[Congressional Record Volume 165, Number 187 (Thursday, November 21, 2019)]
[House]
[Pages H9127-H9145]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   WORKPLACE VIOLENCE PREVENTION FOR HEALTH CARE AND SOCIAL SERVICE 
                              WORKERS ACT


                             General Leave

  Mr. COURTNEY. Madam Speaker, I ask unanimous consent that all Members 
have 5 legislative days to revise and extend their remarks and include 
extraneous materials on H.R. 1309.
  The SPEAKER pro tempore (Ms. Brownley of California). Is there 
objection to the request of the gentleman from Connecticut?
  There was no objection.
  The SPEAKER pro tempore. Pursuant to House Resolution 713 and rule 
XVIII, the Chair declares the House in the Committee of the Whole House 
on the state of the Union for the consideration of the bill, H.R. 1309.
  The Chair appoints the gentlewoman from Texas (Ms. Jackson Lee) to 
preside over the Committee of the Whole.

                              {time}  0916


                     In the Committee of the Whole

  Accordingly, the House resolved itself into the Committee of the 
Whole House on the state of the Union for the consideration of the bill 
(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, with Ms. Jackson Lee in the chair.
  The Clerk read the title of the bill.
  The CHAIR. Pursuant to the rule, the bill is considered read the 
first time.
  General debate shall be confined to the bill and shall not exceed 1 
hour equally divided and controlled by the Chair and ranking minority 
member of the Committee on Education and Labor.
  The gentleman from Connecticut (Mr. Courtney) and the gentlewoman 
from North Carolina (Ms. Foxx) each will control 30 minutes.
  The Chair recognizes the gentleman from Connecticut.
  Mr. COURTNEY. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, today's vote on H.R. 1309 is an important milestone in 
what has been a 7-year process of getting the Occupational Safety and 
Health Administration to effectively act to protect the healthcare and 
social service workforce from skyrocketing rates of violence.
  Sadly, in America today, nurses, doctors, social workers, EMTs, and 
nursing assistants are more likely to be the victim of on-the-job 
violence than any other sector of our Nation's workforce.
  This violence comes in the form of assaults, kicking, hitting, 
choking, and spitting from patients and residents and clients or those 
who may accompany them. It affects a worker's sense of safety at work. 
It contributes to burnout, absenteeism, high workers' compensation 
costs, and stress. Tragically, it can also lead to death.
  According to the Bureau of Labor Statistics, healthcare and social 
service workers are more than five times as likely to suffer a serious 
injury from workplace violence than workers in other settings. And this 
chart, which shows the red line of healthcare workers versus other 
sectors in the U.S. economy vividly, powerfully demonstrates the data 
that is coming into the Department of Labor on this issue.
  In psychiatric hospitals, that number is drastically higher. In a 
recent survey, nearly 50 percent of emergency room physicians report 
having been physically assaulted at work, and 60 percent of those who 
have these occurrences said they happened in the past year.
  As this graph shows, these numbers are on the rise. The incidents of 
violence in the workplace have increased 80 percent over the last 
decade.
  Since OSHA has not effectively addressed this emergency, this bill is 
necessary to ensure that a standard is issued and enforced in a 
reasonable period of time.
  Using past precedent, the bill calls for an interim final standard 
within 1 year and a final standard within 42 months. The public comment 
and rulemaking process is preserved in the development of the final 
standard.
  Very simply, the standard required by the bill would require that 
covered employers, such as hospitals and psychiatric facilities, 
develop a workplace violence prevention plan that is tailored to the 
specific conditions and hazards present at each workplace. It is not a 
one-size-fits-all requirement.
  Madam Chair, developing a plan is not rocket science. For over 20 
years, OSHA has published voluntary guidelines on violence prevention 
that include commonsense measures, such as training staff about how to 
identify high-risk patients, share the information with coworkers, not 
be alone, and ways to de-escalate threats. We know from the Joint 
Commission on Hospital Accreditation that these measures work, and the 
problem is, though, that there is no consistent enforceable standard to 
ensure their application, and that is precisely what this bill does.
  While we will never eliminate all risk or stop every violent attack, 
research on the measures in this legislation have been shown to 
substantially cut the incidence of serious injury from workplace 
violence. The nurses, doctors, social workers, and EMTs who care for us 
in our times of crisis and need deserve to have these protections soon, 
not in 7 years and not in 20 years, as is likely if we fail to pass 
this legislation into law, leaving OSHA rulemaking to its own dilatory, 
almost comatose, devices.
  I would like to thank the large coalition of healthcare 
professionals, their organizations, and union representation who have 
diligently fought for these protections for years; the subcommittee 
chair, Alma Adams, of the Workforce Subcommittee on Education and Labor 
and Chairman  Bobby Scott for their leadership; also, Richard Miller 
and Jordan Barab, our committee staff, who have done amazing work, as 
well as Maria Costigan from my personal office, who have just worked 
night and day for years to try and get us to this point.
  Madam Chair, I reserve the balance of my time.


[[Page H9128]]


                                         House of Representatives,


                             Committee on Energy and Commerce,

                                Washington, DC, September 6, 2019.
     Hon. Bobby Scott,
     Chair, Committee on Education and Labor,
     Washington, DC.
       Dear Chairman Scott: I write concerning H.R. 1309, the 
     ``Workplace Violence Prevention for Health Care and Social 
     Service Workers Act,'' which was additionally referred to the 
     Committee on Energy and Commerce.
       In recognition of the desire to expedite consideration of 
     H.R. 1309, the Committee on Energy and Commerce agrees to 
     waive formal consideration of the bill as to provisions that 
     fall within the rule X jurisdiction of the Committee on 
     Energy and Commerce. The Committee takes this action with the 
     mutual understanding that we do not waive any jurisdiction 
     over the subject matter contained in this or similar 
     legislation, and that the Committee will be appropriately 
     consulted and involved as this bill or similar legislation 
     moves forward so that we may address any remaining issues 
     within our jurisdiction. I also request that you support my 
     request to name members of the Committee on Energy and 
     Commerce to any conference committee to consider such 
     provisions.
       Finally, I would appreciate the inclusion of this letter in 
     the report on the bill and into the Congressional Record 
     during floor consideration of H.R. 1309.
           Sincerely,
                                                Frank Pallone, Jr.
     Chairman.
                                  ____

         Committee on Education and Labor, House of 
           Representatives,
                                Washington, DC, September 9, 2019.
     Hon. Frank Pallone, Jr.,
     Chairman, House Committee on Energy and Commerce, Washington, 
         DC.
       Dear Chairman Pallone: In reference to your letter of 
     September 6, 2019, I write to confirm our mutual 
     understanding regarding H.R. 1309, the ``Workplace Violence 
     Prevention for Health Care and Social Service Workers Act.''
       I appreciate the Committee on Energy and Commerce's waiver 
     of consideration of H.R. 1309 as specified in your letter. I 
     acknowledge that the waiver was granted only to expedite 
     floor consideration of H.R. 1309 and does not in any way 
     waive or diminish the Committee on Energy and Commerce's 
     jurisdictional interests over this or similar legislation.
       I would be pleased to include our exchange of letters on 
     this matter in committee report for H.R. 1309 and in the 
     Congressional Record during floor consideration of the bill 
     to memorialize our joint understanding.
       Again, thank you for your assistance with these matters.
           Sincerely,
                                        Robert C. ``Bobby'' Scott,
                                                         Chairman.

