Illness and Injury Prevention Programs: What Employers Need to Know
Most state-level Occupational Safety and Health Administrations (OSHA) require employers to have a general workplace safety program. Of the 34 states that have legally mandated safety programs, California has one of the most comprehensive and longest standing: the Injury and Illness Prevention Program (IIPP), which has served as a model for other State Plans.
Cal/OSHA requires every employer to have an IIPP, regardless of size or sector. Many employers have an IIPP but fail to meet all the requirements of the standard, which is detailed in Title 8, California Code of Regulations (T8CCR) §3203. Others, especially small business owners in low-risk industries, incorrectly assume that they do not need a written general safety program, putting their businesses and employees at risk.
OSHA Enforcement Statistics
Missing or inadequate IIPPs are so commonplace that year after year, T8CCR section §3203 ranks #1 as Cal/OSHA’s most frequently cited standard. The trend continued for Cal/OSHA’s most recently reported fiscal year (from October 2021 to September 2022): almost 14 percent of all citations were for IIPP violations (1,122 of 8,084 total violations), and nearly 39 percent of all inspections found IIPP violations (1,077 of 2,796 total inspections), resulting in over $1 million in proposed penalties across all sectors.
A million dollars might seem like a drop in the ocean compared to California’s $3.4 trillion economy. However, IIPP violations could have a significant impact on individual businesses. In 2021, dozens of companies, including small businesses, were fined over $18,000 for IIPP violations. In addition to fines, employers who do not have or properly utilize an IIPP can face direct and indirect financial consequences: higher worker’s compensation insurance rates, litigation, negative press, reduced morale and productivity.
So what is an Illness and Injury Prevention Program? What are the requirements according to Title 8?
IIPPs are workplace safety protocols that serve as the foundation or central hub for more specific programs, such as fall protection, hearing protection, first aid, personal protective equipment, and ergonomics. Like many other OSHA standards, the language in the law is intentionally vague, because IIPPs need to be tailored to the specific safety needs of each workplace. The number and types of subprograms would differ vastly between an office building and construction site, but the IIPP needs to describe which of these subprograms are in place, why they are required (potential hazards), and how they are integrated into daily operations.
While IIPPs are broad, Cal/OSHA requires the following eight elements:
- Assigning the workplace’s IIPP administrators and their responsibilities
- Assessing workplace hazards
- Investigation of accidents, injuries, and illnesses
- Correction of hazards
- Communication with employees and methods for involving them in safety-related activities
- Occupational safety and health training
- Systems for ensuring employee compliance with safety procedures
- Recordkeeping and documentation of the program and program activities
A Written Safety Program
While an IIPP is a collection of safety measures, it is also a document, which is often organized according to the eight “elements” required by Cal/OSHA. “Communication with employees” can take many forms including meetings, committees, training programs, posting, written communications, and/or an anonymous hazard reporting system.
Title 8 is clear, however, that the program must be put into writing. A company must provide any employee with access to a printed or electronic version of its IIPP within five days upon request. Even communications that are verbal in nature, such as hands-on training, hazard inspections, and meetings, require detailed records that must be kept for one year
Committees can be highly efficient in covering the eight elements required in an IIPP, and they only have to meet every quarter. However, simply forgetting to take and maintain notes of safety meetings can put the program at risk of falling out of compliance: once committees become the core of the safety program, a company must provide meeting notes to employees upon request.
Small Companies and Staffing Agencies: Exemptions and Requirements
Cal/OSHA eases some requirements for smaller companies. Title 8 allows companies with fewer than 10 employees to “instruct employees orally in general safe work practices with specific instructions with respect to hazards unique to the employees’ job assignment.” Also, they only need to maintain inspection records until the hazard is corrected instead of one year
It should be noted that all employers with less than 10 employees must still have an IIPP, even if they do not have to provide written copies.
A 2019 Cal/OSHA Appeals Board decision set a precedent requiring IIPPs for the smallest of businesses. The board ruled that Jace Varchese, a man who paid his family to help him flip houses, still qualified as an employer and was therefore accountable for not having an IIPP.
Other rulings have set precedents making both staffing agencies and their clients accountable for providing safety training, hazard identification, hazard correction, and other IIPP components.
How to Get Help with IIPPs:
Keeping such a broad and comprehensive program in compliance can seem like a daunting task, especially for companies that are not small enough to be exempt from the documentation requirements but not large enough to hire a full-time safety manager. Cal/OSHA recommends several resources that can help companies build their IIPPs including risk managers, health and safety specialists from insurance companies, and consultants from Cal/OSHA.
