New Cal/OSHA Regulation Aimed at Workplace Violence Prevention in Health Care

May 25, 2017

On April 1, 2017, a Cal/OSHA regulation took effect that requires specified health care facilities to implement workplace violence prevention plans to help protect workers who may be exposed to violence on the job.

This new General Industry Safety Order –the Workplace Violence Prevention in Health Care—is codified at Section 3342 of Title 8 of the California Code of Regulations, and expands on Senate Bill 1299, which only required a standard for hospitals.

The new standard applies to the following health care facilities*, service categories, and operations:  

• Home health care and home-based hospice
• Emergency medical services and medical transport
• Drug treatment programs
• Outpatient medical services to the incarcerated in correctional and detention settings

* There have been questions and confusion regarding what is considered a “health facility”. The definition included in the regulation states:any facility, place, or building that is organized, maintained, and operated for the diagnosis, care, prevention, or treatment of human illness, physical or mental, including convalescence and rehabilitation and including care during and after pregnancy, or for any one or more of these purposes, for one or more persons, to which the persons are admitted for a 24-hour stay or longer.

The new standard defines “workplace violence” as any act of violence or threat of violence that occurs at the work site, excluding lawful acts of self-defense or defense of others, and outlines specific types of violence including:

• The threat or use of physical force against an employee that results in, or has a high likelihood of resulting in injury, psychological trauma or stress, regardless of whether the employee sustains an injury.
• An incident involving the threat or use of a firearm or other dangerous weapon, including the use of common objects as weapons, regardless of whether the employee sustains an injury.
• Four workplace violence types:
  1. “Type 1 violence”—workplace violence committed by a person who has no legitimate business at the work site, including violent acts by anyone who enters the workplace with the intent to commit a crime.
  2. “Type 2 violence”—workplace violence directed at employees by customers, clients, patients, students, inmates, or visitors, or other individuals accompanying a patient.
  3. “Type 3 violence”—workplace violence against an employee by a present or former employee, supervisor, or manager.
  4. “Type 4 violence”—workplace violence committed in the workplace by someone who does not work there, but has or is known to have had a personal relationship with an employee.

Health care facilities are now required to establish, implement, and maintain an effective workplace violence prevention plan (Plan).

The written Plan may be incorporated into the written IIPP or maintained as a separate document, and must be in effect at all times in every unit, service, or operation. The Plan must be in writing, must be specific to the hazards and corrective measures for the unit, service, or operation, and must be available to employees at all times.

Extensive details about what must be included in the written Plan are outlined in Section 3342 Workplace Violence Prevention in Healthcare.