Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Workplace Violence Pre-
vention for Health Care and Social Service Workers Act’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents for this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. 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 fa-
cilities receiving Medicare funds. 
TITLE I—WORKPLACE VIOLENCE 
PREVENTION STANDARD 
SEC. 101. WORKPLACE VIOLENCE PREVENTION STANDARD. 
(a) INTERIM FINAL STANDARD.— 
(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of this Act, the Secretary of 
Labor shall issue an interim final standard on work-
place violence prevention— 
(A) to require certain employers in the 
health care and social service sectors, and certain 
employers in sectors that conduct activities simi-
lar to the activities in the health care and social 
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service sectors, to develop and implement a com-
prehensive workplace violence prevention plan 
and carry out other activities or requirements 
described in section 103 to protect health care 
workers, social service workers, and other per-
sonnel from workplace violence; and 
(B) that shall, at a minimum, be based on 
the Guidelines for Preventing Workplace Violence 
for Healthcare and Social Service Workers pub-
lished by the Occupational Safety and Health 
Administration of the Department of Labor in 
2015 and adhere to the requirements of this title. 
(2) INAPPLICABLE PROVISIONS OF LAW AND EX-
ECUTIVE
ORDER.—The following provisions of law 
and Executive orders shall not apply to the issuance 
of the interim final standard under this subsection: 
(A) The requirements applicable to occupa-
tional safety and health standards under section 
6(b) of the Occupational Safety and Health Act 
of 1970 (29 U.S.C. 655(b)). 
(B) The requirements of chapters 5 and 6 of 
title 5, United States Code. 
(C) Subchapter I of chapter 35 of title 44, 
United States Code (commonly referred to as the 
‘‘Paperwork Reduction Act’’). 
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(D) Executive Order 12866 (58 Fed. Reg. 
51735; relating to regulatory planning and re-
view), as amended. 
(3) NOTICE
AND
COMMENT.—Notwithstanding 
paragraph (2)(B), the Secretary shall, prior to 
issuing the interim final standard under this sub-
section, provide notice in the Federal Register of the 
interim final standard and a 30-day period for pub-
lic comment. 
(4) EFFECTIVE DATE OF INTERIM STANDARD.— 
The interim final standard shall— 
(A) take effect on a date that is not later 
than 30 days after issuance, except that such in-
terim final standard may include a reasonable 
phase-in period for the implementation of re-
quired engineering controls that take effect after 
such date; 
(B) be enforced in the same manner and to 
the same extent as any standard promulgated 
under section 6(b) of the Occupational Safety 
and Health Act of 1970 (29 U.S.C. 655(b)); and 
(C) be in effect until the final standard de-
scribed in subsection (b) becomes effective and 
enforceable. 
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(5) FAILURE TO PROMULGATE.—If an interim 
final standard described in paragraph (1) is not 
issued not later than 1 year of the date of enactment 
of this Act, the provisions of this title shall be in effect 
and enforced in the same manner and to the same ex-
tent as any standard promulgated under section 6(b) 
of the Occupational Safety and Health Act (29 U.S.C. 
655(b)) until such provisions are superseded in whole 
by an interim final standard issued by the Secretary 
that meets the requirements of paragraph (1). 
(b) FINAL STANDARD.— 
(1) PROPOSED
STANDARD.—Not later than 2 
years after the date of enactment of this Act, the Sec-
retary of Labor shall, pursuant to section 6 of the Oc-
cupational Safety and Health Act (29 U.S.C. 655), 
promulgate a proposed standard on workplace vio-
lence prevention— 
(A) for the purposes described in subsection 
(a)(1)(A); and 
(B) that shall include, at a minimum, re-
quirements contained in the interim final stand-
ard promulgated under subsection (a). 
(2) FINAL STANDARD.—Not later than 42 months 
after the date of enactment of this Act, the Secretary 
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shall issue a final standard on such proposed stand-
ard that shall— 
(A) provide no less protection than any 
workplace violence standard adopted by a State 
plan that has been approved by the Secretary 
under section 18 of the Occupational Safety and 
Health Act of 1970 (29 U.S.C. 667), provided the 
Secretary finds that the final standard is feasible 
on the basis of the best available evidence; and 
(B) be effective and enforceable in the same 
manner and to the same extent as any standard 
promulgated under section 6(b) of the Occupa-
tional Safety and Health Act of 1970 (29 U.S.C. 