  Ms. FOXX of North Carolina. Madam Chair, I yield myself such time as 
I may consume.
  Madam Chair, I rise today in opposition to H.R. 1309, the Workplace 
Violence Prevention for Health Care and Social Service Workers Act.
  American workers deserve to be kept out of harm's way while on the 
job, allowing them to return home to their families and loved ones 
healthy and safe.
  According to the Bureau of Labor Statistics, healthcare and social 
service workplaces experience the highest rate of workplace violence, 
totaling 71 percent of all workplace violence injuries in 2017, and 
these workers are more than four times as likely to suffer a workplace 
violence injury.
  There is no question that these caregivers deserve meaningful and 
effective protections, but H.R. 1309 is shortsighted and partisan, and 
it fails to address the important issue in an effective, feasible 
manner.
  In the Education and Labor Committee's single hearing on this issue 
back in February, Members on both sides of the aisle expressed a desire 
to work together to produce real policy solutions.
  Committee Republicans believe there can be a bipartisan response to 
this issue that would aid in the rulemaking process and provide 
protection to healthcare and social service workers.
  Instead, committee Democrats have decided to advance legislation that 
circumvents the long-established rulemaking process and blocks valuable 
input from workers and other stakeholders who know better than we do 
how to prevent workplace violence in these unique circumstances.
  The Occupational Safety and Health Administration, or OSHA, the 
Federal agency that helps ensure safe and healthful working conditions, 
is currently working on a workplace violence prevention rule for 
healthcare and social assistance workplaces, which includes gathering 
important stakeholder input to create the most feasible and effective 
Federal safety and health standards possible.
  However, by requiring OSHA to circumvent established rulemaking 
procedures under the Occupational Safety and Health Act and the 
Administrative Procedure Act, H.R. 1309 would undermine and threaten 
this ongoing collaborative and evidence-based process by denying OSHA 
the ability to be responsive to important feedback from the public and 
impacted stakeholders.
  H.R. 1309 severely limits the participation of industry, worker 
representatives, the scientific community, and the public from having a 
say in the development of a new comprehensive standard. Democrats are 
rejecting a thorough response to this complex and highly technical 
issue that is backed by meaningful input.
  Furthermore, this legislation turns a blind eye to comprehensive 
research and data. Currently, there is no agreed-upon set of policies 
to prevent and mitigate workplace violence for healthcare and social 
service workers, and researchers in the field have pointed out the need 
for additional studies to determine the most effective response.
  In 2019, the Centers for Disease Control and Prevention said further 
research was needed to identify effective strategies that prevent 
workplace violence in healthcare and social service settings.
  Additionally, in 2016, the Government Accountability Office, GAO, 
noted there have been a limited number of studies done on the 
effectiveness of workplace violence prevention programs, and GAO chose 
not to call on OSHA to establish a standard without further study.
  Continuing with their record of rushed and haphazard legislation, 
Democrats are pushing a false sense of urgency with H.R. 1309. This 
bill wrongly implies that Congress should impose a swift and sweeping 
standard immediately, ignoring that OSHA is already enforcing workplace 
violence prevention. In 2019, the Occupational Safety and Health Review 
Commission upheld penalties issued by OSHA under the general duty 
clause against healthcare facilities for not adequately addressing 
workplace violence.
  I will remind my colleagues on the other side of the aisle that, 
according to a 2018 American Hospital Association survey, 97 percent of 
respondents indicated they already have workplace violence policies in 
place.
  To make matters even worse, H.R. 1309 mandates yet another costly and 
burdensome regulation. Simply put, financially struggling healthcare 
facilities such as rural hospitals and small businesses cannot afford 
another costly, congressionally imposed mandate from Washington.
  Democrats will argue they didn't intend for the bill to have such a 
large scope and to cost so much. What else didn't they intend to happen 
when they rushed through this process, forcing an overly prescriptive 
mandate on the public?
  Madam Chair, Republicans are committed to ensuring that healthcare 
and social service workers are protected from workplace violence. There 
is bipartisan support for OSHA's current efforts to create a standard 
on workplace violence prevention. However, Congress should aid in the 
rulemaking process, not circumvent it, as H.R. 1309 does.

  H.R. 1309 will likely have many unintended consequences which 
negatively impact healthcare and social services workplaces, in 
addition to imposing a costly mandate on healthcare providers. I urge 
my colleagues to join me in opposing this unnecessary legislation so we 
can get to work on a bipartisan solution.
  Madam Chair, I reserve the balance of my time.
  Mr. COURTNEY. Madam Chair, I yield myself such time as I may consume.
  I would just note that this is a bipartisan effort. There are 227 
cosponsors in the House, 8 Republicans. And again, we have had lots of 
engagement, accommodated a number of the issues that came up at the 
public hearing process.
  Again, I would just note that I appreciate the fact that the ranking 
member spoke highly of OSHA's volunteer guidelines, which I have in my 
hand here. Those are actually incorporated into the bill language for 
the interim final standard. So we are working exactly with the 
guidelines that she endorsed.

[[Page H9129]]

  Madam Chair, I yield 2 minutes to the gentleman from California (Mr. 
Khanna), an early advocate of this measure.
  Mr. KHANNA. Madam Chair, I thank the gentleman from Connecticut for 
his tireless, bipartisan leadership in shepherding this bill to this 
historic point. It was my honor to work on the healthcare worker 
portions of this bill, and I am proud that it will pass today.
  Madam Chair, I rise today in support of the Workplace Violence 
Prevention for Health Care and Social Service Workers Act.
  For far too long, the workers who serve on the front lines of our 
communities have had to work in dangerous conditions without adequate 
protection. Every day, our nurses and social service workers face high 
levels of dangers, levels that most of us would find unacceptable in 
our own occupation. Their courage to keep working, despite these risks 
of violence, exemplifies the selfless nature of healthcare.

                              {time}  0930

  This bill follows what California has done in creating a nationwide 
workplace violence prevention standard, so people no longer have to 
work in fear.
  Since the implementation of California's own standard, healthcare 
workers have experienced marked improvements in workplace violence 
prevention measures. The California Nurses Association reports that 
hospitals in California are seeing increased security staffing, 
increased training, and comprehensive reporting. These commonsense 
protections did not exist prior to California's standard.
  It is time to expand these protections to healthcare and social 
service workers nationwide. This affects real people. We have heard 
stories of people who have been injured, killed, whose families have 
been harmed because of this kind of violence.
  Madam Chair, I include in the Record a letter from National Nurses 
United in support of this legislation. National Nurses United has 
boldly led on this issue for many years, including getting the 
standards across the finish line in California.

                                       National Nurses United,

                                Washington, DC, November 18, 2019.
       Dear Representative: This week, the House of 
     Representatives is scheduled to vote on H.R. 1309, the 
     Workplace Violence Prevention for Health Care and Social 
     Service Workers Act, sponsored by Congressman Joe Courtney. 
     National Nurses United, representing more than 155,000 
     registered nurses (RNs) across the country, is firmly in 
     support of this bill and strongly urges you to vote in favor 
     of it.
       Our members work at the bedside in every state in the 
     nation, and we know that when nurses are unsafe, our patients 
     are also at risk. Violence on the job has become endemic for 
     RNs and other workers in healthcare and social assistance 
     settings. Nurses report being punched, kicked, bitten, 
     beaten, and threatened with violence as they provide care to 
     others--and far too many have experienced stabbings and 
     shootings. But there are practical steps that healthcare and 
     social service employers can take to fulfill their 
     obligations to protect their employees from this serious 
     occupational hazard. We know that violence can be prevented 
     through the development and implementation of plans that are 
     tailored to specific patient care units and facilities. These 
     plans must assess and address the range of risks for 
     violence--from the sufficiency of staffing and security 
     systems to patient-specific risk factors.
       H.R. 1309 mandates that the Occupational Safety and Health 
     Administration promulgate a workplace violence prevention 
     standard that would require healthcare and social service 
     employers to develop and enforce plans to protect their 
     employees from violence on the job. To ensure that workplace 
     violence prevention plans are effective, workers (including 
     nurses, other direct care employees, security personnel and 
     ancillary staff) must be involved throughout all stages of 
     plan development, implementation, and review, which go hand-
     in-hand with the standard's comprehensive training 
     requirements. The enforceable occupational health and safety 
     standard established in this legislation is necessary to 
     create and maintain protections against workplace violence 
     that our members, other workers in healthcare and social 
     settings, and, importantly, our patients deserve.
       This bi-partisan legislation is of high priority for RNs 
     across the country, and we hope you will join with us in 
     supporting it and voting yes on H.R. 1309 on the floor of the 
     House of Representatives.
           Sincerely,
     Bonnie Castillo, RN,
       Executive Director.
     Zenei Cortez, RN,
       President.
     Deborah Burger, RN,
       President.
     Jean Ross, RN,
       President.

