On April 7, 2023, LeadingAge submitted comments to the Occupational Safety and Health Administration (OSHA), with feedback on a possible future rule related to incidents of workplace violence perpetrated by patients/residents/clients and visitors toward employees in health care and social assistance settings.

At this stage OSHA has not issued a proposed regulation. Instead, the agency has developed a framework relating to workplace violence that shows its current thinking about provisions a future rule could include. As currently drafted, this initial framework would:

• apply to aging services providers, including adult day services, home health agencies, assisted living, life plan communities, and nursing homes, as well as to hospitals, behavioral health, and other provider types;
• require development of a written workplace violence prevention program, which would be based on an organizational risk assessment and include implementation of measures to control identified risks;
• prescribe staff training, as well as the recording and investigation of workplace violence incidents.

In March 2023, OSHA convened a Small Business Advocacy Review (SBAR) panel for the purpose of discussing the potential regulatory framework with businesses that would be affected by it, and to obtain recommendations on ways OSHA could make it more cost-effective and less burdensome for affected small entities, if OSHA proceeded to rulemaking in the future.  

The Panel consists of representatives from OSHA, the Small Business Administration’s Office of Advocacy, and the Office of Information and Regulatory Affairs in the White House Office of Management and Budget. It held a series of teleconferences with provider organizations from across the country, which included LeadingAge members and other aging services providers.  As part of this process, OSHA also invited comments from the general public.

Along with comments about specific sections of the initial framework, our letter noted that OSHA should avoid duplication of existing requirements already in place, such as through licensing and certification standards, if the agency proceeds to rulemaking. We further noted that any regulatory standard must be general, rather than overly prescriptive, so that a provider organization would have the flexibility to tailor and implement a program that is appropriate to its size and setting, to the population the organization serves, and to the specific services it provides.

The next step in the current process is for the SBAR Panel to publish a report that captures and summarizes the comments, concerns, and suggestions expressed during the meetings, which is expected to be completed by May 1. OSHA will then take the matter under advisement and determine whether to proceed to a formal notice-and-comment rulemaking at some point in the future. No timetable is known, but it is likely that OSHA will need significant time to continue its evaluation, given the complexity of the issues involved.