[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1309 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 1309
To direct the Secretary of Labor to issue an occupational safety and
health standard that requires covered employers within the health care
and social service industries to develop and implement a comprehensive
workplace violence prevention plan, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 19, 2019
Mr. Courtney (for himself, Mr. Scott of Virginia, Ms. Adams, Ms. Wilson
of Florida, Ms. Bonamici, Mr. DeSaulnier, Ms. Wild, Ms. Omar, Mr.
Garamendi, Mr. Espaillat, Mr. Khanna, Ms. Pingree, Ms. Norton, Mr.
Himes, Mr. Pocan, Ms. Schakowsky, Ms. Clarke of New York, Ms. Ocasio-
Cortez, Ms. Velazquez, Ms. McCollum, Mr. Lipinski, Mr. Sires, Mr.
Peterson, Mr. Raskin, Mr. Engel, Mr. Larson of Connecticut, and Ms.
Haaland) introduced the following bill; which was referred to the
Committee on Education and Labor, and in addition to the Committees on
Energy and Commerce, and Ways and Means, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To direct the Secretary of Labor to issue an occupational safety and
health standard that requires covered employers within the health care
and social service industries to develop and implement a comprehensive
workplace violence prevention plan, and for other purposes.
Be it enacted by the Senate and House of Representatives 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. FINDINGS.
Congress finds the following:
(1) In a 2016 report entitled, ``Workplace Safety and
Health: Additional Efforts Needed to Help Protect Health Care
Workers from Workplace Violence'', the Government
Accountability Office reported 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, psychiatric, home health, and
personal care aides are all at increased risk for injury caused
by workplace violence. The Bureau of Labor Statistics reported
that in 2017, rates of violence and injury caused by persons in
these workplaces ranged from 3 times to as high as 61.9 times
the average American workplace.
(3) The Bureau of Labor Statistics reports that health care
and social service workers suffered 69 percent of all workplace
violence injuries caused by persons in 2017 and are nearly 5
times as likely to suffer a workplace violence injury than
workers overall.
(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 assaulted at work, and 8 in 10 report that this
violence is affecting patient care.
(5) Workplace violence in health care and social service
sectors is increasing. Bureau of Labor Statistics data show
that private sector injury rates of workplace violence in
health care and social service sectors increased by 63 percent
between 2006 and 2016. 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 violence prevention legislation
are strongly associated with reductions in workplace violence.
(8) Studies have found that proper staff training,
appropriate staffing levels, sufficient resources, and the use
of evidence based interventions (such as effective
communication with patients using de-escalation techniques and
noncoercive use of medications) can reduce the risks to the
safety of both patients and staff, using least-restrictive
measures.
(9) The Occupational Safety and Health Administration has
issued ``Guidelines for Preventing Workplace Violence for
Healthcare and Social Service Workers'', however, this guidance
is not enforceable. Absent an enforceable standard, employers
lack mandatory requirements to implement an effective and
ongoing violence prevention program that provides 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 Administration's authority to
utilize the General Duty Clause of the Occupational Safety and
Health Act of 1970 to enforce against workplace violence
hazards, arguing 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 Administration
(OSHA) received two petitions for rulemaking in July of 2016,
calling on OSHA to promulgate 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 January 10, 2017, OSHA conducted
a public meeting to receive stakeholder input and to supplement
the online comments submitted in response to the RFI. At that
meeting, OSHA announced it accepted the petitions and would
develop a Federal standard to prevent workplace violence in
health care and social service settings. OSHA's efforts to move
forward with rulemaking have been halting, inconsistent, and
slow. Therefore, legislation is necessary to ensure the 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 promulgate
an interim final standard on workplace violence prevention--
(A) to require certain employers in the healthcare
and social service sectors, and certain employers in
sectors that conduct activities similar to the
activities in the healthcare and social service
sectors, to develop and implement a comprehensive
workplace violence prevention plan 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 Violence for
Healthcare and Social Service Workers published by the
Occupational Safety and Health Administration of the
Department of Labor in 2015 and adhere to the
requirements of this title.
