Workplace Violence Prevention in Health Care

    New Section 3342
Public hearing: Dec. 17, 2015
Comment period: Oct. 30, 2015 - Dec. 17, 2015
Filed with Secretary of State: Dec. 8, 2016
Effective date: Apr. 1, 2017

Rulemaking Documents

Documents Relied Upon

  1. Ahmed E. Gomaa, MD, Loren C. Tapp, MD, Sara E. Luckhaupt, MD, et al. "Occupational Traumatic Injuries Among Workers in Health Care Facilities - United States, 2012–2014," MMWR Morb Mortal Wkly Rep 2015;64:405-10,
  2. California HealthCare Foundation, "California Nurses: Taking the Pulse," California Health Care Almanac, March 2014
  3. Cal/OSHA (1998), "Guidelines for Security and Safety of Health Care and Community Service Workers,
  4. Cal/OSHA (1995), "Guidelines for Workplace Security,"
  5. Joint Commission on Accreditation of Healthcare Organizations, "Preventing violence in the health care setting," Sentinel Event Alert Issue 45: June 3, 2010,
  6. Leigh, J. Paul, Markis, Carrie A., Iosif, Ana-Maria, Romano, Patrick S., "California's nurse-to-patient ratio law and occupational injury," Int Arch Occup Environ Health. 2015 May;88(4):477-84.
  7. McPhaul, K., Lipscomb, J., (September 30, 2004). "Workplace Violence in Health Care: Recognized but not Regulated." Online Journal of Issues in Nursing. Vol. 9 No. 3, Manuscript 6,
  8. NIOSH, "Workplace Violence Prevention for Nurses, CDC Course No. WB1865 - NIOSH Pub. No. 2013-155,"
  9. OSHA, (2015), "Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, OSHA 3148-04R 2015,"
  10. OSHA, (2011), "OSHA Enforcement Procedures for Investigating or Inspecting Workplace Violence Incidents, CPL 02-01-052, September 8, 2011,"
  11. OSHA, "Workplace Violence OSHA Safety and Health Topics,"
  12. Peek-Asa, Corinne, et al. "Evaluation of Safety and Security Programs to Reduce Violence in Health Care Settings Final Report," January 2007, NIOSH Contract 200-2001-08014 and NIOSH R01-OH007934,
  13. Speroni, Karen Gabel, et al. "Incidence and Cost of Nurse Workplace Violence Perpetrated by Hospital Patients or Patient Visitors." Journal of Emergency Nursing 40.3 (2014): 218-228.
  14. Occupational Safety and Health Standards Board Petition No. 538, submitted by Richard Negri, Health and Safety Director, Service Employees International Union (SEIU) Katherine Hughes, Liaison, SEIU Nurse Alliance of California (Feb. 10, 2014).
  15. Occupational Safety and Health Standards Board Petition No. 539, submitted by Bonnie Castillo, Director of Government Relations, California Nurses Association (Feb. 20, 2014).
  16. Division of Occupational Safety and Health's evaluation of Petition No. 538, (Apr. 10, 2014).
  17. Division of Occupational Safety and Health's evaluation of Petition No. 539, (Apr. 23, 2014).
  18. Occupational Safety and Health Standards Board revised petition decision regarding Petitions No. 538 and 539, (Jun. 19, 2014).
  19. September 10, 2014, November 13, 2014, November 19, 2014, February 5, 2015, and April 1, 2015, Advisory Committee minutes and attendance sheets*.
  20. Smokler Lewis, P. et al. "The Impact of Workplace Incivility on the Work Environment, Manager Skill, and Productivity" The Journal of Nursing Administration, Vol. 41, No. 1, January 2011.
  21. California Department of Public Health, "All Facilities Letter, AFL 09-49, "Hospital Security Plans", November 19, 2009
  22. Federal Register, Vol. 66, No. 12, pp. 5321-5323, January 18, 2001,
  23. Federal Register, Vol. 79, No. 181, pp. 56166-56168, September 18, 2014

