An Act To Enhance the Security of Hospital Patients, Visitors and Employees
Maine Legislature, Session 125, LD 0472
Committee: Health and Human Services
Sponsors: CELLI, RIOUX
Amends: 22 MRSA §1832, 34-A MRSA §1803

Legislative Document 
No. 472 
H.P. 365 
House of Representatives, February 10, 2011 
An Act To Enhance the Security of Hospital Patients, Visitors and 
Employees 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
HEATHER J.R. PRIEST 
Clerk 
Presented by Representative CELLI of Brewer. 
Cosponsored by Representative: RIOUX of Winterport. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  22 MRSA §1832 is enacted to read: 
§1832.  Safety and security in hospitals 
1.  Safety and security plan.  By January 1, 2012 and annually thereafter, a hospital 
shall adopt a safety and security plan to protect the patients, visitors and employees of the 
hospital from aggressive and violent behavior.  A hospital safety and security plan must 
comply with the provisions of this subsection. 
A.  In developing a safety and security plan, a hospital shall consider guidelines and 
standards on violence in health care facilities issued by the department, the 
Department of Labor and the federal Department of Labor, Occupational Safety and 
Health Administration. 
B.  In developing a safety and security plan, a hospital shall consult with affected 
employees, including but not limited to any recognized collective bargaining agent.  
A hospital may consult with its affected employees. 
C.  A safety and security plan must provide for adequate employee training to prevent 
and respond to violent acts. 
D.  A safety and security plan must include the following security considerations: 
(1)  The physical layout of the hospital; 
(2)  Staffing and staffing patterns and patient classification systems and an 
analysis of their contribution and connection to aggressive and violent behavior; 
(3)  The adequacy of the hospital's security systems, protocols and policies, 
including the availability of security personnel; 
(4)  The potential security risks associated with specific units or areas of the 
hospital where there is a greater likelihood that a patient, visitor or other person 
may exhibit aggressive or violent behavior; 
(5)  Public access to the hospital; 
(6)  Potential security risks associated with working late night or early morning 
hours; 
(7)  The potential use of a trained response team to assist an employee during an 
incident of aggressive or violent behavior; 
(8)  Employee security in areas surrounding the hospital, including employee 
parking areas; 
(9)  Policies and training related to appropriate response to aggressive and violent 
behavior; and 
(10)  Efforts to cooperate with law enforcement regarding aggressive and violent 
behavior in the hospital. 
E.  A safety and security plan must include the following: 
(1)  Personnel training policies to protect patients, visitors and employees, 
including education on recognizing the potential for violence, when and how to 
seek assistance, how to report an incident of aggressive or violent behavior and 
how to file criminal charges.  For employees regularly assigned to an emergency 
department or psychiatric unit, the policies must require annual training related 
to: 
(a)  General and personal safety measures; 
(b)  Factors that predict aggression and violence; 
(c)  Obtaining the patient history of a patient who has a history at the hospital 
of violent behavior; 
(d)  Characteristics of aggressive and violent patients and of victims; 
(e)  Verbal and physical maneuvers to defuse potentially violent situations 
and avoid violent behavior; 
(f)  Strategies to avoid physical harm; 
(g)  Restraining techniques, including the appropriate use of chemical 
restraints; and 
(h)  Any resources available to employees for coping with incidents of 
violence, including but not limited to critical incident stress management, 
debriefing and employee assistance programs; 
(2)  A system for responding to immediate threats and incidents of aggressive or 
violent behavior, including immediate assistance if needed; 
(3)  A system for investigating threats or incidents of aggressive and violent 
behavior that must include interviewing any person who was threatened with or 
was the subject of aggressive or violent behavior; 
(4)  A system for reporting to the hospital, recording and monitoring situations of 
risk, threats and incidents of aggressive and violent behavior; 
(5)  A system for reporting to the Department of Public Safety, Bureau of State 
Police incidents of aggressive and violent behavior.  The system must require 
reporting all criminal threatening or assaults committed by a patient or a person 
accompanying a patient, with recording of the date, time and location of the 
incident, the name of the person who committed the criminal threatening or 
assault and the person who was the victim of the criminal threatening or assault, a 
description of the incident and the response of the hospital.  The system must 
require reporting within 24 hours all assaults that result in injury and all criminal 
threatening and all assaults that involve the use of a firearm or other dangerous 
weapon or that present an urgent or emergent threat to the health, safety or 
welfare of patients, visitors or employees. The system must require reporting all 
other reportable incidents within 72 hours; and 
(6)  Modifications in job design, staffing, security, equipment or facilities to 
prevent or address aggressive and violent behavior against patients, visitors or 
employees. 
