These incidents of violence, which can range from verbal assaults to attacks with weapons, have many healthcare workers on alert as they navigate their day-to-day responsibilities. The authors conclusion that opportunities exist for a finer focus on modernized interventions to prevent workplace violence is especially noteworthy and should encourage action from the healthcare industry and policymakers. [iv] Chaumont Menndez et al. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Rave Mobile Safety holds U.S. Due to HCAPS scores driving hospital decisions, these behaviors are often times overlooked to maintain patient satisfaction. Suzanne Marsh, MPA, is a Team Lead in the NIOSH Division of Safety Research. [vi] NIOSH research evaluated the effect of cameras installed citywide on taxi driver homicide rates in 26 U.S. cities spanning 15 years and found those cities with camera-equipped taxis experienced a 3-fold reduction in driver homicides compared with control cities. Nurs Forum, 54(1), 7783. Again, well likely never know how many confrontations escalated into workplace violence. (7 days ago) WebMay 10, 2022 Nine in ten healthcare workers have witnessed or directly experienced (or been in close proximity to) violence from a patient or a patients . Rave Guardian 8,165,562; 8,126,424; 9,071,643; Patents Pending. There However, this does not mean they are the most dangerous states to work in. This blog is part of aseriesfor the NIOSH 50th Anniversary. a promotion). Discover key findings on the biggest safety concerns healthcare workers have today. Workplace violence doesnt necessarily have to be physical or verbal. NSC members, log in to get the NSC workplace violence safety toolkit, complete with a safety talk, tip sheet, posters and more. One of the most startling cases in the last decade was the killing of renowned cardiac surgeon and professor at Harvard Medical School Dr. Michael Davidson, who was shot by a patients son after the patient had passed away. Most every "place" is somebody's workplace. Rave Alert 8,825,687; 9,077,676; Patents Pending. Journal of Environmental and Occupational Medicine, 50(12), 1430-1441. doi:10.1097/JOM.0b013e31818a388e, [25] Byon, D. H., Storr, C., Edwards, L., & Lipscomb, J. Revisions are in red type. Its more likely their efforts are being focused in the wrong areas due to regulations requiring events such as the periodic testing of fire alarms and fire drill procedures. At this moment any enviroment has become dangerous. WebIn 2020, there were 45,979 deaths by suicide in the United States, which is about 1 suicide every 11 minutes. NIOSH will continue to conduct research on these events and identify possible prevention strategies to address these unique situations. The remainder were attributable to outside actors. Epub 2019 Oct 13. A majority occurred in retail and dining establishments and were perpetrated by a customer or client. This is because the majority took place on hospital grounds, while those that took place inside an Emergency Department or on a ward were the result of the shooter removing a firearm from a security guard or law enforcement officer. (2015). The International Association for Healthcare Security & Safety has reported a near doubling of assaults per 100 hospital beds between 2016-2021, across the United States. No one was injured, but ten people died. While a victim of quid pro quo can benefit from this type of workplace violence, the potential exists for the victim to be subsequently blackmailed to keep the something of value offered to them (i.e. Since the pandemic began in early 2020, U.S. media have reported on retail workers and workers in other industries being verbally assaulted, spit on, and physically attacked while enforcing COVID-19 mitigation practices such as mask wearing or physical distancing. Am J of Ind Med 57:527-538. [2013]. WebWorkplace violence on healthcare professionals and underreporting: Characterization and knowledge gaps for prevention Workplace violence on healthcare professionals [viii] NIOSH/OSHA [2019]. (2018). This is an informative and well-written blog post that highlights a critical issue in the healthcare industry the high risk of workplace violence faced by home healthcare workers. It provides measures such as the occupations with the highest rates of fatal and nonfatal workplace violence; the victim-offender relationship in incidents of workplace violence; the proportion of injuries that led to days away from work or were treated in emergency departments (EDs); and the involvement of weapons, emotional distress, and A summary of the four types of workplace violence are: (1) Type I, criminal intent, an employee is robbed, or their property is vandalized; (2) Type II, a patient/client or family member attacks an employee; (3) Type III, a co-worker threatens or attacks another co-worker; and (4) Type IV, personal relationship, when someone known to the employee outside of work, such as a significant other, threatens or attacks the employee while at work. Hospital staff are receiving the brunt of this bad behavior which is causing a decrease in interest in bedside nursing. Each year, the National Safety Council release an Injury Facts report revealing the number of injuries and days lost due to workplace assaults. 