  Mr. KHANNA. I want to thank, again, the gentleman from Connecticut 
for his leadership.
  Ms. FOXX of North Carolina. Madam Chair, I yield 3 minutes to the 
gentleman from Georgia (Mr. Allen).
  Mr. ALLEN. Madam Chair, those who work in hospitals and in social 
services are remarkable. They provide Americans with compassion and 
care in some of life's most difficult situations. But every day these 
workers face real risk of workplace violence.
  The Bureau of Labor Statistics reports healthcare and social service 
workplaces have higher rates of workplace violence. No American should 
feel threatened while on the job. That is why the Occupational Safety 
and Health Administration, or OSHA, has recently taken steps to work 
with stakeholders and industry partners to analyze the issue on how to 
best protect these workers.
  H.R. 1309 threatens this collaborative work and denies OSHA the 
ability to respond to feedback from the public and stakeholders.
  As a small business owner, I know that top-down mandates simply do 
not work. The bottom-up approach is the tried-and-true method. Gather 
input from all impacted before creating a new policy.
  This bill also lacks the research needed to identify and prevent 
workplace violence in these settings. In 2016, the Government 
Accountability Office said there haven't been enough studies done on 
the effectiveness of workplace violence prevention programs and that 
OSHA needed to review it further. Why do some of my colleagues think 
they know better than the industry, worker representatives, the 
scientific community, and the public?
  Let's also not forget that rushed mandates like this one come at a 
cost. The Congressional Budget Office estimates the cost to private 
entities will be at least $1.8 billion in the first 2 years that the 
rushed OSHA rule is in effect and $750 million annually after that. It 
is also estimated to cost public facilities at least $100 million in 
the first 2 years and $55 million annually after that.
  When I am back home in my district and talk to healthcare providers, 
the last thing they want is another costly government mandate from 
Washington. So let's not put the cart before the horse here.
  Workplace violence is a serious issue, and it needs a serious 
solution. We should not pass this bill until we have a thoroughly 
vetted and researched fix. So let OSHA do their job to develop an 
effective solution by working with the very people that we are trying 
to help.
  I urge my colleagues to oppose this bill.
  Mr. COURTNEY. Madam Chair, again very quickly, the mandate costs that 
CBO scored, the $1.7 billion, that is spread out over 200,000 
facilities, if you read their note closely. If you do the math, we are 
talking about a $9,000 cost per year for facilities. That, in my 
opinion, in terms of protecting their workforce, is not a high price to 
pay to make sure that the people who work there are safe.
  Madam Chair, I yield 2 minutes to the gentlewoman from North Carolina 
(Ms. Adams), the chair of the Subcommittee on Workforce Protections, 
and I want to thank her for moving this bill this calendar year.
  Ms. ADAMS. Madam Chair, I thank the gentleman from Connecticut for 
yielding. I rise today to join my colleagues in strong support of H.R. 
1309, the Workplace Violence Prevention for Health Care and Social 
Service Workers Act.
  Workplace violence impacts over 15 million healthcare workers in this 
country. These workers offer critical assistance to some of the most 
vulnerable members of our society. They work in our hospitals, our 
nursing homes, our hospices, and they do this, despite the fact that 
they are nearly five times as likely to suffer serious workplace 
violence injury than workers in other sectors.
  And those statistics account just for physical injuries. So when the 
body recovers from workplace assaults, these professionals are often 
plagued with career-ending post-traumatic stress disorders for the rest 
of their lives.
  So I am glad that the House is considering the gentleman from 
Connecticut's bill today to finally compel OSHA

[[Page H9130]]

to create a standard to protect these workers in their places of work.
  Madam Chair, it can take up to 20 years for OSHA to issue standards, 
as in the case of its silica and beryllium standards. Our Nation's 
healthcare and social service workers cannot afford to wait that long 
while they serve under the constant threat of violence.
  H.R. 1309 takes a different approach. It would require OSHA to issue 
an interim standard requiring employers to develop and implement a 
workplace violence prevention plan within 1 year and a final standard 
within 42 months. Contrary to the claims of my friends on the other 
side of the aisle, this is not a radical requirement.
  OSHA has already held extensive public comment on this topic since 
1996, and H.R. 1309 would allow OSHA to conduct a full public comment 
and hearing process before a final standard is issued. Our healthcare 
and social service workers cannot wait, and neither can we.
  Madam Chair, I include in the Record a support letter from 
organizations representing our Nation's healthcare and social service 
workers, as well as a support letter from AFL-CIO.

                                                November 20, 2019.
     House of Representatives,
     Washington, DC.
       Dear Representative: On behalf of the undersigned 
     organizations representing nurses, social workers, 
     psychiatric, home health and personal care aides, as well as 
     other workers in the healthcare and social service 
     industries, we urge you to vote yes on H.R. 1309, the 
     Workplace Violence Prevention for Health Care and Social 
     Service Workers Act. When healthcare and social service 
     professionals show up to work, they shouldn't have to worry 
     about whether they are going to be injured in an assault. The 
     many professionals who face risk of assault every day include 
     not only those working in hospitals, clinics and mental 
     health facilities, but also those providing services in 
     patients' homes, and outside the four walls of an office.
       Healthcare and social service workers are nearly five times 
     more likely to be assaulted than other workers, and the 
     violence is growing. Between 2007 and 2017, the rate of 
     violent injuries grew by 123 percent in hospitals, 201 
     percent in psychiatric hospitals and substance use treatment 
     facilities, and 28 percent in social service settings. The 
     costs of this violence are high: in injury rates, in 
     professionals being driven from doing the work they love, and 
     in workers' compensation claims and staff shortages.
       Currently, there is no federally enforceable violence 
     prevention standard specifically covering healthcare and 
     social services, and federal guidelines do not cover those 
     working in public facilities. H.R. 1309 would require 
     hospitals, residential treatment facilities, clinics at 
     correctional or detention facilities, substance use disorder 
     treatment centers, and other service facilities to develop 
     and implement comprehensive violence prevention plans and 
     provide whistleblower protections for workers. We hear from 
     members about violence all the time: a nurse choked to the 
     point of unconsciousness; a case manager who has suffered 
     bone fractures and debilitating brain injuries from being 
     thrown against walls and floors; social workers brutally 
     attacked, and even killed, when conducting visits to client 
     homes.
       No one should face violence, intimidation, or fear for 
     their safety while working to help others and save lives. 
     Violence is not just ``part of the job,'' and studies show 
     that prevention plans work. Many violent incidents can be 
     predicted and minimized with the right staffing, policies and 
     protocols; and this legislation builds upon well-established 
     guidelines from the Department of Labor.
       This bill is essential to making healthcare and social 
     service settings safer for workers, but also safer healing 
     environments for patients. When a patient harms a social 
     worker or other clinician, it is traumatizing not only for 
     the clinician but also for the patient; and it sets treatment 
     back for months, if not years. Patients witnessing violence 
     also are traumatized.
       We urge you to support the nurses, social workers and other 
     healthcare and social service professionals in your district 
     by voting for H.R. 1309, the Workplace Violence Prevention 
     for Health Care and Social Service Workers Act.
       Alliance for Retired Americans, American Art Therapy 
     Association, American Association for Psychoanalysis in 
     Clinical Social Work, American Counseling Association, 
     American Federation of State, County and Municipal Employees 
     (AFSCME), American Federation of Teachers, American Public 
     Health Association, Coalition of Labor Union Women (CLUW) of 
     Southwestern PA, Communications Workers of America (CWA), 
     Emergency Nurses Association, International Association of 
     Machinists and Aerospace Workers, Midstate Education & 
     Service Foundation, National Association of County Behavioral 
     Health & Developmental Disability Directors (NACBHDD), 
     National Association of Rural Mental Health (NARMH), National 
     Association of Social Workers, National COSH, National Nurses 
     United, National Rural Social Work Caucus, People's Action, 
     Philadelphia Area Project on Occupational Safety and Health 
     (PhilaPOSH), Rhode Island Committee on Occupational Safety 
     and Health (RICOSH), School Social Work Association of 
     America, Service Employees International Union (SEIU), Smart 
     Transportation, United Food and Commercial Workers 
     International Union, United Steelworkers, Worksafe.
                                  ____



