In an effort to protect health care workers, on May 15, 2023, Texas Governor Greg Abbott signed into law Senate Bill (“SB”) 240, requiring health care Facilities (importantly defined below) to adopt, implement, and enforce a written workplace violence prevention policy and plan by September 1, 2024.
As detailed below, this law only applies to Texas licensed facilities. As such, the typical Texas private practice or medical office will not need to comply with this new law. However, this does not prevent a private practice desiring to develop its own similar policy from implementing the SB 240’s requirements.
What facilities does SB 240 apply to?
SB 240 only applies to specific Texas licensed facilities as defined in SB 240. As mentioned above, Texas private practices are not included. SB 240 defines a health care “Facility” as:
- Home and community support services agencies that are licensed or licensed and certified to provide home health services and that employ at least two registered nurses;
- Licensed hospitals and hospitals maintained or operated by a Texas state agency that are exempted from licensing;
- Licensed nursing facilities that employ at least two registered nurses;
- Licensed ambulatory surgical centers;
- Freestanding emergency medical care facilities; and
- Licensed psychiatric hospitals.
What is SB 240?
To combat the increase in violence against health care workers and employees, SB 240 requires health care Facilities to adopt, implement, and enforce a written workplace violence prevention policy and plan to protect health care providers and employees from violent behavior and threats of violent behavior at these health care Facilities. The law also requires health care providers and employees to report incidents of workplace violence at their Facility and it prohibits a Facility from discouraging a health care provider or employee from exercising their right to contact or file a report with law enforcement regarding such an incident.
Facilities are prohibited from disciplining, discriminating against, or retaliating against another person who in good faith reports an incident of workplace violence or advises a health care provider or employee of their right to report such an incident. An appropriate licensing agency is authorized to take disciplinary action against an individual who violates SB 240.
Following any incident of workplace violence, a Facility must offer immediate post-incident services, including any necessary acute medical treatment for each health care provider or employee of the Facility who is directly involved in the incident.
Workplace Violence Prevention Committee
Under the new law, Facilities must establish or authorize an existing workplace violence prevention committee to develop, review, and evaluate all workplace violence prevention plans. These committees must include:
- One registered nurse who provides direct patient care at the Facility being discussed and
- One security services Facility employee, if on staff.
The committee must annually review and evaluate the plan and report the results of the evaluation to the Facility’s governing body. A health care system that owns or operates more than one Facility is permitted to establish a single committee for all of the system’s Facilities if the committee develops a violence prevention plan for implementation at each Facility that is distinctly identifiable for each Facility in the system.
Workplace Violence Prevention Plan
The Workplace Violence Prevention Plan must:
- Require the Facility to provide at least annual workplace violence prevention training or education to the Facility’s health care providers and employees, including temporary employees, who provide direct patient care;
- Prescribe a system for responding to and investigating violent incidents or potentially violent incidents at the Facility; and
- Require health care providers and employees to report incidents of workplace violence through the Facility’s occurrence reporting system.
Workplace Violence Prevention Policy
Under SB 240, a Facility’s workplace violence prevention policy must require the Facility to:
- Provide significant consideration of the violence prevention plan recommended by the Facility’s committee and evaluate any existing Facility violence prevention plan;
- Encourage health care providers and employees of the Facility to provide confidential information on workplace violence to the committee;
- Include a process to protect Facility health care providers or employees who provide information to the committee from retaliation; and
- Comply with Texas Health and Human Services Commission rules relating to workplace violence.
The workplace violence prevention policy must be “based on the practice setting” and must do the following (although this can be done by incorporating other policies by reference):
- Adopt a definition of “workplace violence” that includes “an incident involving the use of a firearm or other dangerous weapon, regardless of whether a health care provider or employee is injured by the weapon,” and “an act or threat of physical force against a health care provider or employee that results in, or is likely to result in, physical injury or psychological trauma”;
- Require the Facility to provide at least annually workplace violence prevention training or education that may be included in other required training or education provided to the Facility’s health care providers and employees who provide direct patient care;
- Prescribe a system for responding to and investigating violent incidents or potentially violent incidents at the Facility;
- Address physical security and safety;
- Require the Facility to solicit information from health care providers and employees when developing and implementing the workplace violence prevention plan;
- Allow health care providers and employees to report incidents of workplace violence through the Facility’s existing occurrence reporting systems; and
- Require the Facility to adjust patient care assignments, to the extent practicable, to prevent a health care provider or employee of the Facility from treating or providing services to a patient who has intentionally physically abused or threatened the provider or employee.
National Implications of SB 240
While the law focuses on Texas, it underscores a larger trend: several other states, including California, Connecticut, and New York, have also adopted similar policies aimed at preventing workplace violence. California has long led the nation in addressing workplace violence via the California Division of Occupational Safety and Health’s (Cal/OSHA) Workplace Violence Prevention in Health Care standard, which requires employers to implement a violence incident log, recordkeeping, a workplace violence prevention plan as well as review of this plan, and training.
These measures are timely, as the Occupational Safety and Health Administration (“OSHA”) is set to propose a federal standard for workplace violence in health care, placing further emphasis on the necessity of safety protocols. In early 2023, OSHA convened a panel of small businesses, including hospitals, emergency rooms, psychiatric hospitals, home health care agencies, emergency medical services, and social assistance providers to offer input on a prospective rule, thus jumpstarting the process of developing new federal regulations.
OSHA Stated That Any Forthcoming Rule Would Establish the Following:
- A programmatic approach to workplace violence prevention;
- Workplace violence hazard assessments;
- Workplace violence control measures;
- Preventive training;
- Violent incident investigations and record-keeping;
- Anti-retaliatory provisions; and
- Strategies that avoid stigmatization of health care patients and social assistance clients.
Navigate Workplace Violence Policies with ByrdAdatto
At ByrdAdatto, we help businesses understand Texas’ latest guidelines for addressing violence in a private medical practice. Our legal team can help you interpret the policy and develop a plan of action for your business. If you have questions about SB 240 or other practice management matters, contact ByrdAdatto.
