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Legislation Aims to Reduce Violence Against Healthcare and Social Service Workers

Dec 12, 2018

U.S. Representative Joe Courtney (CT), a senior member of the House Education and Workforce Committee, has introduced legislation aimed at curtailing rising rates of on-the-job violence affecting healthcare and social service employees such as nurses, physicians, emergency responders, medical assistants and social service workers. The Workplace Violence Prevention for Health Care and Social Service Workers Act (HR 7141) would require OSHA to issue a standard requiring healthcare and social service employers to write and implement a workplace violence prevention plan to prevent and protect employees from violent incidents. 

“We expect health care and social service employees to care for us in our times of need, but . . . these men and women are faced with rising rates of violence, often from patients and their families,” Courtney says. “This legislation [would] compel OSHA to . . . create an enforceable standard to ensure that employers are taking these risks seriously and creating safe workplaces that their employees deserve.”

A 2016 study by the Government Accountability Office reported that rates of violence against healthcare workers are up to 12 times higher than rates for the overall workforce, and 70% of nonfatal workplace assaults in 2016 occurred in the health care and social assistance sectors. Data from the Bureau of Labor Statistics indicate that healthcare and social service workers suffered 69 percent of all workplace violence injuries caused by persons in 2016 and are nearly five times as likely to suffer a workplace violence injury than workers overall.  

OSHA issued ‘‘Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers’’ in 2015, but those are advisory and not enforceable. "Currently, OSHA can take enforcement actions against employers under the General Duty Clause of the OSH Act and can issue penalties of up to $129,336 per affected worker," explains Adele Abrams, ASSP's federal representative. That process can be difficult, however, she says, because the agency must provide that the "cited employer was aware of a recognized hazard (in this case, workplace violence risks) that could cause death or serious bodily harm to its own employees, that employees were exposed to the hazard within the previous six months and that there is a feasible method of abatement."

Abrams also reports that OSHA's fall 2018 regulatory agenda included the agency's Prevention of Workplace Violence in Healthcare and Social Assistance rulemaking, which was initiated in 2016. The agency plans to hold a Small Business Regulatory Enforcement Fairness Act panel on the rulemaking in March 2019. According to Abrams, that means consideration of HR 7141 "could occur contemporaneously with an OSHA rulemaking initiative."

The minimum requirements in a mandated program would include: 

  • unit-specific assessments and implementation of prevention measures;
  • physical changes to the work environment;
  • staffing for patient care and security;
  • employee involvement in all phases of the workplace violence prevention plan;
  • hands-on training;
  • recordkeeping requirements and a violent incident log;
  • protections for employees to report workplace violence to their employer and law enforcement.

In late October 2018, ASSP hosted the Women's Workplace Safety Summit, and workplace violence involving women was one of three focus topics of the event. Workplace violence has a disproportionate impact on women and is the leading cause of fatalities for workers who are women. 

Abrams says that while no action is likely to occur on the legislation the current session, it is quite likely the measure will be reintroduced in January 2019.


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