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House advances bill requiring Vermont hospitals to adopt workplace-violence prevention plans
Summary
The House adopted a strike-all amendment to H.259 requiring Vermont hospitals to develop security plans, incident-reporting systems and training; the Green Mountain Care Board will consider related costs in budget reviews, and the measure includes an exemption from the CON process for security-plan expenditures.
The Vermont House on March 18 adopted a strike-all amendment to H.259, a bill that would require hospitals to develop and implement workplace-violence prevention plans, create incident-reporting systems, set training standards and include certain costs in hospital budget review with the Green Mountain Care Board.
Representative from Bristol (the committee sponsor) told the House the bill responds to an uptick in violence against health-care workers and the lack of uniform requirements in Vermont hospitals. "H.259 will require uniform standards and requirements for developing workplace-violence prevention programs based on evidence and best practices," the sponsor said on the floor, citing testimony from health-care coalitions and Vermont program for quality in health care that found gaps in training, data collection and physical-site measures.
The strike-all amendment requires hospitals to perform security risk assessments that cover emergency departments and other high-risk patient-care areas; establish teams that include health-care employees and law-enforcement representatives to advise plan development; maintain at least one employee trained in de-escalation in emergency and direct-care areas; and offer trauma-informed victim support and liaison functions with law enforcement. The plan must include incident reporting that tracks reported incidents and incidents reported to law enforcement and must prohibit discrimination or retaliation against employees who report incidents or participate in investigations. The amendment also directs the Agency of Human Services to work with hospitals to identify funding or incentives and requires hospitals to file costs associated with implementation in their annual budget review. The Green Mountain Care Board is directed to consider such costs during hospital budget reviews, and the bill includes an exemption for certificate-of-need review with respect to security-plan-related expenditures.
Committee witnesses reported included hospital association representatives, nursing organizations, the Vermont Program for Quality in Health Care (which the sponsor quoted), Green Mountain Care Board staff and law-enforcement officials. The House Health Care Committee reported favorably on the strike-all amendment by a 10-0-1 vote.
On the floor, several members expressed strong support for the bill's intent to protect health-care workers, while others raised concerns about potential unfunded mandates and the interaction with civil-rights protections and prior statutory changes addressing law-enforcement removal of violent persons. The member from Northfield said hospitals face financial strain and that implementing security plans could become an unfunded mandate despite the CON exemption; the member from Barrytown asked whether testimony addressed capital costs such as construction or staff hiring, and the committee sponsor replied there was no specific testimony quantifying such costs. The member from Northfield also requested technical amendments to clarify cross-references related to when law enforcement should remain with a patient.
The House adopted the committee amendment on a voice vote; the ayes had it and third reading was ordered. The act is set to take effect on July 1, 2025.
