Posts Tagged ‘guns’

Healthcare providers struggle with violence-related risk management

Wednesday, March 23rd, 2016

There’s no question but that healthcare workers face a growing threat of violence from patients while going about their day-to-day jobs. In a 2015 survey, the International Healthcare Security and Safety Foundation reported a 40% increase in violent crime from 2012 to 2014, with more than 10,000 violent incidents mostly directed at employees. High stress, armed patients and visitors, drug and alcohol intoxication, mental health issues and more all contribute to an increasingly dangerous environment. OSHA reports that:

From 2002 to 2013, the rate of serious workplace violence incidents (those requiring days off for an injured worker to recuperate) was more than four times greater in healthcare than in private industry on average. In fact, healthcare accounts for nearly as many serious violent injuries as all other industries combined.

Recently, Susannah Levine reported on the challenge that healthcare facilities face in her Risk & Insurance article, Hospitals Struggle with Security Risks. The article discusses the pros and cons of an armed approach to healthcare security, as well as the insurance implications of various risk management and security measures. Liability insurance may be a determining factor as to whether healthcare facilities opt for armed security or rely on less lethal tools like Tasers and sprays.

“Barry Kramer, senior vice president, Chivaroli & Associates, a health care insurance broker, said that armed security in health care settings is more of a risk management concern than a coverage issue.

“It would be highly unusual for our clients’ liability policies to exclude claims involving security guards, whether or not they’re armed with guns,” he said.

He said many health care risk managers are not equipped to manage exposures associated with licensing and certifying guards or registering the facility’s own firearms.

For facilities that lack the bandwidth to manage, train and track certifications for in-house security staff, Kramer said,third-party vendors, such as local law enforcement or private security companies, can be contracted, since they have firearms experience as well as liability insurance coverage.”

In February, the New York Times discussed various approaches and philosophies that healthcare facilities employ to mitigate risk. The article by Elisabeth Rosenthal – When the Hospital Fires the Bullet – centers on the case of a 26-year-old mental health patient who was shot by police in a Houston hospital. In the course of the article, Roenthal presents various approaches to security:

To protect their corridors, 52 percent of medical centers reported that their security personnel carried handguns and 47 percent said they used Tasers, according to a 2014 national survey. That was more than double estimates from studies just three years before. Institutions that prohibit them argue that such weapons — and security guards not adequately trained to work in medical settings — add a dangerous element in an already tense environment. They say many other steps can be taken to address problems, particularly with people who have a mental illness.

Rosenthal contrasts the approach of Boston’s Massachusetts General Hospital, where the strongest weapons its security officers carry is pepper spray to that of the Cleveland Clinic, which has its own fully armed police force and also employs off-duty officers.

Guns in hospitals

Meanwhile, as risk managers struggle with the dilemma of whether to arm or not to arm, patients and visitors are often armed, enabled by state and local gun laws – just one more factor that healthcare facilities are coping with. At of the beginning of the year, Texas law allows for guns in state mental health hospitals. Campus Safety Magazine reports on how Kansas College Hospitals are preparing to allow guns on campus to comply with a new law. Gun laws in health systems vary by state – while a federal law bars guns from schools, there is no such law about firearms in hospitals.

Healthcare Violence Prevention Resources

OSHA: Worker Safety in Hospitals – Caring for our Caregivers

OSHA: Preventing Workplace Violence: A Road Map for Healthcare Facilities

OSHA: Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers

Mitigating Workplace Violence at Ambulatory Care Sites

Emergency Department Violence Fact Sheet

Healthcare Crime Survey 2015

Prior related posts

More perils for healthcare workers

Violence in healthcare: 61% of all workplace assaults are committed by healthcare patients

Report on violence & aggression to Maine’s caregivers; Injuries include bites, kicks, being hit

