H 259 — An act relating to preventing workplace violence in hospitals

HOSPITALS;

DUTIES (a) Hospitals shall file the following information at the time and place and in the manner established by the Board:

(1) a budget for the forthcoming fiscal year;

(2) financial information, including costs of operation, revenues, assets, liabilities, fund balances, other income, rates, charges, units of services, and wage and salary data;

(3) scope-of-service and volume-of-service information, including inpatient services, outpatient services, and ancillary services by type of service provided;

(4) utilization information;

(5) new hospital services and programs proposed for the forthcoming fiscal year;

BILL AS PASSED BY THE HOUSE H.259 Page 7 of 15 (6) costs associated with implementing their security plan pursuant to section 1911b of this title, including capital investments, program operation, and staff;

(7) known depreciation schedules on existing buildings, a four-year capital expenditure projection, and a one-year capital expenditure plan;

and (7)(8) such other information as the Board may require.

* * * Sec.

4.

18 V.S.A.

§ 9456 is amended to read:

§ 9456.

BUDGET REVIEW (a) The Board shall conduct reviews of each hospital’s proposed budget based on the information provided pursuant to this subchapter and in accordance with a schedule established by the Board.

* * * (c) Individual hospital budgets established under this section shall:

* * * (5) include a finding that the analysis provided in subdivision (b)(9) of this section is a reasonable methodology for reflecting a reduction in net revenues for non-Medicaid payers;

and (6) demonstrate that they support equal access to appropriate mental health care that meets standards of quality, access, and affordability equivalent BILL AS PASSED BY THE HOUSE H.259 Page 8 of 15 to other components of health care as part of an integrated, holistic system of care;

and (7) allocate sufficient funds to ensure that the hospital is able to fully support all of the costs associated with operating its security plan pursuant to section 1911b of this title.

* * * Sec.

5.

EFFECTIVE DATE This act shall take effect on July 1, 2025.

Sec.

1.

18 V.S.A.

§ 1911b is added to read:

§ 1911b.

WORKPLACE VIOLENCE PREVENTION PLANNING (a)(1) A hospital licensed pursuant to this chapter shall establish and implement a security plan for preventing workplace violence and managing aggressive behaviors.

Each hospital shall establish a team for the purpose of providing advice during the development of the hospital’s security plan.

The hospital shall select individuals from the following groups to serve on its security plan development team:

(A) health care employees providing direct patient care at the hospital;

(B) representatives from the designated agency serving the region where the hospital is located;

and (C) representatives of relevant law enforcement agencies.

BILL AS PASSED BY THE HOUSE H.259 Page 9 of 15 (2) The security plan shall be based on the results of a security risk assessment that addresses all high-risk areas of the hospital, including the emergency department, and all patient care areas.

The security risk assessment shall be conducted in consultation with the medical and nursing directors of each department and those hospital employees supervising other high-risk areas of the hospital.

The security risk assessment shall consider overall patient volume, crime rates in the community, and the availability of law enforcement to respond to violent incidents at the hospital.

(3) The security plan shall include an option for health care employees who provide direct patient care to request an identification badge containing only their first name or their first name and last initial.

(4)(A) The security plan shall require at least one hospital employee trained in de-escalation strategies to be present at all time in the hospital’s emergency department and all other patient care areas.

(B) The security plan shall require that a hospital employee trained in trauma-informed care and victim support serve as a liaison to law enforcement, support victims through the legal process, and ensure that the response to incidents of violence at the hospital prioritize the safety and retention of hospital employees providing health care services to the extent permitted under State and federal law.

BILL AS PASSED BY THE HOUSE H.259 Page 10 of 15 (5) The security plan shall establish training requirements for appropriate hospital employees on the following:

(A) the culture of safety as determined by the hospital;

(B) response to the presence or use of weapons;

(C) defensive tactics;

(D) de-escalation techniques;

(E) appropriate physical restraint and seclusion techniques;

(F) crisis intervention;

(G) trauma-informed care and strategies;

(H) clinician well-being practices;

(I) presence and intervention of law enforcement;

and (J) safely addressing situations involving patients, family members, or other individuals who pose a risk of self-harm or harm to others.

(6) The security plan shall include guidelines indicating when a law enforcement officer should remain with a patient who has demonstrated violence or harm to others pursuant to 18 V.S.A.

§ 1883.

The guidelines shall be developed jointly by a health care provider representative and law enforcement.

(7)(A) A hospital shall review and evaluate the security plan developed pursuant to this subsection annually in conjunction with the data collected BILL AS PASSED BY THE HOUSE H.259 Page 11 of 15 pursuant to subdivision (b)(3) of this section.

If necessary, the hospital shall revise the security plan.

(B) The security plan and any annual revisions to the security plan shall be distributed annually to all hospital employees, volunteers, the hospital’s board of directors, relevant law enforcement agencies, and any other partners identified by the security plan development team.

(b)(1) A hospital licensed pursuant to this chapter shall establish and utilize a workplace violence incident reporting system to document, track, analyze, and evaluate incidents of workplace violence at the hospital.

Data collection through the reporting system and resulting analysis shall be used to improve workplace safety and to manage aggressive behaviors, including improvements achieved through continuing education in targeted areas such as de-escalation training, risk identification, and prevention planning.

(2) All hospital employees shall be notified about the existence of the reporting system and shall receive training on how to report incidents of workplace violence to the hospital, hospital security, law enforcement, or any other entity the hospital deems appropriate.

(3) A hospital shall use its reporting system to track the following:

(A) the number of reported incidents;

BILL AS PASSED BY THE HOUSE H.259 Page 12 of 15 (c) A hospital shall adopt a policy prohibiting discrimination or retaliation for:

(d)(1) A hospital shall post a notice in a conspicuous location, either electronically or in print, indicating that hospital employees do not tolerate an VT LEG #381862 v.1 AS PASSED BY HOUSE H.259 Page 5 of 7 unsafe work environment where any type of threatening or aggressive behavior is present.

BILL AS PASSED BY THE HOUSE H.259 Page 13 of 15 Sec.

§§ 9435 9435 is amended to read:

§§ 9454 9454 is amended to read:

DUTIES VT LEG #381862 v.1 AS PASSED BY HOUSE H.259 Page 6 of 7 (a) Hospitals shall file the following information at the time and place and in the manner established by the Board:

BILL AS PASSED BY THE HOUSE H.259 Page 14 of 15 (6) costs associated with implementing their security plan pursuant to section 1911b of this title, including capital investments, program operation, and staff;

§§ 9456 9456 is amended to read:

BUDGET REVIEW VT LEG #381862 v.1 AS PASSED BY HOUSE H.259 Page 7 of 7 (a) The Board shall conduct reviews of each hospital’s proposed budget based on the information provided pursuant to this subchapter and in accordance with a schedule established by the Board.

and (6) demonstrate that they support equal access to appropriate mental health care that meets standards of quality, access, and affordability equivalent BILL AS PASSED BY THE HOUSE H.259 Page 15 of 15 to other components of health care as part of an integrated, holistic system of care;

VT LEG #381862 v.1