1309, or the Workplace Violence Prevention for Health Care and Social Service Workers Act, gained traction when first introduced. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. NIOSH and its partners are working to address issues related to violence in health care. We take your privacy seriously. Your email address will not be published. If an employer fails to protect an employee from retaliation or is the perpetrator of the workplace violence OSHA operates a whistleblower protection program and has previously taken employers to court for retaliating against employees. LaborPress. Fatal occupational injuries by selected worker characteristics and selected event or exposure, All U.S., all ownerships, 2020. An employer should have policies in place to protect employees who report workplace violence from retaliation. Kicking, hitting, pushing, or beating have been the cause of 7.7% of workplace fatalities. unfortunately this is nursing environment , stay safe!! WebNationwide, 70% of those who experience trauma from workplace violence are employed in healthcare or related fields ( Bureau of Labor Statistics, 2018 ); more than 40% of nurses report being physically assaulted and 68% report verbal abuse ( Byon et al., 2021 ). CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. According to one recent survey, the annual turnover rate of hospital certified nursing assistants (CNAs) was 27.7% (nearly double the turnover rate of nurses and physician assistants). Reducing violence in the workplace is one of the objectives in the NORA Traumatic Injury Prevention Research Agenda. According to the Bureau of Labor Statistics, 20,050 workers in the private industry experienced trauma from nonfatal workplace violence in 2020. [xi] Bryant-Genevier J, et al. Accessed March 9, 2021. Revised: June 2021. O Programa de Ps-Graduao em Letras decorre de uma proposta apresentada pelo Departamento de Letras da Universidade Federal do Maranho e elaborada em consonncia com os dispositivos do Estatuto, do Regimento Geral, do Regimento dos Cursos de Ps-Graduao stricto sensu e lato sensu da UFMA e deste Regimento Interno, estando previsto no Plano de Desenvolvimento Institucional - PDI - 2012-2016.O Curso de Mestrado Acadmico em Letras, do Programa de Ps-Graduao em Letras - PGLetras, aprovado pela Resoluo 1007/2013 - CONSEPE-UFMA, de 6 de maio de 2013, e recomendado pela CAPES com nota 3 e rea de concentrao em Estudos da Linguagem, est estruturado em trs linhas de pesquisa: Linha 1 - Descrio e Anlise do Portugus Brasileiro; Linha 2 - Estudos de Linguagem e Prticas Discursivas e 3- Estudos Tericos e Crticos em Literatura. The impact of workplace violence can range from psychological issues to physical injury, or even death. The blog itself is not available in a PDF. Amazing Read!. [26] Arnetz, J. E., & Arnetz, B. This growth may be impacted by shifts during the pandemic to telemedicine and in-home care. According to HR Daily Advisor, the stress of the pandemic has raised stressed levels and lowered thresholds for confrontation over previously non-existent issues such as social distancing and hand hygiene. Introduction. The median annual pay for home health and personal care aides in 2020 was $27,080 annually and $13.02 hourly (BLS Occupational Outlook Handbook [7]). Federal OSHA has various publications, standards, statistics, technical assistance and The discrepancy between reported workplace violence and unreported workplace violence is expected to worsen when statistics for 2020 are produced. The study found that, over a 27-year period from 1992 to 2019, nearly 18,000 persons were killed at work, on duty, or in violence that was work-related, using data from BLSs Census of Fatal Occupational Injuries. Workplace violence (WPV) against healthcare providers is a serious problem that has many health, safety, and legal consequences [].It disrupts healthcare settings all over the world [].The World Health Organization (WHO) defines the act of violence as the intentional use of physical force, threatened or actual, against Doctors are attacked as well, but according to statistics from the Emergency Nurses Association, not as often as nurses, likely because they often spend less time interacting with patients. The following year, NSC Injury Facts claimed large discrepancies existed between the number of reported injuries and the number of worker compensation claims. 