As discussed in a recent post on this blog, a number of states have enacted legislation to address the increased violence against healthcare employees. In Connecticut, a new statute requiring healthcare institutions to take a variety of actions to protect employees from workplace violence took effect on October 1, 2011.
The law covers all hospitals, nursing homes and facilities for treatment of substance abuse, mental illness and intellectual disabilities that have 50 or more full or part-time employees. Effective October 1, 2011, covered employers are required to:
- Establish and convene an ongoing workplace safety committee composed of representatives from administration, physician, nursing and other direct patient care staff, security personnel and any other staff the institution deems appropriate. At least 50% of the committee members must be “nonmanagement employees.” The committee must meet at least once every quarter, and make minutes and other records from its proceedings available to all employees.
- Maintain records that “detail” incidents of workplace violence, including the specific area or department where the incident occurred, and to report this information to the Department of Public Health at its request.
- Undertake a risk assessment of the factors that put any health care employee (defined to include volunteers) at risk of being a victim of workplace violence. This obligation continues annually thereafter.
By January 1, 2012, and each January first thereafter, in collaboration with the workplace safety committee, covered employers are required to develop and implement a written workplace violence prevention and response plan.
The law also requires that each health care employer, “to the extent practicable,” adjust patient care assignments “so that no health care employee who requests an adjustment to his or her patient care assignment is required to treat or provide services to a patient who the employer knows to have intentionally physically abused or threatened the employee.” Patient behavior, including physical abuse or threats, will not be considered “intentional,” however, if it is a “direct manifestation of the patient’s condition or disability.” In determining whether it would be practicable to adjust patient care assignments, health care employers are to give “due consideration to the employer’s obligation to meet the needs of all patients.”
If the institution determines that adjustment of a health care employee’s patient care assignment is not practicable, any health care employee who has been physically abused or threatened by a patient may request that a second health care employee “be present when treating such patient.” This portion of the statute is not entirely clear. Because it refers to physical abuse and threats generally, not just to “intentional” conduct by the patient (as does the provision concerning adjustment of patient care assignments), a request for the presence of a second employee might be appropriate when patients are physically abusive or threatening as a result of mental illness or other medical condition. There is further ambiguity in the provision, however, because it does not expressly require the employer to comply when an employee makes such a request. This point might eventually be addressed in regulations that the statute empowers the Connecticut Labor Commissioner to adopt as necessary to carry out the purposes of the statute.
The statute also requires that covered health care employers report to local law enforcement agencies within 24 hours “any act which may constitute an assault or related offense” under state criminal law “against a health care employee acting in the performance of his or her duties.” This reporting obligation does not apply if the act was committed by a person whose conduct is a clear and direct manifestation of mental retardation, physical disability or mental disability.