The Vermont Psychiatric Care Hospital in Berlin faces $14,000 in fines for what state inspectors say was a failure to protect front-line workers from patients who become dangerous.
The Vermont Occupational Safety and Health Administration says in the citations that it found three "serious" violations of employee safety.
The 25-bed state-owned hospital serves patients with a designation called Level 1, meaning they are considered dangerous and may be suicidal or homicidal. Some of the patients come to the hospital from the criminal justice system.
"Employees providing inpatient care to patients were exposed to the hazard of workplace violence, including but not limited to physical assaults, such as spitting, biting, kicking, punching, scratching, and choking that resulted in minor to serious physical injury," the first citation says.
"Personal protective equipment such as arm guards, shin guards, chest guards, mouth guards are not available and not required to be worn when dealing with patients engaging in assaultive behavior," the second citation says.
"Employer has not completed a workplace hazard assessment with respect to workplace assaults on employees by patients at the facility, and made a determination as to (personal protective equipment) required if a patient turns violent," the third citation says.
VOSHA inspected the hospital after a direct employee complaint. VOSHA has given management at the Department of Mental Health until June 27 to address the citations.
The U.S. Department of Health and Human Services says the vast majority of people with mental illness are not violent, and people with mental health issues are more likely to experience violence themselves than inflict it on others. However, staffing levels and safety have been issues at the hospital since it opened in mid-2014.
Doug Gibson, the president of the Vermont State Employees' Association, said the union made a request under the Vermont Public Records Act and found out there have been more than 200 assaults — mostly minor — at the hospital between January 2015 and June 2016.
"The majority of those were nominal, but there were some that required medical attention, even trips to the hospital," Gibson said. "We've heard about it from employees for years. It's been an ongoing issue."
In 2015 the lead psychiatrist at the hospital said there is a high prevalence of people with paranoid schizophrenia who stay at the hospital. In February, the Vermont State Employees' Association organized a hearing to tell the Legislature about the challenges hospital workers are facing at work.
One worker told the Legislature that she was assaulted to the point of needing time off under workers' compensation insurance. Another said the staff is routinely required to work double shifts. Another said the workers have had to call police to de-escalate situations.
Three weeks later, the Agency of Human Services decided not to reappoint Jeff Rothenberg, the CEO of the hospital, to his position.
Al Gobeille, the secretary of the Agency of Human Services, said the agency is going through the interview process to appoint a new CEO. "We're planning on putting a new person in and hoping that that will be, in large part, part of the solution," Gobeille said.
He said VOSHA has a process that will allow his staff to dispute any facts of the case. But he said the state is committed to improving workplace safety.
"These are our teammates. We want them safe, so anything they find we'll do, but we don't necessarily agree with their findings," Gobeille said. "We want it to be a safe place to work, so we're going to get on that."
"The overall general nature of it is that we need to do a better job with staff safety and staff training, and I don't think any reasonable person would say those aren't good goals, regardless," he said.