HB0399 94TH GENERAL ASSEMBLY

LRB094 05629 DRJ 36444 b

94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
HB0399

Introduced 1/25/2005, by Rep. Lou Lang

SYNOPSIS AS INTRODUCED:

New Act
30 ILCS 5/3-2	from Ch. 15, par. 303-2

Creates the Health Care Setting Violence Prevention Act. Requires health care settings, including hospitals, mental health evaluation and treatment facilities, community mental health programs, home health agencies, and hospice programs, by July 1, 2006, to adopt and implement a plan to reasonably prevent and protect employees from violence at the setting. Requires a health care setting to file copies of its plan, and copies of changes to the plan, with the Department of Labor and the Department of Human Services. Requires a review of the plan at least once every 3 years. Requires health care settings to provide violence prevention training to employees by July 1, 2007. Requires health care settings to keep records of violent acts against an employee, a patient, or a visitor and to forward copies of such records to the Department of Labor and the Department of Human Services. Provides for enforcement of the Act by the Department of Labor, and authorizes the Director of Labor to issue an order for correction to a health care setting fixing a time for abatement of a violation. Amends the Illinois State Auditing Act. Requires that the Auditor General's audits of certain mental health and developmental disabilities facilities under the jurisdiction of the Department of Human Services include their records concerning reports of suspected abuse of facility staff by facility residents or patients. Effective immediately.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning employment.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 1. Short title. This Act may be cited as the Health Care Setting Violence Prevention Act.

Section 5. Findings. The General Assembly finds as follows:

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

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

(3) Patients, visitors, and health care employees should be assured a reasonably safe and secure environment in health care settings.

(4) Many health care settings have undertaken efforts to ensure 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.

Section 10. Definitions. In this Act:

"Department" means the Department of Labor.

"Director" means the Director of Labor.

"Employee" means any individual who is employed on a full-time, part-time, or contractual basis by a health care setting.

"Evaluation and treatment facility" means any facility that can provide directly, or by direct arrangement with other public or private agencies, emergency evaluation and treatment, outpatient care, and timely and appropriate inpatient care to persons suffering from a mental disorder, and that is recognized as such by the Department of Human Services. The term may include a physically separate and separately operated portion of a State mental health facility. The term does not include a correctional institution or facility or jail.

"Health care setting" means any of the following:

(1) A public or private hospital licensed under the Hospital Licensing Act or a hospital organized under the University of Illinois Hospital Act.

(2) A facility under the jurisdiction of the Department of Human Services described in Section 4 of the Mental Health and Developmental Disabilities Administrative Act.

(3) A public or private evaluation and treatment facility.

(4) A community mental health facility established under the Community Mental Health Act.

(5) A public or private home health agency licensed under the Home Health Agency Licensing Act.

(6) A public or private hospice program licensed under the Hospice Program Licensing Act.

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

Section 15. Workplace violence plan.

(a) By July 1, 2006, every health care setting must adopt and implement a plan to reasonably prevent and protect employees from violence at the setting. The plan must address security considerations related to the following items, as appropriate to the particular setting, based on the hazards identified in the assessment required under subsection (b):

(1) The physical attributes of the health care setting.

(2) Staffing, including security staffing.

(3) Personnel policies.

(4) First aid and emergency procedures.

(5) The reporting of violent acts.

(6) Employee education and training.

(b) Before adopting the plan required under subsection (a), a health care setting must 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 must include, but need not be 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 5 years or for the years for which records are available for assessments involving home health agencies or hospice programs.

(c) In adopting the plan required by subsection (a), a health care setting may consider any guidelines on violence in the workplace or in health care settings issued by the Department of Public Health, the Department of Human Services, the Department of Labor, the federal Occupational Safety and Health Administration, Medicare, and health care setting accrediting organizations.

(d) Promptly after adopting a plan under subsection (a), a health care setting must file copies of its plan with the Department of Labor and with the Department of Human Services.