655(b)). 
SEC. 102. SCOPE AND APPLICATION. 
In this title: 
(1) COVERED FACILITY.— 
(A) IN GENERAL.—The term ‘‘covered facil-
ity’’ includes the following: 
(i) Any hospital, including any spe-
cialty hospital, in-patient or outpatient set-
ting, or clinic operating within a hospital 
license, or any setting that provides out-
patient services. 
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(ii) Any residential treatment facility, 
including any nursing home, skilled nurs-
ing facility, hospice facility, and long-term 
care facility. 
(iii) Any non-residential treatment or 
service setting. 
(iv) Any medical treatment or social 
service setting or clinic at a correctional or 
detention facility. 
(v) Any community care setting, in-
cluding a community-based residential fa-
cility, group home, and mental health clin-
ic. 
(vi) Any psychiatric treatment facility. 
(vii) Any drug abuse or substance use 
disorder treatment center. 
(viii) Any independent freestanding 
emergency centers. 
(ix) Any facility described in clauses 
(i) through (viii) operated by a Federal 
Government agency and required to comply 
with occupational safety and health stand-
ards pursuant to section 1960 of title 29, 
Code of Federal Regulations (as such section 
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is in effect on the date of enactment of this 
Act). 
(x) Any other facility the Secretary de-
termines should be covered under the stand-
ards promulgated under section 101. 
(B) EXCLUSION.—The term ‘‘covered facil-
ity’’ does not include an office of a physician, 
dentist, podiatrist, or any other health practi-
tioner that is not physically located within a 
covered facility described in clauses (i) through 
(x) of subparagraph (A). 
(2) COVERED SERVICES.— 
(A) IN GENERAL.—The term ‘‘covered serv-
ice’’ includes the following services and oper-
ations: 
(i) Any services and operations pro-
vided in any field work setting, including 
home health care, home-based hospice, and 
home-based social work. 
(ii) Any emergency services and trans-
port, including such services provided by 
firefighters and emergency responders. 
(iii) Any services described in clauses 
(i) and (ii) performed by a Federal Govern-
ment agency and required to comply with 
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occupational safety and health standards 
pursuant to section 1960 of title 29, Code of 
Federal Regulations (as such section is in 
effect on the date of enactment of this Act). 
(iv) Any other services and operations 
the Secretary determines should be covered 
under the standards promulgated under sec-
tion 101. 
(B) EXCLUSION.—The term ‘‘covered serv-
ice’’ does not include child day care services. 
(3) COVERED EMPLOYER.— 
(A) IN GENERAL.—The term ‘‘covered em-
ployer’’ includes a person (including a con-
tractor, subcontractor, a temporary service firm, 
or an employee leasing entity) that employs an 
individual to work at a covered facility or to 
perform covered services. 
(B) EXCLUSION.—The term ‘‘covered em-
ployer’’ does not include an individual who pri-
vately employs, in the individual’s residence, a 
person to perform covered services for the indi-
vidual or a family member of the individual. 
(4) COVERED
EMPLOYEE.—The term ‘‘covered 
employee’’ includes an individual employed by a cov-
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ered employer to work at a covered facility or to per-
form covered services. 
SEC. 103. REQUIREMENTS FOR WORKPLACE VIOLENCE PRE-
VENTION STANDARD. 
Each standard described in section 101 shall include, 
at a minimum, the following requirements: 
(1) WORKPLACE VIOLENCE PREVENTION PLAN.— 
Not later than 6 months after the date of promulga-
tion of the interim final standard under section 
101(a), a covered employer shall develop, implement, 
and maintain an effective written workplace violence 
prevention plan (in this section referred to as the 
‘‘Plan’’) for covered employees at each covered facility 
and for covered employees performing a covered serv-
ice on behalf of such employer, which meets the fol-
lowing: 
(A) 
PLAN
DEVELOPMENT.—Each 
Plan 
shall— 
(i) be developed and implemented with 
the meaningful participation of direct care 
employees, other employees, and employee 
representatives, for all aspects of the Plan; 
(ii) be tailored and specific to condi-
tions and hazards for the covered facility or 
the covered service, including patient-spe-
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cific risk factors and risk factors specific to 
each work area or unit; and 
(iii) be suitable for the size, com-
plexity, and type of operations at the cov-
ered facility or for the covered service, and 
remain in effect at all times. 