(2) Applicability of other statutory requirements.--The
following shall not apply to the promulgation of the interim
final standard under this subsection:
(A) The requirements applicable to occupational
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, and titles 2 and 42, United
States Code.
(3) Effective date of interim standard.--The interim final
standard shall--
(A) take effect on a date that is not later than 30
days after promulgation, except that such interim final
standard may include a reasonable phase-in period for
the implementation of required 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 described
in subsection (b) becomes effective and enforceable.
(4) Failure to promulgate.--If an interim final standard
described in paragraph (1) is not promulgated 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 extent 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 promulgated by the Secretary that
meets the requirements of paragraph (1).
(b) Final Standard.--
(1) Proposed final 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 final
standard on workplace violence prevention--
(A) for the purposes described in subsection
(a)(1)(A); and
(B) that shall include, at a minimum, the elements
contained in the interim final standard promulgated
under subsection (a).
(2) Final standard.--Not later than 42 months after the
date of enactment of this Act, the Secretary shall promulgate a
final standard on such proposed 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); 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.--The term ``covered facility''
includes the following:
(A) Any hospital, including any specialty hospital,
in-patient or outpatient setting, or clinic operating
within a hospital license, or any setting that provides
outpatient services.
(B) Any residential treatment facility, including
any nursing home, skilled nursing facility, hospice
facility, and long-term care facility.
(C) Any non-residential treatment or service
setting.
(D) Any medical treatment or social service setting
or clinic at a correctional or detention facility.
(E) Any community care setting, including a
community-based residential facility, group home, and
mental health clinic.
(F) Any psychiatric treatment facility.
(G) Any drug abuse or substance use disorder
treatment center.
(H) Any independent freestanding emergency centers.
(I) Any facility described in subparagraphs (A)
through (H) operated by a Federal Government agency and
required to comply with occupational safety and health
standards pursuant to section 1960 of title 29, Code of
Federal Regulations.
(J) Any other facility the Secretary determines
should be covered under the standards promulgated under
section 101.
(2) Covered services.--The term ``covered service''
includes the following services and operations:
(A) Any services and operations provided in any
field work setting, including home health care, home-
based hospice, and home-based social work.
(B) Any emergency services and transport, including
such services provided by firefighters and emergency
responders.
(C) Any services described in subparagraphs (A) and
(B) performed by a Federal Government agency and
required to comply with occupational safety and health
standards pursuant to section 1960 of title 29, Code of
Federal Regulations.
(D) Any other services and operations the Secretary
determines should be covered under the standards
promulgated under section 101.
(3) Covered employer.--
(A) In general.--The term ``covered employer''
includes a person (including a contractor,
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 employer'' does
not include an individual who privately employs, in the
individual's residence, a person to perform covered
services for the individual or a family member of the
individual.
(4) Covered employee.--The term ``covered employee''
includes an individual employed by a covered employer to work
at a covered facility or to perform 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, implement, and maintain an effective written workplace
violence prevention plan for covered employees at each covered
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 and, where applicable, employee
representatives and collective bargaining
representatives, for all aspects of the Plan;
(ii) be tailored and specific to conditions
and hazards for the covered facility or the
covered service, including patient-specific
risk factors and risk factors specific to each
work area or unit; and
(iii) be suitable for the size, complexity,
and type of operations at the covered facility
or for the covered service, and remain in
effect at all times.
(B) Plan content.--Each Plan shall include
procedures and methods for the following:
(i) Identification of the individual
responsible for implementation of the Plan.
(ii) With respect to each work area and
unit at the covered facility or while covered
employees are performing the covered service,
risk assessment and identification 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
incidents specific to such covered
facility or such covered service; and
(II) conducted with, at a minimum--
(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,
in a timely manner, hazards that the employer
creates or controls applying industrial 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
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 the annual report
described in paragraph (5) that the
employer creates or controls.
(iv) Reporting, incident response, and
post-incident investigation procedures,
including procedures--
(I) for employees to report
workplace violence risks, hazards, and
incidents;
(II) for employers to respond to
reports of workplace violence;
(III) for employers to perform a
post-incident investigation and
debriefing of all reports of workplace
violence with the participation of
employees and their representatives;
and
(IV) to provide medical care or
first aid to affected employees.
