Health care workers comprise only 13% of the U.S. workforce but experience 60% of all workplace assaults (Wax, Pinette & Cartin, 2016). Workplace violence is the second leading cause of fatal occupational injury and, in 2013, 1 in 4 workplace fatalities were due to assaults and violent acts against healthcare and social service workers (Occupational Safety and Health Administration [OSHA], 2016).

In the healthcare industry workplace violence is a serious and growing concern. Data shows that in the last decade, the rate of violent incidents reported against healthcare workers has increased by 110% (Campbell, 2016).

In 2018, the Clinic confiscated a staggering 30,000 weapons from patients and visitors in its system in the Northeast Ohio region.

(Harris-Taylor, 2019)

Violence against healthcare employees threatens their dignity, health and safety and also has negative repercussions for employers including reduced productivity and quality of care provided, higher employee turnover and increased costs.

OSHA’s Shortfalls

Despite the fact that workplace violence is prevalent, well-documented and often brings devastating consequences for healthcare workers, there are no mandatory federal safety regulations in place to protect vulnerable workers. At the state level, currently only nine states have legislation mandating that certain types of health care facilities implement workplace violence prevention programs.

Currently, OSHA does not require employers to have workplace violence prevention programs and only has voluntary guidelines, which many have found to be ineffective. Even though OSHA had previously agreed to undergo federal rulemaking to address health care workplace violence, action has stalled in recent years. Whether to consider workplace violence as a serious hazard still remains mainly a discretionary issue for the employer to decide.

The HR 1309 Bill

In November 2019, the House of Representative passed The Workplace Violence Prevention for Health Care and Social Service Workers Act (HR 1309) (link: https://www.congress.gov/bill/116th-congress/house-bill/1309), a federal bill to require healthcare employers to implement comprehensive safety plans to protect healthcare workers. The bill was first introduced by Congressman Joe Courtney (link: https://courtney.house.gov/media-center/press-releases/congressman-courtney-introduces-legislation-reduce-violence-against-) in early 2019 and is the culmination of a seven-year effort that began in 2013, when Courtney first requested that the Government Accountability Office (GAO) study trends of workplace violence in the healthcare industry and identify ways for OSHA to reduce it.

The HR 1309 would offer protections to public-sector workers in the states that are not under OSHA oversight and will require employers to develop comprehensive, workplace-specific plans to prevent violence and to directly monitor violent incidents. Some of these requirements would include:
⦁ Procedures for employees to report workplace violence risks, hazards, and incidents.
⦁ Procedures to identify and respond to reports of workplace violence
⦁ Specific solutions and engineering controls for the healthcare workplace environments including weapon detectors and personal electronic alarms (Click here to read more)
⦁ Hands-on, annual workplace prevention training for employees and supervisors.
⦁ Post-incident investigations.
⦁ Recordkeeping. Employers must maintain at all times a violent incident log for recording all workplace violence incidents. Each incident recorded must include the date, time, and location of the incident, names and job titles of involved employees.

Workplaces Included in HR 1309

A wide variety of workplaces would be also be covered in the proposed legislation including:
⦁ Hospitals, residential treatment facilities and non-residential treatment settings
⦁ Medical treatment or social service settings in correctional or detention facilities
⦁ Psychiatric treatment facilities, substance use disorder treatment centers
⦁ Community care settings, and federal health care facilities, as well as field work settings such as home care and home-based hospice, and emergency services and transport services.

What happens next?

The HR1309 bill has received overwhelming support from healthcare workers and nurses’ labor unions in particular. Nurses (link: https://www.nursingworld.org/practice-policy/work-environment/end-nurse-abuse/) represent one group that is particularly affected by workplace violence.

Now that the HR 1309 bill passed in the House, it goes to the Senate for consideration. While many remain optimistic about the future of this bill, others believe the bill is unlikely to pass in the Republican-controlled Senate (Link). However, whether this legislation passes or not, it is unlikely that the demand for safety will go anywhere and nurses’ unions will continue to exert pressure for change. For instance, California OSHA has recently implemented regulations identical to what the HR 1309 bill proposes. The Cleveland Clinic (link: https://www.ideastream.org/news/cleveland-clinic-ceo-calls-violence-against-hospital-staff-an-epidemic) has also recently implemented comprehensive safety measures that include metal detectors, portable panic buttons, safety cameras and plain clothes officers in the buildings.

The issue is not “if” employers would need to adhere to these new workplace violence requirements, but “when”.

 (Taylor, M. & Castellat, B., 2019)

Passage of the HR 1309 bill would mean major change for employers in the healthcare industry. Employers should follow it closely to remain informed of emerging federal regulation changes regarding workplace violence prevention.