I 

117TH CONGRESS 

1ST SESSION H. R. 1195 

To direct the Secretary of Labor to issue an occupational safety and health 

standard that requires covered employers within the health care and 

social service industries to develop and implement a comprehensive workplace violence prevention plan, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 22, 2021 

Mr. COURTNEY (for himself, Mr. SCOTT of Virginia, Mr. BACON, Ms. ADAMS, 

Mr. YOUNG, Mr. KHANNA, Mr. FITZPATRICK, and Mr. COLE) introduced 

the following bill; which was referred to the Committee on Education and 

Labor, and in addition to the Committees on Energy and Commerce, and 

Ways and Means, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL 

To direct the Secretary of Labor to issue an occupational 

safety and health standard that requires covered employers within the health care and social service industries 

to develop and implement a comprehensive workplace 

violence prevention plan, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


khammond on DSKJM1Z7X2PROD with BILLS
2 

•HR 1195 IH

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Workplace Violence 

3 Prevention for Health Care and Social Service Workers 

4 Act’’. 

5 SEC. 2. FINDINGS. 

6 Congress finds the following: 

7 (1) In a 2016 report entitled, ‘‘Workplace Safe8 ty and Health: Additional Efforts Needed to Help 

9 Protect Health Care Workers from Workplace Vio10 lence’’, the Government Accountability Office re11 ported over 730,000 cases of health care workplace 

12 assaults over the 5-year span from 2009 through 

13 2013, based on Bureau of Justice Statistics data. 

14 (2) The health care and social service industries 

15 experience the highest rates of injuries caused by 

16 workplace violence. Nurses, social workers, psy17 chiatric, home health, and personal care aides are all 

18 at increased risk for injury caused by workplace vio19 lence. The Bureau of Labor Statistics reported that 

20 in 2019, rates of violence and injury caused by per21 sons in these workplaces ranged from 3.8 times to 

22 as high as 82 times the average American work23 place. 

24 (3) The Bureau of Labor Statistics reports that 

25 health care and social service workers suffered 73 

26 percent of all workplace violence injuries caused by 


khammond on DSKJM1Z7X2PROD with BILLS
3 

•HR 1195 IH

1 persons in 2018 and are nearly 5 times as likely to 

2 suffer a workplace violence injury than workers over3 all. 

4 (4) According to a survey of 3,500 American 

5 emergency physicians conducted by the American 

6 College of Emergency Physicians, 47 percent of 

7 emergency room doctors have been physically as8 saulted at work, and 8 in 10 report that this vio9 lence is affecting patient care. 

10 (5) Workplace violence in health care and social 

11 service sectors is increasing. Bureau of Labor Statis12 tics data show that private sector injury rates of 

13 workplace violence in health care and social service 

14 sectors increased by 54 percent between 2001 and 

15 2018. Due to under-reporting, actual injury rates 

16 from workplace violence are widely recognized to be 

17 higher than reported levels. 

18 (6) Violence in health care settings has adverse 

19 impacts on workers and patients, compromising 

20 quality of care. 

21 (7) Studies have demonstrated that workplace 

22 violence prevention programs tailored to the needs of 

23 specific work areas and State-based workplace vio24 lence prevention legislation are strongly associated 

25 with reductions in workplace violence. 


khammond on DSKJM1Z7X2PROD with BILLS
4 

•HR 1195 IH

1 (8) Studies have found that proper staff train2 ing, appropriate staffing levels, sufficient resources, 

3 and the use of evidence based interventions (such as 

4 effective communication with patients using de-esca5 lation techniques and noncoercive use of medica6 tions) can reduce the risks to the safety of both pa7 tients and staff, using least-restrictive measures. 

8 (9) The Occupational Safety and Health Ad9 ministration has issued ‘‘Guidelines for Preventing 

10 Workplace Violence for Healthcare and Social Serv11 ice Workers’’, however, this guidance is not enforce12 able. Absent an enforceable standard, employers lack 

13 mandatory requirements to implement an effective 

14 and ongoing violence prevention program that pro15 vides protection of workers from workplace violence. 

16 (10) Nine States have mandated that certain 

17 types of health care facilities implement workplace 

18 violence prevention programs. On April 1, 2018, the 

19 Division of Occupational Safety and Health of the 

20 State of California issued a comprehensive standard 

21 (‘‘Workplace Violence Prevention in Health Care’’) 

22 that requires health care facilities to implement a 

23 workplace violence prevention plan. 

24 (11) Employer organizations have challenged 

25 the Occupational Safety and Health AdministraVerDate Sep 11 2014 22:18 Mar 13, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1195.IH H1195

khammond on DSKJM1Z7X2PROD with BILLS
5 

•HR 1195 IH

1 tion’s authority to utilize the General Duty Clause 

2 of the Occupational Safety and Health Act of 1970 

3 to enforce against workplace violence hazards, argu4 ing that Congress did not intend to cover workplace 

5 violence under such clause when the Act was enacted 

6 in 1970. 