                                                      AFL-CIO,

                                                   March 28, 2019.
     House of Representatives,
     Washington, DC.
       Dear Representative: I am writing on behalf of the AFL-CIO 
     to urge you to co-sponsor the Workplace Violence Prevention 
     for Health Care and Social Services Workers Act (H.R. 1309). 
     This bill, sponsored by Rep. Joe Courtney (D-Conn.) would 
     direct the Occupational Safety and Health Administration to 
     issue a federal workplace violence prevention standard to 
     protect workers in health care and social services from 
     injury and death.
       Workplace violence is a serious and growing safety and 
     health problem that has reached epidemic levels. Workplace 
     violence is now the third leading cause of job deaths, and 
     results in more than 28,000 serious lost-time injuries each 
     year. Nurses, medical assistants, emergency responders and 
     social workers face some of the greatest threats, suffering 
     more than 70% of all workplace assaults. Women workers 
     particularly are at risk, suffering two out of every three 
     serious workplace violence injuries.
       H.R. 1309 would help protect these workers by requiring 
     employers in the health care and social service sectors to 
     develop and implement a workplace violence prevention plan, 
     tailored to specific workplace and employee populations. As 
     part of the plan, employers would be required to identify and 
     correct hazards, develop systems for reporting threats of 
     violence and injuries, provide training for workers and 
     management and protect workers from retaliation for reporting 
     workplace violence incidents. The bill ensures that frontline 
     workers have input, helping employers identify common sense 
     measures like alarm devices, lighting, security, and 
     surveillance and monitoring systems to reduce the risk of 
     violent assaults and injuries.
       The bill's requirements for the workplace violence 
     prevention plan are based upon existing guidelines and 
     recommendations from OSHA, NIOSH and professional 
     associations. Scientific studies have documented that the 
     implementation of such prevention plans significantly reduces 
     the incidence of workplace violence. Similar measures have 
     been adopted in a number of states and implemented by some 
     employers. However, currently there is no federal OSHA 
     workplace standard, and OSHA has been slow to take action. 
     The majority of healthcare and social service workers lack 
     effective protection and remain at serious risk.
       We urge you to support and co-sponsor H.R. 1309 to help 
     protect health care and social service workers from the 
     growing threat of workplace violence and unnecessary injury 
     and death.
           Sincerely,
                                                   William Samuel,
                                     Director, Government Affairs.

  Ms. ADAMS. I ask the House to pass without delay the gentleman from 
Connecticut's legislation.
  Ms. FOXX of North Carolina. Madam Chair, let me be clear, the safety 
of our Nation's healthcare and social service workers is not a partisan 
issue. Regardless of political beliefs, all of us in this Chamber can 
appreciate the hard work and empathy that healthcare workers and 
community caregivers demonstrate every single day on the job.
  Their dedication to caring for the most vulnerable members of our 
communities is extraordinary, and these workers deserve our gratitude, 
our respect, and our commitment to ensuring they are safe on the job.
  The nature of the work in these industries requires healthcare and 
social services workers to interact directly with individuals who are 
experiencing tremendous stress, trauma, and grief, which can cause 
situations to devolve and put workers' safety at risk.
  American workers should be kept out of harm's way on the job, so they 
can return home to their families every day healthy and safe. These 
caregivers deserve protections, but H.R. 1309 is not the right way to 
address this important issue. Our healthcare workers and caregivers 
deserve a thoroughly vetted and researched solution that protects them 
in the workplace. I think we can do better by working together.
  Madam Chair, I reserve the balance of my time.
  Mr. COURTNEY. Madam Chair, I yield 3 minutes to the gentleman from 
Virginia (Mr. Scott), the chairman of the Committee on Education and 
Labor.
  Mr. SCOTT of Virginia. Madam Chair, I want to thank the gentleman 
from Connecticut for yielding and for

[[Page H9131]]

his untiring leadership on workplace safety issues.
  I rise in support of H.R. 1309, the Workplace Violence Prevention for 
Healthcare and Social Service Workers Act.
  Healthcare facilities are where we should be going to get well, but 
too often, hardworking, highly skilled employees of these facilities 
are regularly beaten, kicked, punched, and sometimes killed while 
performing their jobs. Healthcare and social service workers are four 
times as likely to suffer serious workplace violence injuries compared 
to workers in other sectors. Many can never return to work after the 
assault.
  The Government Accountability Office has found the dangers to such 
workers has gotten worse over the past decade. From 2008 to 2017, 
workplace violence incidence rates have more than doubled at private 
hospitals and home healthcare services with the highest rates of 
violence found in psychiatric and substance abuse hospitals.
  Most acts of workplace violence in healthcare facilities are 
foreseeable, and they are preventable by implementing workplace 
violence prevention plans. Although OSHA and the Joint Commission for 
hospital accreditations have issued authoritative guidance, voluntary 
efforts alone are not enough to ensure the safety of these workers.
  Currently, OSHA has no standard for requiring healthcare and social 
service employers to implement workplace violence prevention programs, 
and it takes the agency from 7 to 20 years to issue a new standard. The 
new beryllium standard, for example, which has just been finalized, has 
been under consideration for about 17 years. And that timeframe is not 
unusual.
  Instead of waiting for years or even decades for OSHA to act, H.R. 
1309 would first direct OSHA to issue an interim standard within 1 year 
and a final standard within 42 months, requiring healthcare and social 
service employers to implement a workplace violence prevention plan. 
And further, it protects workers from retaliation for reporting 
assaults to their employers or government authorities.
  Furthermore, since public employees in 24 states lack any OSHA 
protections, this legislation requires public hospitals and skilled 
nursing facilities receiving Medicare funds to comply with the 
workplace violence standards in this bill.
  Healthcare and social service workers play a critical role in 
healthcare for our families and our communities. At the very least, we 
must do whatever we can to ensure that these workers will come home 
uninjured at the end of the workday.
  Madam Chair, I thank Chairman Pallone for his cooperation in moving 
this bill to the floor. I also want to thank Mr. Courtney and 
Representative Alma Adams, chair of the Subcommittee on Workforce 
Protections, for their leadership in advancing this legislation.
  I urge my colleagues to support H.R. 1309.
  Ms. FOXX of North Carolina. Madam Chair, I yield myself such time as 
I may consume.
  Madam Chair, yesterday the Department of Labor issued its fall 2019 
regulatory agenda. The department announced plans to initiate a Small 
Business Regulatory Enforcement Fairness Act panel for the prevention 
of workplace violence in healthcare and social assistance in January. 
This is a very positive and important development.

  Unfortunately, H.R. 1309 encourages and allows OSHA to skip this 
important step of gathering feedback and advice from small businesses, 
all to satisfy the arbitrary 1-year deadline for issuing an interim 
final standard. Shortchanging the views of small businesses at the 
expense of a rushed, sweeping, and overly proscriptive standard is not 
an appropriate trade-off.
  Additionally, the legislative text and scope of H.R. 1309 are so 
proscriptive that OSHA wouldn't be able to deviate from the mandates in 
the bill even if the recommendation from the small business panel are 
contrary to that of H.R. 1309.
  The Trump administration is moving forward with the rule-making 
process. Rather than pass H.R. 1309, we should be allowing OSHA to do 
its work on a comprehensive standard, including soliciting necessary 
input from small businesses.
  Madam Chair, I reserve the balance of my time.
  Mr. COURTNEY. Madam Chair, just really quickly, it is true, yesterday 
that notice went out scheduling that panel. I would just note, that is 
the third time the department has sent out such a notice, and they have 
canceled the prior panels. We will see whether or not it actually 
happens in January.
  We are in the third year of this administration, after a GAO report, 
again after statistics and hearings, where we have asked questions of 
the department to move on this, and frankly, we are talking about 
adopting OSHA's own guidelines in the interim standards.
  This is not some farfetched, radical proposal. It is their own 
recommendations about how you can safely and effectively reduce 
workplace violence.
  Madam Chair, I yield 2 minutes to the gentlewoman from Oregon (Ms. 
Bonamici), a great member of the Education and Labor Committee.
  Ms. BONAMICI. Madam Chair, I rise in strong support of H.R. 1309, the 
Workplace Violence Prevention for Healthcare and Social Service Workers 
Act.
  A few years ago, two workers in Oregon were tragically wounded in a 
workplace stabbing at an organization that provides essential support 
services to youth who are facing addiction, homelessness, and 
behavioral health issues.

