P.L. 2007, c.236 (A3027 1R)

An Act concerning prevention of violence against health care workers and supplementing Title 26 of the Revised Statutes.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. This act shall be known and may be cited as the “Violence Prevention in Health Care Facilities Act.”

2. The Legislature finds and declares that:

a. Violence is an escalating problem in many health care settings in the State and across the nation, and although violence is an increasing problem for many workers, health care workers are at a particularly high risk;

b. According to the Bureau of Labor Statistics, the incidence of injury from nonfatal assaults of health service workers is significantly higher than that of other workers;

c. The actual incidence of violence is likely higher than reported for various reasons, including inadequate reporting mechanisms and because victims under-report incidents out of fear of reprisal, isolation and embarrassment;

d. Violence against health care workers exacts a significant toll on victims, their co-workers, patients, families and visitors;

e. Insurance claims, lost productivity, disruptions to operations, legal expenses and property damage are only a few of the negative effects that workplace violence has on health care facilities;

f. Preventing workplace violence is essential for creating a safe and therapeutic environment for patients;

g. Health care professionals who leave their occupations because of assaults or threats of assault contribute to the general shortage of health care professionals; and

h. It is possible to reduce and mitigate the effects of violence in health care settings through employer-based violence prevention programs.

3. As used in this act:

“Covered health care facility” means a ¹[health care facility] general or special hospital or nursing home¹ licensed by the Department of Health and Senior Services pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), a State or county psychiatric hospital, ¹or¹ a State developmental center ¹[, or a health care service firm regulated by the Division of Consumer Affairs in the Department of Law and Public Safety pursuant to P.L.1989, c.331 (C.34:8-43 et seq.)]¹.

“Health care worker” means an individual who is employed by a covered health care facility.

“Violence” or “violent act” means any physical assault, or any physical or ¹credible¹ verbal threat of assault or harm against a health care worker.

4. Within 6 months of the effective date of this act, a covered health care facility shall establish a violence prevention program for the purpose of protecting health care workers. ¹[A health care system with more than one covered health care facility shall have a violence prevention program at each facility.]¹ The program shall, at a minimum, include the requirements set forth in this section.

a. ¹(1)¹The covered health care facility shall establish a violence prevention committee, which shall include a representative of management ¹, or his designee¹, who shall be responsible for overseeing all aspects of the program. At least 50% of the members of the committee shall be health care workers who provide direct patient care or otherwise have contact with patients. In a facility ¹or health care system¹ where health care workers are represented by ¹[a] one or more¹ collective bargaining ¹[agent,] agents, the management of the facility or system shall consult with¹ the ¹applicable¹collective bargaining ¹[agent shall select] agents regarding the selection of¹ the health care worker committee members.

The remaining committee members shall have experience, expertise, or responsibility relevant to violence prevention.

¹[A health care system with more than one covered health care facility shall have a committee at each facility] (2) In the case of a health care system that owns or operates more than one covered health care facility or Department of Human Services facilities, the violence prevention program and the committee may be operated at the system or department level, provided that: (a) committee membership includes at least one health care worker from each facility who provides direct care to patients, (b) the committee develops a violence prevention plan for each facility, and (c) data related to violence prevention remain distinctly identifiable for each facility¹.

b. Within 18 months of the effective date of this act, the committee shall develop and maintain a detailed, written violence prevention plan that identifies workplace risks, and provides specific methods to address them. The plan shall, at a minimum:

(1) provide an annual comprehensive violence risk-assessment for the covered health care facility that considers, to the extent applicable:

(a) the facility’s layout, access restrictions, crime rate in surrounding areas, lighting, and communication and alarm devices;

(b) ¹[adequacy of] impact of¹ staffing ¹[levels]¹, including security personnel;

(d) a review of any records relating to violent incidents at the facility, including incidents required to be reported pursuant to subsection f. of this section, the ¹Occupational Safety and Health Administration¹ Log of Work-Related Injuries and Illnesses (OSHA Form 300), and workers’ compensation records;

(2) identify violence prevention policies; and

(3) specify methods to reduce identified risks, including training, and changes to job design, staffing, security, equipment and facility modifications.

c. The covered health care facility shall ¹[provide] make¹ a copy of the plan ¹available, upon request,¹ to the Commissioners of Health and Senior Services¹, Children and Families,¹ and Human Services ¹[and the Director of the Division of Consumer Affairs] for on-site inspection¹, and upon request, to each health care worker and collective bargaining agent that represents health care workers at the facility¹, 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 providing copies to workers or collective bargaining agents¹.

d. The covered health care facility shall annually conduct violence prevention training. The training shall include a review of: the facility’s relevant policies; techniques to de-escalate and minimize violent behavior; appropriate responses to workplace violence, including use of restraining techniques, reporting requirements and procedures; location and operation of safety devices; and resources for coping with violence.

e. The covered health care facility shall have ¹[sufficient numbers of]¹ personnel ¹sufficiently¹ trained to identify aggressive and violent predicting factors and ¹the ability¹ to appropriately respond to and manage violent disturbances.

f. The covered health care facility shall keep a record of all violent acts against employees while at work. The records shall be maintained for at least five years following the reported act, during which time employees, their authorized representatives, and the Department of Health and Senior Services shall have access to the record. The record shall include:

(1) the date, time and location of the incident;

(2) the identity and job title of the victim¹, 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 (OSHA Form 300) because it is a privacy concern case under OSHA¹;

(3) whether the act was committed by a patient, visitor, or employee;

(4) the nature of the violent act, including whether a weapon was used;

(5) a description of physical injuries, if any;

(6) the number of employees in the vicinity when the incident occurred and their actions in response to the incident, if any; and

(7) the actions taken by the facility in response to the incident.

¹The records established pursuant to this subsection shall not be considered public or government records under P.L.1963, c.73 (C.47:1A-1 et seq.) or P.L.2001,c.404 (C.47:1A-5 et al.).¹

g. The covered health care facility shall 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.

5. A covered health care facility shall not ¹[retaliate] take any retaliatory action¹ against any health care worker for reporting violent incidents. ¹As used in this section, “retaliatory action” shall have the same meaning as provided in section 2 of P.L.1986, c.105 (C.34:19-2).¹

6. A covered health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) that is in violation of the provisions of this act shall be subject to such penalties as the Commissioner of Health and Senior Services may determine pursuant to sections 13 and 14 of P.L.1971, c.136 (C.26:2H-13 and 26:2H-14). ¹[A covered health care facility that is regulated pursuant to P.L.1989, c.331 (C.34:8-43 et seq.) that is in violation of the provisions of this act shall be subject to such penalties as the Director of the Division of Consumer Affairs may determine pursuant to section 12 of P.L.1989, c.331 (C.34:8-53).]¹

7. The Commissioners of Health and Senior Services and Human Services ¹[and the Director of the Division of Consumer Affairs in the Department of Law and Public Safety]¹ shall adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to carry out the purposes of this act.

8. This act shall take effect immediately.

“Violence Prevention in Health Care Facilities Act,” requires certain health care entities to establish violence prevention programs to protect health care workers.