Sen. Debbie DeFrancesco Halvorson
Filed: 5/26/2005
 
 

 




 

 		












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AMENDMENT TO HOUSE BILL 399 




2
    AMENDMENT NO. ______. Amend House Bill 399, AS AMENDED, by 
3
replacing everything after the enacting clause with the 
4
following:

 
5
    "Section 1. Short title. This Act may be cited as the 
6
Health Care Workplace Violence Prevention Act.
 
7
    Section 5. Findings. The General Assembly finds as follows:
8
        (1) Violence is an escalating problem in many health 
9
    care workplaces in this State and across the nation.
10
        (2) The actual incidence of workplace violence in 
11
    health care workplaces, in particular, is likely to be 
12
    greater than documented because of failure to report such 
13
    incidents or failure to maintain records of incidents that 
14
    are reported.
15
        (3) Patients, visitors, and health care employees 
16
    should be assured a reasonably safe and secure environment 
17
    in a health care workplace.
18
        (4) Many health care workplaces have undertaken 
19
    efforts to ensure that patients, visitors, and employees 
20
    are safe from violence, but additional personnel training 
21
    and appropriate safeguards may be needed to prevent 
22
    workplace violence and minimize the risk and dangers 
23
    affecting people in connection with the delivery of health 
24
    care.

 
 


 






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    Section 10. Definitions. In this Act:
2
    "Department" means (i)  the Department of Human Services, in 
3
the case of a health care workplace that is operated or 
4
regulated by the Department of Human Services, or (ii) the 
5
Department of Public Health, in the case of a health care 
6
workplace that is operated or regulated by the Department of 
7
Public Health.
8
    "Director" means the Secretary of Human Services or the 
9
Director of Public Health, as appropriate.
10
    "Employee" means any individual who is employed on a 
11
full-time, part-time, or contractual basis by a health care 
12
workplace.
13
    "Health care workplace" means a mental health facility or 
14
developmental disability facility as defined in the Mental 
15
Health and Developmental Disabilities Code, other than a 
16
hospital or unit thereof licensed under the Hospital Licensing 
17
Act or operated under the University of Illinois Hospital Act. 
18
"Health care workplace" does not include, and shall not be 
19
construed to include, any office of a physician licensed to 
20
practice medicine in all its branches, an advanced practice 
21
nurse, or a physician assistant, regardless of the form of such 
22
office. 
23
    "Imminent danger" means a preliminary determination of 
24
immediate, threatened, or impending risk of physical injury as 
25
determined by the employee.
26
    "Responsible agency" means the State agency that (i) 
27
licenses, certifies, registers, or otherwise regulates or 
28
exercises jurisdiction over a health care workplace or a health 
29
care workplace's activities or (ii) contracts with a health 
30
care workplace for the delivery of health care services.

31
    "Violence" or "violent act" means any act by a patient or 
32
resident  that causes or threatens to cause an injury to  another 
33
person.

 
 


 






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    Section 15. Workplace violence plan. 
2
    (a) By July 1, 2006 (in the case of a health care workplace 
3
participating in the pilot project under Section 35) or July 1, 
4
2008 (in the case of health care workplaces not participating 
5
in the pilot project), every health care workplace must adopt 
6
and implement a plan to reasonably prevent and protect 
7
employees from violence at  that setting. The plan must address 
8
security considerations related to the following items, as 
9
appropriate to the particular workplace, based on the hazards 
10
identified in the assessment required under subsection (b):

     
11
        (1) The physical attributes of the health care 
12
    workplace.
13
        (2) Staffing, including security staffing.
14
        (3) Personnel policies.
15
        (4) First aid and emergency procedures.
16
        (5) The reporting of violent acts.
17
        (6) Employee education and training.

