Implementing human service workers safety regulations

Information about EOHHS to develop and provide workplace safety training to state employees and community-based providers.

Table of Contents

Overview

On February 15, 2013, Governor Deval Patrick signed legislation which charged EOHHS to promulgate regulations to address workplace violence prevention and crisis responses at provider agencies.  In addition, this legislation designated EOHHS to develop and provide workplace safety training to state employees and community-based providers.

EOHHS recognizes that workplace violence threatens the health and safety of everyone in the workplace.  As a result, the regulations have adopted broad definitions defining where and to whom this applies:

  • Human Service Worker: any person who works for a program. This includes, but is not limited to employees, contracted employees, interns, and volunteers.
  • Program: any entity operated, licensed, certified, or funded by a department, commission, office, board, division, institution, or other entity within EOHHS under M.G.L. c. 6A, § 16 that provides direct services to clients.
  • Workplace: any location where business is conducted or site where a human service worker is considered “on duty.”  Private vehicles used for business are included in 101 CMR 19.02: Workplace.

As part of ongoing implementation efforts, we will be adding information on this topic to this site, so please check back for updates.

Implementation timelines

Effective February 15, 2015

  • Workplace Violence Prevention and Crisis Response Plans are developed and implemented
    • Going forward, plans are required to be reviewed by programs on an annual basis
  • New hires are to be trained within 90 days of hire

By February 2017

  • All existing hires are trained
  • Employees complete mandatory training every two years

Training options

Programs have two options for compliance with the required training:

  1. EOHHS eLearning: In response to the requirements of the Human Service Workers Safety Regulations, EOHHS has developed an e-Learning designed to raise awareness, introduce risk assessment techniques, present de-escalation strategies, offer resources for additional training and highlight pertinent laws and regulations.

    The EOHHS eLearning provides a flexible and cost-effective training for providers to satisfy the minimal regulation requirements.  The training is accessible through our online portal, PACE, and takes approximately 30 minutes to complete.

    For more information, please go to the EOHHS Training page.
  1. Program-specific Training Module:  Providers may choose to provide their own training if they certify their training covers the minimum EOHHS required training elements and that all employees have received training.

    For more information, please go to the Alternative Safety Training page.

External Training Resources

Guidelines for implementation

In accordance with Section 30 of Chapter 3 of the Acts of 2013 and Executive Order 442 Establishing a Policy of Zero Tolerance for Workplace Violence, the Executive Office of Health and Human Services (EOHHS) seeks to ensure a violence free workplace for all human service workers.  EOHHS recognizes that workplace violence threatens the health and safety of all human service workers in the workplace.

Definitions

For purposes of these guidelines, the following definitions apply:

Human Service Workers: any person who works for a program in any capacity.  This includes, but is not limited to employees, contracted employees, interns, and volunteers.

Program: any entity operated, licensed, certified, or funded by a department, commission, office, board, division, institution, or other entity within EOHHS under M.G.L.c.6A. § 16 that provides direct services to clients.

Workplace: any location where business is conducted, or site where the human service worker is considered “on duty.”  Private vehicles used for business are included in this definition.

Workplace Violence: includes but is not limited to physical assault or battery, or both; property damage; and intimidation or threats communicated by any means or other disruptive or aggressive behavior that causes a reasonable person to be in fear of his or her personal safety or that of a colleague. Workplace violence can include actions or communications in person, by letter or note, by telephone, by fax, by electronic mail, or through social media.  Incidents of workplace violence may take place between human service workers, between human service workers and clients or customers, human service workers and acquaintances, partners or spouses, and human service workers and the general public.

Workplace Violence Prevention and Crisis Response Plan (“Plan”): protocols and guidelines that establish measures to reduce workplace violence.

Introduction

These guidelines, consistent with 101 CMR 19.00, establish zero tolerance for workplace violence of any kind, while recognizing that exposure to threats from, or the violent acts of persons in the Commonwealth's care or custody, or the public at large, is an unavoidable component of certain occupations.  These guidelines apply to all programs licensed, certified, operated or funded by a department or division of EOHHS or that provide direct services to clients.  All programs must have a workplace violence prevention and crisis response plan for human service workers that meets the criteria set forth in 101 CMR 19.04.

