Workplace Violence Prevention for Health Care and Social Service Workers Act

In a 2016 report entitled, “Workplace Safety and Health: Additional Efforts Needed to Help Protect Health Care Workers from Workplace Violence”, the Government Accountability Office reported over 730,000 cases of health care workplace assaults over the 5-year span from 2009 through 2013, based on Bureau of Justice Statistics data.

The health care and social service industries experience the highest rates of injuries caused by workplace violence. Nurses and nursing, psychiatric, home health, and personal care aides all are at high risk.

The 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 are nearly 5 times as likely to suffer a workplace violence injury than workers overall.

According to a survey of 3,500 American emergency physicians conducted by the American College of Emergency Physicians, 47 percent of emergency room doctors have been physically assaulted at work, and 8 in 10 report that this violence is affecting patient care.

Workplace violence in health care and social service sectors is increasing. Bureau of Labor Statistics data show that private sector injury rates of workplace violence in health care and social service sectors increased by 63 percent between 2006 and 2016. Due to under-reporting, actual injury rates from workplace violence are widely recognized to be higher than reported levels.

Violence against workers in health care settings is most commonly due to assaults by patients or clients, or persons accompanying patients or clients.

The Occupational Safety and Health Administration has issued “Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers”, however, this guidance is not enforceable. Absent an enforceable standard, employers lack mandatory requirements to implement a violence prevention program, and workers lack sufficient protection from workplace violence.

Studies have demonstrated that workplace violence prevention programs tailored to the needs of specific work areas and State-based workplace violence prevention legislation are strongly associated with reductions in workplace violence. Proper staff training, appropriate staffing levels, sufficient resources, and the use of evidence-based practices in the provision of services (such as effective communication with patients using de-escalation techniques) can reduce risks to the safety of both patients and staff.

Nine States have mandated that certain types of health care facilities implement workplace violence prevention programs. On April 1, 2018, the Division of Occupational Safety and Health of the State of California issued a comprehensive standard (“Workplace Violence Prevention in Health Care”) that requires health care facilities to implement a workplace violence prevention plan.

Employer organizations have challenged the Occupational Safety and Health Administration’s authority to utilize the General Duty Clause of the Occupational Safety and Health Act of 1970 to enforce against workplace violence hazards, arguing that Congress did not intend to cover workplace violence under such clause when the Act was enacted in 1970.

The Occupational Safety and Health Administration (OSHA) received two petitions for rulemaking in July of 2016, calling on OSHA to promulgate a violence prevention standard for health care and social service sectors. On December 6, 2016, OSHA issued a Request for Information (RFI) soliciting information on this issue. On January 10, 2017, OSHA conducted a public meeting to receive stakeholder input and to supplement the online comments submitted in response to the RFI. At that meeting, OSHA announced it accepted the petitions and would develop a Federal standard to prevent workplace violence in health care and social service settings. In the spring of 2017, the workplace violence prevention standard was removed from active consideration and placed on the Department of Labor’s “long-term agenda”. Subsequently, it was placed back on the regulatory agenda. OSHA’s efforts to move forward with rulemaking have been halting and inconsistent. Therefore, legislation is necessary to ensure the timely development of a standard to protect workers in health care and social service settings.