7 (12) The Occupational Safety and Health Ad8 ministration (OSHA) received two petitions for rule9 making in July of 2016, calling on OSHA to pro10 mulgate a violence prevention standard for health 

11 care and social service sectors. On December 6, 

12 2016, OSHA issued a Request for Information 

13 (RFI) soliciting information on this issue. On Janu14 ary 10, 2017, OSHA conducted a public meeting to 

15 receive stakeholder input and to supplement the on16 line comments submitted in response to the RFI. At 

17 that meeting, OSHA announced it accepted the peti18 tions and would develop a Federal standard to pre19 vent workplace violence in health care and social 

20 service settings. The Trump administration failed to 

21 meet any of its deadlines to move the workplace vio22 lence rulemaking forward. It normally takes OSHA 

23 ten to twenty years to finalize a major OSHA stand24 ard. Therefore, legislation is necessary to ensure the 


khammond on DSKJM1Z7X2PROD with BILLS
6 

•HR 1195 IH

1 timely development of a standard to protect workers 

2 in health care and social service settings. 

3 SEC. 3. TABLE OF CONTENTS. 

4 The table of contents for this Act is as follows: 

Sec. 1. Short title. 

Sec. 2. Findings. 

Sec. 3. Table of contents. 

TITLE I—WORKPLACE VIOLENCE PREVENTION STANDARD 

Sec. 101. Workplace violence prevention standard. 

Sec. 102. Scope and application. 

Sec. 103. Requirements for workplace violence prevention standard. 

Sec. 104. Rules of construction. 

Sec. 105. Other definitions. 

TITLE II—AMENDMENTS TO THE SOCIAL SECURITY ACT 

Sec. 201. Application of the workplace violence prevention standard to certain 

facilities receiving Medicare funds. 

5 TITLE I—WORKPLACE VIOLENCE 

6 PREVENTION STANDARD 

7 SEC. 101. WORKPLACE VIOLENCE PREVENTION STANDARD. 

8 (a) INTERIM FINAL STANDARD.— 

9 (1) IN GENERAL.—Not later than 1 year after 

10 the date of enactment of this Act, the Secretary of 

11 Labor shall issue an interim final standard on work12 place violence prevention— 

13 (A) to require certain employers in the 

14 health care and social service sectors, and cer15 tain employers in sectors that conduct activities 

16 similar to the activities in the health care and 

17 social service sectors, to develop and implement 

18 a comprehensive workplace violence prevention 


khammond on DSKJM1Z7X2PROD with BILLS
7 

•HR 1195 IH

1 plan and carry out other activities or require2 ments described in section 103 to protect health 

3 care workers, social service workers, and other 

4 personnel from workplace violence; and 

5 (B) that shall, at a minimum, be based on 

6 the Guidelines for Preventing Workplace Vio7 lence for Healthcare and Social Service Work8 ers published by the Occupational Safety and 

9 Health Administration of the Department of 

10 Labor in 2015 and adhere to the requirements 

11 of this title. 

12 (2) INAPPLICABLE PROVISIONS OF LAW AND

13 EXECUTIVE ORDER.—The following provisions of law 

14 and Executive orders shall not apply to the issuance 

15 of the interim final standard under this subsection: 

16 (A) The requirements applicable to occupa17 tional safety and health standards under section 

18 6(b) of the Occupational Safety and Health Act 

19 of 1970 (29 U.S.C. 655(b)). 

20 (B) The requirements of chapters 5 and 6 

21 of title 5, United States Code. 

22 (C) Subchapter I of chapter 35 of title 44, 

23 United States Code (commonly referred to as 

24 the ‘‘Paperwork Reduction Act’’). 


khammond on DSKJM1Z7X2PROD with BILLS
8 

•HR 1195 IH

1 (3) NOTICE AND COMMENT.—Notwithstanding 

2 paragraph (2)(B), the Secretary shall, prior to 

3 issuing the interim final standard under this sub4 section, provide notice in the Federal Register of the 

5 interim final standard and a 30-day period for pub6 lic comment. 

7 (4) EFFECTIVE DATE OF INTERIM STAND8 ARD.—The interim final standard shall— 

9 (A) take effect on a date that is not later 

10 than 30 days after issuance, except that such 

11 interim final standard may include a reasonable 

12 phase-in period for the implementation of re13 quired engineering controls that take effect 

14 after such date; 

15 (B) be enforced in the same manner and 

16 to the same extent as any standard promul17 gated under section 6(b) of the Occupational 

18 Safety and Health Act of 1970 (29 U.S.C. 

19 655(b)); and 

20 (C) be in effect until the final standard de21 scribed in subsection (b) becomes effective and 

22 enforceable. 

23 (5) FAILURE TO PROMULGATE.—If an interim 

24 final standard described in paragraph (1) is not 

25 issued not later than 1 year of the date of enactment 


khammond on DSKJM1Z7X2PROD with BILLS
9 

•HR 1195 IH

1 of this Act, the provisions of this title shall be in ef2 fect and enforced in the same manner and to the 

3 same extent as any standard promulgated under sec4 tion 6(b) of the Occupational Safety and Health Act 

5 (29 U.S.C. 655(b)) until such provisions are super6 seded in whole by an interim final standard issued 

7 by the Secretary that meets the requirements of 

8 paragraph (1). 

9 (b) FINAL STANDARD.— 

10 (1) PROPOSED STANDARD.—Not later than 2 

11 years after the date of enactment of this Act, the 

12 Secretary of Labor shall, pursuant to section 6 of 

13 the Occupational Safety and Health Act (29 U.S.C. 