     
18
    (b) Before adopting the plan required under subsection (a), 
19
a health care workplace must conduct a security and safety 
20
assessment to identify existing or potential hazards for 
21
violence and determine the appropriate preventive action to be 
22
taken. The assessment must include, but need not be limited to, 
23
a measure of the frequency of, and an identification of the 
24
causes for and consequences of, violent acts at the workplace 
25
during at least the preceding 5 years or for the years for 
26
which records are available.

     
27
    (c) In adopting the plan required by subsection (a), a 
28
health care workplace may consider any guidelines on violence 
29
in the workplace or in health care workplaces issued by the 
30
Department of Public Health, the Department of Human Services, 
31
the federal Occupational Safety and Health Administration, 
32
Medicare, and health care workplace accrediting organizations.

33
    (d) It is the intent of the General Assembly that any 
 


 






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violence protection and prevention plan developed under this 
2
Act be appropriate to the setting in which it is to be 
3
implemented. To that end, the General Assembly recognizes that 
4
not all health care services are provided in a facility or 
5
other formal setting. Many health care services are provided in 
6
other, less formal settings. The General Assembly finds that it 
7
may be inappropriate and impractical for all health care 
8
workplaces to address workplace violence in the same manner. 
9
When enforcing this Act, the Department shall allow a health 
10
care workplace sufficient flexibility in recognition of the 
11
unique circumstances in which the health care workplace may 
12
deliver services.
13
    (e) Promptly after adopting a plan under  subsection (a), a 
14
health care workplace must file a copy of its plan with the 
15
Department. The Department shall then forward a copy of the 
16
plan to the appropriate responsible  agency. 
17
    (f) A health care workplace must review its plan at least 
18
once every 3 years and must report each such review to the 
19
Department, together with any changes to the plan adopted by 
20
the health care workplace. If a health care workplace does not 
21
adopt any changes to its plan in response to such a review, it 
22
must report that fact to the Department. A health care 
23
workplace must promptly report to the Department all changes to 
24
the health care workplace's plan, regardless of whether those 
25
changes were adopted in response to a periodic review required 
26
under this subsection. The Department shall then forward a copy 
27
of the review report and changes, if any, to the appropriate 
28
responsible agency. 
29
    (g) A health care workplace that is required to submit 
30
written documentation of active safety and violence prevention 
31
plans to comply with national accreditation standards shall be 
32
deemed to be in compliance with subsections (a), (b), (c), and 
33
(f) of this Section when the health care workplace forwards a 
34
copy of that documentation to the Department.
 
 


 






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    Section 20. Violence prevention training. By July 1, 2006 
2
(in the case of a health care workplace participating in the 
3
pilot project under Section 35) or July 1, 2009 (in the case of 
4
health care workplaces not participating in the pilot project), 
5
and on a regular basis thereafter, as set forth in the plan 
6
adopted under Section 15, a health care workplace must provide 
7
violence prevention training to all its affected employees as 
8
determined by the plan. For temporary employees, training must 
9
take into account unique circumstances. A health care workplace 
10
also shall provide periodic follow-up training for its 
11
employees as appropriate.  The training may vary by the plan and 
12
may include, but need not be limited to, classes, videotapes, 
13
brochures, verbal training, or other verbal or written training 
14
that is determined to be appropriate under the plan. The 
15
training must address the following topics, as appropriate to 
16
the particular health care workplace and to the duties and 
17
responsibilities of the particular employee being trained, 
18
based on the hazards identified in the assessment required 
19
under Section 15:

     
20
        (1) General safety procedures.
21
        (2) Personal safety procedures.
22
        (3) The violence escalation cycle.
23
        (4) Violence-predicting factors.
24
        (5) Obtaining patient history from a patient with a 
25
    history of violent behavior.
26
        (6) Verbal and physical techniques to de-escalate and 
27
    minimize violent behavior.
28
        (7) Strategies to avoid physical harm.
29
        (8) Restraining techniques, as permitted and governed 
30
    by law.
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        (9) Appropriate use of medications to reduce violent 
32
    behavior.
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        (10) Documenting and reporting incidents of violence.
 