(B) PLAN CONTENT.—Each Plan shall in-
clude procedures and methods for the following: 
(i) Identification of the individual and 
the individual’s position responsible for im-
plementation of the Plan. 
(ii) With respect to each work area and 
unit at the covered facility or while covered 
employees are performing the covered serv-
ice, risk assessment and identification of 
workplace violence risks and hazards to em-
ployees exposed to such risks and hazards 
(including environmental risk factors and 
patient-specific risk factors), which shall 
be— 
(I) informed by past violent inci-
dents specific to such covered facility 
or such covered service; and 
(II) conducted with, at a min-
imum— 
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(aa) direct care employees; 
(bb) where applicable, the 
representatives of such employees; 
and 
(cc) the employer. 
(iii) Hazard prevention, engineering 
controls, or work practice controls to correct 
hazards, in a timely manner, applying in-
dustrial hygiene principles of the hierarchy 
of controls, which— 
(I) may include security and 
alarm systems, adequate exit routes, 
monitoring systems, barrier protection, 
established areas for patients and cli-
ents, lighting, entry procedures, staff-
ing and working in teams, and systems 
to identify and flag clients with a his-
tory of violence; and 
(II) shall ensure that employers 
correct, in a timely manner, hazards 
identified in any violent incident in-
vestigation described in paragraph (2) 
and any annual report described in 
paragraph (5). 
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(iv) Reporting, incident response, and 
post-incident investigation procedures, in-
cluding procedures— 
(I) for employees to report work-
place violence risks, hazards, and inci-
dents; 
(II) for employers to respond to 
reports of workplace violence; 
(III) for employers to perform a 
post-incident investigation and debrief-
ing of all reports of workplace violence 
with the participation of employees 
and their representatives; 
(IV) to provide medical care or 
first aid to affected employees; and 
(V) to provide employees with in-
formation about available trauma and 
related counseling. 
(v) Procedures for emergency response, 
including procedures for threats of mass 
casualties and procedures for incidents in-
volving a firearm or a dangerous weapon. 
(vi) Procedures for communicating 
with and training the covered employees on 
workplace violence hazards, threats, and 
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work practice controls, the employer’s plan, 
and procedures for confronting, responding 
to, and reporting workplace violence threats, 
incidents, and concerns, and employee 
rights. 
(vii) Procedures for— 
(I) ensuring the coordination of 
risk assessment efforts, Plan develop-
ment, and implementation of the Plan 
with other employers who have employ-
ees who work at the covered facility or 
who are performing the covered service; 
and 
(II) determining which covered 
employer or covered employers shall be 
responsible for implementing and com-
plying with the provisions of the 
standard applicable to the working 
conditions over which such employers 
have control. 
(viii) Procedures for conducting the 
annual evaluation under paragraph (6). 
(C) AVAILABILITY
OF
PLAN.—Each Plan 
shall be made available at all times to the cov-
ered employees who are covered under such Plan. 
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(2) VIOLENT INCIDENT INVESTIGATION.— 
(A) IN GENERAL.—As soon as practicable 
after a workplace violence incident, risk, or haz-
ard of which a covered employer has knowledge, 
the employer shall conduct an investigation of 
such incident, risk, or hazard under which the 
employer shall— 
(i) review the circumstances of the in-
cident, risk, or hazard, and whether any 
controls or measures implemented pursuant 
to the Plan of the employer were effective; 
and 
(ii) solicit input from involved employ-
ees, their representatives, and supervisors 
about the cause of the incident, risk, or haz-
ard, and whether further corrective meas-
ures (including system-level factors) could 
have prevented the incident, risk, or hazard. 
(B) DOCUMENTATION.—A covered employer 
shall document the findings, recommendations, 
and corrective measures taken for each investiga-
tion conducted under this paragraph. 
(3) TRAINING AND EDUCATION.—With respect to 
the covered employees covered under a Plan of a cov-
ered employer, the employer shall provide training 
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and education to such employees who may be exposed 
to workplace violence hazards and risks, which meet 
the following requirements: 
(A) Annual training and education shall 
include information on the Plan, including iden-
tified workplace violence hazards, work practice 
control measures, reporting procedures, record 
keeping requirements, response procedures, anti- 
retaliation policies, and employee rights. 