14 655), promulgate a proposed standard on workplace 

15 violence prevention— 

16 (A) for the purposes described in sub17 section (a)(1)(A); and 

18 (B) that shall include, at a minimum, re19 quirements contained in the interim final stand20 ard promulgated under subsection (a). 

21 (2) FINAL STANDARD.—Not later than 42 

22 months after the date of enactment of this Act, the 

23 Secretary shall issue a final standard on such pro24 posed standard that shall— 


khammond on DSKJM1Z7X2PROD with BILLS
10 

•HR 1195 IH

1 (A) provide no less protection than any 

2 workplace violence standard adopted by a State 

3 plan that has been approved by the Secretary 

4 under section 18 of the Occupational Safety 

5 and Health Act of 1970 (29 U.S.C. 667); and 

6 (B) be effective and enforceable in the 

7 same manner and to the same extent as any 

8 standard promulgated under section 6(b) of the 

9 Occupational Safety and Health Act of 1970 

10 (29 U.S.C. 655(b)). 

11 SEC. 102. SCOPE AND APPLICATION. 

12 In this title: 

13 (1) COVERED FACILITY.— 

14 (A) IN GENERAL.—The term ‘‘covered fa15 cility’’ includes the following: 

16 (i) Any hospital, including any spe17 cialty hospital, in-patient or outpatient set18 ting, or clinic operating within a hospital 

19 license, or any setting that provides out20 patient services. 

21 (ii) Any residential treatment facility, 

22 including any nursing home, skilled nurs23 ing facility, hospice facility, and long-term 

24 care facility. 


khammond on DSKJM1Z7X2PROD with BILLS
11 

•HR 1195 IH

1 (iii) Any non-residential treatment or 

2 service setting. 

3 (iv) Any medical treatment or social 

4 service setting or clinic at a correctional or 

5 detention facility. 

6 (v) Any community care setting, in7 cluding a community-based residential fa8 cility, group home, and mental health clin9 ic. 

10 (vi) Any psychiatric treatment facility. 

11 (vii) Any drug abuse or substance use 

12 disorder treatment center. 

13 (viii) Any independent freestanding 

14 emergency centers. 

15 (ix) Any facility described in clauses 

16 (i) through (viii) operated by a Federal 

17 Government agency and required to comply 

18 with occupational safety and health stand19 ards pursuant to section 1960 of title 29, 

20 Code of Federal Regulations (as such sec21 tion is in effect on the date of enactment 

22 of this Act). 

23 (x) Any other facility the Secretary 

24 determines should be covered under the 

25 standards promulgated under section 101. 


khammond on DSKJM1Z7X2PROD with BILLS
12 

•HR 1195 IH

1 (B) EXCLUSION.—The term ‘‘covered facil2 ity’’ does not include an office of a physician, 

3 dentist, podiatrist, or any other health practi4 tioner that is not physically located within a 

5 covered facility described in clauses (i) through 

6 (x) of subparagraph (A). 

7 (2) COVERED SERVICES.— 

8 (A) IN GENERAL.—The term ‘‘covered 

9 service’’ includes the following services and op10 erations: 

11 (i) Any services and operations pro12 vided in any field work setting, including 

13 home health care, home-based hospice, and 

14 home-based social work. 

15 (ii) Any emergency services and trans16 port, including such services provided by 

17 firefighters and emergency responders. 

18 (iii) Any services described in clauses 

19 (i) and (ii) performed by a Federal Gov20 ernment agency and required to comply 

21 with occupational safety and health stand22 ards pursuant to section 1960 of title 29, 

23 Code of Federal Regulations (as such sec24 tion is in effect on the date of enactment 

25 of this Act). 


khammond on DSKJM1Z7X2PROD with BILLS
13 

•HR 1195 IH

1 (iv) Any other services and operations 

2 the Secretary determines should be covered 

3 under the standards promulgated under 

4 section 101. 

5 (B) EXCLUSION.—The term ‘‘covered serv6 ice’’ does not include child day care services. 

7 (3) COVERED EMPLOYER.— 

8 (A) IN GENERAL.—The term ‘‘covered em9 ployer’’ includes a person (including a con10 tractor, subcontractor, a temporary service 

11 firm, or an employee leasing entity) that em12 ploys an individual to work at a covered facility 

13 or to perform covered services. 

14 (B) EXCLUSION.—The term ‘‘covered em15 ployer’’ does not include an individual who pri16 vately employs, in the individual’s residence, a 

17 person to perform covered services for the indi18 vidual or a family member of the individual. 

