Courtney bill to protect health workers from violence set for House vote

U.S. Rep. Joe Courtney

Washington – The U.S. House is expected to vote on a bill this week sponsored by Rep. Joe Courtney that aims to protect nurses and other health care and social workers who are physically attacked by patients or their family members.

Under Courtney’s bill, the Labor Department would have to issue a rule requiring health care and social service employers to implement workplace violence prevention plans

The bill — called H.R. 1309 or the “Workplace Violence Prevention for Health Care and Social Service Workers Act” — would define workplace violence as any act or threat of force against an employee that could result in a physical injury, psychological trauma, or stress.

The bill, expected to go to a vote on Thursday, would also include any act where a firearm or an improvised weapon was used.

“We’ve worked toward this vote for months,” said Courtney, D-2nd District, who said he consulted doctors, nurses, social service workers and others to craft the legislation.

Stephanie Paulmeno, president of the Connecticut Nurses Association, said there’s a level of workplace violence that has many nurses fearing for their safety — and that the frequency of assaults is increasing.

“They have been slapped, they have been kicked, they have been hit,” Paulmeno said. “People in health care are more likely to be assaulted than police officers or prison guards.”

A supporter of Courtney’s bill, Paulmeno said surveys show nurses are highly regarded by the public.

Still, about one-in-four nursing professionals are the victims of an assault in the workplace during their careers.

Paulmeno said the prevalence of violence can be attributed to the fact that nurses “are dealing with people at the worst times of their lives.”

Stephanie Paulmeno, president of the Connecticut Nurses Association

According to the data from the Bureau of Labor Statistics, there were 14.8 nonfatal injuries from assaults for every 10,000 full-time workers across the private health care and social assistance industry in 2018.

And a 2016 GAO study reported that rates of violence against health care workers are up to 12 times higher than rates for the overall workforce.

Paulmeno said there’s a reluctance to report these assaults since that could result in negative patient satisfaction surveys that are key to a health care professional’s reputation.

She said Courtney’s bill “puts the onus” of safeguarding health care and social service professionals on “where it needs to be”– on hospitals, doctor’s offices, long-term care facilities and other workplaces.

A new financial burden on hospitals

The American Federation of Teachers and other groups have joined the nation’s nurses in supporting Courtney’s bill.

“This bill is a crucial step in reducing the staggering number of preventable physical and psychological assaults on social workers and other health and social services professionals,” said Angelo McClain, Chief Executive Office of the National Association of Social Workers.

But the legislation is not supported by the nation’s hospitals and nursing homes.

“Because hospitals have already implemented specifically tailored policies and programs to address workplace violence, we do not believe that the OSHA standards required by H.R. 1309 are warranted..,” wrote Thomas Nickels, executive vice president of the American Hospital Association, to members of the House Education and Labor who considered the bill earlier this year.

Nickles said there’s “some evidence” that increases in assaults in health care workplaces “are being driven, in part, by growing numbers of behavioral health patients reporting to and being treated in emergency departments and other settings in acute care, general hospitals.”

“The opioid epidemic, which continues to affect communities nationwide, presents another challenge,” Nickles said.

He suggested Congress provide more money for behavioral health treatment.

During the House Education and Labor Committee consideration of his bill, Courtney said “every person who has worked in a hospital, a psychiatric aide, a social worker, or emergency responder knows how serious and pervasive (workplace violence) is, and how it affects their ability to do their jobs.”

“Close to home for me was an incident that occurred to Helene Andrews, a registered nurse from Danbury, Connecticut who was assaulted multiple times during her career,” Courtney told his colleagues. “Shortly before she retired, she was thrown to the floor by a patient and her pelvis was shattered.”

One reason hospitals don’t like the bill is that it would cost them money.

The Congressional Budget Office initially estimated, if the bill becomes law, the cost of operating private health care facilities would increase by at least $2.7 billion in the first two years and at least $1.3 billion annually thereafter. The CBO then revised and lowered its estimate and said the cost to private entities would be at least $1.8 billion in the first two years and at least $750 million annually thereafter.

“The costs would stem from activities such as annual training of personnel, development and implementation of plans to prevent violence in the workplace, and development and maintenance of certain changes to infrastructure,” the CBO said.

The CBO also said that the cost of implementing the bill “would be partially offset by savings from a decrease in payments for workers’ compensation claims resulting from workplace violence.”

While Courtney’s bill is likely to be approved by the Democratic-led U.S. House, the legislation’s future in the U.S. Senate is less clear.

Sen. Tammy Baldwin, D-Wis., has introduced a similar bill in the Senate. It has 29 co-sponsors, including Sens. Richard Blumenthal and Chris Murphy. But all sponsors are Democrats and the legislation has not advanced in the GOP-led chamber.