                              {time}  0945

  Following the incident, Oregon AFSCME members organized to improve 
difficult working conditions that were compromising the quality of 
services for vulnerable clients as well as the safety of employees.
  Unfortunately, the experience of these workers is too common. 
According to a November 2018 report from the U.S. Bureau of Labor 
Statistics, healthcare and social service workers face a 
disproportionate risk of on-the-job violence and injuries.
  The workers in Oregon, and healthcare and social service workers 
across the country, need evidence-based workplace violence prevention 
plans tailored to the needs of the populations they serve. That is why 
I am proud to be an original cosponsor of H.R. 1309, introduced by my 
colleague, Congressman Courtney.
  Healthcare and social service workers help to care for our families, 
friends, and loved ones. Today, we have the chance to support their 
well-being in the workplace.
  Madam Chair, I include in the Record a letter in support of the 
Workplace Violence Prevention for Health Care and Social Service 
Workers Act from the National Association of Social Workers.

       Good morning: We are writing today to encourage your boss 
     to vote to approve H.R. 1309, the Workplace Violence 
     Prevention for Health Care and Social Service Workers Act, 
     which is scheduled to come to the House floor for a vote next 
     week. This bipartisan legislation is instrumental in 
     promoting safer working conditions for millions of social 
     workers, nurses and other similar professionals who 
     experience unacceptably high levels of violence on the job.
       The National Association of Social Workers represents the 
     interests of over 750,000 social workers nationwide who are 
     employed in wide variety of settings, including hospitals, 
     community clinics, schools and correctional facilities among 
     others. Many social workers provide services outside the four 
     walls of an office, such as in family homes.
       As you may know, healthcare and social service workers are 
     nearly five times more likely to be assaulted at work than 
     other professionals, and the rate of violence is growing. 
     Between 2007 and 2017, the rate of violent injuries grew by 
     123% in hospitals, 201% in psychiatric hospitals and 
     substance use treatment facilities, and 28% in social service 
     settings. The costs of this violence are high: in injury 
     rates, in professionals being driven from doing the work they 
     love, in workers' compensation claims and staff shortages. 
     Workplace violence is also highly problematic for patients. 
     Safe environments are healing environments.
       Currently, there is no federal enforceable violence 
     prevention standard covering healthcare and social services 
     and federal guidelines do not cover those working in public 
     facilities. H.R. 1309 would require hospitals, residential 
     treatment facilities, substance use disorder treatment 
     centers, clinics at correctional or detention facilities, and 
     other service facilities to develop and implement 
     comprehensive violence prevention plans and provide whistle-
     blower protections for workers. These commonsense plans can 
     be customized to reflect the unique safety needs and concerns 
     of each setting.
       When the Workplace Violence Prevention for Health Care and 
     Social Service Workers

[[Page H9132]]

     Act comes before your boss for consideration, we urge your 
     boss to support its passage.
       Thank you for your consideration and please let me know if 
     you have any questions.
           Sincerely,

                                   Dina L. Kastner, MSS, MLSP,

                                           Senior Field Organizer,
                           National Association of Social Workers.

  Ms. BONAMICI. Madam Chair, I urge my colleagues to support this 
legislation.
  Ms. FOXX of North Carolina. Madam Chair, I reserve the balance of my 
time.
  Mr. COURTNEY. Madam Chair, I yield 3 minutes to the gentlewoman from 
Iowa (Ms. Finkenauer), one of our great new freshmen.
  Ms. FINKENAUER. Madam Chair, I rise today in support of H.R. 1309, 
the Workplace Violence Prevention for Health Care and Social Service 
Workers Act.
  I also rise today to share Tina Suckow's story with the House of 
Representatives.
  Tina is my constituent, and she is a proud Iowan, wife, mother, 
grandmother, and AFSCME member. She is also a dedicated nurse who spent 
15 years caring for those living with mental health conditions.
  Tragically, this tough and thick-skinned woman, with a great sense of 
humor and a natural gift for helping people, can now no longer 
physically work.
  More than a year ago, Tina was horribly injured at the State of 
Iowa's Independence Mental Health Institute in my district.
  An aggressive patient triggered a call for additional assistance. 
Although Tina was working in a different section of the campus at the 
time, she made her way over to help, with about a dozen other 
coworkers.
  For roughly 45 minutes, the patient was erratic and repeatedly 
threatened to hurt the first person who tried to get close to him. When 
nothing worked to calm him, a supervisor grabbed a padded shield, but 
nobody knew that the facility even had this equipment, and they weren't 
trained to use it.
  As her coworker approached with the shield, Tina became trapped 
between it and the patient. He hit Tina in the head so many times that 
she lost consciousness.
  After dedicating her career and her life to caring for others, Tina 
was now the one in need. Since then, she has been in and out of 
surgeries, and the emotional damage remains. That day was the worst day 
of Tina's life.
  Sadly, the State has made it worse by denying her unpaid time off 
requests and kicking her off the payroll.
  Tina wants her story shared today so that employees like her are 
protected.
  I am personally upset that it is hard to do in States like Iowa. You 
see, in 2017, I was a State representative in Iowa who spent 2 days 
fighting back against the gutting of collective bargaining in my State, 
where they went after our teachers, our corrections officers, our bus 
drivers, and folks like Tina. I stood on that floor and voted ``no.''
  Unfortunately, we didn't have the votes. That bill passed, and they 
gutted the rights of folks like Tina all across my State. Iowa's 
working families are continuing to pay the price for those politically 
motivated attacks.
  Nearly 1,000 jobs in our State have been eliminated since 2011. These 
staffing shortages, because of this and the failure to train employees 
on vital safety measures, have put lives like Tina's on the line.
  In that same facility, several other employees have been attacked in 
the last year.
  The CHAIR. The time of the gentlewoman has expired.
  Mr. COURTNEY. Madam Chair, I yield an additional 1 minute to the 
gentlewoman from Iowa.
  Ms. FINKENAUER. Madam Chair, in other facilities across the State, 
they have been attacked in the last year. It is unconscionable. This 
isn't how you treat people.
  The law also created a system that was rigged against working people, 
forcing employees to go through costly recertification processes and 
trying to stop them from being able to collectively bargain and being 
able to fight for their rights.
  Luckily for us in Iowa, our public employees are strong. They banded 
together and were recertified, and I am proud to represent them.
  Today, I will be casting this vote for Tina Suckow, who I know is 
watching at home today.
  This bill will require places like the State of Iowa to stop failing 
their employees, by requiring workplace protections. It is a first step 
in protecting Iowans on the front lines.
  I am standing with our hardworking men and women today who ask for a 
safe workplace, and now I am standing with them on the floor of the 
U.S. House, proudly voting ``yes'' for them and folks all across my 
State.
  Madam Chair, I include in the Record a letter from AFSCME in support 
of H.R. 1309.

         American Federation of State, County and Municipal 
           Employees, AFL-CIO,
                                Washington, DC, November 19, 2019.
     House of Representatives,
     Washington, DC.
       Dear Representative: On behalf of the members of the 
     American Federation of State, County and Municipal Employees 
     (AFSCME), I urge you to support the ``Workplace Violence 
     Prevention for Health Care and Social Service Workers Act'' 
     (H.R. 1309), which protects workers and their right to be 
     safe from violence at their workplace. H.R. 1309 requires the 
     Occupational Safety and Health Administration (OSHA) to issue 
     a standard on workplace violence prevention in health care 
     and social service assistance settings.
       Enactment of H.R. 1309 is needed because:
       The current OSHA guidance is voluntary. It does not require 
     employers to address the high risk of violence on the job for 
     health care workers and social service workers. Some 70 
     percent of all nonfatal workplace assaults typically occur in 
     these two sectors and has increased over the years.
       It challenges the myth that workplace violence is random, 
     unpreventable and just part of the job. There is a degree of 
     uncertainty, but workplace violence has clear patterns and 
     detectable risk factors in health care and social service 
     settings. Actions can be taken to reduce the risk of 
     workplace violence.
       The cost of inaction is high. It is calculated in the pain, 
     loss, suffering and the disruption to lives, workplaces and 
     communities caused by these incidents to workers and their 
     families.
       We ask that you send a clear message that Congress will not 
     ignore the harm and suffering caused to health care, 
     behavioral health and social service workers by workplace 
     violence. Please vote in support of H.R. 1309.
           Sincerely,
                                                       Scott Frey,
                           Director of Federal Government Affairs.