19 (4) COVERED EMPLOYEE.—The term ‘‘covered 

20 employee’’ includes an individual employed by a cov21 ered employer to work at a covered facility or to per22 form covered services. 


khammond on DSKJM1Z7X2PROD with BILLS
14 

•HR 1195 IH

1 SEC. 103. REQUIREMENTS FOR WORKPLACE VIOLENCE 

2 PREVENTION STANDARD. 

3 Each standard described in section 101 shall include, 

4 at a minimum, the following requirements: 

5 (1) WORKPLACE VIOLENCE PREVENTION

6 PLAN.—Not later than 6 months after the date of 

7 promulgation of the interim final standard under 

8 section 101(a), a covered employer shall develop, im9 plement, and maintain an effective written workplace 

10 violence prevention plan (in this section referred to 

11 as the ‘‘Plan’’) for covered employees at each cov12 ered facility and for covered employees performing a 

13 covered service on behalf of such employer, which 

14 meets the following: 

15 (A) PLAN DEVELOPMENT.—Each Plan 

16 shall— 

17 (i) be developed and implemented with 

18 the meaningful participation of direct care 

19 employees, other employees, and employee 

20 representatives, for all aspects of the Plan; 

21 (ii) be tailored and specific to condi22 tions and hazards for the covered facility 

23 or the covered service, including patient24 specific risk factors and risk factors spe25 cific to each work area or unit; and 


khammond on DSKJM1Z7X2PROD with BILLS
15 

•HR 1195 IH

1 (iii) be suitable for the size, com2 plexity, and type of operations at the cov3 ered facility or for the covered service, and 

4 remain in effect at all times. 

5 (B) PLAN CONTENT.—Each Plan shall in6 clude procedures and methods for the following: 

7 (i) Identification of the individual and 

8 the individual’s position responsible for im9 plementation of the Plan. 

10 (ii) With respect to each work area 

11 and unit at the covered facility or while 

12 covered employees are performing the cov13 ered service, risk assessment and identi14 fication of workplace violence risks and 

15 hazards to employees exposed to such risks 

16 and hazards (including environmental risk 

17 factors and patient-specific risk factors), 

18 which shall be— 

19 (I) informed by past violent inci20 dents specific to such covered facility 

21 or such covered service; and 

22 (II) conducted with, at a min23 imum— 

24 (aa) direct care employees; 


khammond on DSKJM1Z7X2PROD with BILLS
16 

•HR 1195 IH

1 (bb) where applicable, the 

2 representatives of such employ3 ees; and 

4 (cc) the employer. 

5 (iii) Hazard prevention, engineering 

6 controls, or work practice controls to cor7 rect hazards, in a timely manner, applying 

8 industrial hygiene principles of the hier9 archy of controls, which— 

10 (I) may include security and 

11 alarm systems, adequate exit routes, 

12 monitoring systems, barrier protec13 tion, established areas for patients 

14 and clients, lighting, entry procedures, 

15 staffing and working in teams, and 

16 systems to identify and flag clients 

17 with a history of violence; and 

18 (II) shall ensure that employers 

19 correct, in a timely manner, hazards 

20 identified in any violent incident in21 vestigation described in paragraph (2) 

22 and any annual report described in 

23 paragraph (5). 


khammond on DSKJM1Z7X2PROD with BILLS
17 

•HR 1195 IH

1 (iv) Reporting, incident response, and 

2 post-incident investigation procedures, in3 cluding procedures— 

4 (I) for employees to report work5 place violence risks, hazards, and inci6 dents; 

7 (II) for employers to respond to 

8 reports of workplace violence; 

9 (III) for employers to perform a 

10 post-incident investigation and de11 briefing of all reports of workplace vi12 olence with the participation of em13 ployees and their representatives; 

14 (IV) to provide medical care or 

15 first aid to affected employees; and 

16 (V) to provide employees with in17 formation about available trauma and 

18 related counseling. 

19 (v) Procedures for emergency re20 sponse, including procedures for threats of 

21 mass casualties and procedures for inci22 dents involving a firearm or a dangerous 

23 weapon. 

24 (vi) Procedures for communicating 

25 with and training the covered employees on 


khammond on DSKJM1Z7X2PROD with BILLS
18 

•HR 1195 IH

1 workplace violence hazards, threats, and 

2 work practice controls, the employer’s plan, 

3 and procedures for confronting, responding 

4 to, and reporting workplace violence 

5 threats, incidents, and concerns, and em6 ployee rights. 

7 (vii) Procedures for— 

8 (I) ensuring the coordination of 

9 risk assessment efforts, Plan develop10 ment, and implementation of the Plan 

11 with other employers who have em12 ployees who work at the covered facil13 ity or who are performing the covered 

14 service; and 

15 (II) determining which covered 

16 employer or covered employers shall 

17 be responsible for implementing and 

18 complying with the provisions of the 

19 standard applicable to the working 

20 conditions over which such employers 

21 have control. 

22 (viii) Procedures for conducting the 

23 annual evaluation under paragraph (6). 

24 (C) AVAILABILITY OF PLAN.—Each Plan 

25 shall be made available at all times to the covVerDate Sep 11 2014 22:18 Mar 13, 2021 Jkt 019200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\H1195.IH H1195

khammond on DSKJM1Z7X2PROD with BILLS
19 

•HR 1195 IH

1 ered employees who are covered under such 

2 Plan. 

3 (2) VIOLENT INCIDENT INVESTIGATION.— 

4 (A) IN GENERAL.—As soon as practicable 

5 after a workplace violence incident, risk, or haz6 ard of which a covered employer has knowledge, 

7 the employer shall conduct an investigation of 

8 such incident, risk, or hazard under which the 

9 employer shall— 

10 (i) review the circumstances of the in11 cident, risk, or hazard, and whether any 

12 controls or measures implemented pursu13 ant to the Plan of the employer were effec14 tive; and 

15 (ii) solicit input from involved employ16 ees, their representatives, and supervisors 

17 about the cause of the incident, risk, or 

18 hazard, and whether further corrective 

19 measures (including system-level factors) 

20 could have prevented the incident, risk, or 

21 hazard. 

