Revision: March 8, 2016, midnight
\t \t\tSB 516-FN - AS INTRODUCED
2016 SESSION
\t16-2956
\t01/05
SENATE BILL\t516-FN
AN ACT\trelative to preventing violence in health care facilities.
SPONSORS:\tSen. Woodburn, Dist 1; Sen. Soucy, Dist 18; Sen. Hosmer, Dist 7; Sen. Watters, Dist 4; Sen. Kelly, Dist 10; Sen. Lasky, Dist 13; Sen. Feltes, Dist 15; Sen. Fuller Clark, Dist 21; Rep. Shurtleff, Merr. 11; Rep. Rosenwald, Hills. 30
COMMITTEE:\tHealth and Human Services
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ANALYSIS
\tThis bill requires certain licensed health care facilities to establish a violence prevention program and to annually conduct violence prevention training for its employees. This bill grants rulemaking authority to the commissioner of the department of health and human services for the purposes of the bill.
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Explanation:\tMatter added to current law appears in bold italics.
\t\tMatter removed from current law appears [in brackets and struckthrough.]
\t\tMatter which is either (a) all new or (b) repealed and reenacted appears in regular type.
\t16-2956
\t01/05
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Sixteen
AN ACT\trelative to preventing violence in health care facilities.
Be it Enacted by the Senate and House of Representatives in General Court convened:
\t1 New Subdivision; Violence Prevention Programs. Amend RSA 151 by inserting after section 46 the following new subdivision:
Violence Prevention Programs
\t151:47 Definitions: In this subdivision:
\t\tI. "Commissioner" means the commissioner of the department of health and human services.
\t\tII. “Covered health care facility” means a general or special hospital, a nursing home, a state or county psychiatric hospital, or a state developmental center licensed under this chapter.
\t\tIII. “Health care worker” means a person who is employed by a covered health care facility.
\t\tIV. “Violence” or “violent act” means a physical assault, or any physical or credible verbal threat of assault or harm against a health care worker.
\t151:48 Violence Prevention Programs Required.
\t\tI. Within 6 months of the effective date of this subdivision, a covered health care facility shall establish a violence prevention program for the purpose of protecting health care workers. The program shall, at a minimum, include the following requirements:
\t\t\t(a) The covered health care facility shall establish a violence prevention committee, which shall include a representative of management, or designee, who shall be responsible for overseeing all aspects of the program. At least 50 percent of the members of the committee shall be health care workers who provide direct patient care or otherwise have direct contact with patients. In a covered health care facility or health care system where health care workers are represented by one or more collective bargaining agents, the management of the facility shall consult with the applicable collective bargaining agents regarding the selection of the health care worker committee members. The remaining committee members shall have experience, expertise, or responsibility relevant to violence prevention.
\t\t\t(b) In a health care system that owns or operates more than one covered health care facility, the violence prevention program and the committee may be operated at the system or department level provided that:
\t\t\t\t(1) The committee membership includes at least one health care worker from each facility in the system who provides direct care to patients;
\t\t\t\t(2) The committee develops a violence prevention plan for each facility; and
\t\t\t\t(3) Data related to violence prevention remains distinctly identifiable for each facility.
\t\tII. Within 18 months of the effective date of this chapter, the committee shall develop and maintain a detailed, written violence prevention plan that identifies workplace risks and provides specific methods to address such risks. The plan shall, at a minimum:
\t\t\t(a) Provide an annual comprehensive violence risk-assessment for the covered health care facility that considers, to the extent applicable:
\t\t\t\t(1) The facility’s layout, access restrictions, crime rate in surrounding areas, lighting, communication and alarm devices.
\t\t\t\t(2) Impact of staffing, including security personnel.
\t\t\t\t(3) The presence of individuals who pose a risk of violence.
\t\t\t\t(4) A review of any records relating to violent incidents at the facility, including incidents required to be reported pursuant to RSA 151:49, III, the Occupational Safety and Health Administration Log of Work-Related Injuries and Illnesses, and workers’ compensation records.
\t\t\t(b) Identify violence prevention policies.
\t\t\t(c) Specify methods to reduce identifiable risks, including training, and changes to job design, staffing, security, equipment, and facility modifications.