(B) Additional hazard recognition training 
shall be provided for supervisors and managers 
to ensure they— 
(i) can recognize high-risk situations; 
and 
(ii) do not assign employees to situa-
tions that predictably compromise the safety 
of such employees. 
(C) Additional training shall be provided 
for each such covered employee whose job cir-
cumstances have changed, within a reasonable 
timeframe after such change. 
(D) Applicable training shall be provided 
under this paragraph for each new covered em-
ployee prior to the employee’s job assignment. 
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(E) All training shall provide such employ-
ees opportunities to ask questions, give feedback 
on training, and request additional instruction, 
clarification, or other followup. 
(F) All training shall be provided in-person 
and by an individual with knowledge of work-
place violence prevention and of the Plan, except 
that any annual training described in subpara-
graph (A) provided to an employee after the first 
year such training is provided to such employee 
may be conducted by live video if in-person 
training is impracticable. 
(G) All training shall be appropriate in 
content and vocabulary to the language, edu-
cational level, and literacy of such covered em-
ployees. 
(4) RECORDKEEPING
AND
ACCESS
TO
PLAN 
RECORDS.— 
(A) IN GENERAL.—Each covered employer 
shall— 
(i) maintain for not less than 5 
years— 
(I) records related to each Plan of 
the employer, including workplace vio-
lence risk and hazard assessments, and 
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identification, evaluation, correction, 
and training procedures; 
(II) a violent incident log de-
scribed in subparagraph (B) for re-
cording all workplace violence inci-
dents; and 
(III) records of all incident inves-
tigations as required under paragraph 
(2)(B); and 
(ii)(I) make such records and logs 
available, upon request, to covered employ-
ees and their representatives for examina-
tion and copying in accordance with section 
1910.1020 of title 29, Code of Federal Regu-
lations (as such section is in effect on the 
date of enactment of this Act), and in a 
manner consistent with HIPAA privacy 
regulations (defined in section 1180(b)(3) of 
the Social Security Act (42 U.S.C. 1320d– 
9(b)(3))) and part 2 of title 42, Code of 
Federal Regulations (as such part is in ef-
fect on the date of enactment of this Act); 
and 
(II) ensure that any such records and 
logs that may be copied, transmitted elec-
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tronically, or otherwise removed from the 
employer’s control for purposes of this 
clause omit any element of personal identi-
fying information sufficient to allow identi-
fication of any patient, resident, client, or 
other individual alleged to have committed 
a violent incident (including the individ-
ual’s name, address, electronic mail address, 
telephone number, or social security num-
ber, or other information that, alone or in 
combination with other publicly available 
information, reveals such individual’s iden-
tity). 
(B) VIOLENT
INCIDENT
LOG
DESCRIP-
TION.—Each violent incident log shall— 
(i) be maintained by a covered em-
ployer for each covered facility controlled by 
the employer and for each covered service 
being performed by a covered employee on 
behalf of such employer; 
(ii) be based on a template developed 
by the Secretary not later than 1 year after 
the date of enactment of this Act; 
(iii) include, at a minimum, a descrip-
tion of— 
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(I) the violent incident (including 
environmental risk factors present at 
the time of the incident); 
(II) the date, time, and location of 
the incident, and the names and job ti-
tles of involved employees; 
(III) the nature and extent of in-
juries to covered employees; 
(IV) a classification of the perpe-
trator who committed the violence, in-
cluding whether the perpetrator was— 
(aa) a patient, client, resi-
dent, or customer of a covered em-
ployer; 
(bb) a family or friend of a 
patient, client, resident, or cus-
tomer of a covered employer; 
(cc) a stranger; 
(dd) a coworker, supervisor, 
or manager of a covered employee; 
(ee) a partner, spouse, par-
ent, or relative of a covered em-
ployee; or 
(ff) any other appropriate 
classification; 
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(V) the type of violent incident 
(such as type 1 violence, type 2 vio-
lence, type 3 violence, or type 4 vio-
lence); and 
(VI) how the incident was abated; 
(iv) not later than 7 days after the em-
ployer learns of such incident, contain a 
record of each violent incident, which is up-
dated to ensure completeness of such record; 
(v) be maintained for not less than 5 
years; and 
(vi) in the case of a violent incident 
involving a privacy concern case, protect 
the identity of employees in a manner con-
sistent with section 1904.29(b) of title 29, 
Code of Federal Regulations (as such section 
is in effect on the date of enactment of this 
Act). 
