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HOUSE DOCKET, NO. 3627 FILED ON: 1/20/2023
HOUSE . . . . . . . . . . . . . . . No. 2381
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Michael J. Moran
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act requiring health care facilities to develop and implement programs to prevent workplace
violence.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Michael J. Moran18th Suffolk1/17/2023Steven S. Howitt4th Bristol2/24/2023 1 of 10
HOUSE DOCKET, NO. 3627 FILED ON: 1/20/2023
HOUSE . . . . . . . . . . . . . . . No. 2381
By Representative Moran of Boston, a petition (accompanied by bill, House, No. 2381) of
Michael J. Moran and Steven S. Howitt for legislation to require health care facilities to develop
and implement programs to prevent workplace violence. Public Safety and Homeland Security.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 2506 OF 2021-2022.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
_______________
An Act requiring health care facilities to develop and implement programs to prevent workplace
violence.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Chapter 111 of the general laws is hereby amended by inserting after
2section 243 the following new section:-
3 Section 244. (a) For the purposes of this section, the following words shall have the
4following meanings:-
5 "Aggravated interference with the conduct of a health care facility”, conduct as defined
6by section 13½ of chapter 265. 2 of 10
7 “Employee”, an individual employed by, or contracted for employment by, providing
8health care services at, volunteering at, or participating in an educational course of instruction at
9a health care facility, as defined in this section.
10 “Health care facility”, a hospital as defined under section 51 of chapter 111 of the general
11laws.
12 “Interference with the conduct of a health care facility”, conduct as defined by section
1313½ of chapter 265.
14 “Workplace violence”, any attempted or actual harmful or unpermitted touching of
15another person that results in injury and occurs in a health care facility.
16 (b) Not withstanding any general or special law to the contrary, within six months of the
17date of enactment, the department shall develop statewide standards for evaluating and
18addressing known security risks at health care facilities. These workplace safety and violence
19prevention standards shall be based on existing state laws and regulations as well as national
20accreditation and professional association standards for health care facilities for the purpose of
21ensuring consistency in the development of and annual review of internal operations preventing
22known risks.
23 These standards shall include, but not be limited to: working in a health care facility in an
24region with higher than average criminal activity; working in public settings; guarding or
25maintaining property or possessions; working in high-traffic areas of a health care facility;
26working late night or early morning hours; working alone or in small numbers; working in areas
27of a health care facility where patients or visitors are in crisis; working in areas where patients or
28visitors may exhibit violent or involuntary behavior and; working in areas with known security 3 of 10
29risks. In developing such standards, the department shall convene and consult with an advisory
30committee comprised of representatives from: the Office of Health Equity; the Massachusetts
31Health and Hospital Association; the Massachusetts Association of Behavioral Health Systems;
32the Organization of Nurse Leaders; the Emergency Nurses Association Massachusetts Chapter;
33the Massachusetts Nurses Association; the National Association of Social Workers
34Massachusetts Chapter; the Massachusetts Association of Community Health Workers; the
35Massachusetts Chapter of Emergency Physicians; 1199 SEIU United Healthcare Workers East;
36The National Alliance on Mental Illness Massachusetts and; the Massachusetts Organization for
37Addiction Recovery. The department shall ensure that workplace safety standards do not exhibit
38any bias against specific patient populations, or the race, ethnicity, language, disability status,
39sexual orientation, or gender identity of patients or visitors. The department shall ensure that
40standards do not stigmatize or bias against patients with mental health, behavioral health, or
41substance use disorder presentation.
42 Following development of the statewide standards, each health care facility shall be
43required to provide a summary of its operational policy that complies with the standards and
44includes a description of: (i) the development of security risk identification; (ii) engagement with
45employees on potential risks; (iii) evaluation of incidents that have occurred; and (iv) periodic
46reassessments of programs and policies. Such summaries shall be submitted to the department
47within six months after the advisory committee promulgates its standards, and shall be updated
48when a health care facility makes a substantive change to its operational policy for security risk
49assessment.
50 (c) The health care facility shall develop and implement a program to minimize the
51danger of workplace violence to employees based on the statewide standards developed pursuant 4 of 10
52to subsection (b), which shall include appropriate employee training and a system for the
53ongoing reporting and monitoring of incidents and situations involving violence or the risk of
54violence. Employee training program policies shall include: crisis de-escalation strategies;
55competency in behavioral health, mental health, and substance use disorder; implicit bias
56training; and trauma informed care. Employees shall also be trained in methods of reporting to
57appropriate public safety officials, bodies or agencies and processes necessary for the filing of
58criminal charges. Each health care facility shall develop a written plan setting forth the facility’s
59workplace violence prevention plan. The health care facility shall make the plan available on site
60to each employee and allow any of its employees to review the plan on site upon request.