(v) Procedures for emergency response,
including procedures for threats of mass
casualties and procedures for incidents
involving a firearm or a dangerous weapon.
(vi) Procedures for communicating with and
training of 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 employee rights.
(vii) Procedures for coordination of risk
assessment efforts, Plan development, and
implementation of the Plan with other employers
who have employees who work at the covered
facility or who are performing the covered
service.
(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 covered 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 hazard 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
incident, 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 employees,
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 employer shall
document the findings, recommendations, 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 training 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 includes
information on the Plan, including identified workplace
violence hazards, work practice control measures,
reporting procedures, record keeping requirements,
response procedures, and employee rights.
(B) Additional hazard recognition training for
supervisors and managers to ensure they can recognize
high-risk situations and do not assign employees to
situations that predictably compromise their safety.
(C) Additional training for each such covered
employee whose job circumstances has changed, within a
reasonable timeframe after such change.
(D) New employee training prior to assignment.
(E) All training provides such employees
opportunities to ask questions, give feedback on such
training, and request additional instruction,
clarification, or other followup.
(F) All training is provided in-person and by an
individual with knowledge of workplace violence
prevention and of the Plan.
(G) All training is appropriate in content and
vocabulary to the language, educational level, and
literacy of such covered employees.
(4) Recordkeeping and access to plan records.--
(A) In general.--Each covered employer shall--
(i) maintain at all times--
(I) records related to each Plan of
the employer, including workplace
violence risk and hazard assessments,
and identification, evaluation,
correction, and training procedures;
(II) a violent incident log
described in subparagraph (B) for
recording all workplace violence
incidents; and
(III) records of all incident
investigations as required under
paragraph (2)(B); and
(ii) make such records and logs available,
upon request, to covered employees and their
representatives for examination and copying in
accordance with section 1910.1020 of title 29,
Code of Federal Regulations, 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, and ensure that any such records
and logs removed from the employer's control
for purposes of this clause omit any element of
personal identifying information sufficient to
allow identification of any patient, resident
or client alleged to have committed a violent
incident (including the person's name, address,
electronic mail address, telephone number, or
social security number, or other information
that, alone or in combination with other
publicly available information, reveals such
person's identity).
(B) Violent incident log description.--Each violent
incident log shall--
(i) be maintained by a covered employer 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 description
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, names and job titles
of involved employees;
(III) the nature and extent of
injuries to covered employees;
(IV) a classification of the
perpetrator who committed the violence,
including whether the perpetrator was--
(aa) a patient, client, or
customer of a covered employer;
(bb) a family or friend of
a patient, client, or customer
of a covered employer;
(cc) a stranger with
criminal intent;
(dd) a coworker,
supervisor, or manager of a
covered employee;
(ee) a partner, spouse,
parent, or relative of a
covered employee; or
(ff) any other appropriate
classification;
(V) the type of violent incident
(such as type 1 violence, type 2
violence, type 3 violence, or type 4
violence); 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 consistent
with section 1904.29(b) of title 29, Code of
Federal Regulations.
(C) Annual summary.--
(i) Covered employers.--Each covered
employer shall prepare an annual summary of
each violent incident log for the preceding
calendar year that shall--
(I) with respect to each covered
facility, and each covered service, for
which such a log has been maintained,
include the total number of violent
incidents, the number of recordable
injuries related to such incidents, and
the total number of hours worked by the
covered employees for such preceding
year;
(II) be completed on a form
provided by the Secretary;
(III) be posted for three months
beginning February 1 of each year in a
manner consistent with the requirements
of section 1904 of title 29, Code of
Federal Regulations, relating to the
posting of summaries of injury and
illness logs;
(IV) be located in a conspicuous
place or places where notices to
employees 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 paragraph.
(5) Annual report.--Not later than February 15 of each
year, each covered employer shall report to the Secretary, the
frequency, quantity, 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).
