I 

118TH CONGRESS 

1ST SESSION H. R. 2584 

To protect hospital personnel from violence, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 13, 2023 

Mr. BUCSHON (for himself and Ms. DEAN of Pennsylvania) introduced the 

following bill; which was referred to the Committee on the Judiciary 

A BILL 

To protect hospital personnel from violence, 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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Safety From Violence 

5 for Healthcare Employees Act’’ or the ‘‘SAVE Act’’. 

6 SEC. 2. PREVENTION OF VIOLENCE AGAINST HOSPITAL 

7 PERSONNEL. 

8 (a) FINDINGS.—Congress makes the following find9 ings: 


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1 (1) The incidence of assault and intimidation 

2 against hospital employees poses a serious national 

3 problem. 

4 (2) The problem of assault and intimidation 

5 against hospital and health care employees preceded 

6 the COVID–19 pandemic. According to an April 

7 2020 Bureau of Labor Statistics report, the health 

8 care and social service industries experienced the 

9 highest rates of injuries caused by workplace vio10 lence and were 5 times as likely to suffer a work11 place violence injury than workers overall in 2018. 

12 That report also found that the incidence rate for 

13 workplace violence against health care workers had 

14 steadily increased since 2011. The COVID–19 pan15 demic exacerbated this growing problem. 

16 (3) Workplace violence in hospitals inhibits hos17 pital employees from performing their duties and 

18 thereby disrupts the delivery of health care services 

19 and leads to adverse patient outcomes. Violence to20 wards hospital workers also has been associated with 

21 decreased productivity and quality of care, employee 

22 absenteeism, and increased employee turnover. 

23 (4) State and local authorities are now and will 

24 continue to be responsible for prosecuting the over25 whelming majority of violent crimes in the United 


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1 States, including assault and intimidation against 

2 hospital employees. These authorities can address 

3 the problem of assault and intimidation against hos4 pital employees more effectively with greater Federal 

5 law enforcement involvement. 

6 (5) Existing Federal law is inadequate to ad7 dress this problem. 

8 (6) Assault and intimidation against hospital 

9 employees substantially affects interstate commerce 

10 in many ways, including the following: 

11 (A) Health care services are a significant 

12 part of the national economy. In 2021, expendi13 tures on health care services accounted for 18.3 

14 percent of the country’s gross domestic product 

15 (or $4,300,000,000,000). Within health care, 

16 hospitals and health systems are economic pil17 lars that create jobs and support economic 

18 growth across State lines. In 2021, hospitals di19 rectly employed 6,350,000 individuals. More 

20 broadly, hospitals supported 17,815,000 jobs 

21 throughout the entire interstate economy—1 

22 out of 8 jobs in the United States—and sup23 ported nearly $4,000,000,000 in overall eco24 nomic activity. 


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1 (B) The health care market, and hospitals 

2 in particular, are heavily regulated by the Fed3 eral Government. 

4 (C) Hospital revenue comes from interstate 

5 or Federal sources, such as out-of-State insur6 ers or Medicare. 

7 (D) Hospital employees who are victims of 

8 assault or intimidation are prevented from pur9 chasing goods and services, obtaining or sus10 taining employment, or participating in other 

11 commercial activity. 

12 (E) Facilities and instrumentalities of 

13 interstate commerce have been used in the com14 mission of assault and intimidation against hos15 pital employees. 

16 (F) Assault and intimidation against hos17 pital employees has been committed using arti18 cles that have traveled in interstate commerce. 

19 (7) In Summit Health, Ltd. v. Pinhas, 500 

20 U.S. 322, 329–30 (1991), the Supreme Court of the 

21 United States held that it is ‘‘clear’’ that hospitals 

22 are ‘‘regularly’’ engaged in interstate commerce, per23 forming services for out-of-State patients and gener24 ating revenues from out-of-State sources. 


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1 (8) In Taylor v. United States, 579 

2 U.S.lll(2016), the Supreme Court of the United 

3 States ruled that activities that affect commerce 

4 may be regulated so long as they substantially affect 

5 interstate commerce in the aggregate, even if their 

6 individual impact on interstate commerce is minimal. 

7 In addition, as the United States Court of Appeals 

8 for the Fourth Circuit recognized in United States 

9 v. Hill, 927 F.3d 188 (4th Cir. 2019), Taylor and 

10 other Supreme Court decisions establish that when 

11 Congress may regulate an economic or commercial 

12 activity—as it may with respect to hospitals—it also 

13 may regulate violent conduct that interferes with or 

14 affects that activity. Accordingly, if individuals are 

15 engaged in ongoing economic or commercial activity 

16 subject to congressional regulation—as hospital em17 ployees are—then Congress also may prohibit violent 

18 crime that interferes with or affects such individuals’ 

19 ongoing economic or commercial activity. 

20 (9) Federal jurisdiction over certain violent 

21 crimes against hospital employees enables Federal, 

22 State, and local authorities to work together as part23 ners in the investigation and prosecution of such 

24 crimes. 