Documents Relied Upon 1st 15-day Notice

  1. Franks, P., Kocher, N., and Chapman, S. January 2004. Emergency Medical Technicians and Paramedics in California. University of California, San Francisco, The Center for the Health Professions," (Issue Brief) 2004-01_EMTs_and_Paramedics_in_California.pdf
  2. Kirkwood, S. May 2013. It's Time to Stop the Violence, NEMSMA launches initiative to address attacks on EMS providers. National EMS Management Association
  3. Oliver, A. and R. Levine. 2015. Workplace Violence: A Survey of Nationally Registered Emergency Medical Services Professionals. Epidemiology Research International Vol. 2015.
  4. Taylor JA, Davis AL, Barnes B, Lacovara AV, Patel R. Injury risks of EMS responders: evidence from the National Fire Fighter Near-Miss Reporting System. BMJ Open. 2015;5.
  5. California Health and Human Services Agency, Department of Developmental Services, Plan for the Closure of Sonoma Developmental Center, October 1, 2015:
  6. California Health and Human Services Agency, Department of Developmental Services, Plan for the Closure of Fairview Developmental Center and Porterville Developmental Center General Treatment Area, April 1, 2016:
  7. The Future of State Developmental Centers, 2015 May Revision:

Documents Relied Upon 2nd 15-day Notice

  1. None

Documents Relied Upon 3rd 15-day Notice

  1. Data on the number of employees in the California Department of State Hospitals:
  2. Data on the number and type of health facilities in state government, local government and the private sector licensed by the California Department of Public Health: and
  3. Data on the number of California state entities and local government entities which provide emergency medical services or patient transport services:
  4. Data on the number of employees in various health care sectors in state government, local government and the private sector in California:,,,,,
  5. Data on the number of local government and private sector employers which provide emergency medical services or patient transport services in California:
  6. Data on the number of local government correctional facilities in California:
  7. Data on the number of private sector correctional facilities in California: and
  8. Data on the rate of lost day work injuries due to workplace violence in health care in California:
  9. Data on employment numbers in the category of health care practitioners/technical operations in California:
  10. Data on the employment numbers in the category of health care support in California:
  11. Data on the cost of injuries from workplace violence in healthcare:
  12. Data on the indirect costs of workplace injuries:
  13. Criteria for determining small business:
  14. Department Of Health And Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. NIOSH Hazard Review, Occupational Hazards in Home Healthcare, Publication No. 2010–125, January 2010
  15. Bureau of Labor Statistics. Table R-4. Number of nonfatal occupational injuries and illnesses involving days away from work by industry and selected events or exposures leading to injury or illness, 2006. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics
  16. G. C. Hanson, N.A. Perrin, H. Moss, N. Laharnar, and N. Glass. Workplace violence against homecare workers and its relationship with workers health outcomes: a cross-sectional study, BMC Public Health, vol. 15, no. 11 (2015): 1-13
  17. Gerberich SG, Church TR, McGovern PM, Hansen HD, Nachreiner NM, Geisser MS, Ryan AD, Mongin SJ, Watt GD, Jurek A (2005) Risk Factors for Work-Related Assaults on Nurses. Epidemiology 16, 704–9
  18. United States Government Accountability Office. Workplace Safety And Health: Additional Efforts Needed to Help Protect Health Care Workers from Workplace Violence, Report to Congressional Requesters (GAO-16-11). March 2016
  19. Rosen, T., Lachs, M. S., Bharucha, A. J., Stevens, S. M., Teresi, J. A., Nebres, F., and Pillemer, K. (2008). Resident-to-Resident Aggression in Long-Term Care Facilities: Insights from Focus Groups of Nursing Home Residents and Staff. Journal of the American Geriatrics Society, 56(8), 1398–1408.

* Please contact to request a copy of the Advisory Committee handwritten attendance sheets.

October 2020