117TH CONGRESS 
1ST SESSION H. R. 1195 
AN ACT 
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,
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Workplace Violence 
Prevention 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 
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 
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; 
(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; and 
(C) that provides for a period determined 
appropriate by the Secretary, not to exceed 1 
year, during which the Secretary shall prioritize 
technical assistance and advice consistent with 
section 21(d) of the Occupational Safety and 
Health Act of 1970 (29 U.S.C. 670(d)) to em-
ployers subject to the standard with respect to 
compliance with the standard. 
(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:
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 
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— 
(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), pro-
vided the Secretary finds that the final stand-
ard 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 
Occupational 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 fa-
cility’’ 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. 
(ii) Any residential treatment facility, 
including any nursing home, skilled nurs-
ing facility, hospice facility, Alzheimer’s 
and memory care 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 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. 
(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). 
(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. 
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
(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; 
(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). 
(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 
workplace violence hazards, threats, and 
work practice controls, the employer’s plan, 
and procedures for confronting, responding 
to, 
and 
reporting 
workplace 
violence 
threats, incidents, and concerns, and em-
ployee 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 em-
ployees who work at the covered facil-
ity or who are performing the covered 
service; and 
(II) determining which covered 
employer or covered employers shall 
be responsible for implementing and 
complying 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. 
(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 pursu-
ant to the Plan of the employer were effec-
tive; and 
(ii) solicit input from involved employ-
ees, their representatives, and supervisors 
about the cause of the incident, risk, or 
hazard, and whether further corrective 
measures (including system-level factors) 
could have prevented the incident, risk, or 
hazard. 
(B) DOCUMENTATION.—A covered em-
ployer shall 
document 
the 
findings, 
rec-
ommendations, and corrective measures taken 
for each investigation conducted under this 
paragraph. 
(3) TRAINING AND EDUCATION.—With respect 
to the covered employees covered under a Plan of a 
covered employer, the employer shall provide train-
ing and education to such employees who may be ex-
posed 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 safe-
ty 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) Additional training shall be provided 
for each such covered employee whose job cir-
cumstances require working with victims of tor-
ture, trafficking, or domestic violence. 
(E) Applicable training shall be provided 
under this paragraph for each new covered em-
ployee prior to the employee’s job assignment.
(F) All training shall provide such employ-
ees opportunities to ask questions, give feed-
back on training, and request additional in-
struction, clarification, or other followup. 
(G) All training shall be provided in-person 
and by an individual with knowledge of work-
place violence prevention and of the Plan, ex-
cept that any annual training described in sub-
paragraph (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. 
(H) 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 
violence risk and hazard assessments,
and identification, evaluation, correc-
tion, 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 sec-
tion 1910.1020 of title 29, Code of Federal 
Regulations (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 effect on the date of enactment of this 
Act); and 
(II) ensure that any such records and 
logs that may be copied, transmitted elec-
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 ad-
dress, telephone number, or social security 
number, or other information that, alone 
or in combination with other publicly avail-
able information, reveals such individual’s 
identity). 
(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 serv-
ice 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—
(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 titles 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 
employer; 
(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 em-
ployee; 
(ee) a partner, spouse, par-
ent, or relative of a covered em-
ployee; or
(ff) any other appropriate 
classification; 
(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 
employer learns of such incident, contain a 
record of each violent incident, which is 
updated 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 sec-
tion 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— 
(I) with respect to each covered 
facility, 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 record-
able injuries related to such inci-
dents; 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 en-
actment of this Act), relating to the
posting of summaries of injury and ill-
ness logs; 
(IV) be located in a conspicuous 
place or places where notices to em-
ployees are customarily posted; and 
(V) not be altered, defaced, or 
covered 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 
summaries required under this subpara-
graph. 
(5) ANNUAL REPORT.— 
(A) REPORT
TO
SECRETARY.—Not later 
than February 15 of each year, each covered 
employer shall report to the Secretary, on a 
form provided by the Secretary, the frequency, 
quantity, and severity of workplace violence, 
and any incident response and post-incident in-
vestigation (including abatement measures) for 
the incidents set forth in the annual summary 
of the violent incident log described in para-
graph (4)(C). The contents of the report of the
Secretary to Congress shall not disclose any 
confidential information. 
(B) REPORT
TO
CONGRESS.—Not later 
than 6 months after February 15 of each year, 
the Secretary shall submit to Congress a sum-
mary of the reports received under subpara-
graph (A). 
(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 in-
cident log; and 
(B) compliance with training required by 
each standard described in section 101, and 
specified 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 (including
an agent of the employer) from the discrimina-
tion or retaliation described in subparagraph 
(B). 
(B) PROHIBITION.—No covered employer 
shall discriminate or retaliate against any em-
ployee for— 
(i) reporting a workplace violence inci-
dent, threat, or concern to, or seeking as-
sistance or intervention with respect to 
such incident, threat, or concern from, the 
employer, law enforcement, local emer-
gency services, or a local, State, or Federal 
government 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 section 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 Safe-
ty and Health Act of 1970 (29 U.S.C. 667)—
(1) nothing in this title shall be construed to 
curtail 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; 
(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; and 
(4) nothing in this Act shall be construed to 
limit or diminish any protections in relevant Federal, 
State, or local law related to— 
(A) domestic violence; 
(B) stalking; 
(C) dating violence; and 
(D) sexual assault. 
SEC. 105. OTHER DEFINITIONS. 
In this title: 
(1) WORKPLACE VIOLENCE.— 
(A) IN GENERAL.—The term ‘‘workplace 
violence’’ means any act of violence or threat of 
violence, without regard to intent, that occurs
at a covered facility or while a covered employee 
performs a covered service. 
(B) EXCLUSIONS.—The term ‘‘workplace 
violence’’ does not include lawful acts of self-de-
fense or lawful acts of defense of others. 
(C) INCLUSIONS.—The term ‘‘workplace 
violence’’ 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 em-
ployee sustains an injury, psychological 
trauma, or stress; and 
(ii) an incident involving the threat or 
use of a firearm or a dangerous weapon, 
including the use of common objects as 
weapons, 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 
facility 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 intent to commit a crime. 
(3) TYPE 2 VIOLENCE.—The term ‘‘type 2 vio-
lence’’ means workplace violence directed at a cov-
ered employee by customers, clients, patients, stu-
dents, inmates, 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 cov-
ered employee by a present or former employee, su-
pervisor, or manager. 
(5) TYPE 4 VIOLENCE.—The term ‘‘type 4 vio-
lence’’ means workplace violence directed at a cov-
ered employee by an individual who is not an em-
ployee, but has or is known to have had a personal 
relationship 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.