Health Wonk Review & Other Noteworthy News

Thursday, January 17th, 2013

Health Wonk Review: The Inauguration Edition is freshly posted by Chris Fleming at the Health Affairs Blog. Here’s a preview: 2013 predictions, healthcare spending, risky behaviors, nursing workforce projections and more. A good and substantive edition: Get your wonk on.
Electric car crashes could pose new risk for first responders – With the proliferation of hybrids and new technologies, emergency workers that respond to the scene of an auto accident could be subject to shocks from batteries that have not powered down. See our prior post on Electric Vehicle Safety Training for first responders.
Are the flu & Tamiflu overhyped? – At Managed Care Matters, Joe Paduda casts a skeptical eye on the hoopla over the flu and the media’s propensity to blow everything up into a crisis. If it’s not shark month or killer bee week, we need some fear-factor issue to fascinate, worry, and horrify us. Don’t miss his comments on Tamiflu. But if you do need some workplace guidance, see Influenza tools & tips for you & your employees at HR Web Cafe. Also of interest: NIOSH Research on Airborne Influenza Transmission
A Primer on Fee Schedules – Peter Rousmaniere’s most recent column in Risk & Insurance is a good bookmark. He offers an overview and a rundown on the status quo on this complex and important managed care issue of how doctors get paid.
Internet-Use Disorder: The Newest Disability? – There’s apparently a growing catalog of technology related maladies – we’ve previously discussed Blackberry Thumb, Cell Phone Elbow, IPod Ear. But this one is actually included in the DSM-5 – although as a condition that requires further research. Jon Hyman of Ohio Employer’s Blog thinks it bears watching because if it is deemed a psychiatric disorder, then employees who suffer from it may be protected by the ADA. See his post for more on this.
For Americans Under 50, Stark Findings on Health – “Younger Americans die earlier and live in poorer health than their counterparts in other developed countries, with far higher rates of death from guns, car accidents and drug addiction, according to a new analysis of health and longevity in the United States.” Access the full report.
Drugs & Guns: Arming Investigators – Dave DePaolo posts that the Texas Medical Board (TMB) has asked the state’s attorney general to rule on whether the board may authorize its investigators to carry concealed handguns as private citizens when investigating pill mills. Drugs are a big and dangerous business. Ohio recently approved such a measure so the request is not without precedent.
CT officials hope to change workers comp law for Sandy Hook responders – Some lawmakers are looking to extend benefits to first responders for PTSD related to incidents like Sandy Hook (although it is unlikely any legislation would be retroactive). Currently, state law extends workers compensation benefits only to those who had a serious injury/fatality but not PTSD. We’ve seen this issue before: (Uncompensable) Nightmare at Work.
News Briefs

Guns on campus: things are heating up in Texas

Thursday, February 24th, 2011

Amid much controversy, the Texas Legislature is considering SB354, a bill that would allow licensed students and professors to carry concealed handguns on college campuses. The bill has passed a Senate committee and has been referred to the Committee of Criminal Justice, where it will be up for a hearing. (Follow SB354). With support from Governor Rick Perry and more than half the members of the House signing on as co-authors, most observers think that the bill will be passed. But according to an article by Patrick Williams in the Dallas Observer, concealed guns on campus is not necessarily a fait accompli: “[Similar] legislation has failed 43 times in 23 states since Virginia Tech,” Malte says, referring to the 2007 campus mass murder that claimed 32 lives. “Every time somebody said this is a done deal over the last three years, it was defeated.”
Utah is currently the only state that allows guns on campus, but legislation is on the docket in several other states. Fox Business News reports that eight other states currently have campus carry legislation underway. These include Arizona, Florida, Michigan, Mississippi, Oklahoma, Nebraska, New Mexico, and Tennessee.
With sympathetic Republicans at or approaching supermajority status in a few of these states, the political stars are in alignment for success. Ultimately, the deciding factor may come down to the strength of student and parental support or opposition. Keep Guns Off Campus says that the American Association of State Colleges and Universities (AASCU) and 271 colleges and universities in 36 states – 189 four-year colleges and universities and 82 community colleges and technical schools – have joined the Campaign to Keep Guns Off Campus. (See Listing). On the other hand,
Students for Concealed Carry on Campus point to widespread support – not the least of which is the mighty power and deep pockets of the NRA.