(6) Annual evaluation.--Each covered employer shall conduct
an annual written evaluation, conducted with the full, active
participation of covered employees and employee
representatives, of--
(A) the implementation and effectiveness of the
Plan, including a review of the violent incident log;
and
(B) compliance with training required by each
standard described in section 101, and specified in the
Plan.
(7) Anti-retaliation.--
(A) Policy.--Each covered employer shall adopt a
policy prohibiting any person (including an agent of
the employer) from discriminating or retaliating
against any employee for reporting, or seeking
assistance or intervention from, a workplace violence
incident, threat, or concern to the employer, law
enforcement, local emergency services, or a government
agency, or participating in an incident investigation.
(B) Prohibition.--No covered employer shall
discriminate or retaliate against any employee for
reporting, or seeking assistance or intervention from,
a workplace violence incident, threat, or concern to
the employer, law enforcement, local emergency
services, or a government agency, or for 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 Safety 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; and
(2) the rights, privileges, or remedies of covered
employees shall be in addition to the rights, privileges, or
remedies provided under any Federal or State law, or any
collective bargaining agreement.
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-defense or 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 injury,
psychological trauma, or stress, without regard
to whether the covered employee 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 violence''--
(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 violence'' means
workplace violence directed at a covered employee by customers,
clients, patients, students, 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 violence'' means
workplace violence directed at a covered employee by a present
or former employee, supervisor, or manager.
(5) Type 4 violence.--The term ``type 4 violence'' 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 relationship with such employee.
(6) Threat of violence.--The term ``threat of violence''
means a statement or conduct that causes a person to fear for
his or her safety because there is a reasonable possibility the
person might be physically injured, and that serves no
legitimate purpose.
(7) Alarm.--The term ``alarm'' means a mechanical,
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, regardless of whether such instrument was designed for
that purpose.
(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 workplace or creates a
barrier between a covered employee and the hazard.
(B) Inclusions.--For purposes of reducing workplace
violence hazards, the term ``engineering 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 securing items that could be used as weapons,
furniture affixed to the floor, opaque glass in patient
rooms (which protects privacy, but allows the health
care provider to see where the patient is before
entering the room), closed-circuit television
monitoring and video recording, sight-aids, and
personal alarm devices.
(10) Environmental risk factors.--
(A) In general.--The term ``environmental risk
factors'' means factors in the covered facility or area
in which a covered service is performed 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 working in an isolated area,
poor illumination or blocked visibility, and lack of
physical barriers between employees and persons at risk
of committing workplace violence.
(11) Patient-specific risk factors.--The term ``patient-
specific risk factors'' means factors specific to a patient
that may increase the likelihood or severity of a workplace
violence incident, including--
(A) a patient's psychiatric condition, treatment
and medication status, 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 experience
confusion or disorientation, to be non-responsive to
instruction, or to behave unpredictably.
(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 hazards.
(B) Inclusions.--The term ``work practice
controls'' includes assigning and placing sufficient
numbers of staff to reduce patient-specific Type 2
workplace violence hazards, provision of dedicated and
available safety personnel such as security guards,
employee training on workplace violence prevention
method and techniques to de-escalate and minimize
violent behavior, and employee training on procedures
for response in the event of a workplace violence
incident and for post-incident response.
TITLE II--AMENDMENTS TO THE SOCIAL SECURITY ACT
SEC. 201. APPLICATION OF THE WORKPLACE VIOLENCE PREVENTION STANDARD TO
CERTAIN FACILITIES 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 at the end the
period and inserting ``; and''; and
(C) by inserting after subparagraph (Y) the
following new subparagraph:
``(Z) in the case of hospitals that are not otherwise
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 safety and health plan), to comply with the
Workplace Violence Prevention Standard (as promulgated under
section 101 of the Health Care Workplace Violence Prevention
Act of 2018).''; and
(2) in subsection (b)(4)--
(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 Pathogens Standard)'';
and
(B) in subparagraph (B)--
(i) by striking ``(a)(1)(U)'' and inserting
``(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 referred
to in such subsection by a hospital or skilled
nursing facility, as applicable, that is
subject to the provisions of such Act)'' before
the period at the end.
(b) Effective Date.--The amendments made by subsection (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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