  Ms. FOXX of North Carolina. Madam Chair, I reserve the balance of my 
time.
  Mr. COURTNEY. Madam Chair, I yield 2 minutes to the gentlewoman from 
Illinois (Ms. Schakowsky).
  Ms. SCHAKOWSKY. Madam Chair, I thank Mr. Courtney for yielding, and I 
proudly rise today in support of his legislation.
  The frequency and scale of workplace violence are alarmingly high, 
but no statistic, even the startling ones that we have learned about, 
can fully reflect the pain, loss, and suffering that these incidents 
can cause.
  As we consider the bill before us today, I ask that you remember and 
honor Pamela Knight.
  Pamela was an AFSCME Council 31, Local 448 member. She worked for the 
Illinois Department of Children and Family Services as a child 
protection specialist.
  She had been sent to take a 2-year-old child into protective custody 
from an abusive father. As she got out of her car, Pamela was attacked 
by the boy's father. Brutally beaten, Ms. Knight suffered blunt force 
trauma to her head.
  After 11 years on the job, she succumbed to her injuries, paying the 
ultimate price for protecting children from abuse and neglect.
  Pamela and her fellow DCFS employees are the front line of defense in 
protecting children in Illinois and around the country. In this vital 
work, they can encounter families in crisis stemming from poverty, 
substance abuse, mental illness, and domestic violence.
  For two decades, OSHA has worked with employers on voluntary 
guidelines to address workplace violence, yet the rate of violence has 
gone up.
  Enough is enough. Today, we can do the right thing by Pamela Knight 
and the unsung heroes in healthcare and social services by passing this 
important, critical, and necessary piece of legislation.
  Ms. FOXX of North Carolina. Madam Chair, I continue to reserve the 
balance of my time.
  Mr. COURTNEY. Madam Chair, I yield 3 minutes to the gentlewoman

[[Page H9133]]

from Florida (Ms. Wilson), the chair of the Subcommittee on Health, 
Employment, Labor, and Pensions.
  Ms. WILSON of Florida. Madam Chair, I am pleased to speak in support 
of this important and necessary piece of legislation.
  Through my work as chairwoman of the Subcommittee on Health, 
Employment, Labor, and Pensions, and as former ranking member of the 
Subcommittee on Workforce Protections, I have worked extensively on 
protecting America's workers from unsafe conditions in the workplace.
  This legislation is an important step toward protecting our 
healthcare and social service workers from workplace violence. 
Unfortunately, it also is a very necessary step.
  We know that healthcare and social service workers experience the 
highest rate of serious injury due to workplace violence. They, 
literally, are jumped on and beaten up by their patients at work, 
thrown against walls and floors, suffering bone fractures and brain 
injuries.
  These workers have a lost time injury rate of 14.8 per 10,000 
workers, compared to 3.1 for all other workers, according to the Bureau 
of Labor Statistics.
  Currently, Federal efforts to protect workers from workplace violence 
depends solely on the use of OSHA's general duty clause. That part of 
the Occupational Safety and Health Act requires employers to provide a 
workplace free from recognized hazards. However, it is legally 
cumbersome to apply and is mostly applied after an injury occurs. What 
is needed are standards to prevent injuries in advance, not after-the-
fact enforcement.
  While OSHA has adopted guidelines for preventing violence against 
healthcare and social service workers, these are only temporary and 
voluntary. This legislation will codify these guidelines and provide 
OSHA with the necessary authority to require healthcare facilities and 
social service providers to develop and implement a workplace violence 
prevention plan.
  Madam Chair, while these changes are important to the entire Nation, 
they are even more important to my district in Florida. Given the large 
population of senior citizens, the need for healthcare and social 
service workers is great.
  Performing these jobs can be both physically and emotionally 
draining, even without the threat of being attacked. The added danger 
of physical violence may lead many potential healthcare and social 
service workers to seek employment elsewhere, to leave the field 
altogether, or quit.
  Violence in the workplace has a cascading effect on everyone 
involved, from the workers who bear the brunt of the violent attacks, 
to the families they serve, to the patients who witness the violence, 
some in a very fragile state.
  What we do know from evidence and research is that healthcare 
facilities that have violence prevention plans have cut the rate of 
injuries and related workers' compensation costs.
  The Acting CHAIR (Mr. Hastings). The time of the gentlewoman has 
expired.
  Mr. COURTNEY. Mr. Chair, I yield an additional 30 seconds to the 
gentlewoman from Florida.
  Ms. WILSON of Florida. Mr. Chair, for these reasons, I urge every 
Member to vote ``yes'' on H.R. 1309, the Workplace Violence Prevention 
for Health Care and Social Service Workers Act.
  Mr. Chair, I include in the Record a letter in support of this 
legislation from the American Federation of Teachers.

                                Washington, DC, November 19, 2019.
     House of Representatives,
     Washington, DC.
       Dear Representative: On behalf of the 1.7 million members 
     of the American Federation of Teachers, including 170,000 
     healthcare workers, I strongly urge you to vote YES on H.R. 
     1309, the Workplace Violence Prevention for Health Care and 
     Social Service Workers Act. I also want to thank Rep. Joe 
     Courtney (D-Conn.) for his leadership on this bill and for 
     his steadfast commitment to protecting all healthcare 
     workers.
       When healthcare professionals show up to work, they 
     shouldn't have to worry about whether they are going to be 
     injured in an assault. Sadly, healthcare and social service 
     workers are nearly five times more likely to be assaulted 
     while on the job than the rest of our workforce. The costs of 
     this violence are high: in injury rates, in professionals 
     being driven from doing the work they love, and in workers' 
     compensation claims and staff shortages.
       H.R. 1309 would require hospitals and other facilities to 
     develop and implement comprehensive violence prevention plans 
     and provide whistleblower protections for nurses and other 
     workers facing violence. Current federal workplace 
     protections do not focus on healthcare and social service 
     workers and don't cover those working in public facilities. 
     This bill is a chance to make healthcare settings safer 
     environments for staff and patients alike. As one of the 
     largest healthcare unions in the country, the AFT has been 
     striving to address workplace violence for years; this is our 
     members' top healthcare priority.
       I hear from AFT healthcare members about violence all the 
     time: A nurse was choked to the point of unconsciousness last 
     year; a nurse was stabbed in 2017; members have suffered bone 
     fractures and brain injuries from being thrown against walls 
     and floors. The House Education and Labor Committee held a 
     hearing on the topic of workplace violence earlier this year. 
     In her testimony, the AFT witness described being attacked:
       He then spun around on his back and kicked his leg high 
     into the air striking me in the neck, hitting with such force 
     to my throat that my head snapped backward; I heard this 
     ``bang'' and ``pop, `` and all the air just rushed out of me. 
     . . . Since June 2015, I have been diagnosed with moderate to 
     severe post-traumatic stress disorder, moderate anxiety, 
     insomnia, depressive disorder and social phobia related to 
     this incident. . . . I LOVED being a nurse. I have a huge 
     problem still calling myself a nurse. I do not know what to 
     call myself now. There is a deep loss when you used to make a 
     difference in the lives of people, in your true calling and 
     with passion. Now, that space is filled with extreme sadness 
     and fear. . . . I lost my career.
       No one should face violence or intimidation, or fear for 
     their safety, while working to heal others and save lives. 
     Violence is not just ``part of the job,'' and studies show 
     that prevention plans work. Many violent incidents can be 
     predicted and minimized with the right staffing, policies and 
     protocols, and this legislation builds upon well-established 
     guidelines from the Department of Labor.
       I strongly urge you to support the nurses, social workers 
     and other healthcare professionals in your district by voting 
     YES on H.R. 1309.
           Sincerely,
                                                 Randi Weingarten.
                                                        President.