 






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        (11) The process whereby employees affected by a 
2
    violent act may debrief or be calmed down and the tension 
3
    of the situation may be reduced.
4
        (12) Any resources available to employees for coping 
5
    with violence.
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        (13) The workplace violence prevention plan adopted 
7
    under Section 15.

8
        (14) The protection of confidentiality in accordance 
9
    with the Health Insurance Portability and Accountability 
10
    Act of 1996 and other related provisions of law.
 
11
    Section 25. Record of violent acts. Beginning no later than 
12
July 1, 2006 (in the case of a health care workplace 
13
participating in the pilot project under Section 35) or July 1, 
14
2008 (in the case of health care workplaces not participating 
15
in the pilot project), every health care workplace must keep a 
16
record of any violent act against an employee, a patient, or a 
17
visitor occurring at the workplace. At a minimum, the record 
18
must include the following:

     
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        (1) The health care workplace's name and address.
20
        (2) The date, time, and specific location at the health 
21
    care workplace where the violent act occurred.
22
        (3) The name, job title, department or ward assignment, 
23
    and staff identification or other identifier of the victim, 
24
    if the victim was an employee.
25
        (4) A description of the person against whom the 
26
    violent act was committed as one of the following:

     
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            (A) A patient.
28
            (B) A visitor.
29
            (C) An employee.
30
            (D) Other.
31
        (5) A description of the person committing the violent 
32
    act as one of the following:

     
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            (A) A patient.
 


 






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            (B) A visitor.
2
            (C) An employee.
3
            (D) Other.
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        (6) A description of the type of violent act  as one of 
5
    the following:

     
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            (A) A verbal or physical threat that presents 
7
        imminent danger.
8
            (B) A physical assault with major soreness, cuts, 
9
        or large bruises.
10
            (C) A physical assault with severe lacerations, a 
11
        bone fracture, or a head injury.
12
            (D) A physical assault with loss of limb or death.
13
            (E) A violent act requiring employee response, in 
14
        the course of which an employee is injured.
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        (7) An identification of any body part injured.
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        (8) A description of any weapon used.
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        (9) The number of employees in the vicinity of the 
18
    violent act when it occurred.
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        (10) A description of actions taken by employees and 
20
    the health care workplace in response to the violent act. 
 
21
    Section 30. Assistance in complying with Act. A health care 
22
workplace that needs assistance in complying with this Act may 
23
contact the federal Department of Labor for assistance. The 
24
Illinois departments of Human Services and Public Health shall 
25
collaborate with representatives of health care workplaces to 
26
develop technical assistance and training seminars on 
27
developing and implementing a workplace violence plan as 
28
required under Section 15. Those departments shall coordinate 
29
their assistance to health care workplaces.
 
30
    Section 35. Pilot project; task force. 
31
    (a) The Department of Human Services and the Department of 
32
Public Health shall initially implement this Act as a one-year 
 


 






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pilot project in which only the following health care 
2
workplaces shall participate:
3
        (1) The Chester Mental Health Center.
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        (2) The Alton Mental Health Center.
5
        (3) The Douglas Singer Mental Health Center.
6
        (4) The Jacksonville Developmental Center.
7
    Each health care workplace participating in the pilot 
8
project shall comply with this Act as provided in this Act.
9
    (b) The Governor shall convene a 6-member task force 
10
consisting of the following: one member appointed by the 
11
President of the Senate; one member appointed by the Minority 
12
Leader of the Senate; one member appointed by the Speaker of 
13
House of Representatives; one member appointed by the Minority 
14
Leader of the House of Representatives; one representative from 
15
a statewide association representing licensed registered 
16
professional nurses; and one representative from the 
17
Department of Human Services. The task force shall submit a 
18
report to the Illinois General Assembly by July 1, 2007 that 
19
shall (i) evaluate the effectiveness of the health care 
20
workplace violence prevention pilot project in the facilities 
21
participating in the pilot project and (ii) make 
22
recommendations concerning the implementation of workplace 
23
violence prevention programs in all health care workplaces.
 