Although OSHA’s Consultation Service is free, any hazard identified by an OSHA consultant must be abated within a specified time period. Companies with open violations found during a compliance inspection (which are usually in response to an accident or complaint) are not eligible for consultation until the citation has been issued and becomes a final order. Although the OSHA consultation is confidential, employers will be reported to an enforcement office if they fail to correct an imminent danger or serious hazard that was previously cited.
Instead, companies can choose to hire professional safety consultants, who help inspect the workplace for hazards by simulating an OSHA inspection then write their IIPP. Third-party consultants can write a Title 8-compliant safety program within hours by using an IIPP template and asking employers a series of questions about the workplace. Consultants can see if emergency supplies like first aid kits meet compliance or train employees in the specific safety programs required by the IIPP such as first aid and CPR.
COVID-19 and IIPPs
Another common misconception about IIPPs is that Cal/OSHA only requires high-risk industries to have them. In fact, IIPPs have been legally required for all employers since 1991. Many companies learned this the hard way during the COVID-19 pandemic, when Cal/OSHA started using the IIPP standard to enforce the state’s COVID policy.
Title 8 has always required employers to update IIPPs when they identify a new workplace hazard, including airborne pathogens such as the COVID-19 virus. Inspectors are finding that employers are failing to protect their workers from the virus by not updating their IIPPs to include COVID training and protocols on social distancing, protective barriers, ventilation, personal protective equipment (PPE), and reporting.
As of October 2022, 453 out of 1,095 of COVID-19-related violations found by Cal/OSHA cite at least one subsection of IIPP standard. Workplace accidents and illnesses resulting in injury or death can lead to a “Serious violation,” which carries a fine between $18,000 and $25,000.
Dozens of low-risk businesses such as retail stores, grocery stores, and restaurants are facing Serious violations from OSHA inspections triggered by reports of employees becoming seriously ill or dying from COVID-19. They include large corporations and franchises (Ralphs Grocery Company, Walmart, Amazon, and KFC-Taco Bell), small businesses and staffing agencies, even healthcare providers and government employers (Los Angeles County Superior Court, LAPD, and UCLA).
A Cal/OSHA inspection on September 5th, 2020 found that a Walmart in Riverside, CA violated the IIPP standard by failing to identify and correct unsafe work conditions and practices related to COVID-19. The store was fined $22,950 because workers did not have proper face masks and the register area lacked physical barriers.
Cal/OSHA fined Foster Poultry Farms, Inc. and several staffing agencies nearly $300,000 after multiple COVID-19 outbreaks hospitalized dozens of employees and led to 16 deaths. Cal/OSHA issued multiple serious violations relating to the company’s IIPP, “many of which stemmed from failing to properly communicate, assess, correct, and train on COVID-19 workplace hazards.”
An even larger fine, however, involves a restaurant called Apple Bistro, which refused to enforce mask mandates and social distancing, initially resulting in a Serious-Willful violation and a $108,000 penalty. The owner openly refused to cooperate with OSHA and other agencies, causing OSHA to raise the fine to $675,000 and drawing attention from several news outlets
As with each of these cases, OSHA inspections involving IIPPs are usually triggered by formal complaint or a referral. Referrals can be made by an employee reporting anonymously, another government agency (i.e. local health department or police), media coverage, a customer, or an OSHA inspector who observes the conditions from a public space.
On November 20th, 2020, the Cal/OSHA’s Standards Board added emergency temporary standards to Title 8 to protect workers from COVID-19. Subsection 3205 is largely based on the IIPP standard, and covers prevention, outbreaks, as well as employer-provided housing and transportation. While the emergency standards have reduced the number of IIPP enforcement cases due to COVID-19, the number of inspections for IIPP violations not related to COVID-19 will likely increase as restrictions start to lift.
Even prior to the COVID-19 pandemic, workplace illnesses had a significant economic and human cost across the U.S.. A 1997 study estimated that more than 60,000 workers die each year from occupational illnesses, and more than 850,000 develop new illnesses annually. A 2003 study estimated that between 10,000 and 20,000 workers die each year from cancer due to occupational exposures, and between 5,000 and 24,000 die from work-related Chronic Obstructive Pulmonary Disease.
OSHA estimated that the annual cost for all workplace-related fatalities was $40 billion in 2010.3 Other studies estimated the annual cost for non-fatal workplace injuries at $186 billion, and fatal and non-fatal illnesses at $46 and $12 billion, respectively.
While adverse financial consequences can incentivize employers to invest in safety programs, companies should keep in mind that these programs were designed to protect employees. Workplace safety programs like California’s IIPP are effective in preventing serious injury and illness. Five years after implementing IIPP in 1991, California saw a 19 percent decrease in workplace illnesses and injuries. OSHA found that similar state programs reduced incidents of illness and injury by 9 to more than 60 percent.3