22 (B) DOCUMENTATION.—A covered em23 ployer shall document the findings, rec24 ommendations, and corrective measures taken 


khammond on DSKJM1Z7X2PROD with BILLS
20 

•HR 1195 IH

1 for each investigation conducted under this 

2 paragraph. 

3 (3) TRAINING AND EDUCATION.—With respect 

4 to the covered employees covered under a Plan of a 

5 covered employer, the employer shall provide train6 ing and education to such employees who may be ex7 posed to workplace violence hazards and risks, which 

8 meet the following requirements: 

9 (A) Annual training and education shall 

10 include information on the Plan, including iden11 tified workplace violence hazards, work practice 

12 control measures, reporting procedures, record 

13 keeping requirements, response procedures, 

14 anti-retaliation policies, and employee rights. 

15 (B) Additional hazard recognition training 

16 shall be provided for supervisors and managers 

17 to ensure they— 

18 (i) can recognize high-risk situations; 

19 and 

20 (ii) do not assign employees to situa21 tions that predictably compromise the safe22 ty of such employees. 

23 (C) Additional training shall be provided 

24 for each such covered employee whose job cirVerDate Sep 11 2014 22:18 Mar 13, 2021 Jkt 019200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\H1195.IH H1195

khammond on DSKJM1Z7X2PROD with BILLS
21 

•HR 1195 IH

1 cumstances have changed, within a reasonable 

2 timeframe after such change. 

3 (D) Applicable training shall be provided 

4 under this paragraph for each new covered em5 ployee prior to the employee’s job assignment. 

6 (E) All training shall provide such employ7 ees opportunities to ask questions, give feed8 back on training, and request additional in9 struction, clarification, or other followup. 

10 (F) All training shall be provided in-person 

11 and by an individual with knowledge of work12 place violence prevention and of the Plan, ex13 cept that any annual training described in sub14 paragraph (A) provided to an employee after 

15 the first year such training is provided to such 

16 employee may be conducted by live video if in17 person training is impracticable. 

18 (G) All training shall be appropriate in 

19 content and vocabulary to the language, edu20 cational level, and literacy of such covered em21 ployees. 

22 (4) RECORDKEEPING AND ACCESS TO PLAN

23 RECORDS.— 

24 (A) IN GENERAL.—Each covered employer 

25 shall— 


khammond on DSKJM1Z7X2PROD with BILLS
22 

•HR 1195 IH

1 (i) maintain for not less than 5 

2 years— 

3 (I) records related to each Plan 

4 of the employer, including workplace 

5 violence risk and hazard assessments, 

6 and identification, evaluation, correc7 tion, and training procedures; 

8 (II) a violent incident log de9 scribed in subparagraph (B) for re10 cording all workplace violence inci11 dents; and 

12 (III) records of all incident inves13 tigations as required under paragraph 

14 (2)(B); and 

15 (ii)(I) make such records and logs 

16 available, upon request, to covered employ17 ees and their representatives for examina18 tion and copying in accordance with sec19 tion 1910.1020 of title 29, Code of Federal 

20 Regulations (as such section is in effect on 

21 the date of enactment of this Act), and in 

22 a manner consistent with HIPAA privacy 

23 regulations (defined in section 1180(b)(3) 

24 of the Social Security Act (42 U.S.C. 

25 1320d–9(b)(3))) and part 2 of title 42, 


khammond on DSKJM1Z7X2PROD with BILLS
23 

•HR 1195 IH

1 Code of Federal Regulations (as such part 

2 is in effect on the date of enactment of this 

3 Act); and 

4 (II) ensure that any such records and 

5 logs that may be copied, transmitted elec6 tronically, or otherwise removed from the 

7 employer’s control for purposes of this 

8 clause omit any element of personal identi9 fying information sufficient to allow identi10 fication of any patient, resident, client, or 

11 other individual alleged to have committed 

12 a violent incident (including the individ13 ual’s name, address, electronic mail ad14 dress, telephone number, or social security 

15 number, or other information that, alone 

16 or in combination with other publicly avail17 able information, reveals such individual’s 

18 identity). 

19 (B) VIOLENT INCIDENT LOG DESCRIP20 TION.—Each violent incident log shall— 

21 (i) be maintained by a covered em22 ployer for each covered facility controlled 

23 by the employer and for each covered serv24 ice being performed by a covered employee 

25 on behalf of such employer; 


khammond on DSKJM1Z7X2PROD with BILLS
24 

•HR 1195 IH

1 (ii) be based on a template developed 

2 by the Secretary not later than 1 year 

3 after the date of enactment of this Act; 

4 (iii) include, at a minimum, a descrip5 tion of— 

6 (I) the violent incident (including 

7 environmental risk factors present at 

8 the time of the incident); 

9 (II) the date, time, and location 

10 of the incident, and the names and 

11 job titles of involved employees; 

12 (III) the nature and extent of in13 juries to covered employees; 

14 (IV) a classification of the perpe15 trator who committed the violence, in16 cluding whether the perpetrator was— 

17 (aa) a patient, client, resi18 dent, or customer of a covered 

19 employer; 

20 (bb) a family or friend of a 

21 patient, client, resident, or cus22 tomer of a covered employer; 

