Audit, Compliance and Risk Blog

Employees in the health care and social service sectors suffer workplace violence at much higher rates than in most other sectors, largely because of the higher risk from their patients and clients. In response to these risks, worker protection agencies and professional organizations have developed guidelines for workplace violence prevention in these sectors. Increasingly, worker protection laws and regulations are being revised to require these activities. Most recently, in December 2015 California has proposed to expand state requirements for security plans to include explicit workplace violence prevention programs.

Existing Requirements For Security Plans

• Conduct a security and safety assessment at least annually.

• Use the assessment to develop a security plan with measures to protect personnel, patients, and visitors from aggressive or violent behavior. Each plan is to include security considerations relating to all of the following:

  • Physical layout

  • Staffing

  • Security personnel availability

  • Policy and training related to appropriate responses to violent acts.

  • Efforts to cooperate with local law enforcement regarding violent acts at the facility;

• Provide appropriate training to appropriate employees, which must include all hospital employees regularly assigned to an emergency room.

• Report all assault and battery cases (defined by reference to the state Penal Code) to law enforcement within 72 hours.

New Proposal For Workplace Violence Prevention Programs

California adopted additional requirements effective January 1, 2015, requiring the California Department of Industrial Relations (DIR; rules are adopted by the state Occupational Safety and Health Standards Board (OSHSB) and administered by the Division of Occupational Safety and Health (Cal/OSHA)) to require licensed hospitals to expand their Injury and Illness Prevention Programs (IIPPs) to include workplace violence prevention plans. OSHSB proposed rules on December 17, 2015, which are to be finalized by July 1, 2016.These new requirements will apply to in-patient health facilities, out-patient medial offices and clinics, home health care and home-based hospices, paramedic and emergency medical services, mobile clinics (and comparable field operations), drug treatment programs, and ancillary health care operations.

These employers are to prepare workplace violence prevention plans including all of the following:

• Names or job titles of the persons responsible for implementing the Plan.

• Effective procedures to obtain the active involvement of employees and their representatives in developing, implementing, and reviewing the Plan.

• Methods the employer will use to coordinate implementation of the Plan with other employers whose employees work in the health care facility, service, or operation.

• A policy prohibiting the employer from disallowing an employee from, or taking punitive or retaliatory action against an employee for, seeking assistance and intervention from local emergency services or law enforcement when a violent incident occurs.

• Effective procedures to accept and respond to reports of workplace violence, including Type 3 violence, and to prohibit retaliation against an employee who makes such a report.

• Procedures to ensure that supervisory and non-supervisory employees comply with the Plan.

• Procedures to communicate with employees regarding workplace violence matters, including:

  • How employees will document and communicate to other employees and between shifts and units, information regarding conditions that may increase the potential for workplace violence incidents.

  • How an employee can report a violent incident, threat, or other workplace violence concern.

  • How employees can communicate workplace violence concerns without fear of reprisal.

  • How employee concerns will be investigated, and how employees will be informed of the results of the investigation and any corrective actions to be taken.

• Procedures to develop and provide required training.

• Assessment procedures to identify and evaluate environmental risk factors.

• Procedures to identify and evaluate patient-specific risk factors and assess visitors.

• Procedures to correct workplace violence hazards in a timely manner.

• Procedures for post-incident response and investigation.

These employers must also prepare and maintain a violent incident log, and to report specified violent incidents to Cal/OSHA. Cal/OSHA is to post annual reports of violent incidents (protecting employee privacy), beginning by January 1, 2017.
Record keeping requirements are specified. Employers also provide an annual review of the effectiveness of the plan.

Self-Assessment Checklist

Does the organization operate any activities or facilities that will be subject to Cal/OSHA’s workplace violence prevention plan requirements?

• If so, does it maintain a workplace violence prevention plan?

Does the organization record incidents of workplace violence?

• If so, does it maintain a separate violent incident log?

Where Can I Go For More Information?

• California OSHSB webpage for health sector WVP proposal  

• Cal/OSHA IIPP webpage 

• OSHA workplace violence webpage 

Specialty Technical Publishers (STP) provides a variety of single-law and multi-law services, intended to facilitate clients’ understanding of and compliance with requirements. These include:

• OSHA Auditing - Federal Compliance Guide: Facilities

• OSHA Auditing - California Occupational Health and Safety Audit Guide

• Workplace Violence Prevention: A Practical Guide to Security on the Job

• Directors' and Officers' Liability

• Directors' Liability in Canada 

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