24
    Section 40. Rules. The Department shall adopt rules to 
25
implement this Act.

 
26
    Section 900. The Mental Health and Developmental 
27
Disabilities Administrative Act is amended  by adding Section 72 
28
as follows:
 
29
    (20 ILCS 1705/72  new)
30
    Sec. 72. Violent acts against employees of facilities under 
31
the Department's jurisdiction. Within 6 months after the 
 


 






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effective date of this amendatory Act of the 94th General 
2
Assembly, the Department shall adopt rules prescribing the 
3
procedures for reporting, investigating, and responding to 
4
violent acts against employees of facilities under the 
5
Department's jurisdiction. As used in this Section, "violent 
6
acts" has the meaning ascribed to that term in the Health Care 
7
Workplace Violence Prevention Act.
 
8
    Section 905. The Illinois State Auditing Act is amended  by 
9
changing Section 3-2 as follows:
 
10
    (30 ILCS 5/3-2)  (from Ch. 15, par. 303-2)

11
    Sec. 3-2. Mandatory and directed post audits. The Auditor 
12
General
shall conduct a financial audit, a compliance audit, or 
13
other attestation
engagement, as is appropriate to the agency's 
14
operations under generally
accepted
government auditing 
15
standards, of each State agency except the Auditor
General or 
16
his office at least once
during every biennium, except as is 
17
otherwise provided in regulations
adopted under Section 3-8. 
18
The general direction and supervision of the
financial audit 
19
program may be delegated only to an individual who is a

20
Certified Public Accountant and a payroll employee of the 
21
Office of the
Auditor General. In the conduct of financial 
22
audits, compliance audits, and
other attestation engagements, 
23
the
Auditor General may inquire into and report upon matters 
24
properly within
the scope of a performance audit, provided that

25
such inquiry
shall be limited to matters arising during the 
26
ordinary course of the
financial audit.


27
    In any year the Auditor General shall conduct any special 
28
audits as may
be necessary to form an opinion on the financial 
29
statements of
this State, as
prepared by the Comptroller, and 
30
to certify that this presentation is in
accordance with 
31
generally accepted accounting principles for government.


32
    Simultaneously with the biennial compliance audit of the

 


 






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Department of
Human Services, the
Auditor General shall
conduct 
2
a program audit of each facility under the jurisdiction of that

3
Department that is described in Section 4 of the
Mental Health

4
and Developmental Disabilities Administrative Act.  The program 
5
audit
shall include an examination of the records of each 
6
facility concerning
(i) reports of suspected abuse or neglect 
7
of any patient or resident of the
facility and (ii) reports of 
8
violent acts against  facility staff by patients or residents.  
9
The Auditor General shall report the findings of the program

10
audit to the Governor and the General Assembly, including 
11
findings
concerning patterns or trends relating to (i) abuse or 
12
neglect of facility
patients and residents or (ii) violent acts 
13
against  facility staff by patients or residents.  However, for 
14
any year for which the Inspector
General submits a report to 
15
the Governor and General Assembly as required under
Section 6.7 
16
of the Abused and Neglected Long Term Care Facility Residents

17
Reporting Act, the Auditor General need not conduct the program 
18
audit otherwise
required under this paragraph.


19
    The Auditor General shall conduct a performance

audit of a

20
State agency when so directed by the Commission, or by either 
21
house of
the General Assembly, in a resolution identifying the 
22
subject, parties
and scope.  Such a directing resolution may:


23
        (a) require the Auditor General to examine and report 
24
    upon specific
management efficiencies or cost 
25
    effectiveness proposals specified therein;


26
        (b) in the case of a program audit, set forth specific 
27
    program
objectives, responsibilities or duties or may 
28
    specify the program
performance standards or program 
29
    evaluation standards to be the basis of
the program audit;


30
        (c) be directed at particular procedures or functions 
31
    established by
statute, by administrative regulation or by 
32
    precedent; and


33
        (d) require the Auditor General to examine and report 
34
    upon specific
proposals relating to state programs 
 


 






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    specified in the resolution.