\t\tIII. The covered health care facility shall make a copy of the plan available, upon request, to the commissioner for on-site inspection, and upon request, to each health care worker and collective bargaining agent that represents health care workers at the facility, except that in the event the committee determines that the plan contains information that would pose a threat to security if made public, any such information shall be excluded before being provided to workers or collective bargaining agents.
\t151:49 Violence Prevention Training. Covered health care facilities shall:
\t\tI. Annually conduct violence prevention training. The training shall include a review of the facilities relevant policies, techniques to de-escalate and minimize violent behavior, appropriate responses to workplace violence in health care settings, including use of restraining techniques, reporting requirements and procedures, location and operation of safety devices, and resources for coping with violence.
\t\tII. Have personnel sufficiently trained to identify aggressive and violent predicting factors and the ability to appropriately respond to and manage incidents of violence.
\t\tIII. Keep a record of all violent acts against employees while at work. The records shall be maintained for at least 5 years following the reported act, during which time employees, their authorized representatives, and the commissioners shall have access to the record. The record shall include:
\t\t\t(a) The date, time, and location of the incident.
\t\t\t(b) The identity and job title of the victim, except that the victim’s identity shall not be included if it would not be entered on the Occupational Safety and Health Administration Log of Work-Related Injuries and Illnesses because it is a privacy concern under OSHA.
\t\t\t(c) Whether the act was committed by a patient, visitor, or employee.
\t\t\t(d) The nature of the violent act, including whether a weapon was used.
\t\t\t(e) A description of physical injuries, if any.
\t\t\t(f) The number of employees in the vicinity when the incident occurred and their reactions in response to the incident, if any.
\t\t\t(g) The actions taken by the facility in response to the incident.
\t\tIV. Establish a post-incident response system that provides, at a minimum, an in-house crisis response team for employee-victims and their co-workers, and individual and group crisis counseling, which may include support groups, family crisis intervention, and professional referrals.
\t151:50 Retaliatory Action Prohibited. A covered health care facility shall not take any retaliatory action against any health care worker for reporting violent incidents.
\t151:51 Penalties. Any covered health care facility which violates the provisions of this subdivision shall be subject to disciplinary action under the chapter and any other appropriate sanctions under this chapter.
\t2 New Subparagraph; Violence Prevention Programs; Rulemaking. Amend RSA 151:9, I by inserting after subparagraph (o) the following new subparagraph:
\t\t\t(p) Procedures for establishing violence prevention programs pursuant to RSA 151:47 - 151:51.
\t3 Effective Date. This act shall take effect January 1, 2017.
\t\t\t\t\t\t\t\t\t\t\t16-2956
\t\t\t\t\t\t\t\t\t\t\t1/25/16
SB 516-FN- FISCAL NOTE
AN ACT\trelative to preventing violence in health care facilities.
FISCAL IMPACT:
The Judicial Branch and New Hampshire Association of Counties state this bill, as introduced, will increase state expenditures by an indeterminable amount and may increase county expenditures by $8,640 in FY 2017 and each year thereafter. There will be no impact on local expenditures, or on state, county, or local revenue.
METHODOLOGY:
The Judicial Branch states this bill requires certain health and residential facilities licensed under RSA 151 to establish violence prevention committees and develop violence prevention programs. The bill also requires such facilities to conduct annual violence prevention training, and keep a record of all violent acts committed against facility staff while on the job. The bill imposes criminal penalties which may have the following impact upon the Branch:
| FY 2017 | FY 2018 |
Violation Level Offense | $48 | $51 |
Class B Misdemeanor | $50 | $53 |
Class A Misdemeanor | $70 | $74 |
Routine Criminal Felony Case | $449 | $470 |
Appeals | Varies | Varies |
It should be noted average case cost estimates for FY 2017 and FY 2018 are based on data that is more than ten years old and does not reflect changes to the courts over that same period of time or the impact these changes may have on processing the various case types. | ||
The New Hampshire Association of Counties states this bill requires counties with assisted living facilities to establish violence prevention programs. The Association estimates the related cost at $8,640 per year (three counties with assisted living facilities * an estimated cost of $2,880 per county, based on an assumption of $30 per hour, eight hours per month, and 12 months per year.)
The Department of Health and Human Services and the Department of Justice state this bill will have no fiscal impact.