Any human service worker who engages in workplace violence or threatens to commit an act of workplace violence is subject to disciplinary action, up to and including termination of employment or contract.  Offending human service workers may also be subject to criminal and civil complaints.  Retaliation by alleged offenders or programs against a human service worker for reporting an incident of workplace violence or any other violation of 101 CMR 19.00 is prohibited.

General provisions

  • Each program faces unique challenges to minimize risk and maximize safety.  Every program must consider and evaluate its exposure to workplace violence and develop an appropriate plan based on their program’s particular circumstances, functions, personnel and the clientele served.
  • Every program is encouraged to establish a safety committee to develop a workplace violence prevention and crisis response plan.  This may include a Safety Administrator, who ensures that a workplace violence prevention and response plan is in place and monitors safety committee activities including monitoring compliance with mandated human service worker training.
  • Each program must provide a copy of the current plan, which may be electronic, to any human service worker upon request and must make available a copy of the plan in a public place where all human service workers can readily access it.

Workplace violence prevention and crisis response plan

All programs must develop and maintain a workplace violence prevention and crisis response plan using existing staff resources that includes two components:

Prevention strategies

Working to minimize the risks associated with workplace violence through the implementation of prevention strategies requires a commitment to health and safety that begins with the program leadership and extends to every human service worker.

Prevention strategies must include, but are not limited to:

  • Development of safety planning tools, policies, protocols and guidelines that incorporate measures to reduce the risk of workplace violence for human service workers (e.g., enhanced building security features, emergency contact alarms, additional training, staffing plans, and program policies). 
  • Mandatory enrollment in training developed and offered by EOHHHHS (eLearning or paper-based version), or mandatory participation in an alternative training program that meets the minimum requirements established by EOHHS.  Programs must require new human service workers to participate in the required training within the first three months of employment.  All human service workers must participate in such training at least once every two years. Programs must maintain a written record of such participation, and must make this record available to EOHHS upon request.
  • An annual risk assessment of workplace violence incident reports and measures taken.  This risk assessment will inform the implementation of policy modifications seeking to increase human service worker safety based on the program’s past experience with incidents of workplace violence. The risk assessment may include, but is not limited to review of past workplace violence incidents and near misses, review of high risk activities conducted by staff, and review of facility security features. 

Prevention strategies may include:

  • The use of technology as a means for calling for help.
  • Review of staffing, security features, and escape strategies.
  • Establishment of a workplace violence prevention and response team or committee that monitors compliance with the program’s workplace violence policies and procedures.

Crisis response protocols

All programs must develop procedures for immediate responses to any incident of workplace violence to a human service worker.

Crisis response protocols must include, but are not limited to:

  • A clear description of procedures for reporting acts or threats of workplace violence. These procedures must be made known to every human service worker. 
  • Establishment of a system, such as an electronic database, for centrally recording all incidents of workplace violence against any human service worker including but not limited to threats of violence, verbal and physical assaults, and acts of intimidation. Such records must at a minimum include the names of the parties involved, date and location of the incident, description of the incident, and the nature of any injuries. Except as requested pursuant to 101 CMR 19.07, all records created under 101 CMR 19.04(A)(2) are confidential to the extent permitted by law.
  • Measures the program will take in response to an incident of workplace violence, including both immediate crisis response and follow-up measures, such as investigation, retraining, mediation, or disciplinary action.
  • Resources for victims and perpetrators, including where they can go for help.
  • A statement that any use of work time or workplace facilities to commit or threaten to commit acts of workplace violence is cause for discipline up to and including termination of employment or contract.
  • A statement that retaliation or any other violation of workplace violence policies against anyone who reports an incident of workplace violence is prohibited.

Crisis response protocols may include:

  • Establishment of a staff response team or committee that assists human service workers who are subjected to workplace violence.
  • Emergency reporting in all situations involving physical assault and battery or a serious threat of physical violence to 911 or an internal response team.

Additional requirements

  • All programs must review their workplace violence prevention and crisis response plan at least annually, including all reported incidents and measures taken, and must modify the plan as indicated necessary by the review. 
  • Upon EOHHS request, each program must report to EOHHS about compliance with the workplace violence prevention and crisis response plan requirements.
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