23 (cc) a stranger; 


khammond on DSKJM1Z7X2PROD with BILLS
25 

•HR 1195 IH

1 (dd) a coworker, supervisor, 

2 or manager of a covered em3 ployee; 

4 (ee) a partner, spouse, par5 ent, or relative of a covered em6 ployee; or 

7 (ff) any other appropriate 

8 classification; 

9 (V) the type of violent incident 

10 (such as type 1 violence, type 2 vio11 lence, type 3 violence, or type 4 vio12 lence); and 

13 (VI) how the incident was 

14 abated; 

15 (iv) not later than 7 days after the 

16 employer learns of such incident, contain a 

17 record of each violent incident, which is 

18 updated to ensure completeness of such 

19 record; 

20 (v) be maintained for not less than 5 

21 years; and 

22 (vi) in the case of a violent incident 

23 involving a privacy concern case, protect 

24 the identity of employees in a manner con25 sistent with section 1904.29(b) of title 29, 


khammond on DSKJM1Z7X2PROD with BILLS
26 

•HR 1195 IH

1 Code of Federal Regulations (as such sec2 tion is in effect on the date of enactment 

3 of this Act). 

4 (C) ANNUAL SUMMARY.— 

5 (i) COVERED EMPLOYERS.—Each cov6 ered employer shall prepare and submit to 

7 the Secretary an annual summary of each 

8 violent incident log for the preceding cal9 endar year that shall— 

10 (I) with respect to each covered 

11 facility, and each covered service, for 

12 which such a log has been maintained, 

13 include— 

14 (aa) the total number of vio15 lent incidents; 

16 (bb) the number of record17 able injuries related to such inci18 dents; and 

19 (cc) the total number of 

20 hours worked by the covered em21 ployees for such preceding year; 

22 (II) be completed on a form pro23 vided by the Secretary; 

24 (III) be posted for 3 months be25 ginning February 1 of each year in a 


khammond on DSKJM1Z7X2PROD with BILLS
27 

•HR 1195 IH

1 manner consistent with the require2 ments of section 1904 of title 29, 

3 Code of Federal Regulations (as such 

4 section is in effect on the date of en5 actment of this Act), relating to the 

6 posting of summaries of injury and ill7 ness logs; 

8 (IV) be located in a conspicuous 

9 place or places where notices to em10 ployees are customarily posted; and 

11 (V) not be altered, defaced, or 

12 covered by other material. 

13 (ii) SECRETARY.—Not later than 1 

14 year after the promulgation of the interim 

15 final standard under section 101(a), the 

16 Secretary shall make available a platform 

17 for the electronic submission of annual 

18 summaries required under this subpara19 graph. 

20 (5) ANNUAL REPORT.— 

21 (A) REPORT TO SECRETARY.—Not later 

22 than February 15 of each year, each covered 

23 employer shall report to the Secretary, on a 

24 form provided by the Secretary, the frequency, 

25 quantity, and severity of workplace violence, 


khammond on DSKJM1Z7X2PROD with BILLS
28 

•HR 1195 IH

1 and any incident response and post-incident in2 vestigation (including abatement measures) for 

3 the incidents set forth in the annual summary 

4 of the violent incident log described in para5 graph (4)(C). The contents of the report of the 

6 Secretary to Congress shall not disclose any 

7 confidential information. 

8 (B) REPORT TO CONGRESS.—Not later 

9 than 6 months after February 15 of each year, 

10 the Secretary shall submit to Congress a sum11 mary of the reports received under subpara12 graph (A). 

13 (6) ANNUAL EVALUATION.—Each covered em14 ployer shall conduct an annual written evaluation, 

15 conducted with the full, active participation of cov16 ered employees and employee representatives, of— 

17 (A) the implementation and effectiveness 

18 of the Plan, including a review of the violent in19 cident log; and 

20 (B) compliance with training required by 

21 each standard described in section 101, and 

22 specified in the Plan. 

23 (7) PLAN UPDATES.—Each covered employer 

24 shall incorporate changes to the Plan, in a manner 

25 consistent with paragraph (1)(A)(i) and based on 


khammond on DSKJM1Z7X2PROD with BILLS
29 

•HR 1195 IH

1 findings from the most recent annual evaluation con2 ducted under paragraph (6), as appropriate. 

3 (8) ANTI-RETALIATION.— 

4 (A) POLICY.—Each covered employer shall 

5 adopt a policy prohibiting any person (including 

6 an agent of the employer) from the discrimina7 tion or retaliation described in subparagraph 

8 (B). 

9 (B) PROHIBITION.—No covered employer 

10 shall discriminate or retaliate against any em11 ployee for— 

12 (i) reporting a workplace violence inci13 dent, threat, or concern to, or seeking as14 sistance or intervention with respect to 

15 such incident, threat, or concern from, the 

16 employer, law enforcement, local emer17 gency services, or a local, State, or Federal 

18 government agency; or 

19 (ii) exercising any other rights under 

20 this paragraph. 