(C) ANNUAL SUMMARY.— 
(i) COVERED EMPLOYERS.—Each cov-
ered employer shall prepare and submit to 
the Secretary an annual summary of each 
violent incident log for the preceding cal-
endar year that shall— 
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(I) with respect to each covered fa-
cility, and each covered service, for 
which such a log has been maintained, 
include— 
(aa) the total number of vio-
lent incidents; 
(bb) the number of recordable 
injuries related to such incidents; 
and 
(cc) the total number of 
hours worked by the covered em-
ployees for such preceding year; 
(II) be completed on a form pro-
vided by the Secretary; 
(III) be posted for 3 months be-
ginning February 1 of each year in a 
manner consistent with the require-
ments of section 1904 of title 29, Code 
of Federal Regulations (as such section 
is in effect on the date of enactment of 
this Act), relating to the posting of 
summaries of injury and illness logs; 
(IV) be located in a conspicuous 
place or places where notices to em-
ployees are customarily posted; and 
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(V) not be altered, defaced, or cov-
ered by other material. 
(ii) SECRETARY.—Not later than 1 
year after the promulgation of the interim 
final standard under section 101(a), the 
Secretary shall make available a platform 
for the electronic submission of annual sum-
maries required under this subparagraph. 
(5) ANNUAL REPORT.— 
(A) REPORT
TO
SECRETARY.—Not later 
than February 15 of each year, each covered em-
ployer shall report to the Secretary, on a form 
provided by the Secretary, the frequency, quan-
tity, and severity of workplace violence, and any 
incident response and post-incident investigation 
(including abatement measures) for the incidents 
set forth in the annual summary of the violent 
incident log described in paragraph (4)(C). The 
contents of the report of the Secretary to Con-
gress shall not disclose any confidential informa-
tion. 
(B) REPORT TO CONGRESS.—Not later than 
6 months after February 15 of each year, the 
Secretary shall submit to Congress a summary of 
the reports received under subparagraph (A). 
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(6) ANNUAL
EVALUATION.—Each covered em-
ployer shall conduct an annual written evaluation, 
conducted with the full, active participation of cov-
ered employees and employee representatives, of— 
(A) the implementation and effectiveness of 
the Plan, including a review of the violent inci-
dent log; and 
(B) compliance with training required by 
each standard described in section 101, and spec-
ified in the Plan. 
(7) PLAN
UPDATES.—Each covered employer 
shall incorporate changes to the Plan, in a manner 
consistent with paragraph (1)(A)(i) and based on 
findings from the most recent annual evaluation con-
ducted under paragraph (6), as appropriate. 
(8) ANTI-RETALIATION.— 
(A) POLICY.—Each covered employer shall 
adopt a policy prohibiting any person (includ-
ing an agent of the employer) from the discrimi-
nation or retaliation described in subparagraph 
(B). 
(B) PROHIBITION.—No covered employer 
shall discriminate or retaliate against any em-
ployee for— 
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(i) reporting a workplace violence inci-
dent, threat, or concern to, or seeking assist-
ance or intervention with respect to such in-
cident, threat, or concern from, the em-
ployer, law enforcement, local emergency 
services, or a local, State, or Federal gov-
ernment agency; or 
(ii) exercising any other rights under 
this paragraph. 
(C) ENFORCEMENT.—This paragraph shall 
be enforced in the same manner and to the same 
extent as any standard promulgated under sec-
tion 6(b) of the Occupational Safety and Health 
Act (29 U.S.C. 655(b)). 
SEC. 104. RULES OF CONSTRUCTION. 
Notwithstanding section 18 of the Occupational Safety 
and Health Act of 1970 (29 U.S.C. 667)— 
(1) nothing in this title shall be construed to cur-
tail or limit authority of the Secretary under any 
other provision of the law; 
(2) the rights, privileges, or remedies of covered 
employees shall be in addition to the rights, privi-
leges, or remedies provided under any Federal or 
State law, or any collective bargaining agreement; 
and 
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(3) nothing in this Act shall be construed to 
limit or prevent health care workers, social service 
workers, and other personnel from reporting violent 
incidents to appropriate law enforcement. 
