Dr. Craig Bates was working in the MetroHealth emergency room on a Sunday morning three years ago when a patient arrived after a motor vehicle crash. 

He and his team started checking on her injuries and the status of her health. The patient was worked up, Bates said, and lashed out, ultimately kicking him. He fell back and put his hand behind his head to protect it. His left wrist snapped backwards. 

“I was like, ‘My hand is numb. My left hand is numb. What am I going to do?’” Bates said. “You know, I was freaking out.” 

Bates, an emergency physician, has worked in MetroHealth emergency rooms for more than 20 years. The assault left him with some of the most tangible impacts of workplace violence – a broken wrist, 15 months away from full duties, years of occupational therapy and an end to his ability to work as a physician on Metro Life Flight helicopters. 

But it’s far from the only violent situation he’s experienced or witnessed at work. Once, a man jumped at Bates after he shared the news that someone had died. Regularly, he said, people at the emergency room threaten to find him outside the hospital and conduct a “separate settling of accounts.” Nurses and patient care technicians, who spend more time at patients’ bed sides, often have it even worse, he said. 

That’s why Bates feels like proposed legislation from Cleveland’s City Council to increase penalties for “menacing” health care workers is a step in the right direction. Under city law, menacing is when a threat of physical harm is made to another person, their property or their family. It has to be done knowingly, meaning the person must be aware the threat causes the fear of harm.

Current city laws call menacing a fourth degree misdemeanor. The proposed legislation would raise that to a first degree and add a mandatory three-day jail sentence if the person was a health care worker.  

Cleveland Council President Blaine Griffin and Council Member Michael Polensek, the chair of the Safety Committee, cosponsored the bill last fall – listing national statistics about the rise in violence against health care workers as a precursor. Nationally, people working in the health care and social service industries are five times as likely to suffer a workplace violence injury than workers overall, according to 2018 data from the Bureau of Labor Statistics. Health workers’ reports of being harassed at work more than doubled, from 6.4% in 2018 to 13.4% in 2022, according to the Centers for Disease Control and Prevention. 

In Cleveland in 2024, about one in 10 workers were employed as health care practitioners or as health care support staff, like medical assistants. One Cleveland hospital, Cleveland Clinic, said it would like to see the legislation passed.

“We have to protect our frontline services,” Polensek said. “…I put hospital employees and caregivers as first line, front line. We can’t let them be assaulted or threatened. The job is hard enough.” 

But the proposal has drawn pushback and questions from some council members. Council Member Stephanie Howse-Jones said she worried the law could be used to criminalize patients, especially Black and brown ones, who are experiencing trauma and feel they’re not being listened to. That’s drawn from her own experience of being treated poorly in health care settings, she said. 

“What’s your response when you are treated poorly, when you were coming for help, right?” Howse-Jones said. “And I don’t think it is the responsibility of the person who is in that moment of crisis to be able to be like, ‘Oh, you gotta be on your best behavior.’”

Howse-Jones said she plans to propose adding a “trauma-informed” checklist to the legislation. It would require extra steps before prosecutors could charge with the crime of menacing. She also plans to request the city track data, including demographics, on menacing charges.     

A spokesperson for Cleveland City Council wrote in a statement that leaders from the city’s hospital systems are discussing Council’s concerns and how to create legislation that will “provide safety in an equitable manner for healthcare workers.”

New legislation initiated by Cleveland Clinic 

Polensek said the proposed legislation was initiated by the Cleveland Clinic. The City of Akron passed a similar law last September, supported by the Cleveland Clinic and Summa Health, which runs several hospitals there. 

Representatives of Cleveland Clinic spoke in favor of the bill at a Cleveland City Council Safety committee meeting in November. 

Workplace violence is a growing concern at the hospital system, said Dallas Moyer, senior project manager for Cleveland Clinic’s Center for Workplace Violence Prevention, at the committee meeting. The number of workplace violence incidents reported at Cleveland Clinic facilities in Cleveland rose nearly 36% from 2023 to 2025, topping 1,600 reports last year. About 60% of the incidents involved physical contact, while about 30% involved non-physical behavior such as verbal threats or intimidation, according to a spokesperson for the Cleveland Clinic. The remaining incidents involved “disruptive behavior” requiring security response.  

In the meeting, Moyer said the perpetrators can be patients, visitors and family members.

“The prevalence of workplace violence is no longer limited to our emergency departments and our behavioral health units,” Moyer said. “It’s rising across all care settings, including inpatient units, outpatient facilities and community clinics.”

Cleveland Clinic Police Chief Deon McCaulley told council members that the hospital encourages caregivers to report “physical and verbal violence.” When it occurs, Cleveland Clinic officers respond and encourage the victim to consider prosecution, he said. The Clinic also offers advocacy to navigate the prosecution process, he added. 

He believes the proposed law would deter misbehavior in the health care system. 

“Beyond that, it allows for accountability,” McCaulley said. It shows “that threats to any health care worker is no longer a smack on the wrist.”

The city’s other two major hospital systems, MetroHealth and University Hospitals, were not present at the November meeting. Signal Cleveland asked both hospitals whether they supported the legislation. University Hospitals wrote in a statement that it is having productive discussions with the city and other stakeholders to understand the impact of the proposal. In a statement, a spokesperson for MetroHealth wrote that it will stay engaged in City Council’s efforts to “help ensure the safety of our caregivers.”  

“Violence against healthcare workers is a serious concern, and MetroHealth is committed to addressing it thoughtfully and proactively,” the statement read.