F.  A safety and security plan must provide for: 
(1)  An appropriate response by the hospital that protects the alleged perpetrator 
and the alleged victim; 
(2)  The right of an employee to seek assistance and intervention from law 
enforcement and evaluation and treatment for physical or emotional injuries 
without retaliation by the hospital; and 
(3)  Evaluation and treatment for an employee who is a victim of an incident of 
violence, including, if requested by the employee, access to individual crisis 
counseling, support group counseling, peer assistance and professional referrals 
to address trauma or distress. 
G.  A safety and security plan must include a system for tracking incidents of 
aggressive and violent behavior and the hospital's responses to those incidents as part 
of the hospital's quality assessment and improvement program. 
2.  Security staffing.  A hospital shall provide security staffing to meet the 
requirements of a safety and security plan under subsection 1 and shall provide training to 
security staff on the role of security, the identification of factors that predict violence and 
aggression and management of critical incidents. 
3.  Immunity.  A hospital or employee of a hospital who in good faith makes a report 
to the Department of Public Safety pursuant to a safety and security plan under subsection 
is immune from liability for making the report. 
4.  Interference prohibited.  A person may not interfere with or obstruct reporting 
pursuant to a safety and security plan under subsection 1.  A person who violates this 
subsection commits a Class E crime. 
5.  Penalties.  The department may impose an administrative penalty against a 
hospital or a licensee of a hospital for a violation of the reporting requirements of a safety 
and security plan adopted pursuant to subsection 1 in an amount not exceeding $7,500 for 
a first violation, $10,000 for a 2nd violation and $12,500 for a 3rd or subsequent 
violation. 
6.  Department of Public Safety response.  When the Department of Public Safety 
receives a report that indicates an ongoing, urgent or emergent threat of imminent danger 
of death or serious injury to the patients, visitors or employees of a hospital, the 
Department of Public Safety shall visit the hospital to inspect or investigate the threat 
within 2 business days of receiving the report and shall complete any investigation and 
report to the Department of Health and Human Services within 45 days. 
Sec. 2.  34-A MRSA §1803, sub-§3, ¶A-1 is enacted to read: 
A-1.  Adopt standards for safety and security plans in correctional facilities and 
county jails to protect inmates and employees from aggression and violence; 
Sec. 3.  Report.  The Department of Health and Human Services shall report to the 
Legislature by January 31st each year, beginning in 2013, regarding reports on incidents 
of violence in hospitals made to the department for the previous year pursuant to hospital 
safety and security plans required under the Maine Revised Statutes, Title 22, section 
1832.  The report must protect patient and employee confidentiality, must provide the 
total number of reports, must identify the hospital facilities and any inspections or 
investigations, must provide information on any administrative penalties levied by the 
department for violations and may include recommendations on how to prevent incidents 
of violence in hospitals. 
SUMMARY 
This bill requires the adoption of safety and security plans to protect patients, visitors  
and employees in hospitals.  The plan would require training for employees, a system for 
reporting, investigation of incidents of violence, a guarantee of the employee's right to 
seek assistance and treatment, immunity for good faith reporting of incidents and 
reporting to the Department of Public Safety and from that department to the Department 
of Health and Human Services.  It requires the State Board of Corrections to adopt 
standards for safety and security plans in correctional facilities and county jails.  It also 
requires annual reporting from the Department of Health and Human Services to the 
Legislature on reports of violence in hospitals.