78% of Emergency Department physicians and 100% of Emergency Department nurses have experienced violence from patients within the last year. Between 2.5% and 44% of home healthcare workers have reported being physically assaulted [15],[17],[23-25]. According to the National Institute for Occupational Safety and Health, workplace violence falls into four categories: Criminal intent, customer/client, worker-on-worker and personal relationship, which overwhelmingly targets women. (2001). Findings are presented for 13 indicators of workplace violence, using data from five federal data collections. Prevention is the primary responsibility of the employer; but, there are also roles and responsibilities for home healthcare workers, such as actively participating in training, following employer policies, reporting incidents to the employer, and participating in safety committees. Meanwhile, the Bureau of Labor Statistics projects a need for 11% more WebWorkplace violence is any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site. By Chaumont Menendez C, Dalsey E. Morgantown, WV: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication 2020-100 (revised 11/2019), https://doi.org/10.26616/NIOSHPUB2020100revised112019. [15] Nakaishi, L., Moss, H, Weinstein, M., Perrin, N., Rose, L., & Anger, W. K. (2013). Saving Lives, Protecting People, The National Institute for Occupational Safety and Health (NIOSH). All this is Great information very helpful. You will be subject to the destination website's privacy policy when you follow the link. [10] Shea, T., Sheehan, C., Donohue, R., Cooper, B., & De Cieri, H. (2017). The rise of violence in the healthcare workplace is a startling phenomenon. This phenomenon of widespread violence is prevalent throughout the healthcare industry. (2000). d to address the scale of under-reporting by issuing a, affecting the electronic reporting of injuries. The issue is currently receiving attention in Congress [28]. Evidence from scientific studies supports existing interventions for managing workplace violence in healthcare, particularly for home healthcare workers. Occupational violence and aggression experienced by nursing and caring professionals. doi:101136/oemed-2018-105604, [23] Quinn, M. M., Markkanen, K. P., Galligan, J. C., Sama, R. S., Kriebel, D. Gore, R. J. Fatal work injuries totaled 80 in 2021 for Minnesota, the U.S. Bureau of Labor Statistics reported today. Different strategies can be used to protect home healthcare workers from violence. Violence can occur in any workplace and among any type of worker, but the risk for fatal violence is greater for workers in sales, protective services, and transportation, while the risk for nonfatal violence resulting in days away from work is greatest for healthcare and social assistance workers. assaults resulted in 20,050 injuries and 392 fatalities, National Institute for Occupational Safety and Health. Researchers have also reported that physical or verbal threats of violence were associated with providing home care services to patients with a history of violence or patients with mental illness or substance use disorders [25]. Call for assistance in assessing/responding, if needed.Avoid an audience when dealing with the employee.Remain calm, speaking slowly, softly, and clearly.Ask the employee to sit down; see if s/he is able to follow directions.Ask questions relevant to the employee's complaint such as:What can you do to try to regain control of yourself?More items Your email address will not be published. Personal care aides, home health aides, nursing assistants, and other care assistants are very important home healthcare workers who help clients with activities of daily living (e.g., bathing, dressing, and feeding), provide skilled nursing care including assistance with medication administration, and perform housekeeping chores [3],[4]. In 2016, OSHA attempted to address the scale of under-reporting by issuing a Final Rule affecting the electronic reporting of injuries. The World Health Organization categorized workplace violence as physical, psychological (emotional), sexual, and racial [11]. Of the Preventing workplace violence to home healthcare workers. One way to approach this is to apply Haddons Matrix to workplace violence in home healthcare (Table 1, adapted from McPhaul and Lipscomb [29]). Prior to visit, employer should clearly describe to patient the expectations for patient and family behavior. In the publication Dealing with Workplace Violence (PDF), the agency notes that not only can bullying be a form of intimidation, it can also be an indicator of potentially violent physical behavior. There are various measures that can be implemented to prevent workplace violence cases. They help us to know which pages are the most and least popular and see how visitors move around the site. This legislation requires certain employers in healthcare and the social sectors to investigate workplace violence incidents, risks, or hazards as soon as