Nurses in Ohio have been raising concerns about safety for a few years. A 2024 survey by the Ohio Nurses Association found 65% of nurses experienced workplace violence in the last 12 months. So legislation adding penalties for menacing is needed and appreciated, said Patricia Kane, the president of the psychiatric nurses’ union at MetroHealth’s Cleveland Heights hospital. She and her staff receive threats frequently, she said. One of her co-workers was recently told by a patient at work that he would rape and kill her children, she said.  

The proposed legislation won’t apply to the Cleveland Heights hospital because of its location, but Kane is in favor of it.

“Any measure anywhere, it doesn’t have to affect me – I support it if it seeks to to help provide a safer environment for our health care workers,” Kane said. 

Commander Ellen Kazimer, a spokesperson for Cleveland EMS, said the ordinance would not apply to first responders. But she said the agency supports measures to deter acts or threats of violence toward health care workers.

The Cleveland Association of Rescue Employees, the union representing EMS employees, is also in favor of the bill, said Tim Sommerfelt, a representative for the union. He said EMS workers have experienced a rising number of assaults in recent years.

“Assaults on healthcare providers are always unacceptable,” Sommerfelt wrote. “The use of alcohol, drugs, or mental crises should not give individuals a free pass to hurt those trying to help.” 

Enforcing rules around ‘menacing’ 

Menacing – just like other crimes – can result in arrest and prosecution. 

Council members had questions about how enforcement of the proposed legislation would occur. In the November meeting, council members Brian Kazy and Richard Starr asked whether factors such as mental health crises or awakening from anesthesia would be taken into consideration. 

Jennifer O’Leary, special counsel at Cleveland City Council, said that the legislation requires the offender to know or have reason to know that the victim is a health care worker.

“There has to be an awareness,” she said. 

McCaulley, the Cleveland Clinic police chief, added that police in Ohio have discretion on how to proceed when dealing with misdemeanor cases. To determine whether to arrest, cite or warn an individual, police take into consideration what circumstances occurred prior to the violation. That includes whether a person is coming out of anesthesia or not, he said. 

“If a police officer takes that into consideration and says that the intent of the individual was not to commit a violation, then a police officer at that point will certainly still document it by way of a report, but maybe not necessarily cite the individual or arrest that individual,” McCaulley said. 

This drew concern from Howse-Jones. She said she worries relying on judgment calls will result in biased implementation – specifically, more Black and brown people getting arrested or charged under the new law. 

That worry is pulled from how she has been treated in health care settings, she said in an interview. Several years ago, while her mom was having a procedure at the Cleveland Clinic, Howse-Jones said she went back and forth with front desk staff over whether she could head to the room where her mom was located. (The doctor had given her the location, she said.) The front desk staff couldn’t find the information and wouldn’t let her proceed. Howse-Jones, who is her mom’s legal guardian, headed in the direction of her mother anyway.    

Several minutes later, several police officers showed up to Howse-Jones’ location. The police officers ultimately left after a conversation with her and a Cleveland Clinic employee whom Howse-Jones had called to join her in the hospital. 

“I’m just here trying to advocate for my mother, who can’t advocate for herself, right?” said Howse-Jones, whose mother has dementia. “And I can see very clearly how, at times, people can be criminalized for their interactions with different health care providers, police officers in that setting.”

Kane, though, said that she sees the proposed City Council legislation as an opportunity to protect marginalized people who are working in health care.  

“The primary victims of menacing that I see in my work environment are women of color,” Kane said. “… And we need to make it much easier for them to have access to protection and recognition.” 

Charging decisions around menacing  

Howse-Jones said she hopes to add language into the bill that would require police and hospital systems to complete a “trauma-informed care checklist” before a person can be charged with menacing. The goal is to reduce the likelihood that charging decisions are made based on bias, she said.  

According to preliminary language she shared, that checklist would include documenting whether the perpetrator understood their surroundings, whether their behavior was “involuntary or crisis-driven” and whether they had any indicators of an acute behavioral health crisis. The checklist wouldn’t excuse “intentional threats or acts of violence,” it read.  

Howse-Jones acknowledged that health care workers often see violence in their jobs. She said the traumas, crises and emotions all present in health care settings, especially an emergency room or behavioral health facility, make that an unfortunate reality. Dealing with it, she said, is a question for health care systems and their policies, training and staffing.  

“I believe the responsibility is on the organization and the trained professionals, not the everyday layperson who was supposed to come for help,” Howse Jones said. “ …That ain’t on them.”

Bates wrote in a statement that Howse-Jones’ proposals are a good start, but he has some concerns with them. When dealing with his own assault, he wrestled with whether to press charges or not. As a physician, he said his job is to advocate for patients even when it’s difficult. 

Ultimately, Bates decided he wanted accountability and to deter future attacks on health care providers. He pressed charges but pushed for his assailant to receive probation, to give her space to rebuild her life. 

Bate’s case was cut-and-dry: It was caught on a police body camera, and he broke a bone as a result of the assault. Bates said police almost immediately told him he would be able to press charges. Not every case is as simple, Bates said. Some health care workers don’t report violence in the first place, because it’s so normalized in the workplace. Others’ situations are more muddied – no witnesses, no physical evidence – which can make it harder to press charges.   

“People say horrible things, and push you or kick you or spit on you, and a lot of that stuff doesn’t go reported or charged,” Bates said.  

Menacing adds another layer of subjectivity: Bates said he’s developed a thick skin for certain threats, but other workers may feel greater fear. He said a challenge with the proposed legislation will be how well it can be enforced.   

“Is it going to be consistently caught and enforced in a way that doesn’t really put the onus on the recipient to be, quote, difficult, to push it?” he asked.