Follow-on to “Guns at Work”

The spate of campus carry legislation is a natural adjunct to the NRA’s major “guns at work” legislative initiative, which has been sweeping the country in recent years to considerable success. According to the NRA, there are now 13 states that have laws permitting employees to have guns at work: Alaska, Arizona, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Minnesota, Mississippi, Oklahoma, and Utah. While the particulars of these laws vary, such laws generally allow licensed gun owners to keep guns locked in their cars at work, including on employer-owned parking lots. In some states, certain business such as hospitals, schools and prisons are exempt. This is an issue that has pitted the rights of an employer to establish policy for their private property (employer-owned parking lots) against second amendment rights. It’s an issue that has been opposed by employer groups and associations.
For more history on the Guns at Work issue, see prior postings on the topic below.
Three new state laws limit employer restrictions on guns at work
Guns at work: coming to a neighborhood near you?
Workers with guns
Guns at work

Turkey Shoot

Thursday, December 3rd, 2009

William Wehnke, 51, claims to have spotted a wild turkey in his field in rural Annsville, New York (population 3,000). He took aim and fired at the turkey and managed to hit Matthew Brady, a workers comp investigator, who happened to be crouching in the field, dressed in camouflage. Brady was apparently performing surveillance on Wehnke, who is collecting workers comp benefits for an unspecified injury. Whatever his disability, Wehnke is obviously capable of operating a shotgun.
Local authorities are not buying Wehnke’s story about the turkey. He’s been arraigned on a three-count grand jury indictment that includes felony second-degree assault and unlawful manner of taking. He is even charged with using inappropriate ammunition for hunting turkeys. Wehnke is in a lot of trouble for his little turkey shoot.
Investigator Brady was hit in the side, back and legs. He underwent surgery and presumably filed his own workers comp claim for what is surely a work-related – if highly unusual – disability.
Images – Lasting and Otherwise
I could not help but think of the other Mathew (sic) Brady, the 19th century photographer whose iconic images of the Civil War still resonate with us. As pathetic as investigator Brady’s situation is, his earlier namesake fared even worse. After the Civil War, Mathew Brady found that war-weary Americans had little interest in purchasing photographs of the bloody conflict. Having risked his fortune on his Civil War enterprise, Brady lost the gamble and fell into bankruptcy. His negatives were neglected until 1875, when Congress purchased the entire archive for $25,000, which might sound like a lot, but was not even enough to cover Brady’s debts. He died in 1896, penniless and unappreciated. In his final years, Brady said, “No one will ever know what I went through to secure those negatives. The world can never appreciate it. It changed the whole course of my life.”
The world may ultimately take little note of the suffering of the other Matthew Brady, wounded as he crouched in that desolate Annsville field. His life, too, has been significantly changed. But he at least will benefit from the wonders of modern medicine and the cushion of weekly indemnity, until he once again pursues his craft as a comp investigator. But the next time he is asked to don camouflage, he just might want to take a pass.

Cavalcade of Risk, health care reform, bankrupt insurers, guns at work and more

Thursday, November 20th, 2008

Joe Paduda is hosting the post-election edition of Cavalcade of Risk. Dedicated blogger that he is, his post comes to us from Las Vegas, where he offers observations from the floor of the National Workers Comp and Disability Conference. Joe has been a roving workers comp reporter lately. His recent trip follows on the heels of his reports from the Workers Compensation Research Institute Annual Meeting, where he offered his analysis of the best presentation, along with other posts from the conference that you might want to read.
Health care reform – The health care bloggers and pundits are weighing on on the announcement that Tom Daschle has been named as Health and Human Services Secretary. Ezra Klein says that he was picked because he has the skill set to get health care plan through Congress; Jonathon Cohn talks about his likely approach, and Bob Laszewski of Health Care Policy and Marketplace Review offers his thoughts on the Daschle pick. And for those who are still on the fence about the necessity of health care reform, Sarah Rubenstein of the WSJ Health Blog reports that under PPOs, the the most common type of insurance offered by employers, health care deductibles doubled to $1,000 in 2008, according to a recent survey by Mercer.
When insurers bite the dustWhat happens to workers compensation claims when an insurance company goes bankrupt? Ronald Ryan of Michigan Workers’ Compensation Law blog discusses how this situation is handled in Michigan. State laws differ. Questions about bankrupt insurers are weighing heavily on the minds of employers and claimants lately. We’ve talked about what happens in the case of insurer insolvencies before, as well as employer bankruptcies and comp. The Insurance Information Institute provides an excellent overview of insurer insolvencies and state Guaranty Funds – a page you might want to bookmark, given the times.
Guns at work – While there likely won’t be a decision until next year, the NRA and Oklahoma employers squared off yesterday in federal appeals court in Denver on the issue of guns at work in Oklahoma. These types of laws pit the rights of gun owners against the rights of private property owners – in this case, employers – to control their own property. The Oklahoma law forbid employers the right to bar employees from keeping guns in locked cars on their property, but a district court issued a permanent injunction against the law’s enforcement on the basis that the law was preempted by employer obligations to maintain a safe workplace under the Occupational Safety and Health Act. Michael Fox of Jottings By an Employer’s Lawyer discusses yesterday’s court proceeding. He sees the potential for the law of unintended consequences to come into play in relation to the interpretation of the General Duty Clause of the Occupational Safety and Health Act, which could increase exposure to OSHA violations for other employers. For more, see our background on this case as the issue evolved.
Safety sensitive employees – When it comes to safety, can you require physicals of all employees? Attorney Lindsay Harris offers tips on periodic medical exams for safety-sensitive positions HR Daily Advisor.

