Bill H.259 would require standardized hospital workplace-violence prevention plans

Representative Marie Cortes introduced H.259 to the Senate Health & Welfare Committee, proposing statewide, standardized workplace-violence prevention plans for hospitals.

Cortes said the measure responds to a rise in threats and assaults against health-care workers and was developed with nurses, nurse practitioners and hospital stakeholders. "This is another bill where the stakeholders all worked on it together and came to consensus," Cortes said.

The bill would require each licensed hospital to establish and implement a security plan addressing high-risk areas such as emergency departments, form a security-plan team that includes frontline health-care workers and law enforcement representatives, and base the plan on a security risk assessment. The plan must provide for at least one hospital employee trained in de-escalation to be present at all times in emergency and patient-care areas and require a trauma-informed-care liaison to law enforcement to support victims and prioritize staff safety and retention. H.259 also would allow staff who provide direct patient care to request an identification badge showing only a first name or a first name and last initial.

H.259 would require hospitals to establish a workplace-violence incident reporting system to document, track, analyze and evaluate incidents and the number of incidents reported to law enforcement. Hospitals would be required to train employees on how to use the system, prohibit retaliation against reporters, and post conspicuous notices for patrons that remind them staff do not tolerate threatening or aggressive behavior and note legal consequences for assaulting hospital employees.

The bill directs the Agency of Human Services (AHS) to work with hospitals to identify incentives and funding to support program development and operation and states that nothing in the section requires a hospital to make capital investments to implement a security plan. H.259 would add expenditures necessary to implement a security plan to the list of items excluded from the Certificate of Need (CON) subchapter and would require hospitals to file costs associated with implementing the plan with the Green Mountain Care Board as part of budget filings. The bill includes an effective date of July 1, 2025.

Cortes cited statistics and testimony to explain the bill's urgency: she said that, "from June 2023 through December 2024, six Vermont hospitals reported 89 incidents of workplace violence against health-care workers," that Vermont hospital workers have a reported rate of 7.8 days away from work, job restrictions or transfers per 10,000 workers related to workplace violence, and that recruiting a replacement nurse can cost about $88,000. She provided examples of assaults and said the incidents have led to traumatic brain injuries, pregnancy loss and PTSD among affected workers.

Katie (legislative staff) walked the committee through bill text during the hearing, outlining the proposed new statutory subsection (1911b), the required elements of security plans, the reporting system, the CON exemption, and the Green Mountain Care Board filing and budget-review requirements. Katie summarized required training topics in the bill as including de-escalation, defensive tactics, response to weapons, trauma-informed care, crisis intervention and clinician well-being practices.

Committee members asked whether nursing and medical schools provide relevant training and whether the problem extends beyond hospitals to other care settings such as clinics and mental-health programs. Senator Gulick and others noted workplace violence occurs in other settings that serve volatile or high-need populations and that the 2023 Act 24 (S.36 of 2023) already involved public-safety coordination; Cortes said H.259 is intended to dovetail with that work and clarify when law enforcement should be involved.

No formal vote or committee action occurred during the hearing. The committee scheduled additional testimony and planned to resume the hearing after a brief recess; a witness was expected at 11:15.