  Ms. FOXX of North Carolina. Mr. Chairman, I reserve the balance of my 
time.
  Mr. COURTNEY. Mr. Chair, I yield 2 minutes to the gentlewoman from 
Texas (Ms. Jackson Lee).
  Ms. JACKSON LEE. Mr. Chair, I thank the gentleman from Connecticut 
(Mr. Courtney) for yielding, and I thank him for his leadership.
  I rise as a cosponsor of the Workplace Violence Prevention for Health 
Care and Social Service Workers Act.
  Mr. Chair, I thank the chairman of the full committee, Mr. Scott, and 
chairwoman of the subcommittee, Ms. Adams. I thank the complete 
committee for bringing this important legislation to the floor.
  As I have listened to testimony over the last couple of days, I began 
to frame a concept that we must do the right thing.
  As I have interacted with my constituents, as I understand the work 
of healthcare workers and social service workers, they take care of the 
broken of our society, some who may be ill, some who may have 
necessities of life that have not been fulfilled.

                              {time}  1000

  These individuals are under enormous pressure, yet our workers in the 
workplace caring for these people have the largest heart. They train to 
be sympathetic and empathetic.
  I am reminded of a situation in my local hospital where an individual 
broke loose because that person was suffering from a mental challenge, 
illness, health need, mixed in with a population that was there for 
other reasons. That person was in the mix of healthcare workers trying 
to care for others, but trying to be kind, sympathetic, and caring, but 
that person was in a state of crisis that was threatening to the 
patients and threatening to the workers.
  This is a crucial act. We are at a crisis moment. It is important to 
recognize that these incidents, as have been evidenced on the floor of 
the House, happen every day, even as we speak. Those individuals with 
that person were not able to bring him to a resolve, and law 
enforcement had to be engaged.
  Those are situations that make it difficult. We need this interim 
response, and we need it quickly. 200,000 facilities will be covered, 
and, as was evidenced on the floor by Mr. Courtney, at $9,000 per 
facility. That is a

[[Page H9134]]

worthwhile investment to stop someone who is injured from having a 
lifelong series of injuries.
  The Acting CHAIR. The time of the gentlewoman has expired.
  Mr. COURTNEY. Mr. Chairman, I yield an additional 30 seconds to the 
gentlewoman from Texas.
  Ms. JACKSON LEE. Coming from the Texas Medical Center in my community 
and many other hospitals and seeing the proliferation of health 
clinics, federally qualified health clinics, and social service 
agencies all attempting to do the right thing--and the patients who are 
there deserve to have the best care possible, but they are, in many 
instances, ill; they are, in many instances, broken. In order to have 
the staff continue to serve them, let's protect those workers. Let's 
stand alongside those workers.
  Mr. Chairman, I ask my colleagues to enthusiastically support this 
legislation and let us begin to stand alongside those who work with 
those who are most in need.
  Ms. FOXX of North Carolina. Mr. Chairman, I continue to reserve the 
balance of my time.
  Mr. COURTNEY. Mr. Chairman, I have exhausted all speakers, and I am 
prepared to close on my side.
  Mr. Chairman, I reserve the balance of my time.
  Ms. FOXX of North Carolina. Mr. Chairman, I am prepared to close and 
yield myself such time as I may consume.
  Mr. Chairman, as we debate the impact of H.R. 1309 on healthcare 
providers, I note that this bill is in violation of the House's pay-as-
you-go, or paygo, rule.
  The paygo rule requires that legislation affecting direct spending 
not increase the deficit. Any legislation projected to increase direct 
spending must be offset by equivalent amounts of direct spending cuts, 
revenue increases, or a combination of both.
  According to the nonpartisan Congressional Budget Office, H.R. 1309 
will increase the deficit by $60 million between 2020 and 2029. In 
addition, CBO estimates the cost of H.R. 1309 to private entities will 
be at least $1.8 billion in the first 2 years and at least $750 million 
annually thereafter.
  Democrats wrote this particular paygo rule months ago, and they are 
already abandoning it. It is not hard to find $60 million in savings 
for the taxpayers, and the Democrats' failure to do so speaks volumes 
about their regard for fiscal discipline. This significant violation of 
the budget rules is yet another reason to oppose this bill.
  Madam Chair, protecting the safety of healthcare and social service 
workers is not a partisan issue. I reiterate that statement. All of us 
here today, regardless of our political beliefs, appreciate the hard 
work and empathy that healthcare workers and community caregivers 
demonstrate every single day on the job.
  There is much agreement on both sides of the aisle that these workers 
deserve protections in the workplace. Given this bipartisan interest, 
it is frustrating that the Democrats have moved forward with the rushed 
and ill-conceived legislation we are debating today.
  H.R. 1309 ignores expert and practical input; imposes mandates that 
may ultimately harm the very people this legislation intends to 
protect; forecloses better, more protective and feasible solutions that 
would result from the established rulemaking process; fails to allow 
meaningful public input; and imposes costly requirements on regulated 
entities.
  Our healthcare workers and caregivers deserve a thoroughly vetted and 
researched solution that protects them in the workplace, but H.R. 1309 
badly fails to deliver on that front.
  Madam Chair, I strongly urge a ``no'' vote, and I yield back the 
balance of my time.
  Mr. COURTNEY. Madam Chair, I yield myself such time as I may consume.
  Madam Chair, regarding the paygo issue, just to be clear, paygo 
applies to the budget impact. And the gentlewoman is absolutely 
correct; CBO calculated a $60 million deficit impact over 10 years in 
the Medicare program. Again, we spend over $700 billion a year in 
Medicare, and, by all projections, that is going to go up.
  By the way, $60 million is for rural hospitals. If you read the CBO 
note, that is really the retroactive impact that has caused that, 
really, budget dust in terms of the impact to the Medicare program.
  Madam Chair, we have heard today about the urgency that this 
emergency requires. We understand the statistics. Workers are uniquely 
vulnerable in the healthcare setting to violence as they care for the 
most vulnerable among us.
  We know how to help. We know that evidence-based practices will lower 
this trend line. And we know that when hospitals and other facilities 
adopt them, rates of violence against staff go down.
  In closing, I would like to share a few words from a letter written 
to me by Gene Sausse from Louisiana about his sister, Lynne Truxillo, 
who was a nurse in Baton Rouge, Louisiana, until her death just this 
past April of this year in the hands of a patient while she worked.
  Lynne saw the patient attacking one of her colleagues, and when she 
intervened, the patient turned on her, grabbed her by the back of the 
neck, slammed it into a desk, and she passed out and suffered 
additional injuries. A few days later, she died from her injuries.
  Lynne's brother came to Washington, unannounced to my office, a few 
months ago to share his family's grief and explained why we cannot wait 
another 20 years for OSHA to act. This is what he said:
  ``It wasn't until days after my sister, Registered Nurse Lynne Sausse 
Truxillo, was brutally attacked and murdered by a patient inside of 
Baton Rouge General Hospital during her shift 6 months ago did I learn 
that violent workplace incident rates are four times higher in 
healthcare than all other industries. . . . As a small business owner 
in New Orleans, I have firsthand experience with the complex and often 
burdensome nature of government regulation. I get that, and I support 
fewer regulations in certain circumstances. However, in the 6 months 
since Lynne's death, I've learned how gravely and disproportionately 
vulnerable healthcare workers are to acts of workplace violence against 
them. The data, stats, and facts are undeniable on the subject. There's 
practically a news story every day somewhere in America about it. It is 
unconscionable that less care is given for the health and well-being of 
those who care for us when we need it most. Thank you for trying to 
spare other families from the kind of grief and tragedy mine has 
endured every day since we lost our beautiful sister, mother, and 
daughter.''
  She should be home making Thanksgiving dinner for her children--
mother of two. But because we don't have a national enforceable 
standard to reduce workplace violence in healthcare settings and social 
work, this gentleman--he is not a lobbyist; he is not a super-PAC; he 
is a brother--came to Washington at his own expense, like so many 
others, to talk about the fact that we have a crisis. It is our job to 
address that crisis, and that is what this bill does.
  Madam Chair, I urge a ``yes'' vote on H.R. 1309, and I yield back the 
balance of my time.
  Ms. JACKSON LEE. Madam Chair, I rise to speak in strong support of 
H.R. 1309, the Workplace Violence Prevention for Health Care and Social 
Service Workers Act.''
  This bill offers workplace violence protection to our nation's 
caregivers--including nurses, social workers, and many others who 
dedicate their lives to caring for those in need.
  Last year, the Bureau of Labor Statistics (BLS) reported that health 
care and social service workers were nearly five times as likely to 
suffer a serious workplace violence injury than workers in other 
sectors.
  Public employees, such as care givers in state and local government, 
health care and social service work, suffer particularly high rates of 
workplace violence.
  In 2017, state government health care and social service workers were 
almost nine times more likely to be injured by an assault than private-
sector health care workers.
  Workplace violence often causes both physical and emotional harm.
  Victims of these incidents often suffer career-ending post-traumatic 
stress disorders that take away their livelihoods and weaken an already 
stretched health care workforce.
  In 2018, the Bureau of Labor Statistics reported that 707,400 Social 
Workers are employed in the United States.
  Social worker employment is expected to grow 16 percent between 2016 
and 2026; a much faster rate than the average career in the United 
States.