Three new state laws limit employer restrictions on guns at work

Monday, August 4th, 2008

This summer, risk managers in Florida, Georgia, and Louisiana have a new concern to add to their checklist of health, safety and prevention issues: guns at work. These three states have recently enacted legislation that will allow employees to keep guns in locked cars at the work site. These laws not only overrule any existing company policies which forbid guns on company property, they mean that it is now illegal for employers to prohibit employees from keeping loaded guns in their cars during work hours.
The three states are the latest in a series of states that have passed such legislation. Other states with similar laws include Alaska, Kansas, Kentucky, Minnesota, Mississippi, and Nebraska. At least 13 other states have rejected similar laws; Oklahoma passed similar statute, but it was struck down in October 2007 on the grounds that the law conflicts with federal law, specifically, the 1970 Occupational Health and Safety Act. OSHA requires employers to reduce any any workplace risks that could lead to death or serious bodily harm. OSHA also encourages employers to prevent gun-related workplace injuries.
While each law varies in its particulars, there are some restrictions. In most cases, the laws apply to to licensed gun holders, for example, and some types of businesses may be exempt. In Florida, these include aerospace companies, nuclear power plants, hospitals, schools, prisons, and manufacturers that use combustible materials. Most laws offer employers some limited protection from any liability that should occur as the result of the laws, but this would likely not protect an employer from such things as business interruption, loss of business, or qualifying employee workers compensation or disability claims, to name a few matters.
Employer challenges
In Florida and Georgia, several large employers are keeping bans in place. Disney, Universal Studios, a Georgia Pacific paper plant, and Atlanta’s Hartsfield-Jackson International Airport are maintaining gun prohibitions and facing NRA-financed lawsuits from gun owners. States are struggling to clarify the laws on questions such as which employers should qualify for an exemption and exactly who does and doesn’t the law apply to? Right now, employers may not restrict employees from keeping a gun in a locked car, but vendors and visitors may be restricted.
Both sides claim rights. Gun owners claim their right to have guns, although the recent Supreme Court ruling suggested this right is not without some restrictions. Employers claim such laws are a a violation of the private property rights provided by the Constitution and an imposition on their violence prevention measures, which they must take to be in compliance with OSHA. Employers cite the five fatalities at an Atlantis Plastics in Henderson, Kentucky as an example of what could go wrong. In that case, a disgruntled worker retrieved a .45 caliber pistol from his car shortly after being escorted out of the workplace, returning to shoot his supervisor and four co-workers. This type of incident is unfortunately not rare. The Bureau of Labor Statistics data reveals 787 weapon “assaults and other violent acts” in workplaces in 2006. There were 439 workplace homicides by gunfire.
The recent spate of legislation is hardly the last we will hear on the matter of guns at work. Buoyed by the recent Supreme Court decision which struck down the 1976 Washington D.C. handgun ban, the NRA is stepping up its challenges to existing state gun control laws. If this issue hasn’t surfaced in your state yet, rest assured, it will.
Prior posts on this topic
Guns at work – coming to a neighborhood near you?
Workers with guns
Guns at work