61 (d) Each health care facility shall designate a senior manager responsible for the
62development and support of an in-house crisis response team for employee-victims of workplace
63violence. Said team shall implement an opt-in staff action program that includes, but is not
64limited to, anonymous group crisis interventions, individual crisis counseling, staff victims’
65support groups, employee victims’ family crisis intervention, peer-help or professional referrals.
66 (e) Each health care facility shall report every twelve months all incidents of assault and
67assault and battery under section 13I of chapter 265, aggravated interference with the conduct of
68a health care facility under section 13I½ of chapter 265, and interference with the conduct of a
69health care facility under section 13I½ of chapter 265, to the department of public health and the
70office of the district attorney. The department of public health shall make an annual public report
71on the prior year’s data using aggregated statewide data of reported incidents.
72 (f) The commissioner of public health shall adopt rules and regulations necessary to
73implement the purposes of this act. The rules and regulations shall include such guidelines as the 5 of 10
74commissioner deems appropriate regarding workplace violence prevention programs required
75pursuant to this act, and related reporting and monitoring systems and employee training.
76 SECTION 2. Chapter 149 of the general laws is hereby amended by adding after section
77187 the following new section:-
78 Section 187½. (a) For purposes of this section, the following words shall have the
79following meanings, unless the context clearly indicates otherwise:
80 “Employee”, an individual employed by a health care facility as defined in this section.
81 “Health care facility”, a hospital as defined under section 51 of chapter 111 of the general
82laws.
83 (b) A health care facility shall permit an employee to take paid leave from work if: (i) the
84employee is a victim of assault or assault and battery as defined under section 13I of chapter 265,
85or aggravated interference with the conduct of a health care facility, as defined under section
8613I½ of chapter 265, occurred in the line of duty; and (ii) the employee is using the leave from
87work to: seek or obtain victim services or legal assistance; obtain a protective order from a court;
88appear in court or before a grand jury; or meet with a district attorney.
89 (c) An employee seeking leave from work under this section shall provide appropriate
90advance notice of the leave to the health care facility as required by the facility's leave policy.
91 (d) A health care facility may require an employee to provide documentation evidencing
92that the employee has been a victim of assault or assault and battery sustained in the line of duty
93and that the leave taken is consistent with the conditions of clauses (i) and (ii). 6 of 10
94 (e) If an unscheduled absence occurs, the health care facility shall not take any negative
95action against the employee if the employee, within 30 days from the unauthorized absence or
96within 30 days from the last unauthorized absence in the instance of consecutive days of
97unauthorized absences, provides documentation that the unscheduled absence meets the criteria
98of clauses (i) and (ii).
99 (f) An employee shall provide such documentation to the health care facility within a
100reasonable period after the health care facility requests documentation relative to the employee’s
101absence.
102 (g) All information related to the employee's leave under this section shall be kept
103confidential by the health care facility and shall not be disclosed, except to the extent that
104disclosure is: (i) requested or consented to, in writing, by the employee; (ii) ordered to be
105released by a court of competent jurisdiction; (iii) otherwise required by applicable federal or
106state law; (iv) required in the course of an investigation authorized by law enforcement,
107including, but not limited to, an investigation by the attorney general; or (v) necessary to protect
108the safety of the employee or others employed at the facility.
109 (h) An employee seeking leave under this section shall not have to exhaust all annual
110leave, vacation leave, personal leave or sick leave available to the employee, prior to requesting
111or taking leave under this section.
112 (i) No health care facility shall coerce, interfere with, restrain or deny the exercise of, or
113any attempt to exercise, any rights provided under this section or to make leave requested or
114taken hereunder contingent upon whether or not the victim maintains contact with the alleged
115abuser. 7 of 10
116 (j) No health care facility shall discharge or in any other manner discriminate against an
117employee for exercising the employee’s rights under this section. The taking of leave under this
118section shall not result in the loss of any employment benefit accrued prior to the date on which
119the leave taken under this section commenced. Upon the employee’s return from such leave, the
120employee shall be entitled to restoration to the employee’s original job or to an equivalent
121position.
122 (k) The attorney general shall enforce this section and may seek injunctive relief or other
123equitable relief to enforce this section.
