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OSHRC Holds Integra Health Management Accountable for Workplace Violence

March 8, 2019
Despite raising safety concerns, a social worker was fatally stabbed after meeting alone with a client who had a history of violent criminal behavior.

Integra Health Management is to blame following the death of a worker who was stabbed during a home visit, according to the  Occupational Safety and Health Review Commission (OSHRC).

The social service employer was cited with multiple safety violations after the employee was stabbed nine times left bleeding on a front lawn after a December 2012 home visit to an agency client with a history of mental illness and violent criminal behavior.

“It is well-known – and tragic – that healthcare and social service workers are frequent victims of workplace violence,” said Jessica Martinez, co-executive director of the National Council for Occupational Safety and Health (National COSH), in a statement. “Employers have a legal responsibility to act on this knowledge and provide a safe and healthy workplace. Integra failed and a social service worker lost her life.”

Following the tragedy, the U.S. Occupational Safety and Health Administration (OSHA), found a “serious violation” of the general duty clause of the Occupational Safety and Health (OSH) Act by exposing workers “to the hazard of being physically assaulted by members [clients] with a history of violent behavior.”

Healthcare workers are five times more likely than workers in other sectors to be the victim of workplace violence, according to the U.S. Bureau of Labor Statistics.

Stronger protections are needed, Martinez said.

“A specific OSHA standard on workplace violence is required to offer better protect to healthcare and social service workers,” she recommended. “Instead of waiting for more workers to be injured or killed, Congress should direct OSHA to provide stronger enforcement.”

National COSH filed an amicus curiae brief in the OSHRC proceeding, Secretary of Labor vs. Integra Health Management, Inc. The case was decided on March 4, 2019.

“This ruling will help prevent future tragedies,” said attorney Randy Rabinowitz, who represented National COSH, the National Association of Social Workers and the Service Employees International Union (SEIU) as amici in this case. “Employers are now on notice of their responsibility under existing law to reduce the risks of workplace violence.”

The murdered social service worker, who is not identified by name in the OSHRC ruling, raised safety concerns to her supervisor after a previous home visit. Despite these concerns, she was assigned – alone – to complete a required assessment with the client.

Two citations against Integra were upheld in 2015 by an OSHA administrative law judge. Integra appealed the ruling. This week’s decision by the OSHRC upholds the original citations, which included $10,500 in proposed penalties and a requirement that Integra implement a workplace violence prevention program.

In its amicus brief, National COSH argued that Integra had the ability to reduce the risk of workplace violence through:

  • increasing the training for service coordinators
  • assigning an experienced service coordinator to initial assessments of patients with a history of violence
  • or implementing a mandatory buddy system so a service coordinator would not face a potentially violent situation alone.

None of these abatement measures require changes to the physical aspects of the workplace, according to National COSH. 

In January 2017, in response to a petition from National COSH, the AFL-CIO, SEIU, National Nurses United and other labor and public health advocates, OSHA initiated a rulemaking process to issue a workplace violence prevention standard for healthcare and social service workers.

The rulemaking process has since been stalled. In February, Rep. Joe Courtney (D-CT), introduced the Workplace Violence Prevention for Health Care and Social Service Workers Act, which directs OSHA to issue standard requiring health care and social service employers to implement a plan to reduce the risk of workplace violence.

“We can never accept that violence is just ‘part of the job’,” Martinez said. “Assaults on healthcare and social service workers are not random. They are not unpredictable. These are known hazards -- and like other hazards, the risks can be reduced with rigorous standards and tough enforcement.”

About the Author

EHS Today Staff

EHS Today's editorial staff includes:

Dave Blanchard, Editor-in-Chief: During his career Dave has led the editorial management of many of Endeavor Business Media's best-known brands, including IndustryWeekEHS Today, Material Handling & LogisticsLogistics Today, Supply Chain Technology News, and Business Finance. In addition, he serves as senior content director of the annual Safety Leadership Conference. With over 30 years of B2B media experience, Dave literally wrote the book on supply chain management, Supply Chain Management Best Practices (John Wiley & Sons, 2021), which has been translated into several languages and is currently in its third edition. He is a frequent speaker and moderator at major trade shows and conferences, and has won numerous awards for writing and editing. He is a voting member of the jury of the Logistics Hall of Fame, and is a graduate of Northern Illinois University.

Adrienne Selko, Senior Editor: In addition to her roles with EHS Today and the Safety Leadership Conference, Adrienne is also a senior editor at IndustryWeek and has written about many topics, with her current focus on workforce development strategies. She is also a senior editor at Material Handling & Logistics. Previously she was in corporate communications at a medical manufacturing company as well as a large regional bank. She is the author of Do I Have to Wear Garlic Around My Neck?, which made the Cleveland Plain Dealer's best sellers list.

Nicole Stempak, Managing Editor:  Nicole Stempak is managing editor of EHS Today and conference content manager of the Safety Leadership Conference.

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