practicable; provide training and education to employees who may be exposed to workplace violence hazards and risks; meet record keeping requirements; and prohibit acts of discrimination or retaliation against employees for reporting workplace violence incidents, threats, or concerns.. In our 2019-2020 Workplace Safety and Preparedness Report, 30% of respondents said they were unaware or unsure of their employers Emergency Preparedness Plans for the most common types of workplace emergencies. I am so glad that this blog was written to bring more awareness to Home Healthcare in regards to the growth, diversity, and high-risk for workplace violence faced on both sides. B. Scientific studies have linked violence in home healthcare settings to negative emotional, cognitive, behavioral, physical, and psychosocial outcomes among workers. 2Bureau of Labor Statistics (2020). With regards to reporting retaliation to OSHA, the time limit is 30 days after the retaliatory event. This was the first NIOSH publication to identify high-risk occupations and workplaces. They help us to know which pages are the most and least popular and see how visitors move around the site. Our analysis of BLS data sorted states by their relative sizes and the number of accidents in each to determine which the ten most dangerous states to work in actually are. Substantial resources have been directed towards understanding, preventing, and managing workplace violence. The issue of violence in home healthcare will likely increase as the industry is projected to grow dramatically in the coming years. Post-incident support services can have great value for home healthcare workers well-being. 2023.1. Methods. The adverse effects of violence can severely impact the delivery of healthcare services and the quality of care, and can result in diminished productivity, job dissatisfaction, drug and alcohol use, and poor health outcomes among workers [13]. [i] CDC [2013]. Policy, Politics, & Nursing Practice, 19(34), 5771. Objectives. Saving Lives, Protecting People, Tamara Felice Small, PhD; Susan Goodwin Gerberich, PhD, MSPH; Anthony Oliveri, PhD, MPH, CIH, CSP; Christina Socias-Morales, DrPH; Dawn Castillo; and Richard Olawoyin, PhD, CSP, 1. In 2008, NIOSH undertook a large state-wide study to measure physical and non-physical violence directed at teachers and school staff in Pennsylvania. Taxi drivers, for example, are more than 20 times more [2014]. Incidence data reveal that in 2018 health care and social In 2019, workers in convenience stores had a 14 times higher rate of deaths due to work-related violence than in private industry overall (6.8 homicides per 100,000 workers vs. 0.48 per 100,000 workers). 492 Old Connecticut Path Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Retrieved June 28, 2021, from https://www.who.int/violence_injury_prevention/injury/work9/en/. We focus on eliminating the leading causes of preventable injuries and deaths. March 9, 2021. Home healthcare workers are also at risk for violence as they work closely with patients and often are in close contact with the public while they provide healthcare services to patient. Empower your community and prevent dangerous incidents with the most widely-used preventative tip software. In the 1980s a series of shootings at post offices drew public attention towards the issue of workplace violence. However, it was particularly noted in the report that more than a third of female respondents were unaware of workplace violence emergency plans, despite workplace violence being the second leading cause of death for women in the workplace. A February report from the Insecurity Insight and the University of California, Berkeley 's Human Rights Center found that more than 1,100 threats or violent acts against health care workers and facilities occurred worldwide in 2020, with around 400 of those attacks related to Covid-19. C, Casteel, C., Nocera, M., Harrison, R., & Peek-Asa, C. (2016). Home care aides experiences of verbal abuse: A survey of characteristics and risk factors. Journal of Industrial Medicine, 59, 23-30. doi:10.1002/ajim.22543, [20] Canton, N. A., Sherman, F. M, Magda, A. L., Westra, J. L., Pearson, M. J., & Raveis, H. V. (2009). Home Care and Hospice Professional, 27(6), 364-373. doi:10.1097/01. WebIn many cases, the hazards are easily identified and are fairly obvious, such as untidy work areas, damaged fitness machines, torn carpets, unclean change rooms, unmaintained air-conditioning units and so on. SmartPrepare 8,751,265; Patents Pending. Impact of a crime prevention ordinance for small retail establishments. A lot can happen in the chaotic minutes before police arrive; DHS advises staying calm and exercising one of three options: Run, hide or fight. [28] H. R. 1195. Read more about our comment policy . Workplace violence (WPV) against healthcare providers is a serious problem that has many