(e) A health care setting must review its plan at least once every 3 years and must report each such review to the Department of Labor and to the Department of Human Services, together with any changes to the plan adopted by the health care setting. If a health care setting does not adopt any changes to its plan in response to such a review, it must report that fact to each department. A health care setting must promptly report to the Department of Labor and to the Department of Human Services all changes to the health care setting's plan, regardless of whether those changes were adopted in response to a periodic review required under this subsection.

Section 20. Violence prevention training. By July 1, 2007, and on a regular basis thereafter, as set forth in the plan adopted under Section 15, a health care setting must provide violence prevention training to all its affected employees as determined by the plan. Unless an affected employee is a temporary employee, the training must occur (i) within 90 days after the effective date of this Act, in the case of an employee who is employed on that effective date, and (ii) within 90 days after the employee's term of employment begins, in the case of an employee who is hired after that effective date. For temporary employees, training must take into account unique circumstances. A health care setting also shall provide periodic follow-up training for its employees as appropriate. The training may vary by the plan and may include, but need not be limited to, classes, videotapes, brochures, verbal training, or other verbal or written training that is determined to be appropriate under the plan. The training must address the following topics, as appropriate to the particular health care setting and to the duties and responsibilities of the particular employee being trained, based on the hazards identified in the assessment required under Section 15:

(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 a history of 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 of violence.

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

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

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

Section 25. Record of violent acts.

(a) Beginning no later than July 1, 2006, every health care setting must keep a record of any violent act against an employee, a patient, or a visitor occurring at the setting. At a minimum, the record must include the following:

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

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

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

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

(A) A patient.

(B) A visitor.

(C) An employee.

(D) Other.

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

(A) A patient.

(B) A visitor.

(C) An employee.

(D) Other.

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

(A) A threat of assault with no physical contact.

(B) A physical assault with contact but no physical injury.

(C) A physical assault with mild soreness, surface abrasions, scratches, or small bruises.

(D) A physical assault with major soreness, cuts, or large bruises.

(E) A physical assault with severe lacerations, a bone fracture, or a head injury.

(F) A 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 violent act when it occurred.

(10) A description of actions taken by employees and the health care setting in response to the violent act.

(b) A health care setting must periodically forward copies of each such record of a violent act to the Department of Labor and to the Department of Human Services and other appropriate State agencies, as determined by the Department of Labor in rules.

(c) Each record must be kept for at least 5 years following the violent act reported. During that time, the record must be available for inspection by the Department upon request and must be made available to the General Assembly upon request.

Section 30. Assistance in complying with Act. A health care setting needing assistance in complying with this Act may contact the federal Department of Labor or the Illinois Department of Labor for assistance. The Illinois departments of Labor, Human Services, and Public Health shall collaborate with representatives of health care settings to develop technical assistance and training seminars on developing and implementing a workplace violence plan as required under Section 15. Those departments shall coordinate their assistance to health care settings.

Section 35. Noncompliance with Act; order for correction.

(a) A health care setting that violates this Act or the rules implementing this Act is subject to an order for correction as provided in this Section.

(b) Upon inspection or investigation, if the Director or his or her authorized representative believes that a health care setting has violated any requirement of this Act or the rules implementing this Act, the Director, with reasonable promptness, shall issue an order for correction to the health care setting. The order for correction must be in writing and must describe with particularity the nature of the violation, including a reference to the provisions of this Act or rules of the Department alleged to have been violated. In addition, the order for correction must fix a reasonable time for the abatement of the violation. The Director may prescribe procedures for the issuance of a notice in lieu of an order for correction with respect to de minimis violations that have no direct or immediate relationship to safety or health.

(c) An order for correction, or a copy or copies of an order for correction, issued under the authority of this Section must be prominently posted on the health care setting's premises or as otherwise prescribed in rules adopted by the Director. The Director shall provide by rule for procedures to be followed by an employee representative upon written application to receive copies of orders for correction and notices issued to any health care setting having employees who are represented by that employee representative. The rule may prescribe the form of such an application, the time for renewal of applications, and the eligibility of the applicant to receive copies of orders for correction and notices.