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1 (10) The problem of assault and intimidation 

2 against hospital employees is serious, widespread, 

3 and interstate in nature as to warrant Federal as4 sistance to hospitals to combat that activity. 

5 (b) PROHIBITION ON INTERFERENCE WITH HOS6 PITAL PERSONNEL IN THE PERFORMANCE OF DUTIES.— 

7 (1) IN GENERAL.—Chapter 7 of title 18, United 

8 States Code, is amended by adding at the end the 

9 following: 

10 ‘‘§ 120. Interference with performance of duties of 

11 hospital personnel 

12 ‘‘(a) IN GENERAL.—Whoever knowingly assaults or 

13 intimidates an individual employed by a hospital, or an 

14 entity contracting with a hospital or other medical facility, 

15 during the course of the performance of the duties of such 

16 individual, and, as a result, interferes with the perform17 ance of the duties of such individual or limits the ability 

18 of such individual to perform such duties, shall be fined 

19 under this title, imprisoned not more than 10 years, or 

20 both. 

21 ‘‘(b) ENHANCED PENALTIES.— 

22 ‘‘(1) ACTS INVOLVING DANGEROUS WEAPONS

23 OR ACTS THAT RESULT IN BODILY INJURY.—Who24 ever, in the commission of any act described in sub25 section (a), uses a deadly or dangerous weapon or 


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1 inflicts bodily injury, shall be fined under this title 

2 or imprisoned not more than 20 years, or both. 

3 ‘‘(2) ACTS COMMITTED DURING EMERGENCY

4 DECLARATIONS.—Whoever commits any act de5 scribed in subsection (a) during the period of a dec6 laration of a public emergency for the area in which 

7 the act is committed shall be fined under this title 

8 or imprisoned not more than 20 years, or both. 

9 ‘‘(c) DEFENSE.—It shall be a defense to a prosecu10 tion under this section that— 

11 ‘‘(1) the defendant is a person with a physical, 

12 mental, or intellectual disability; and 

13 ‘‘(2) the conduct of the defendant was a clear 

14 and direct manifestation of such disability. 

15 ‘‘(d) DEFINITIONS.—In this section: 

16 ‘‘(1) HOSPITAL.—The term ‘hospital’ means 

17 any of the following medical facilities: 

18 ‘‘(A) A hospital (as defined in section 

19 1861(e) of the Social Security Act (42 U.S.C. 

20 1395x(e))). 

21 ‘‘(B) A long-term care hospital (as defined 

22 in section 1861(ccc) of such Act (42 U.S.C. 

23 1395x(ccc))). 


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1 ‘‘(C) A rehabilitation facility (as defined in 

2 section 1886(j)(1)(A) of such Act (42 U.S.C. 

3 1395ww(j)(1)(A))). 

4 ‘‘(D) A cancer hospital (as described in 

5 section 1886(d)(1)(B)(iii) of such Act (42 

6 U.S.C. 1395ww(d)(1)(B)(iii))). 

7 ‘‘(E) A children’s hospital (as described in 

8 section 1886(d)(1)(B)(v) of such Act (42 

9 U.S.C. 1395ww(d)(1)(B)(v))). 

10 ‘‘(F) A critical access hospital (as defined 

11 in section 1861(mm)(1) of such Act (42 U.S.C. 

12 1395x(mm)(1))). 

13 ‘‘(G) A rural emergency hospital (as de14 fined in section 1861(kkk)(2) of such Act (42 

15 U.S.C. 1395x(kkk)(2))). 

16 ‘‘(2) DECLARATION OF A PUBLIC EMER17 GENCY.—The term ‘declaration of a public emer18 gency’ means any of the following: 

19 ‘‘(A) A public health emergency declared 

20 by the Secretary of Health and Human Services 

21 under section 319 of the Public Health Service 

22 Act. 

23 ‘‘(B) An emergency or disaster declared by 

24 the President pursuant to the Robert T. StafVerDate Sep 11 2014 23:41 Apr 14, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2584.IH H2584

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1 ford Disaster Relief and Emergency Assistance 

2 Act.’’. 

3 (2) CLERICAL AMENDMENT.—The table of sec4 tions for chapter 7 of title 18, United States Code, 

5 is amended by adding at the end the following: 

‘‘120. Interference with performance of duties of hospital personnel.’’. 

6 (c) GRANTS FOR THE PROTECTION OF THE HOS7 PITAL WORKFORCE AGAINST VIOLENCE.—Title I of the 

8 Omnibus Crime Control and Safe Streets Act of 1968 (34 

9 U.S.C. 10101 et seq.) is amended by inserting after part 

10 OO the following: 

11 ‘‘PART PP—GRANT PROGRAM FOR HOSPITAL 

12 WORKFORCE SAFETY AND SECURITY 

13 ‘‘SEC. 3061. GRANT AUTHORIZATION. 

