In mid-November 2018, Rep. Joe Courtney (D-CT) introduced legislation that would set a deadline for OSHA to issue the first national standard requiring that healthcare and social service employers develop and implement a comprehensive workplace violence prevention plan. The bill was referred to the House Committee on Education and the Workforce; the legislation has 22 cosponsors, all Democrats.
Courtney’s Workplace Violence Prevention for Health Care and Social Workers Act (HR 7141) would fill what advocates of healthcare workers believe is the most unacceptable gap in the entire federal worker protection system. Statistics seem to bear this out. For example, in a 2016 report, the Government Accountability Office said that over 730,000 cases of healthcare workplace assaults occurred between 2009 and 2013. The Bureau of Labor Statistics (BLS) reported that healthcare and social service workers suffered 69 percent of all workplace violence injuries caused by persons in 2016. The BLS added that these workers are nearly five times as likely to suffer a workplace violence injury than workers overall.
“This legislation compels OSHA to do what employees, safety experts, and members of Congress have been calling for for years—create an enforceable standard to ensure that employers are taking these risks seriously and creating the safe workplaces they employees deserve,” said Courtney.
OSHA has been taking the issue seriously, although the Agency’s interest in promulgating a standard has been inconsistent. Just before President Barack Obama left office, OSHA announced that it intended to develop a federal standard to prevent workplace violence in healthcare settings. Several months after President Donald Trump’s inauguration, the rulemaking was removed from the Department of Labor’s long-term regulatory agenda. Subsequently, it was placed back on the regulatory agenda.
OSHA’s recognition that violence in the healthcare system is a major worker safety issue was manifested in an extensive guidance document, Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers (2015 revision). These guidelines are not enforceable. HR 7141 would require that OSHA’s standard be based, at a minimum, on the guidelines document.
The bill notes that nine states have mandated that certain types of healthcare facilities implement workplace violence prevention programs. On April 1, 2018, the Division of Occupational Safety and Health of the State of California issued the nation’s first standard to require that healthcare facilities implement a workplace violence prevention plan.
Scope of the Bill
HR 7141 would apply to hospitals, residential treatment facilities, nonresidential treatment settings, medical treatment or social service settings in correctional or detention facilities, psychiatric treatment facilities, substance use disorder treatment centers, community care settings such as group homes and mental health clinics, federal healthcare facilities such as those operated by the Veterans Administration and the Indian Health Service, as well as field work settings such as home care and home-based hospice, and emergency services and transport services.
Workplace violence is defined in the bill as “any act of violence or threat of violence, without regard to intent, that occurs at a covered facility or while a covered employee performs a covered service.”
Major provisions of the bill include the following:
- Employers must develop and implement a Workplace Violence Prevention Plan (Plan) tailored to the relevant hazards in the specific facility. The plan must be developed with the cooperation of affected employees and, where applicable, their representatives.
- The Plan must include both work practice controls, such as security, staffing, and training on de-escalation techniques, and environmental controls, such as personal alarm devices, adequate exit routes, surveillance monitoring systems, barrier protection, entry procedures, and weapons detectors.
- The Plan must outline procedures for reporting, responding to, and investigating incidents, and providing medical care and first aid to affected employees.
- The Plan must include procedures for training of the workforce, coordination with other employers that have employees who work at the site, and an annual evaluation of the Plan.
- The employer must investigate each incident of workplace violence as soon as practicable, document the findings, and take corrective measures.
- The employer must provide annual in-person training and education to employees. When employees are reassigned, they must receive additional training.
- The employer must record workplace violence incidents in a Violent Incident Log. An annual summary of the Log must be posted in the workplace in a manner similar to the OSHA Annual Summary of Injuries and Illnesses and be transmitted to OSHA.
- The bill prohibits retaliation against a covered employee for reporting a workplace violence incident, threat, or concern to an employer, law enforcement, local emergency services, or a government agency.
The bill would require an interim final standard within 1 year after enactment and a final standard no more than 42 months after enactment.