04-04-2019

The decision arises out of a case involving Integra Health Management. Integra helps its insureds receive medical care through “service coordinators.” These coordinators receive some training on in-home and community safety as well as how to identify potentially dangerous clients. One such young coordinator was assigned to a schizophrenic patient with a prior criminal record for aggravated assault. Integra was unaware of the patient’s background. After several visits, the young coordinator submitted reports that included disturbing behavior and stated she was uncomfortable being alone with the patient. The next time this coordinator visited the home, she was fatally stabbed by the patient.
OSHA cited Integra for violating the general duty clause which requires employers to provide a place of employment “which [is] free from recognized hazards that are causing or are likely causing death or serious physical harm to his employees.” The Review Commission rejected Integra’s argument that workplace violence should be distinguished from general duty violations, finding it is appropriate if there is a “direct nexus” between the type/setting of work performed and the risk of workplace violence. In this situation, service coordinators performed much of their work in the homes of clients identified as having certain “risk factors and high-risk behaviors tending toward violence.” The record reflected the young woman’s reports about concerns and other threatening incidents that had been reported. The Commission has abatement recommendations for employers that include a written workplace violence prevention program, new measures to determine the behavioral history of new clients and more consistent methods of communicating issues with clients to service coordinators.