SEC. 105. OTHER DEFINITIONS. 
In this title: 
(1) WORKPLACE VIOLENCE.— 
(A) IN GENERAL.—The term ‘‘workplace vi-
olence’’ means any act of violence or threat of vi-
olence, without regard to intent, that occurs at a 
covered facility or while a covered employee per-
forms a covered service. 
(B) EXCLUSIONS.—The term ‘‘workplace vi-
olence’’ does not include lawful acts of self-de-
fense or lawful acts of defense of others. 
(C) INCLUSIONS.—The term ‘‘workplace vio-
lence’’ includes— 
(i) the threat or use of physical force 
against a covered employee that results in 
or has a high likelihood of resulting in in-
jury, psychological trauma, or stress, with-
out regard to whether the covered employee 
sustains an injury, psychological trauma, 
or stress; and 
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(ii) an incident involving the threat or 
use of a firearm or a dangerous weapon, in-
cluding the use of common objects as weap-
ons, without regard to whether the employee 
sustains an injury, psychological trauma, 
or stress. 
(2) TYPE 1 VIOLENCE.—The term ‘‘type 1 vio-
lence’’— 
(A) means workplace violence directed at a 
covered employee at a covered facility or while 
performing a covered service by an individual 
who has no legitimate business at the covered fa-
cility or with respect to such covered service; and 
(B) includes violent acts by any individual 
who enters the covered facility or worksite where 
a covered service is being performed with the in-
tent to commit a crime. 
(3) TYPE 2 VIOLENCE.—The term ‘‘type 2 vio-
lence’’ means workplace violence directed at a covered 
employee by customers, clients, patients, students, in-
mates, or any individual for whom a covered facility 
provides services or for whom the employee performs 
covered services. 
(4) TYPE 3 VIOLENCE.—The term ‘‘type 3 vio-
lence’’ means workplace violence directed at a covered 
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employee by a present or former employee, supervisor, 
or manager. 
(5) TYPE 4 VIOLENCE.—The term ‘‘type 4 vio-
lence’’ means workplace violence directed at a covered 
employee by an individual who is not an employee, 
but has or is known to have had a personal relation-
ship with such employee, or with a customer, client, 
patient, student, inmate, or any individual for whom 
a covered facility provides services or for whom the 
employee performs covered services. 
(6) THREAT OF VIOLENCE.—The term ‘‘threat of 
violence’’ means a statement or conduct that— 
(A) causes an individual to fear for such in-
dividual’s safety because there is a reasonable 
possibility the individual might be physically in-
jured; and 
(B) serves no legitimate purpose. 
(7) ALARM.—The term ‘‘alarm’’ means a me-
chanical, electrical, or electronic device that does not 
rely upon an employee’s vocalization in order to alert 
others. 
(8) DANGEROUS WEAPON.—The term ‘‘dangerous 
weapon’’ means an instrument capable of inflicting 
death or serious bodily injury, without regard to 
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whether such instrument was designed for that pur-
pose. 
(9) ENGINEERING CONTROLS.— 
(A) IN GENERAL.—The term ‘‘engineering 
controls’’ means an aspect of the built space or 
a device that removes a hazard from the work-
place or creates a barrier between a covered em-
ployee and the hazard. 
(B) INCLUSIONS.—For purposes of reducing 
workplace violence hazards, the term ‘‘engineer-
ing controls’’ includes electronic access controls 
to employee occupied areas, weapon detectors 
(installed or handheld), enclosed workstations 
with 
shatter-resistant 
glass, 
deep 
service 
counters, separate rooms or areas for high-risk 
patients, locks on doors, removing access to or se-
curing items that could be used as weapons, fur-
niture affixed to the floor, opaque glass in pa-
tient rooms (which protects privacy, but allows 
the health care provider to see where the patient 
is before entering the room), closed-circuit tele-
vision monitoring and video recording, sight- 
aids, and personal alarm devices. 
(10) ENVIRONMENTAL RISK FACTORS.— 
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(A) IN
GENERAL.—The term ‘‘environ-
mental risk factors’’ means factors in the covered 
facility or area in which a covered service is per-
formed that may contribute to the likelihood or 
severity of a workplace violence incident. 
