Starting next year, hospitals and other facilities must conduct workplace assessments and violence prevention training.
California state officials approved regulations that will require healthcare facilities to develop violence prevention programs in 2017 to safeguard workers.
The regulations will require hospitals to create violence prevention programs and train employees to follow protocols. The regulations were approved by the state's Occupational Safety and Health Standards Board and are supported by the state's two largest healthcare labor unions.
However, the California Hospital Association has raised concerns about the logistics of the program and how hospitals will pay for it.
The regulations were adopted after two years of negotiations between the California Division of Occupational Safety and Health (Cal/OSHA) and the California Nurses Association and the Service Employees International Union-United Healthcare Workers West.
"California has set the bar with the strongest workplace violence regulations in the nation," said Bonnie Castillo, the CNA's director of health and safety.
Under the regulations, hospitals and healthcare facilities will need to conduct workplace assessments and implement violence prevention plans with input from employees. The standards will require training to help employees assess risk factors for violence involving patients or visitors and identify problem areas.
Hospitals and facilities will not be held responsible for every act of violence in the workplace but could be cited by Cal/OSHA for not following protocols.
The regulations are slated to go into effect in early 2017, but the timing will depend on how quickly they get through the final approval process, said Julia Bernstein, public information officer for the California Department of Industrial Relations.
The standards must still be approved by the state Department of Finance and the state Office of Administrative Law.
CNA and SEIU members in 2014 petitioned Cal/OSHA to adopt stricter standards to protect healthcare employees in the workplace. The petition cited the death of a psychiatric nurse who was killed by a patient at Napa State Hospital in 2010, an incident that union members said demonstrated the need for better security measures.
The U.S. Bureau of Labor Statistics estimates that violent incidents involving workers are four times more common in healthcare settings than in other industries.
The CHA lauded the intent of the regulations. However, Cal/OSHA has underestimated the fiscal impact of the regulations, which will require initial training and studies to develop violence prevention protocols and training on an ongoing basis for new employees, said Jan Emerson-Shea, the CHA's vice president of external affairs.
"I think the original estimate for initial implementation statewide was $36 million and another $25 million for new training and annual reviews," said Emerson-Shea. "Considering the state has more than 400,000 hospital employees, we believe Cal/OSHA is grossly underestimating those costs."