(d) An order for correction may not be issued under this Section after the expiration of 6 months following a compliance inspection, investigation, or survey revealing a violation of this Act or the rules implementing this Act.

(e) An order for correction may not be issued under this Section if unpreventable employee misconduct led to the violation, but in that case the health care setting must show the existence of all of the following:

(1) A thorough safety program, including work rules, training, and equipment designed to prevent the violation.

(2) Adequate communication of these rules to employees.

(3) Steps to discover and correct violations of its safety rules.

(4) Effective enforcement of its safety program as written in practice and not just in theory.

This subsection (e) does not eliminate or modify any other defenses that may exist to an order for correction.

(f) It is the intent of the General Assembly that any violence protection and prevention plan developed under this Act be appropriate to the setting in which it is to be implemented. To that end, the General Assembly 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 agencies or hospice programs. The General Assembly finds that it is inappropriate and impractical for these agencies and programs to address workplace violence in the same manner as other, facility-based, health care settings. When enforcing this Act with respect to a home health agency or hospice program, the Department shall allow the agency or program sufficient flexibility in recognition of the unique circumstances in which the agency or program delivers services.

Section 40. Rules. The Department shall adopt rules to implement this Act.

Section 90. The Illinois State Auditing Act is amended by changing Section 3-2 as follows:

(30 ILCS 5/3-2) (from Ch. 15, par. 303-2)

Sec. 3-2. Mandatory and directed post audits. The Auditor General shall conduct a financial audit, a compliance audit, or other attestation engagement, as is appropriate to the agency's operations under generally accepted government auditing standards, of each State agency except the Auditor General or his office at least once during every biennium, except as is otherwise provided in regulations adopted under Section 3-8. The general direction and supervision of the financial audit program may be delegated only to an individual who is a Certified Public Accountant and a payroll employee of the Office of the Auditor General. In the conduct of financial audits, compliance audits, and other attestation engagements, the Auditor General may inquire into and report upon matters properly within the scope of a performance audit, provided that such inquiry shall be limited to matters arising during the ordinary course of the financial audit.

In any year the Auditor General shall conduct any special audits as may be necessary to form an opinion on the financial statements of this State, as prepared by the Comptroller, and to certify that this presentation is in accordance with generally accepted accounting principles for government.

Simultaneously with the biennial compliance audit of the Department of Human Services, the Auditor General shall conduct a program audit of each facility under the jurisdiction of that Department that is described in Section 4 of the Mental Health and Developmental Disabilities Administrative Act. The program audit shall include an examination of the records of each facility concerning (i) reports of suspected abuse or neglect of any patient or resident of the facility and (ii) reports of suspected abuse of facility staff by patients or residents. The Auditor General shall report the findings of the program audit to the Governor and the General Assembly, including findings concerning patterns or trends relating to (i) abuse or neglect of facility patients and residents or (ii) abuse of facility staff. However, for any year for which the Inspector General submits a report to the Governor and General Assembly as required under Section 6.7 of the Abused and Neglected Long Term Care Facility Residents Reporting Act, the Auditor General need not conduct the program audit otherwise required under this paragraph.

The Auditor General shall conduct a performance audit of a State agency when so directed by the Commission, or by either house of the General Assembly, in a resolution identifying the subject, parties and scope. Such a directing resolution may:

(a) require the Auditor General to examine and report upon specific management efficiencies or cost effectiveness proposals specified therein;

(b) in the case of a program audit, set forth specific program objectives, responsibilities or duties or may specify the program performance standards or program evaluation standards to be the basis of the program audit;

(c) be directed at particular procedures or functions established by statute, by administrative regulation or by precedent; and

(d) require the Auditor General to examine and report upon specific proposals relating to state programs specified in the resolution.

The Commission may by resolution clarify, further direct, or limit the scope of any audit directed by a resolution of the House or Senate, provided that any such action by the Commission must be consistent with the terms of the directing resolution.

(Source: P.A. 93-630, eff. 12-23-03.)

Section 99. Effective date. This Act takes effect upon becoming law.