21 (C) ENFORCEMENT.—This paragraph shall 

22 be enforced in the same manner and to the 

23 same extent as any standard promulgated 

24 under section 6(b) of the Occupational Safety 

25 and Health Act (29 U.S.C. 655(b)). 


khammond on DSKJM1Z7X2PROD with BILLS
30 

•HR 1195 IH

1 SEC. 104. RULES OF CONSTRUCTION. 

2 Notwithstanding section 18 of the Occupational Safe3 ty and Health Act of 1970 (29 U.S.C. 667)— 

4 (1) nothing in this title shall be construed to 

5 curtail or limit authority of the Secretary under any 

6 other provision of the law; 

7 (2) the rights, privileges, or remedies of covered 

8 employees shall be in addition to the rights, privi9 leges, or remedies provided under any Federal or 

10 State law, or any collective bargaining agreement; 

11 and 

12 (3) nothing in this Act shall be construed to 

13 limit or prevent health care workers, social service 

14 workers, and other personnel from reporting violent 

15 incidents to appropriate law enforcement. 

16 SEC. 105. OTHER DEFINITIONS. 

17 In this title: 

18 (1) WORKPLACE VIOLENCE.— 

19 (A) IN GENERAL.—The term ‘‘workplace 

20 violence’’ means any act of violence or threat of 

21 violence, without regard to intent, that occurs 

22 at a covered facility or while a covered employee 

23 performs a covered service. 

24 (B) EXCLUSIONS.—The term ‘‘workplace 

25 violence’’ does not include lawful acts of self-de26 fense or lawful acts of defense of others. 


khammond on DSKJM1Z7X2PROD with BILLS
31 

•HR 1195 IH

1 (C) INCLUSIONS.—The term ‘‘workplace 

2 violence’’ includes— 

3 (i) the threat or use of physical force 

4 against a covered employee that results in 

5 or has a high likelihood of resulting in in6 jury, psychological trauma, or stress, with7 out regard to whether the covered em8 ployee sustains an injury, psychological 

9 trauma, or stress; and 

10 (ii) an incident involving the threat or 

11 use of a firearm or a dangerous weapon, 

12 including the use of common objects as 

13 weapons, without regard to whether the 

14 employee sustains an injury, psychological 

15 trauma, or stress. 

16 (2) TYPE 1 VIOLENCE.—The term ‘‘type 1 vio17 lence’’— 

18 (A) means workplace violence directed at a 

19 covered employee at a covered facility or while 

20 performing a covered service by an individual 

21 who has no legitimate business at the covered 

22 facility or with respect to such covered service; 

23 and 

24 (B) includes violent acts by any individual 

25 who enters the covered facility or worksite 


khammond on DSKJM1Z7X2PROD with BILLS
32 

•HR 1195 IH

1 where a covered service is being performed with 

2 the intent to commit a crime. 

3 (3) TYPE 2 VIOLENCE.—The term ‘‘type 2 vio4 lence’’ means workplace violence directed at a cov5 ered employee by customers, clients, patients, stu6 dents, inmates, or any individual for whom a covered 

7 facility provides services or for whom the employee 

8 performs covered services. 

9 (4) TYPE 3 VIOLENCE.—The term ‘‘type 3 vio10 lence’’ means workplace violence directed at a cov11 ered employee by a present or former employee, su12 pervisor, or manager. 

13 (5) TYPE 4 VIOLENCE.—The term ‘‘type 4 vio14 lence’’ means workplace violence directed at a cov15 ered employee by an individual who is not an em16 ployee, but has or is known to have had a personal 

17 relationship with such employee, or with a customer, 

18 client, patient, student, inmate, or any individual for 

19 whom a covered facility provides services or for 

20 whom the employee performs covered services. 

21 (6) THREAT OF VIOLENCE.—The term ‘‘threat 

22 of violence’’ means a statement or conduct that— 

23 (A) causes an individual to fear for such 

24 individual’s safety because there is a reasonable 


khammond on DSKJM1Z7X2PROD with BILLS
33 

•HR 1195 IH

1 possibility the individual might be physically in2 jured; and 

3 (B) serves no legitimate purpose. 

4 (7) ALARM.—The term ‘‘alarm’’ means a me5 chanical, electrical, or electronic device that does not 

6 rely upon an employee’s vocalization in order to alert 

7 others. 

8 (8) DANGEROUS WEAPON.—The term ‘‘dan9 gerous weapon’’ means an instrument capable of in10 flicting death or serious bodily injury, without re11 gard to whether such instrument was designed for 

12 that purpose. 

13 (9) ENGINEERING CONTROLS.— 

14 (A) IN GENERAL.—The term ‘‘engineering 

15 controls’’ means an aspect of the built space or 

16 a device that removes a hazard from the work17 place or creates a barrier between a covered 

18 employee and the hazard. 

19 (B) INCLUSIONS.—For purposes of reduc20 ing workplace violence hazards, the term ‘‘engi21 neering controls’’ includes electronic access con22 trols to employee occupied areas, weapon detec23 tors (installed or handheld), enclosed work24 stations with shatter-resistant glass, deep serv25 ice counters, separate rooms or areas for highVerDate Sep 11 2014 22:18 Mar 13, 2021 Jkt 019200 PO 00000 Frm 00033 Fmt 6652 Sfmt 6201 E:\BILLS\H1195.IH H1195

khammond on DSKJM1Z7X2PROD with BILLS
34 

•HR 1195 IH

1 risk patients, locks on doors, removing access to 

2 or securing items that could be used as weap3 ons, furniture affixed to the floor, opaque glass 

4 in patient rooms (which protects privacy, but 

5 allows the health care provider to see where the 

6 patient is before entering the room), closed-cir7 cuit television monitoring and video recording, 

8 sight-aids, and personal alarm devices. 