124 (l) Health care facilities shall notify each employee of the rights and responsibilities
125provided by this section including those related to notification requirements and confidentiality.
126 (m) This section shall not be construed to exempt a health care facility from complying
127with chapter 258B, section 14B of chapter 268 or any other general or special law or to limit the
128rights of any employee under said chapter 258B, said section 14B of chapter 268 or any other
129general or special law.
130 SECTION 3. Chapter 265 of the general laws is hereby amended in section 13I by
131inserting at the end thereof the following:-
132 Any health care employee, as defined in section 244 of chapter 111, who is the victim of
133assault or assault and battery in the line of duty shall be given the option of providing either the
134individual’s home address, the address of the health care facility where the assault or assault and
135battery occurred, the address of a labor organization who is representing the employee, if so
136requested by the employee, or by requesting a judge to impound the individual’s home address.
137In instances where the address of the health care facility or labor organization is used, said 8 of 10
138facility or labor organization shall ensure that the individual receives any documents pertaining
139to the assault or assault and battery by the next business day of receipt by said facility or labor
140organization. The health care facility or labor organization shall demonstrate that it has provided
141any and all documentation by obtaining an acknowledgement of receipt from the individual.
142 SECTION 4. Chapter 265 of the general laws is hereby amended by adding after section
14313I the following new section:-
144 Section 13I½ Interference with the conduct of a health care facility
145 (a) For the purposes of this section, the following words shall have the following
146meanings:-
147 "Aggravated interference with the conduct of a health care facility”, interference with the
148conduct of a health care facility, as defined in this section, knowingly and intentionally, when in
149possession of a weapon, as defined in this section.
150 “Employee”, an individual employed by, or contracted for employment by, providing
151health care services at, volunteering at or participating in an educational course of instruction at a
152health care facility, as defined in this section.
153 “Health care facility”, a hospital as defined under section 51 of chapter 111 of the general
154laws.
155 “Interference with the conduct of a health care facility”, conduct at or in a health care
156facility so as to knowingly and intentionally deny an employee of the health care facility to enter,
157to use the facilities of or to leave any such health care facility; knowingly and intentionally
158impeding any employee of a health care facility from the performance of such employee's duties 9 of 10
159or activities through the use of restraint, abduction, coercion or intimidation or by force and
160violence or threat thereof; or knowingly refusing to leave a health care facility upon being
161requested to leave by the employee charged with maintaining order in such health care facility, if
162such person is committing, threatens to commit or incites others to commit any act that did, or
163would if completed, disrupt, impair, interfere with or obstruct the mission, processes, procedures
164or functions of the health care facility.
165 “Weapon”, a firearm, knife, heavy object, health care instrument, closed fist, shod foot,
166or any other item that could cause bodily injury.
167 Whoever knowingly and intentionally interferes with the conduct of a health care facility
168shall be punished by imprisonment in the house of correction for not less than 90 days nor more
169than two and one-half years or by a fine of not less than $500 nor more than $5,000, or both.
170 Whoever knowingly and intentionally commits aggravated interference with the conduct
171of a health care facility shall be punished by imprisonment in state prison for not more than five
172years or imprisonment in a jail or house of correction for not less than 90 days nor more than two
173and one-half years or by a fine of not less than $500 nor more than $5,000, or any combination
174of said fines and imprisonment.
175 SECTION 5. Notwithstanding any general or special law or rule or regulation to the
176contrary, within twelve months of the date of enactment, the executive office of health and
177human services shall coordinate with the executive office of public safety and security to issue a
178report and recommendations to improve data sharing, communication, and collaboration between
179health care facilities, as defined by section 51 of chapter 111 of the general laws, and public
180safety and law enforcement entities. The regulations shall include but not be limited to: allowing 10 of 10
181health care facilities to access reports on individuals maintained by agencies within each
182department of the executive office of health and human services, and public safety and law
183enforcement officials through a secure electronic medical record, health information exchange,
184or other similar software or information systems connected to health care facilities, for the
185purposes of improving ease of access and utilization of such data for treatment and diagnosis,
186and supporting integration of such data within a patient’s electronic health record for purposes of
187treatment of diagnosis; expansion of safe and appropriate state-operated alternative placement
188options for patients presenting in health care facilities in acute mental health or behavioral health
189crisis and for whom all reasonable clinical interventions have been unsuccessful, and other
190alternatives, such as transfer to a more secure hospital, are unavailable, and; identifying and
191establishing new pathways to enter patients into the forensic system that do not require an arrest.