Vermont nurses press for statewide standards as committee reviews H.259 on hospital workplace violence prevention

Nurses and nursing leaders told the Vermont House Committee on Health Care on Oct. 12 that workplace violence in hospitals has grown into a crisis and asked lawmakers to pass H.259, a bill that would require hospitals to adopt standardized workplace-violence prevention programs, oversight committees that include direct-care staff, annual risk assessments, de-escalation training and trauma-informed victim support.

Elizabeth Kudo, a nurse of 16 years and the Government Affairs Committee chair for the Emergency Nurses Association of Vermont, told the committee that “workplace violence is now considered a pandemic in our field,” and described repeated assaults, stabbings and high levels of underreporting. She cited the Bureau of Labor Statistics finding that workers in “healthcare and social services” are about five times more likely to be assaulted than those in other occupations and said national reporting shows “every hour, three healthcare providers are assaulted.”

The testimony framed workplace violence as a driver of staffing shortages and reduced hospital capacity. Kudo described long emergency-department wait times, shrinking outpatient and behavioral-health resources and rising use of contract nurses as contributors to stress and violence that, in turn, push experienced staff from the workforce. “We have a right to feel and be safe while at work,” she said, arguing for a consistent statewide standard so all Vermont health-care workers receive the same protections.

Betsy Hassan, president of ANA Vermont and director of nursing education and professional development at the University of Vermont Medical Center, reviewed key provisions of H.259. As outlined by Hassan, the bill would require each hospital to develop a workplace-violence prevention program that includes an oversight committee with direct-care staff representation, an annual risk assessment process, de-escalation and defensive-response training, trauma-informed victim support and a facility security plan addressing visitor management and physical protections. The bill also seeks exemption from certificate-of-need review for capital projects tied to workplace safety (for example, ballistic glass or visitor management systems) and asks the Agency of Human Services to help identify incentives and funding sources.

Hassan and Kudo emphasized that the bill is intended to be a “toolbox” for hospitals — not a one-size-fits-all mandate — and said professional organizations have evidence-based toolkits the state can use to set consistent standards. Hassan noted federal guidance from OSHA is outdated and that several states already require workplace-violence programs by law.

Committee members raised implementation questions and concerns about the bill’s interaction with existing statutes. Representative Nate asked whether the bill covers hospital grounds and off-site facilities; witnesses said the bill’s security-plan language is intended to apply to any structure where staff and patients are present, but suggested the committee could clarify that point. Members also sought detail about how the bill would be financed and whether smaller hospitals could meet new requirements without state support.

Matthew (Green Mountain CarePoint), representing the hospital budget regulator, said Green Mountain CarePoint supports the bill’s goals but expressed a technical concern about a provision that would make hospital budget review “shall” require allocation of funds to a workplace-violence plan. “The way the language is written… it’s more prescriptive,” he said, and asked for alternative language that would allow the board to review budgets for consistency with a hospital’s workplace-violence plan rather than require specific funding allocations. He offered to submit proposed language to the committee the same day.

Testimony also noted existing tools and gaps. Witnesses thanked the committee for Act 24 and Act 109 (state statutes referenced in testimony) but said those measures are largely reactive; H.259 is intended to add preventive practices. Witnesses described local programs such as UVM Medical Center’s Code Assist and peer-support trainings, and urged the committee to couple regulatory standards with funding or incentives so hospitals can implement consistent programs without cutting other clinical staff.

Committee members requested that staff circulate a VPQHC report referenced in the hearing (identified in session as the VPQHC report under S-36, January 2024) and asked the bill sponsors and agencies to supply draft alternate language on budget-review wording. No formal vote was taken on H.259 during the hearing.

The committee paused after the testimony to gather the requested materials and await revised bill language. Witnesses said they would continue to work with administration officials, hospitals and law-enforcement partners on implementation details, including uniform training for law enforcement and health-care staff and statewide systems for tracking incidents and “no trespass” alerts.