9 (10) ENVIRONMENTAL RISK FACTORS.— 

10 (A) IN GENERAL.—The term ‘‘environ11 mental risk factors’’ means factors in the cov12 ered facility or area in which a covered service 

13 is performed that may contribute to the likeli14 hood or severity of a workplace violence inci15 dent. 

16 (B) CLARIFICATION.—Environmental risk 

17 factors may be associated with the specific task 

18 being performed or the work area, such as 

19 working in an isolated area, poor illumination 

20 or blocked visibility, and lack of physical bar21 riers between individuals and persons at risk of 

22 committing workplace violence. 

23 (11) PATIENT-SPECIFIC RISK FACTORS.—The 

24 term ‘‘patient-specific risk factors’’ means factors 

25 specific to a patient that may increase the likelihood 


khammond on DSKJM1Z7X2PROD with BILLS
35 

•HR 1195 IH

1 or severity of a workplace violence incident, includ2 ing— 

3 (A) a patient’s treatment and medication 

4 status, and history of violence and use of drugs 

5 or alcohol; and 

6 (B) any conditions or disease processes of 

7 the patient that may cause the patient to expe8 rience confusion or disorientation, be non-re9 sponsive to instruction, behave unpredictably, or 

10 engage in disruptive, threatening, or violent be11 havior. 

12 (12) SECRETARY.—The term ‘‘Secretary’’ 

13 means the Secretary of Labor. 

14 (13) WORK PRACTICE CONTROLS.— 

15 (A) IN GENERAL.—The term ‘‘work prac16 tice controls’’ means procedures and rules that 

17 are used to effectively reduce workplace violence 

18 hazards. 

19 (B) INCLUSIONS.—The term ‘‘work prac20 tice controls’’ includes— 

21 (i) assigning and placing sufficient 

22 numbers of staff to reduce patient-specific 

23 type 2 violence hazards; 


khammond on DSKJM1Z7X2PROD with BILLS
36 

•HR 1195 IH

1 (ii) provision of dedicated and avail2 able safety personnel such as security 

3 guards; 

4 (iii) employee training on workplace 

5 violence prevention methods and tech6 niques to de-escalate and minimize violent 

7 behavior; and 

8 (iv) employee training on procedures 

9 for response in the event of a workplace vi10 olence incident and for post-incident re11 sponse. 

12 TITLE II—AMENDMENTS TO THE 

13 SOCIAL SECURITY ACT 

14 SEC. 201. APPLICATION OF THE WORKPLACE VIOLENCE 

15 PREVENTION STANDARD TO CERTAIN FACILI16 TIES RECEIVING MEDICARE FUNDS. 

17 (a) IN GENERAL.—Section 1866 of the Social Secu18 rity Act (42 U.S.C. 1395cc) is amended— 

19 (1) in subsection (a)(1)— 

20 (A) in subparagraph (X), by striking 

21 ‘‘and’’ at the end; 

22 (B) in subparagraph (Y), by striking at 

23 the end the period and inserting ‘‘; and’’; and 

24 (C) by inserting after subparagraph (Y) 

25 the following new subparagraph: 


khammond on DSKJM1Z7X2PROD with BILLS
37 

•HR 1195 IH

1 ‘‘(Z) in the case of hospitals that are not other2 wise subject to the Occupational Safety and Health 

3 Act of 1970 (or a State occupational safety and 

4 health plan that is approved under 18(b) of such 

5 Act) and skilled nursing facilities that are not other6 wise subject to such Act (or such a State occupa7 tional safety and health plan), to comply with the 

8 Workplace Violence Prevention Standard (as pro9 mulgated under section 101 of the Workplace Vio10 lence Prevention for Health Care and Social Service 

11 Workers Act).’’; and 

12 (2) in subsection (b)(4)— 

13 (A) in subparagraph (A), by inserting 

14 ‘‘and a hospital or skilled nursing facility that 

15 fails to comply with the requirement of sub16 section (a)(1)(Z) (relating to the Workplace Vi17 olence Prevention Standard)’’ after 

18 ‘‘Bloodborne Pathogens standard)’’; and 

19 (B) in subparagraph (B)— 

20 (i) by striking ‘‘(a)(1)(U)’’ and insert21 ing ‘‘(a)(1)(V)’’; and 

22 (ii) by inserting ‘‘(or, in the case of a 

23 failure to comply with the requirement of 

24 subsection (a)(1)(Z), for a violation of the 

25 Workplace Violence Prevention standard 


khammond on DSKJM1Z7X2PROD with BILLS
38 

•HR 1195 IH

1 referred to in such subsection by a hospital 

2 or skilled nursing facility, as applicable, 

3 that is subject to the provisions of such 

4 Act)’’ before the period at the end. 

5 (b) EFFECTIVE DATE.—The amendments made by 

6 subsection (a) shall apply beginning on the date that is 

7 1 year after the date of issuance of the interim final stand8 ard on workplace violence prevention required under sec9 tion 101. 

Æ 


khammond on DSKJM1Z7X2PROD with BILLS