health, safety, and legal consequences [].It disrupts healthcare settings all over the world [].The World Health Organization (WHO) defines the act of violence as the intentional use of physical force, threatened or actual, against This has given rise to many important initiatives, such as the No Silence on ED Violence movement, as well as a refreshed push to increase efforts via legislative and systemic changes. With this projected growth and the movement from hospital-based to home-based care, the risks for workplace violence and other safety concerns for home healthcare workers are expected to increase. Every year, millions of American workers report having been victims of workplace violence. In 2018, assaults resulted in 20,790 injuries and 453 fatalities, according to Injury Facts. Certain industries, including healthcare, service providers and education, are more prone to violence than others. Taxi drivers, for example, are more than 20 times more likely to be murdered on the job than other workers, according to OSHA. Number of nonfatal occupational injuries and illnesses involving days away from work by industry and selected events or exposures leading to injury or illness, private industry, 2020. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. The under-reporting of workplace injuries and workplace violence is not a new phenomenon. The Most Dangerous Profession to Work in is Healthcare. The authors thank fellow Council members who provided input and review on this blog: Christine R. Schuler, PhD, Associate Director of Science, Division of Safety Research, NIOSH, John Swartos, ASP, Regional Safety Manager, Aerotek, Veronica Stanley, MSPH, CIH, CSP, CESCP, Adjunct Faculty, College of Safety and Emergency Service, Columbia Southern University. You may opt-out by. Home Healthcare Services Quarterly, 26(1), 59-77. doi:10.1300/J027v26n01_05, [22] Karlsson, N. D., Markkanen, P. K., Kriebel, D., Gore, R. J., Galligan, C. J., Sama, S. R., & Quinn, M. M. (2019). (2016). Some people commit violence because of revenge, robbery or ideology with or without a component of mental illness. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Studies have presented several consequences of workplace violence in healthcare to include worker burnout, reduced quality of life, and mental health problems (such as emotional exhaustion, suicidal thoughts, depression, and anxiety) [14]. Retrieved from https://www.cdc.gov/niosh/topics/violence/default.html. New York, NY COVID-19 is already responsible for killing some 3,500 healthcare workers across the United States now, Americas nurses say theyre being subjected to another aspect of the ongoing pandemic increasing workplace violence. MMWR 70:947-952. NIOSH worked to further inform workers and employers about the risk and encourage steps to prevent homicide in the workplace in the 1996 document Violence in the Workplace which reviewed what was known about fatal and nonfatal workplace violence to focus needed research and prevention strategies. Some of the most significant findings from that study include: Over the last 50 years, NIOSH has seen changes in the risk of workplace violence. According to our Trends in Corporate Security Report approximately 25% of businesses are unprepared for an active shooter incident, meaning the incident is frequently over before police respond and arrive at the scene. At least 400 WVEs related to COVID-19 were reported in the media between March 1 and October 31, 2020. More than 30% of nurses reported increased attacks against them as of Q4 of 2021. Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. Coronavirus, Corporate, Employee Safety, Healthcare, Incident Collaboration, Mass Notification, Mental Health Emergency Response, Rave Alert, Rave Eyewitness, Rave Guardian, Safety & Protection. Occupational Environmental Medicine,76 (448-454). Further research into improvement mechanisms and the efficacy of these interventions is needed to effectively address the risks of workplace violence to home healthcare workers. Twenty-seven percent involved non-physical violence, 27% involved physical violence, and 41% involved both physical and non-physical violence. 67% of victims who experienced some kind of trauma caused by another person were in this age group. Retrieved from https://www.congress.gov/bill/117th-congress/house-bill/1195, [29] McPhaul KM and Lipscomb JA. Introduction. Dawn Castillo, MPH, is the Director of the NIOSH Division of Safety Research. NIOSH fast facts: taxi drivershow to prevent robbery and violence. 40+ Shocking Workplace Violence in Healthcare Statistics Maria Clark May 6, 2021 A survey found that over 70% of nurses worry about workplace violence. I write about clinical medicine, innovation in healthcare, and health policy. This doesnt necessarily imply employers are failing to prioritize workplace safety. [viii]. This award-winning course, Workplace Violence Prevention for Nurses, has been completed by more than 65,000 healthcare workers. [2013]. In 2016, the New England Journal of Medicine published a comprehensive review of Workplace Violence against Health Care Workers in the United States. