settings. When enforcing this chapter as to home health, hospice, and home care agencies, the department shall allow agencies sufficient flexibility in recognition of the unique circumstances in which these agencies deliver services.

NEW SECTION. Sec. 9. A new section is added to chapter 70.41 RCW to read as follows:

(1) In complying with chapter 49.-- RCW (sections 2 through 8 of this act), a hospital, including a public hospital district, may prohibit any person from carrying a weapon on hospital premises. A hospital may adopt a policy prohibiting weapons and procedures to effectuate the policy. The procedure may include reasonable steps to notify, warn, and if reasonably necessary, disarm persons who enter the hospital premises carrying a weapon, including removal of the person from the premises or taking custody of the weapon until the person leaves the premises. Law enforcement and security personnel may be exempted from this policy. Weapons that may be prohibited include, but are not limited to, weapons listed in RCW 9.41.280(1).

(2) If a hospital prohibits weapons on hospital premises, it shall post signs indicating such throughout the premises.

(3) This section does not give rise to a cause of action against a hospital or public hospital district for either prohibiting or not prohibiting weapons on hospital premises. The standard of liability for a hospital or public hospital district in any cause of action arising from injuries received due to the presence of weapons on the hospital or public hospital district premises shall be the same whether or not the hospital or public hospital district has prohibited weapons.

NEW SECTION. Sec. 10. A new section is added to chapter 5.40 RCW to read as follows:

In any cause of action, whether based in tort, contract or otherwise, for damages arising from injury or death that is against a hospital licensed under chapter 70.41 RCW or a public hospital district authorized under chapter 70.44 RCW, evidence of the hospital or public hospital district prohibiting or not prohibiting weapons on premises is not admissible to prove liability for the injury.

NEW SECTION. Sec. 11. Sections 2 through 8 of this act constitute a new chapter in Title 49 RCW.