California’s SB 553 and National Implications for Workplace Violence Prevention

California's SB 553 introduces comprehensive workplace violence prevention requirements, setting a benchmark for national and state-level regulatory efforts to ensure safer work environments.

• By Kerri R. Greene
• Dec 02, 2024

The growing impact of workplace violence in the United States is profound, leading to physical injuries and psychological trauma for employees and substantial economic losses to employers. California's SB 553 is the first formal regulation to mitigate workplace violence in general industry. Closely following the format of groundbreaking workplace violence prevention in healthcare regulation, the new California regulation promotes workplace violence prevention through comprehensive and proactive prevention strategies. It affects national and international employers with facilities and staff in California and is likely to be used as a model for additional state or national workplace violence regulation. Both regulations mandate general industry and healthcare employers to implement workplace violence prevention plans, identify risks and hazards, adopt measures that protect their employees, and conduct training on workplace violence prevention.

Trends and Problems in Workplace Violence

According to a joint study by the Bureau of Justice Statistics (BJS), Bureau of Labor Statistics (BLS), and the National Institute for Occupational Safety and Health (NIOSH), the United States experienced nearly 18,000 work-related workplace violence homicides from 1992 to 2019. While homicides are down over 50% from the peak of 1994, there were notable increases in incidents from 2014 to 2019. In 2022, the Bureau of Labor Statistics reported 849 workplace homicides, an increase of 11% over 2021.

It is important to note that the BLS annual report includes intentional, self-inflicted injury (suicide) in the fatal statistics, which amounts to about one-third of all fatal occupational injuries attributed to violence. Intentional, self-inflicted fatalities were not included in the joint study. This means that the long-term impact of fatal workplace violence from 1992 to 2019 may have impacted more than 23,000 workers.

Trends in Workplace Violence (2012-2022): An analysis of data from the U.S. Bureau of Labor Statistics reveals patterns and changes in the incidence of workplace violence over the past decade.

From the same joint study, nonfatal workplace violent victimizations averaged 1.3 million annually between 2015 and 2019, underscoring the prevalence and severity of this issue. Although workplace violence encompasses a wide range of behaviors, including verbal threats and harassment, physical assaults, including hitting, kicking, and shoving, accounted for a majority of injuries treated in hospital emergency departments, according to the same BJS study.

Specific industries are disproportionately affected by workplace violence. Sales and related occupations experienced the highest percentage of workplace homicides over the period study (21% of the total), followed closely by protective service occupations such as police officers and security guards (19% of the total). Workers in management occupations accounted for 9% of homicides. Service occupations, which include roles like protective service, healthcare, social services, and education, had the highest rates of nonfatal workplace violence injuries resulting in days away from work. These statistics highlight the disproportionate impact of workplace violence on certain occupational groups, particularly those in service-related roles.

In 2020, BLS reported details on workplace violence, fatalities, and injuries. Service occupations accounted for 52% of nonfatal intentional injuries requiring at least one day away from work, with law enforcement having the highest rates of injuries. Next, healthcare practitioners and technical occupations accounted for approximately 23%. The healthcare and social assistance industry reported an incidence rate of 10.4 per 10,000 full-time workers for nonfatal intentional injuries in 2018, significantly higher than the overall rate of 2.1. Specific sectors within healthcare, such as psychiatric and substance abuse hospitals, experienced even higher rates. The industry recorded an average of 20 workplace homicides per year from 2011 to 2018. The majority of the homicide incidents during that period involved relatives or domestic partners of the healthcare workers (29%) and miscellaneous/unknown relationships (20%), while patients accounted for 15% of the homicides.

The chart above illustrates the distribution of nonfatal workplace intentional injuries by another person across selected occupational groups in 2020 (Source: U.S. Bureau of Labor Statistics).

The underreporting of workplace violence incidents, particularly in healthcare settings, complicates efforts to address the problem. Many incidents, especially those involving verbal abuse or less severe physical contact, go unreported. Many victims of nonfatal workplace violence cited that they did not believe “the incident was important enough” to report to police. A joint Centers for Disease Control and NIOSH study from 2015 found that if workers were injured or lost workdays resulting from a violent incident, they were more likely to document and report formally. However, overall reporting was still only at 88% of incidents. 45% of incidents were reported informally (e.g., verbally to a supervisor), indicating that the ease of reporting methods and the importance of supervisor follow-up can increase reporting, investigation, and control of violence. Reasons for not reporting vary from lack of time to report, unsure how to report, concerns over retaliation, and lack of confidence that a report would change anything.

Workplace violence affects people in different ways, with men more likely to experience fatal incidents, such as homicides, and women more likely to face nonfatal forms of violence. The overall economic burden of workplace violence is estimated at around $56 billion annually. A large portion is attributed to healthcare expenses, representing just one aspect of the broader financial impact. On a personal level, victims of workplace violence often suffer severe psycho-social, physical, and fiscal consequences, which can disrupt their lives and well-being. These individual impacts extend to organizations, leading to increased turnover, absenteeism, and a noticeable drop in productivity and quality of work. The National Safety Council and NIOSH found that the costs associated with workplace violence have been estimated to be as high as $121 billion.

Overview of California’s SB 553 and Its Implementation

California's SB 553 is a comprehensive legislative response to the growing issue of workplace violence. The law requires general industry employers to establish and maintain Workplace Violence Prevention Plans (WVPPs), which include procedures for reporting and responding to incidents. Key components of SB 553 mandate employers to identify workplace hazards, implement corrective actions, and train employees accordingly. Effective July 1, 2024, Cal/OSHA has the authority to enforce compliance with SB 553, including issuing citations and penalties for non-compliance. The agency is also developing a workplace violence prevention standard, expected to be adopted by December 31, 2026.