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. A recent study in conjunction with the American College of Emergency Physicians (ACEP) found that of the 3500+ emergency medicine physicians surveyed, 71% reported witnessing an assault, while a shocking 47% of physicians reported being physically assaulted themselves. WebThe Injuries, Illnesses, and Fatalities (IIF) program produces a wide range of information about workplace injuries and illnesses. Terri Mock doi: 10.3912/OJIN.Vol18No01Man01, [19] Vladutiu, J. WebThe Numbers are Alarming. This is a moderated site and your comments will be reviewed before they are posted. J Occup Environ Med 59:768-774. They help us to know which pages are the most and least popular and see how visitors move around the site. The NIOSH COVID-19 Research Agenda, which includes workplace violence research needs, highlights how new workplace violence risks may arise as the world of work evolves. J Safety Res 44: 6571. (See chart 2 and table 1.) Burnout symptoms in forensic psychiatric nurses and their associations with personality, emotional intelligence and client aggression: A crosssectional study. The following are examples of key prevention measures: Provide standardized protocols that include: Provide comprehensive training to home healthcare workers on workplace violence that includes: Conduct post-visit assessments, recordkeeping, and evaluation. All information these cookies collect is aggregated and therefore anonymous. [ii] Steege A, et al. incidence of violencerelated health care worker injuries has steadily increased for at least a decade. Requirements for formal training and certifications vary, depending not only on the state but also on the job and the health agencys requirements. Workplace violence among Pennsylvania education workers: differences among occupations. WebNurses' Experience With Type II Workplace Violence and Underreporting During the COVID-19 Pandemic Nurses' Experience With Type II Workplace Violence and Underreporting During the COVID-19 Pandemic Workplace Health Saf. Should these events occur, the policies must be enforced, sanctions applied, and the incidents included on the SOII reports. While physical assaults were rare, non-physical violence was not. Patented in Canada. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Clearly, WVEs have impacted industries and occupations differently, especially those requiring workers to be physically present at work during the pandemic. Nurses attitudes towards the reporting of violence in the emergency department. As violence in the healthcare workplace has become rampant, a heightened sense of urgency must dominate the conversation, as even one life injured or lost to this prevalent issue is far too many. These incidents (1) Verbal abuse (58%) is the most common form of non-physical violence, followed by threats (33%) and sexual harassment (12%). Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Violence, job satisfaction, and employment intentions among home healthcare registered nurses. Accessed June 10, 2021. While mass shootings receive a lot of media attention, they actually account for a small number of workplace violence events. Home healthcare workers deliver health services to patients in their homes. Media depictions of unacceptable workplace violence toward nurses. the blog is very reliable. Client history and violence on direct care workers in the home care setting. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. [ix] [x]. Workplace Safety and Health: Additional Efforts Needed to Help Protect Health Care Workers from Workplace Violence Workplace violence is not merely the heinous, violent events that make the news; it is also the everyday occurrences, such as verbal abuse, that are often overlooked. is this study available in pdf. Of those victims who experienced trauma from workplace violence: 1Bureau of Labor Statistics (2020). Preliminary results from the unpublished analysis reveal: As the COVID-19 pandemic continues to evolve, employers and employees may have to continue to enforce COVID-19 mitigation policieswhich could lead to COVID-19-related WVEs. Different strategies can be used to protect home healthcare workers from violence. In 2017, homicides accounted for 22% of fatal injury events for women, but only 8% of fatal injury events for men. Work-related violent deaths in the US taxi and limousine industry 2003 to 2013. WebNational Resource Center on Domestic Violence 2080 Linglestown Road, Suite 106 - Harrisburg, PA 17110 Voice 1 800 537-2238 | Fax 717 545-9456 | Online Contact Form
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