Unions Craft Petition Seeking OSHA Rule Addressing Health Facility Violence

A source familiar with the issue says the coalition, including the American Federation of Teachers (AFT), Service Employees International Union, American Federation of State, County and Municipal Employees, United Steelworkers, National Nurses United (NNU) and others are expected to petition OSHA “to formally begin the process” to craft a standard.

Such a petition could provide a formal mechanism by which the unions could eventually sue the agency to force formal consideration of a standard, a move that may be necessary given uncertainty whether OSHA will agree to develop the standard.

The effort comes days after top Democratic lawmakers, including Sen. Patty Murray (D-WA) and Rep. Bobby Scott (D-VA), the ranking Democrats on Congress’ labor committees, publicly urged OSHA to craft such a standard.

“It is clear to me that OSHA should move forward and develop an enforceable violence prevention standard to help protect our nation’s healthcare workers. Injuries requiring days away from work are financially and emotionally costly for both employers and workers, and these avoidable injuries put pressure on working families to do more with less,” Scott said in an April 14 statement.

“No worker should ever have to fear facing violence on the job,” said Murray.

The lawmakers made their statements as they released a long-awaited report from the Government Accountability Office (GAO) that found a growing number of violent incidents against healthcare workers but limits on OSHA’s current ability to limit it.

According to a fact sheet on the GAO report, OSHA has issued voluntary guidelines on preventing workplace violence in healthcare facilities, which include a risk assessment, employee engagement, flagging high risk patients, environmental controls (locks, escape routes, alarm buttons, etc.), record keeping and evaluation.

But OSHA has no formal standard that requires healthcare facilities to adopt a violence prevention program. Instead, the agency has been forced to rely on the OSHA Act’s “general duty clause” for enforcement, which requires elements of evidence that are complex to develop and sustain in these cases.

According to the fact sheet, from 1991 through October 2014, OSHA issued 18 general duty clause citations to healthcare employers for failing to address workplace violence; 13 of those citations were issued from 2012 through 2014, when OSHA implemented its National Emphasis Program targeting workplace violence in nursing and residential care facilities.

OSHA officials acknowledged that it can be challenging to develop a general duty clause citation for workplace violence, and cited potential benefits of having a workplace violence prevention standard, the fact sheet says. For example, OSHA inspectors can issue nonbinding hazard alert letters warning employers of a serious workplace violence safety concern. But currently, OSHA does not know whether employers have taken steps to address the safety hazards identified in such letters, the sheet says.

GAO Recommendations

Given the limits in OSHA’s authority, the GAO report issued a series of recommendations, including urging OSHA to improve training for inspectors on developing citations for workplace violence hazards and follow-up on hazard alert letters to determine whether an employer has implemented steps to prevent workplace violence, or if a follow-up inspection is needed.

GAO also called for OSHA to “assess the results of its current efforts to determine whether additional action, including development of a standard, is needed.”

But in a response to the recommendation, OSHA stopped short of formally committing to develop a standard. In its Feb. 26 response to an early draft of the GAO report, Administrator David Michaels said the agency “intends to find a cost-effective way to gauge its enforcement efforts to determine whether additional measures, such as developing a workplace violence standard for healthcare workers, is necessary.”

Michaels added that the agency should “continue this important enforcement initiative, and others, to reduce the hazards of workplace violence.”

Such a considered effort appears to fall short of calls by labor representatives who are renewing their long-standing calls for OSHA to quickly move to develop a standard. “The GAO report demonstrates what we already know from our members–it is past time for federal action to protect healthcare workers across the nation, as rates of violence are on the rise and increasing in severity,” Bonnie Castillo, NNU’s director of health and safety, said in a statement following the release of the GAO report.

“To fully protect all healthcare workers in the nation, we need a strong federal OSHA standard requiring workplace violence prevention plans in all hospitals and healthcare facilities. And we need it now,” she said.

Randi Weingarten, AFT’s president, echoed Castillo’s call. “It’s time to treat workplace violence in healthcare settings with the seriousness this crisis warrants. We urge OSHA to promulgate a national standard. Healthcare professionals, patients, and visitors deserve nothing less,” Weingarten said.