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 work-
place 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 employ-
ers within the health care and social service industries 
to develop and implement a comprehensive workplace 
violence prevention plan, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Workplace Violence 
Prevention for Health Care and Social Service Workers 
Act’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) In a 2016 report entitled, ‘‘Workplace Safe-
ty and Health: Additional Efforts Needed to Help 
Protect Health Care Workers from Workplace Vio-
lence’’, the Government Accountability Office re-
ported over 730,000 cases of health care workplace 
assaults over the 5-year span from 2009 through 
2013, based on Bureau of Justice Statistics data. 
(2) The health care and social service industries 
experience the highest rates of injuries caused by 
workplace violence. Nurses, social workers, psy-
chiatric, home health, and personal care aides are all 
at increased risk for injury caused by workplace vio-
lence. The Bureau of Labor Statistics reported that 
in 2019, rates of violence and injury caused by per-
sons in these workplaces ranged from 3.8 times to 
as high as 82 times the average American work-
place. 
(3) The Bureau of Labor Statistics reports that 
health care and social service workers suffered 73 
percent of all workplace violence injuries caused by 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
persons in 2018 and are nearly 5 times as likely to 
suffer a workplace violence injury than workers over-
all. 
(4) According to a survey of 3,500 American 
emergency physicians conducted by the American 
College of Emergency Physicians, 47 percent of 
emergency room doctors have been physically as-
saulted at work, and 8 in 10 report that this vio-
lence is affecting patient care. 
(5) Workplace violence in health care and social 
service sectors is increasing. Bureau of Labor Statis-
tics data show that private sector injury rates of 
workplace violence in health care and social service 
sectors increased by 54 percent between 2001 and 
2018. Due to under-reporting, actual injury rates 
from workplace violence are widely recognized to be 
higher than reported levels. 
(6) Violence in health care settings has adverse 
impacts on workers and patients, compromising 
quality of care. 
(7) Studies have demonstrated that workplace 
violence prevention programs tailored to the needs of 
specific work areas and State-based workplace vio-
lence prevention legislation are strongly associated 
with reductions in workplace violence. 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
(8) Studies have found that proper staff train-
ing, appropriate staffing levels, sufficient resources, 
and the use of evidence based interventions (such as 
effective communication with patients using de-esca-
lation techniques and noncoercive use of medica-
tions) can reduce the risks to the safety of both pa-
tients and staff, using least-restrictive measures. 
(9) The Occupational Safety and Health Ad-
ministration has issued ‘‘Guidelines for Preventing 
Workplace Violence for Healthcare and Social Serv-
ice Workers’’, however, this guidance is not enforce-
able. Absent an enforceable standard, employers lack 
mandatory requirements to implement an effective 
and ongoing violence prevention program that pro-
vides protection of workers from workplace violence. 
(10) Nine States have mandated that certain 
types of health care facilities implement workplace 
violence prevention programs. On April 1, 2018, the 
Division of Occupational Safety and Health of the 
State of California issued a comprehensive standard 
(‘‘Workplace Violence Prevention in Health Care’’) 
that requires health care facilities to implement a 
workplace violence prevention plan. 
(11) Employer organizations have challenged 
the Occupational Safety and Health Administra-
VerDate 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
tion’s authority to utilize the General Duty Clause 
of the Occupational Safety and Health Act of 1970 
to enforce against workplace violence hazards, argu-
ing that Congress did not intend to cover workplace 
violence under such clause when the Act was enacted 
in 1970. 
(12) The Occupational Safety and Health Ad-
ministration (OSHA) received two petitions for rule-
making in July of 2016, calling on OSHA to pro-
mulgate a violence prevention standard for health 
care and social service sectors. On December 6, 
2016, OSHA issued a Request for Information 
(RFI) soliciting information on this issue. On Janu-
ary 10, 2017, OSHA conducted a public meeting to 
receive stakeholder input and to supplement the on-
line comments submitted in response to the RFI. At 
that meeting, OSHA announced it accepted the peti-
tions and would develop a Federal standard to pre-
vent workplace violence in health care and social 
service settings. The Trump administration failed to 
meet any of its deadlines to move the workplace vio-
lence rulemaking forward. It normally takes OSHA 
ten to twenty years to finalize a major OSHA stand-
ard. Therefore, legislation is necessary to ensure the 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
timely development of a standard to protect workers 
in health care and social service settings. 
SEC. 3. TABLE OF CONTENTS. 
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. 
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 cer-
tain employers in sectors that conduct activities 
similar to the activities in the health care and 
social service sectors, to develop and implement 
a comprehensive workplace violence prevention 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
plan and carry out other activities or require-
ments described in section 103 to protect health 
care workers, social service workers, and other 
personnel from workplace violence; and 
(B) that shall, at a minimum, be based on 
the Guidelines for Preventing Workplace Vio-
lence for Healthcare and Social Service Work-
ers published 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 
EXECUTIVE 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’’). 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
(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
STAND-
ARD.—The interim final standard shall— 
(A) take effect on a date that is not later 
than 30 days after issuance, except that such 
interim 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 promul-
gated 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. 
(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 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
of this Act, the provisions of this title shall be in ef-
fect and 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)) until such provisions are super-
seded 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 
Secretary of Labor shall, pursuant to section 6 of 
the Occupational Safety and Health Act (29 U.S.C. 
655), promulgate a proposed standard on workplace 
violence prevention— 
(A) for the purposes described in sub-
section (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 shall issue a final standard on such pro-
posed standard that shall— 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
(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 sec-
tion is in effect on the date of enactment 
of this Act). 
(x) Any other facility the Secretary 
determines should be covered under the 
standards promulgated under section 101. 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
(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 
service’’ includes the following services and op-
erations: 
(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 Gov-
ernment 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 sec-
tion is in effect on the date of enactment 
of this Act). 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
(iv) Any other services and operations 
the Secretary determines should be covered 
under the standards promulgated under 
section 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 em-
ploys 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-
ered employer to work at a covered facility or to per-
form covered services. 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
SEC. 103. REQUIREMENTS FOR WORKPLACE VIOLENCE 
PREVENTION 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 
promulgation of the interim final standard under 
section 101(a), a covered employer shall develop, im-
plement, and maintain an effective written workplace 
violence prevention plan (in this section referred to 
as the ‘‘Plan’’) for covered employees at each cov-
ered facility and for covered employees performing a 
covered service on behalf of such employer, which 
meets the following: 
(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- 
specific risk factors and risk factors spe-
cific to each work area or unit; and 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
(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 cov-
ered service, risk assessment and identi-
fication of workplace violence risks and 
hazards to employees 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— 
(aa) direct care employees; 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
(bb) where applicable, the 
representatives of such employ-
ees; and 
(cc) the employer. 
(iii) Hazard prevention, engineering 
controls, or work practice controls to cor-
rect hazards, in a timely manner, applying 
industrial hygiene principles of the hier-
archy of controls, which— 
(I) may include security and 
alarm systems, adequate exit routes, 
monitoring systems, barrier protec-
tion, established areas for patients 
and clients, lighting, entry procedures, 
staffing and working in teams, and 
systems to identify and flag clients 
with a history 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). 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS
(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 de-
briefing of all reports of workplace vi-
olence with the participation of em-
ployees 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 re-
sponse, including procedures for threats of 
mass casualties and procedures for inci-
dents involving a firearm or a dangerous 
weapon. 
(vi) Procedures for communicating 
with and training the covered employees on 
VerDate Sep 11 2014 
22:18 Mar 13, 2021
Jkt 019200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H1195.IH
H1195
khammond on DSKJM1Z7X2PROD with BILLS