Employers must appoint individuals responsible for implementing the WVPP, ensure active employee participation, and maintain detailed logs of violent incidents for five years. The WVPP must also includeprocedures for hazard identification, employee involvement, and keeping records, with serious injuries and fatalities reported to Cal/OSHA immediately. The law applies broadly across most California employers, with specific exemptions for corrections facilities, law enforcement agencies, teleworkers, workplaces with fewer than ten employees not accessible to the public, and healthcare facilities (already regulated by Title 8, California Code of Regulations, Section 3342.

How to Comply: Challenges and Strategies

Compliance with SB 553 varies based on the effort and resources an organization is willing to commit. At the most basic level, employers can establish their written WVPPs using a template provided by Cal/OSHA. Still, the details needed to make the plan effective for each facility, job function, and workplace violence hazard require a more custom approach. Employers must analyze and control the workplace hazards specific to their operations, provide employee training specific to the risks they face, and perform annual audits for compliance. ⁸ This level of detailed hazard analysis and control requires high effort from employers, and they must involve their employees and employee representatives in the work. Some efficiencies may be gained using hazard analysis, corrective action, incident reporting, and investigation processes from their overall safety program or Injury and Illness Prevention Program (IIPP).

To develop an effective compliance strategy, employers typically begin with a thorough risk assessment to identify potential hazards. This includes evaluating environmental and behavioral risk factors that may contribute to workplace violence. For example, understanding crime levels around a facility or in a service neighborhood, identifying access controls (e.g., door key cards, enclosed service desks), communication devices (radios, panic buttons), and surveillance through cameras, mirrors, or windows. Behavioral risk factors can be addressed for employees through background screening at hire, supervisor training on staff coaching and development, and provision of an employee assistance program. Behavioral risk factors for clients and customers should be considered, such as when an organization handles cash, levies, fines, or fees or if there are likely to be disputes over service, costs, wait times, access, etc.

Identifying and evaluating workplace violence hazards is best done using a security checklist. The checklist should include a review of physical security measures, administrative policies, and type/level of training at each facility or for each job. Using a checklist ensures a uniform, calibrated approach to the assessment and serves as documentation that employers completed this vital step. Once the hazards are identified, controls already in place or planned to mitigate risk further should be documented in detail. Workplace violence hazard controls can take many forms. Employers can take credit for current status, such as installed cameras, auto-locking doors, phone systems, and cleared landscaping around their building. 

Where there may be gaps in controls based on the assessment, incident data, or employee feedback, employers can document planned progress and interim measures. For example, an open service desk that is four feet high and three feet deep is a barrier when serving customers; it is hard to jump over or reach across. If identified risk, incident history, or other factors show that the desk does not adequately reduce the risk of violence, options to improve the condition could be to enclose it on either side with locking doors or add a glass partition.

Employee training on the employer’s plan, job-specific hazards and controls, and how to report and respond to incidents is required. In addition, employees need training on “strategies to avoid physical harm.” This is a broad topic, but it could include personal safety tips, identifying warning signs of violent behavior, use of de-escalation techniques, understanding emergency communication and response options, and locating areas of refuge behind secured doors to get away from violence should it occur. Practical exercises tailored to specific job roles, scenarios, and past incidents enhance employee uptake of this critical knowledge and skill.

Many employers find active threat procedures and response training enhance employee confidence and outcomes in a violent disaster. Incident response kits should contain tools and resources for responding to violence, including first aid supplies, communication devices, and emergency contact numbers. Leveraging existing resources, such as local law enforcement, security vendors, and safety consultants, can provide additional support and expertise in developing and implementing the WVPP.

National Implications and Actions by Other States

California's SB 553 reflects a broader national trend towards more stringent workplace violence prevention regulations. In 2023, more than 100 workplace violence bills were introduced in 27 states, with a quarter of those bills enacted and half remaining under consideration. States vary in their approaches to workplace violence prevention, with some mandating comprehensive WVPPs, safety committees, and employee training. Healthcare settings, due to their higher risk of violence, are often given particular attention. Without a federal OSHA standard, at least eight states have enacted their laws: California, Connecticut, Illinois, Maryland, Minnesota, New Jersey, Oregon, and Washington require employers to implement workplace violence prevention programs. New York mandates such programs, but this requirement is limited to public employers. Four states (Hawaii, Nevada, New Mexico, and Ohio) focus on specific measures such as training, safety committees, and plans to reduce violence or particular industries such as retail workers, convenience stores, and healthcare.

OSHA is currently developing a federal workplace violence prevention standard for healthcare and social service settings, expected to be proposed by December 2024. This proposed rule aims to address the high incidence of workplace violence in these industries at the national level. The rule will likely require healthcare and social services employers to create a written workplace violence prevention policy, train employees, conduct regular hazard assessments, implement hazard mitigation measures, and maintain a log of incidents. The final rule is anticipated in 2025, highlighting the need for employers to review and update their violence prevention and safety policies to ensure compliance.

Conclusion

Workplace violence is a significant issue that demands proactive measures from employers across all industries. California's SB 553 sets a precedent for comprehensive workplace violence prevention, requiring detailed assessment, employee training, and incident response. As other states follow suit and federal regulations potentially emerge, organizations must stay informed about regulatory changes and industry best practices. Employers are encouraged to assess and enhance their current policies, ensuring they are prepared to protect their employees and comply with evolving legal requirements. Committing to a safe and respectful workplace protects employees, the public, and the clients they serve and contributes to each organization's success and reputation.

This article originally appeared in the October 2024 issue of Occupational Health & Safety.