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Resurrected legislation would force OSHA action on violence against health care, social service workers

By Pamela Wolf, J.D.

A similar measure cleared the House in the last Congress with a bipartisan 251-158 vote but died in the Senate.

On February 22, a bipartisan group of lawmakers reintroduced legislation aimed at curbing the rising rates of workplace violence faced by health care and social service employees, such as nurses, emergency responders, medical assistants, physicians, and social workers. The Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1195) would direct OSHA to issue standards requiring health care and social service employers to write and implement a workplace violence prevention plan to prevent and protect employees from assaults at work.

House approval of earlier version. In February 2019, House Democrats introduced similar legislation (H.R. 1309) in the last Congress. That bill passed the House in November 2019 with a bipartisan vote of 251-158, that saw 32 Republicans crossing the aisle to support it. After the bill was received in the Senate, it was read twice and assigned to the Senate Health, Education, Labor, and Pensions Committee where it remained with no further action.

Rising violence. The bill’s sponsors observed that incidents of violence against health care and social service workers is on the rise and have been exacerbated by the COVID-19 pandemic. They pointed to a 2016 Government Accountability Office report showing that rates of violence against health care workers were as much as 12 times higher than rates for the overall workforce, and that 70 percent of nonfatal workplace assaults in 2016 occurred in the health care and social assistance sectors. Bureau of Labor Statistics data for 2016-2017 found a sharp increase in serious injuries because of workplace violence among health care workers, the sponsors noted.

A 2020 survey of registered nurses conducted by National Nurses United found that 20 percent of registered nurses reported increased workplace violence during the COVID-19 pandemic.

Front line employees in these settings interact with a range of patients and clients, often with little training or direction for how to prevent or handle interactions that become violent. The Workplace Violence Prevention in Health Care and Social Services Act would ensure that health care and social service workplaces adopt proven prevention techniques and are prepared to respond in the tragic event of a violent incident.

Earlier OSHA efforts stalled. In 2013, House Democrats requested that the GAO study the trends in healthcare workplace violence and identify options for OSHA to curtail it, and in 2016, lawmakers asked OSHA to develop a workplace safety standard to protect health care workers from this rising violence.

OSHA held a public meeting in January 2017 on the need for a standard to prevent workplace violence in healthcare and social assistance. The meeting was aimed at supplementing written comments submitted in response to its December 7, 2016, request for information by permitting workers to recount their personal experiences with workplace violence, as well as to provide a forum for a discussion among stakeholders. The agency also indicated at that time that it would commence rulemaking on a new standard, but that action stalled under the Trump Administration.

Time to ensure action. According to its sponsors, in the absence of voluntary action from OSHA, the Workplace Violence Prevention in Health Care and Social Services Act is necessary to ensure that nurses, doctors, medical assistants, emergency personnel, and social service workers are not subjected to needless preventable acts of violence on the job.

“Health care and social service workers are routinely subjected to threats, assaults, and injury from foreseeable and preventable acts of workplace violence at rates that significantly exceed all other professions,” said Representative Bobby Scott (D-Va.), one of the bill’s sponsors. “This bill strengthens protections for these frontline workers by requiring that the Occupational Safety and Health Administration issue an enforceable standard within 42 months of enactment that ensures employers adopt plans to address preventable acts of workplace violence.”