Workplace Violence Prevention in Healthcare and Social Service: Calling OSHA to Action

By: Dee Anna D. Hays

November 30, 2018

On November 16, 2018, Representative Joe Courtney (D-CT) introduced House Resolution 7141, the Workplace Violence Prevention for Health Care and Social Service Workers Act. The bill would force the Occupational Safety and Health Administration (OSHA) to issue an interim final rule on workplace violence requiring “certain employers in the healthcare and social service sectors, and certain employers in sectors that conduct activities similar to the activities in the healthcare and social service sectors, to develop and implement a comprehensive workplace violence prevention plan.” The bill broadly defines workplace violence, without regard to intent, to specifically include:

(i) the threat or use of physical force against a covered employee that results in or has a high likelihood of resulting in injury, psychological trauma, or stress, without regard to whether the covered employee sustains an injury, psychological trauma, or stress; and

(ii) an incident involving the threat or use of a firearm or a dangerous weapon, including the use of common objects as weapons, without regard to whether the employee sustains an injury, psychological trauma, or stress.

The full text of the bill spans more than 30 pages and generally expands upon the minimum requirement that a plan be based upon OSHA’s Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. (OSHA also has a page on its website devoted to resources on this topic.) The bill states that plans must include risk assessments; hazard prevention and controls; reporting, incident response, and post-incident investigation procedures; procedures for emergency response; creation of violent incident logs; employee education and training; annual evaluations; and anti-retaliation provisions.

The bill cites multiple statistics to bolster its implementation, including Bureau of Labor Statistics reports that “health care and social service workers suffered 69 percent of all workplace violence injuries caused by persons in 2016” and these rates “increased by 63 percent between 2006 and 2016.” Its introduction follows previous legislation in nine states (California, Connecticut, Illinois, Maine, Maryland, New York, New Jersey, Oregon, and Washington) mandating that certain types of healthcare facilities implement workplace violence prevention programs. And, OSHA’s workplace violence web page emphasizes that homicide is still “the fourth-leading cause of fatal occupational injuries in the United States.”

If passed, the bill would require OSHA to issue the interim final standard within one year of the bill’s passage. Although the bill does not have a high probability of passing before year-end, it will likely be reintroduced in January 2019 with better odds in a Democrat-controlled House of Representatives.

The implications of the bill go far beyond healthcare and signal a growing expectation for all employers to act now to prevent workplace violence. In fact, the California Division of Occupational Safety and Health (Cal/OSHA) is presently considering expanding its workplace violence regulations, which only affect healthcare facilities, to cover employers in all industries. Interested parties are invited to submit written comments on a revised discussion draft for workplace violence prevention in general industry through the end of November 2018.

In the meantime, OSHA will continue to cite employers for failing to take steps to prevent workplace violence under Section 5(a)(1) of the Occupational Safety and Health Act of 1970, otherwise known as the General Duty Clause. Under that statutory provision, employers are required to keep their workplaces “free from recognized hazards that are causing or are likely to cause death or serious physical harm.” OSHA has resolutely taken the position that workplace violence is a serious, recognized hazard. Thus, employers across all industries may want to implement or update workplace violence prevention plans to help protect their workforces and guard against liability.