2
    The Commission may by resolution clarify, further direct, 
3
or limit
the scope of any audit directed by a resolution of the 
4
House or Senate,
provided that any such action by the 
5
Commission must be consistent with
the terms of the directing 
6
resolution.


7
(Source: P.A. 93-630, eff. 12-23-03.)

 
8
    Section 910. The Community Living Facilities Licensing Act 
9
is amended  by changing Section 11 as follows:
 



10
    (210 ILCS 35/11)  (from Ch. 111 1/2, par. 4191)



11
    Sec. 11. Grounds for denial or revocation of a license. The 
12
Department
may deny or begin proceedings to revoke a license if 
13
the applicant or licensee
has been convicted of a felony or 2 
14
or more misdemeanors involving moral
turpitude, as shown by a 
15
certified copy of the court of conviction; if the
Department 
16
determines after investigation that such person has not been

17
sufficiently rehabilitated to warrant the public trust; or upon 
18
other satisfactory
evidence that the moral
character of the 
19
applicant or licensee is not reputable. In addition, the

20
Department may deny or begin proceedings to revoke a license at 
21
any time
if the licensee:

22
    (1) Submits false information either on Department 
23
licensure forms or
during an inspection;

24
    (2) Refuses to allow an inspection to occur;

25
    (3) Violates this Act or rules and regulations promulgated 
26
under this Act;

27
    (4) Violates the rights of its residents;

28
    (5) Fails to submit or implement a plan of correction 
29
within the specified
time period; or
.
30
    (6) Fails to submit a workplace violence prevention plan in 
31
compliance with  the Health Care Workplace Violence Prevention 
32
Act.


 


 






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(Source: P.A. 82-567.)

 
2
    Section 915. The Community-Integrated Living Arrangements 
3
Licensure and
Certification Act is amended  by changing Section 
4
6 as follows:
 



5
    (210 ILCS 135/6)  (from Ch. 91 1/2, par. 1706)


6
    Sec. 6. (a) The Department shall deny an application for a 
7
license,
or revoke or refuse to renew the license of a 
8
community mental health or
developmental services agency, or 
9
refuse to issue a license to the holder
of a temporary permit, 
10
if the Department determines that the applicant,
agency or 
11
permit holder has not complied with a provision of this Act, 
12
the
Mental Health and Developmental Disabilities Code, or 
13
applicable Department
rules and regulations.  Specific grounds 
14
for denial or revocation of a
license, or refusal to renew a 
15
license or to
issue a license to the holder of a temporary 
16
permit, shall include but not be limited to:

17
    (1) Submission of false information either on Department 
18
licensure forms
or during an inspection;

19
    (2) Refusal to allow an inspection to occur;

20
    (3) Violation of this Act or rules and regulations 
21
promulgated under this Act;

22
    (4) Violation of the rights of a recipient; or

23
    (5) Failure to submit or implement a plan of correction 
24
within the
specified time period; or
25
    (6)  Failure to submit a workplace violence prevention plan 
26
in compliance with  the Health Care Workplace Violence 
27
Prevention Act.

28
    (b) If the Department determines that the operation of a 
29
community mental health
or developmental services agency or one 
30
or more of the programs or
placements certified by the agency 
31
under this Act jeopardizes the health,
safety or welfare of the 
32
recipients served by the agency, the Department
may immediately 
 


 






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revoke the agency's license and may direct the agency to

2
withdraw recipients from any such program or placement.

3
(Source: P.A. 85-1250.)


 
4
    Section 999. Effective date. This Act takes effect upon 
5
becoming law.".