14 ‘‘(a) IN GENERAL.—The Attorney General may make 

15 grants under this part to hospitals for the purpose of car16 rying out programs to reduce the incidence of violence at 

17 hospitals, including violence or intimidation against hos18 pital personnel in the performance of their duties. 

19 ‘‘(b) USE OF FUNDS.—A grant awarded under this 

20 part shall be used to reduce the incidence of violence at 

21 hospitals through programs that may include one or more 

22 of the following: 

23 ‘‘(1) Training hospital personnel to prevent vio24 lence or intimidation against others or themselves, 


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1 including de-escalation training and specialized 

2 training in responding to mental health crises. 

3 ‘‘(2) Coordination with State and local law en4 forcement. 

5 ‘‘(3) Placement and use of hospital access con6 trol technologies, video surveillance, metal detection, 

7 panic buttons, status alert systems, restricted access 

8 capabilities, and safe patient and staff rooms, and 

9 other violence-prevention tools or measures. 

10 ‘‘(4) Any other measures that the Attorney 

11 General determines may provide a significant im12 provement in— 

13 ‘‘(A) training for violence prevention at 

14 hospitals; and 

15 ‘‘(B) protection against violence and in16 timidation of hospital personnel. 

17 ‘‘(c) PREFERENTIAL CONSIDERATION IN AWARDING

18 GRANTS.—In awarding grants under this part, the Attor19 ney General shall give preferential consideration, if fea20 sible, to an application from a hospital that— 

21 ‘‘(1) has a demonstrated need for improved se22 curity; 

23 ‘‘(2) has a demonstrated need for financial as24 sistance; and 


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1 ‘‘(3) has evidenced the ability to make the im2 provements for which the grant amounts are sought. 

3 ‘‘(d) EQUITABLE DISTRIBUTION OF GRANT

4 FUNDS.—In awarding grants under this part, the Attor5 ney General shall ensure, to the extent practicable, an eq6 uitable geographic distribution among the regions of the 

7 United States and among urban, suburban, and rural 

8 areas. 

9 ‘‘(e) ADMINISTRATIVE COSTS.—Not more than 2 per10 cent of a grant made under this part may be used for 

11 costs incurred to administer such grant. 

12 ‘‘SEC. 3062. APPLICATIONS. 

13 ‘‘(a) IN GENERAL.—To request a grant under this 

14 part, the chief executive of a hospital shall submit an ap15 plication to the Attorney General at such time, in such 

16 form, and containing such information as the Attorney 

17 General may reasonably require. 

18 ‘‘(b) REQUIREMENTS.—Each application under this 

19 section shall include— 

20 ‘‘(1) a detailed explanation of— 

21 ‘‘(A) the intended uses of funds provided 

22 under the grant; and 

23 ‘‘(B) how the activities funded under the 

24 grant will satisfy the purpose of this part; 


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1 ‘‘(2) an assurance that the applicant shall 

2 maintain and report such programmatic and finan3 cial data, records, and information as the Attorney 

4 General may reasonably require; and 

5 ‘‘(3) a certification, made in a form acceptable 

6 to the Attorney General, that— 

7 ‘‘(A) the programs to be funded by the 

8 grant meet all the requirements of this part; 

9 ‘‘(B) all the information contained in the 

10 application is correct; and 

11 ‘‘(C) the applicant will comply with all pro12 visions of this part and all other applicable Fed13 eral laws. 

14 ‘‘(c) GUIDELINES.—Not later than 90 days after the 

15 date of the enactment of this part, the Attorney General 

16 shall promulgate guidelines to implement this section. 

17 ‘‘SEC. 3063. ANNUAL REPORT TO CONGRESS; GRANT AC18 COUNTABILITY. 

19 ‘‘(a) ANNUAL REPORT.—Not later than 90 days after 

20 the end of the fiscal year for which funding for grants 

21 under this part is made available, the Attorney General 

22 shall submit to Congress a report regarding the activities 

23 carried out under this part. Each such report shall in24 clude, for the preceding fiscal year, the number of grants 

25 funded under this part, the amount of funds provided 


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1 under those grants, and the activities for which those 

2 grant funds were used. 

3 ‘‘(b) GRANT ACCOUNTABILITY.—Section 3026 (relat4 ing to grant accountability) shall apply to grants awarded 

5 by Attorney General under this part. For purposes of the 

6 preceding sentence, any references in section 3026 to part 

7 LL shall be considered references to part PP. 

8 ‘‘SEC. 3064. DEFINITION. 

9 ‘‘For purposes of this part, the term ‘hospital’ has 

10 the meaning given such term in section 120(d)(1) of title 

11 18, United States Code. 

12 ‘‘SEC. 3065. AUTHORIZATION OF APPROPRIATIONS. 

13 ‘‘There are authorized to be appropriated 

14 $25,000,000 for each of fiscal years 2023 through 2032 

15 to carry out this part. Funds appropriated for a fiscal year 

16 pursuant to the preceding sentence shall remain available 

17 until expended.’’. 

Æ 


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