A federal standard to protect health care and social assistance employees from workplace violence is necessary because only a few states have such protections in place and they are sometimes not enforced, union representatives say.

OSHA last week granted a petition filed by a group of labor unions in July 2016 to commence rule-making for a nationwide standard to protect health care and social assistance workers from workplace violence. In 2015, there were more than 11,000 violent incidents against employees in this sector — a number that is nearly as high as all other industries combined, David Michaels said in announcing that the agency would pursue the standard on his last day as assistant secretary of labor for occupational safety and health. 

The agency has previously tried to address this hazard via guidelines and enforcement actions taken under the Occupational Safety and Health Act’s general duty clause. For example, OSHA cited Fort Washington, Pennsylvania-based BHC Northwest Psychiatric Hospital L.L.C., doing business as Brooke Glen Behavioral Hospital, on Jan. 11 for four serious violations under the general duty clause for exposing employees to workplace violence hazards. The agency’s investigation found the facility had a number of incidents in which employees were punched, bit, scratched, grabbed and hit with objects, resulting in serious injuries, with OSHA proposing $32,158 in penalties. 

The OSHA rule-making aims to build on momentum established in California. In October 2016, the California Division of Occupational Safety and Health Administration Standards Board unanimously adopted a standard that aims to reduce violent incidents and protect workers, in response to union petitions. The standard will require that health care employers create a violence prevention plan, keep a comprehensive record of violent incidents and provide workplace violence training. It applies to hospitals, home-based hospice, emergency medical services, emergency medical transport, drug treatment programs and outpatient medical services to the incarcerated in correctional and detention settings.

“I’m happy to say it is now final and goes into effect April 1, despite the new administration, because California is different and that’s kind of cool,” Katherine Hughes, a registered nurse, member of the Service Employees International Union Local 121RN and labor specialist in Pasadena, California, said during an OSHA hearing last week. 

The California standard “serves as a really good model” because it mandates employers maintain a violent incident log with information about every incident, including the use or threat of physical force, that must be reviewed when the effectiveness of the plan is reviewed annually, said Jean Ross, a registered nurse and co-president of the Silver Spring, Maryland-based National Nurses United, which represents more than 150,000 nurses in the United States and petitioned OSHA to pursue a standard. 

As of August 2015, nine states — California, Connecticut, Illinois, Maine, Maryland, New Jersey, New York, Oregon and Washington — enacted laws that require employers with health care and/or social assistance workers to establish a plan or program to protect those workers from workplace violence, according to the U.S. Government Accountability Office. But these state laws vary widely in scope and requirements. For example, New York is the only state that operates its own OSHA program that has a standard that specifically requires a violence prevention program, but coverage is limited to public employees. 

“The New York standard has worked very well and should be used as an example by federal OSHA,” said Dave LeGrande, occupational safety and health director for the Communications Workers of America in Washington, D.C. 

New Jersey has had workplace violence prevention guidelines in place for years, but the stabbing of a worker in 2009 led the union to lobby for a more comprehensive set of guidelines or a standard, he said. 

“Unfortunately, Gov. (Chris) Christie has really prevented that effort from going forward, thus the need for a federal OSHA standard to prevent that kind of politics from preventing possibly death or serious injury,” Mr. LeGrande said. A spokesman for the governor did not respond to the request for comment.  

Bernie Gerard, vice president of the Emerson, New Jersey-based Health Professionals and Allied Employees, a union representing New Jersey health care workers, referred to the “perceived successes” of New Jersey’s requirements, which outlines tasks such as developing committees, performing environmental assessments and involving front-line staff in prevention efforts. 

“It’s all there, but it’s not enforced,” he said. “A standard is a standard, and we really need that.”