The Arming of Healthcare Security

There is likely no single more controversial topic in the field of healthcare security than the arming of healthcare security officers. We will attempt to look at the steps that must be considered if healthcare leadership in an organization is contemplating transitioning to an armed force. This will not be a comparison of the pros and cons of arming. For the sake of this article, it is assumed that a seasoned healthcare security leader has done the necessary research, consulted with legal counsel, and risk managers, and made the calculated decision to make the significant move towards an armed force. 

Perhaps this difficult decision-making process will begin when an honest evaluation of your current team is conducted. Transitioning to an armed security force does not mean you put your current team through training, arm them with the selected firearm, and they become armed officers. The skill, fortitude, and wherewithal necessary to carry a firearm and utilize it under the stress of a critical incident, are traits not everyone possesses. Being a competent security officer in healthcare traditionally meant that you were courteous, helpful, patient, and versed in all the regulatory bodies (TJC, CMS, etc...) that govern the industry.  Becoming an armed healthcare security officer requires much more. It requires a conscious, personal decision and understanding that you will now be in possession of a tool that can cause great bodily harm or death to the person you use it towards.

Step one: Is the analysis and evaluation of your current team. This can include proactive steps of a psychological screening, file reviews, and perhaps, most importantly a one-on-one interview. No current officer should be forced to transition to an armed officer. The organization has a professional obligation to allow tenured officers to “opt out.” In a proprietary guard force, this may require transferring the employee to another position within the hospital. In a contract guard arrangement-this may be an easier task-as the company may have several unarmed contracts to which they can transfer the officer to. Mangers should be prepared that their staffing conditions may change as a result of this analysis. In addition to the transition of those who either do not wish to be armed, or do not meet the selected criteria, the department may be faced with training new officers who may be trained and already armed, but are not yet familiar with the facility. Or, even more challenging, may not have previously worked in the highly regulated healthcare industry. 

Step two: The adoption and implementation of well-vetted policies. It is highly likely that most departments will already have a “use of force” policy. With the implementation of an armed team, this policy will require significant revision. Additionally, each and every use of force by security should be reviewed, but it is recommended that anytime a security officer discharges a firearm at another person, a multi-disciplinary team should conduct an after-action review of the incident. This will run concurrent with the investigation by local law enforcement, but in no way should the administration allow the law enforcement investigation to guide its findings. This is an internal review like any other, that focuses on reviewing the entire incident from a perspective of potential liability the organization faces as a result. Likewise, any policies that address the “authorized equipment” carried by security officers will have to be reviewed. 

Step three:  The selection of a qualified training program/trainers. Just because the hospital system in the next city used a training firm, does not mean that company is the right fit for your organization. It is time for an RFP. Beyond the normal proposal criteria (insurance, experience, etc.) should be the requirement of specific experience with hospital security teams. Of course, any selection should involve compliance with your state’s specific licensing requirements for armed security (in many states, proprietary security teams are exempt from state licensing, but this may not extend to armed security licensing). 

Step four: The armed security program will impact the hospital/system’s general liability coverage. Your security teams may currently carry no protective tools, or they may carry OC spray, expandable batons, tasers, or other “less-than lethal” weapons. Elevating their defensive resources to a lethal weapon will significantly increase the hospital’s potential liability exposure; subsequently, affecting insurance rates/premiums. Regardless of justification, if a healthcare security officer discharges a firearm striking another human being, the likelihood of civil litigation increases exponentially. 

The steps in this transition should take place concurrently. Like many issues in healthcare security, there is no need to reinvent the wheel. Many healthcare security teams across the country have recently transitioned to armed forces. Reach out to your fellow security leaders for guidance. The first question you should ask is “what was your biggest challenge” to getting it done. You will likely learn that the process will take longer than you originally projected. This is likely the most significant change impacting your security department since its inception. Warn your leadership there will be stumbling blocks along the way. Make room and time, as other hospital departments such as legal, HR, Risk, etc… will be working feverishly on modifying their ancillary policies and processes. Most importantly, utilize industry best practices to insure you are aligned with recommended guidelines. The International Association of Healthcare Security & Safety recently developed and distributed guideline: 02.11 “ Security Department: Firearms in the Healthcare Security Program.” This document should be the focal point guiding this difficult transition. 

Michael S. D’Angelo, CPP, CSC, CHPA is a Board Certified Security Consultant specializing in the security of healthcare facilities. In addition to almost a decade in healthcare security management, D’Angelo is a retired Police Captain from the City of South Miami, Florida where he served for over 20 years. He is often called upon by media outlets for his commentary and serves as an expert witness in cases involving hospital security or healthcare workplace violence.  He can be reached at [email protected], www.securedirection.net or 786-444-1109.