More than 50 healthcare workers from UNAC/UHCP and SEIU, as well as health and safety advocates, attended the Cal/OSHA Standards Board meeting in Pasadena on July 16, 2015, to voice their concerns about the changes that DIR and Cal/OSHA management have made to the draft of the pending workplace violence prevention regulation for healthcare workers. Richard Negri, co-lead of the California Safe Care Standard campaign and Health and Safety Director at SEIU Local 121RN, addressed their concerns to the Board:

Good morning. My name is Richard Negri. I am the Health and Safety Director for SEIU Local 121RN. In February 2014, SEIU Local 121RN and the SEIU Nurse Alliance of California petitioned this Board, via Petition 538, to promulgate a comprehensive workplace violence prevention standard for all healthcare workers in the state.

Following five public advisory meetings at which there was general agreement about the definition of workplace violence and the scope and application of the standard, DIR and Cal/OSHA management changed the definition of workplace violence and made other substantive changes to the body of what had been a robust draft of the standard that all of the stakeholders had been discussing and working on over the last seven months.

Although we learned about this in late May, we only received a copy of the revised draft, now titled “Proposed State Standard, Title 8 (Section 3342)” on June 24 after we formally requested it. This Board told us that it received the proposed standard on June 19. In any event, to our knowledge, this draft has not yet been provided to other participants in the advisory process, and before going deeper into the details of some of the changes we found in the draft, we believe the Board should discern whether the various changes applied to the draft – and when they were applied – warrants an additional advisory meeting.

Moving forward, we are here to speak to some of the key substantive issues found in this draft and to ask that the Board please address these and other issues when evaluating the document and formulating a response to it.

1. The definition of workplace violence has been revised to limit acts of violence or so called credible threats of violence to only those that involve physical force. This ignores the fact, backed up by years of scholarship, that there is a continuum of behavior that can and should be interrupted before it escalates. We’d like to kindly remind the Board about a Napa State Hospital patient’s persistent and increasingly alarming verbal and physical intimidation prior to his murdering psych-tech Donna Gross. If Napa management had taken that patient’s behavior seriously, it would have seen that it needed to immediately provide a mechanism of prevention before the situation escalated. Clearly that didn’t happen. Clearly this definition will do nothing to prevent a situation such as Donna’s from happening again.
2. We are concerned about the limitations of the term “credible threat” for several reasons. The definition does not specify who is to be the arbiter of whether a threat is credible or not. What is credible to a small person with a disability may not be credible to an athletic person of large stature. Who decides this? Is it the manager in the human resources office, an employee’s co-worker, perhaps the union rep? The point is that if we are to accept the words “credible threat” in this regulation, we need to know who the arbiter is of what is and isn’t credible. If that arbiter is management – as that is likely who Cal/OSHA is referring to – we have already proven time and again through Donna’s story and the stories of so many others, that management isn’t doing so well when determining if a threat is or isn’t credible.
3. Cal/OSHA’s removal of needed data elements from the violent incident log doesn’t make sense. For example, it removed the following data elements: Verbal Intimidation, Physical Intimidation, and Post Incident Stress. However, in its examples of workplace violence, which appear to be lifted straight from SB 1299, it says that examples of workplace violence include incidents resulting in or having a high likelihood of resulting in “injury, psychological trauma or stress.” So, though they provide an example of workplace violence on one page of the draft, on another – where the recording mandate appears – the way to record that incident is removed.

By now, this Board has probably heard a hundred or more stores – as has DIR and Cal/OSHA management – of the spectrum of violence that healthcare workers face on a daily basis. Many of these are acts or threats of violence that involve physical force. Many are not. The verbal and physical intimidation that healthcare workers deal with is also workplace violence. Left unacknowledged, uninterrupted, and unregulated, this behavior can – and does – escalate into violence that involves physical force. We have to question why this is being omitted. Why put all kinds of policies and procedures and trainings and recordkeeping and reporting in place for one aspect of the hazard but not another?

It is to this end that we ask the Board to please consider this as it reads and applies analysis to the draft it received. We urge the Board to urge Cal/OSHA to enter formal rulemaking after it holds an additional advisory meeting so that we can get these and other questions answered, and if that is not possible, to at least urge the Division to return the Federal OSHA definition that was used in the last publicly-made draft from April 1 http://www.dir.ca.gov/dosh/DoshReg/Workplace-Violence-in-Healthcare/Discussion-Draft-for-04.01.2015-AC.pdf.

We thank you so much for your time and continued effort on this.