(B) CLARIFICATION.—Environmental risk 
factors may be associated with the specific task 
being performed or the work area, such as work-
ing in an isolated area, poor illumination or 
blocked visibility, and lack of physical barriers 
between individuals and persons at risk of com-
mitting workplace violence. 
(11) PATIENT-SPECIFIC
RISK
FACTORS.—The 
term ‘‘patient-specific risk factors’’ means factors spe-
cific to a patient that may increase the likelihood or 
severity of a workplace violence incident, including— 
(A) a patient’s treatment and medication 
status, and history of violence and use of drugs 
or alcohol; and 
(B) any conditions or disease processes of 
the patient that may cause the patient to experi-
ence confusion or disorientation, be non-respon-
sive to instruction, behave unpredictably, or en-
gage in disruptive, threatening, or violent behav-
ior. 
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(12) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Labor. 
(13) WORK PRACTICE CONTROLS.— 
(A) IN GENERAL.—The term ‘‘work practice 
controls’’ means procedures and rules that are 
used to effectively reduce workplace violence haz-
ards. 
(B) INCLUSIONS.—The term ‘‘work practice 
controls’’ includes— 
(i) assigning and placing sufficient 
numbers of staff to reduce patient-specific 
type 2 violence hazards; 
(ii) provision of dedicated and avail-
able safety personnel such as security 
guards; 
(iii) employee training on workplace 
violence prevention methods and techniques 
to de-escalate and minimize violent behav-
ior; and 
(iv) employee training on procedures 
for response in the event of a workplace vio-
lence incident and for post-incident re-
sponse. 
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TITLE II—AMENDMENTS TO THE 
SOCIAL SECURITY ACT 
SEC. 201. APPLICATION OF THE WORKPLACE VIOLENCE 
PREVENTION STANDARD TO CERTAIN FACILI-
TIES RECEIVING MEDICARE FUNDS. 
(a) IN GENERAL.—Section 1866 of the Social Security 
Act (42 U.S.C. 1395cc) is amended— 
(1) in subsection (a)(1)— 
(A) in subparagraph (X), by striking ‘‘and’’ 
at the end; 
(B) in subparagraph (Y), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by inserting after subparagraph (Y) the 
following new subparagraph: 
‘‘(Z) in the case of hospitals that are not other-
wise subject to the Occupational Safety and Health 
Act of 1970 (or a State occupational safety and 
health plan that is approved under 18(b) of such Act) 
and skilled nursing facilities that are not otherwise 
subject to such Act (or such a State occupational safe-
ty and health plan), to comply with the Workplace 
Violence Prevention Standard (as promulgated under 
section 101 of the Workplace Violence Prevention for 
Health Care and Social Service Workers Act).’’; and 
(2) in subsection (b)(4)— 
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(A) in subparagraph (A), by inserting ‘‘and 
a hospital or skilled nursing facility that fails to 
comply with the requirement of subsection 
(a)(1)(Z) (relating to the Workplace Violence 
Prevention Standard)’’ after ‘‘Bloodborne Patho-
gens standard)’’; and 
(B) in subparagraph (B)— 
(i) by striking ‘‘(a)(1)(U)’’ and insert-
ing ‘‘(a)(1)(V)’’; and 
(ii) by inserting ‘‘(or, in the case of a 
failure to comply with the requirement of 
subsection (a)(1)(Z), for a violation of the 
Workplace Violence Prevention standard re-
ferred to in such subsection by a hospital or 
skilled nursing facility, as applicable, that 
is subject to the provisions of such Act)’’ be-
fore the period at the end. 
(b) EFFECTIVE DATE.—The amendments made by sub-
section (a) shall apply beginning on the date that is 1 year 
after the date of issuance of the interim final standard on 
workplace violence prevention required under section 101. 
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Union Calendar No. 3 
117TH CONGRESS 
1ST SESSION 
H. R. 1195 
[Report No. 117–14, Part I] 
A BILL 
To direct the Secretary of Labor to issue an occu-
pational safety and health standard that requires 
covered employers within the health care and so-
cial service industries to develop and implement 
a comprehensive workplace violence prevention 
plan, and for other purposes. 
APRIL 5, 2021 
Reported from the Committee on Education and Labor 
with an amendment 
APRIL 5, 2021 
Committees on Energy and Commerce and Ways and 
Means discharged; committed to the Committee of the 
Whole House on the State of the Union and ordered 
to be printed 
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