[[Page H9135]]

  The ratio of social workers to populations varies widely in the 
United States, ranging from 80 per 100,000 people in Arkansas to 572 
per 100,000 in Washington, D.C.
  Northeast states tend to have high numbers of social workers per 
capita, and the southern states have fewer social workers per capita.
  Social workers work in a variety of settings, including mental health 
clinics, schools, child welfare and human service agencies, hospitals, 
settlement houses, community development corporations, and private 
practices.
  They generally work full time and may need to work evenings, 
weekends, and holidays.
  There is currently no standard from OSHA, the federal agency created 
to protect workers' safety, that requires employers to implement 
violence prevention plans that would help reduce workplace violence 
injuries among health care and social service workers.
  The lack of an enforceable standard means that OSHA has few 
meaningful tools to protect health care workers from the threat of 
workplace violence.
  Unless Congress intervenes, it is highly unlikely there will be any 
action taken to protect health care workers in the next decade.
  The Government Accountability Office estimated, conservatively, that 
it takes OSHA at least 7 years to issue a standard.
  Two of the most significant OSHA standards issued in recent history--
crystalline silica and beryllium, which cause irreversible lung 
disease--each took OSHA 20 years to finalize.
  Despite OSHA promises and its obligation to defend workers' safety, 
the Trump Administration is erecting new barriers that will prevent 
OSHA from protecting caregivers from workplace violence.
  This bill is needed more now due to a shift in the social work 
industry: today's social workers are becoming less focused on solving 
problems and more focused on primary prevention, providing 
interventions in advance to prevent problems from ever occurring in at-
risk populations.
  Social work is more than a job.
  Social workers help millions of Americans live fuller, more 
productive and safer lives.
  They often are the primary front line of assistance to 13.9 percent 
of Americans living below the poverty line.
  Through mentorship, social workers have contributed to a 68 percent 
decline in the juvenile arrest rate between 1996 and 2015.
  The incarceration rate in the United States is approximately 716 per 
100,000, the highest in the world, which means that social workers are 
invaluable in helping the formerly incarcerated transition into 
community life.
  Social workers provide substantial care and services to the mentally 
ill.
  Reports state that 1 in 4 people in the world will be affected by 
mental or neurological disorders at some point in their lives.
  Child Protective Services and its social workers check up on 3.2 
million children each year.
  Every year, more than 3.6 million referrals are made to child 
protection agencies. These referrals involve more than 6.6 million 
children.
  Social Workers are the first line of prevention to prevent over 1.2 
million students drop outs from high school each year (one every 26 
seconds).
  Both Child and Family Social Worker and Clinical Social Worker rank 
among the top 100 best jobs of 2019.
  Professional social workers are the largest group of mental health 
services providers in the United States.
  83 percent of all social workers are female. 86 percent of Master of 
Social Work graduates in 2015 were female.
  47 percent of social workers work in the child, family, and school 
sector, 26 percent work in healthcare, 18 percent work in mental health 
and substance abuse, and 9 percent work in other sectors.
  The primary employers of social workers are governments (41 percent), 
private nonprofit or charitable organizations (34 percent), and 
private-for-profit businesses (22 percent).
  More than 40 percent of all disaster mental health volunteers trained 
by the American Red Cross are professional social workers.
  The importance of social workers has been recognized by Jane Addams, 
a social worker, becoming one of the first women to receive a Nobel 
Peace Prize in 1931.
  I ask my colleagues to join me in supporting H.R. 1309.
  The CHAIR. All time for general debate has expired.
  Pursuant to the rule, the bill shall be considered for amendment 
under the 5-minute rule.
  In lieu of the amendment in the nature of a substitute recommended by 
the Committee on Education and Labor, printed in the bill, an amendment 
in the nature of a substitute consisting of the text of Rules Committee 
Print 116-37, modified by the amendment printed in part A of House 
Report 116-302, shall be considered as adopted.
  The bill, as amended, shall be considered as the original bill for 
the purpose of further amendment under the 5-minute rule and shall be 
considered as read.
  The text of the bill, as amended, is as follows:

                               H.R. 1309

       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. 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 
     promulgate an interim final standard on workplace violence 
     prevention--
       (A) to require certain employers in the health care and 
     social service sectors, and certain 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 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 Health care 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) Notice and comment.--Notwithstanding paragraph (2)(B), 
     the Secretary shall, prior to promulgating the interim final 
     standard under this subsection, provide notice in the Federal 
     Register of the interim final standard and a 30-day period 
     for public 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 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.
       (5) 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 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 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:

[[Page H9136]]

       (1) Covered facility.--
       (A) In general.--The term ``covered facility'' includes the 
     following:
       (i) 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.
       (ii) Any residential treatment facility, including any 
     nursing home, skilled nursing 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, including a community-based 
     residential facility, group home, and mental health clinic.
       (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 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).
       (x) Any other facility the Secretary determines should be 
     covered under the standards promulgated under section 101.
       (B) Exclusion.--The term ``covered facility'' does not 
     include an office of a physician, dentist, podiatrist, or any 
     other health practitioner 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 operations:
       (i) Any services and operations provided in any field work 
     setting, including home health care, home-based hospice, and 
     home-based social work.
       (ii) Any emergency services and transport, including such 
     services provided by firefighters and emergency responders.
       (iii) Any services described in clauses (i) and (ii) 
     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 (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 section 101.
       (B) Exclusion.--The term ``covered service'' does not 
     include child day care services.
       (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, other employees, and 
     employee 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 hazards, in a timely manner, 
     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 any violent incident 
     investigation described in paragraph (2) and any annual 
     report described in paragraph (5).

       (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 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 employee 
     rights.
       (vii) Procedures for--

       (I) ensuring the 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; 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 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 shall include 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 shall be 
     provided for supervisors and managers to ensure they--
       (i) can recognize high-risk situations; and
       (ii) do not assign employees to situations that predictably 
     compromise the safety of such employees.
       (C) Additional training shall be provided for each such 
     covered employee whose job circumstances have changed, within 
     a reasonable timeframe after such change.
       (D) Applicable training shall be provided under this 
     paragraph for each new covered employee prior to the 
     employee's job assignment.
       (E) All training shall provide such employees 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 workplace violence prevention 
     and of the Plan, except that any annual training described in 
     subparagraph (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, educational level, and literacy 
     of such covered employees.
       (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, 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)(I) 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 (as such section is

[[Page H9137]]

     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 electronically, or otherwise 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, client, or 
     other individual alleged to have committed a violent incident 
     (including the individual'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 individual'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, and the 
     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, resident, or customer of a covered 
     employer;
       (bb) a family or friend of a patient, client, resident, or 
     customer of a covered employer;
       (cc) a stranger;
       (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 (as such section is in effect on the date 
     of enactment of this Act).
       (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 (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 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--
       (i) reporting a workplace violence incident, threat, or 
     concern to, or seeking assistance or intervention with 
     respect to such incident, threat, or concern from, the 
     employer, law enforcement, local emergency 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 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 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 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, 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 individual's 
     safety because there is a reasonable possibility the 
     individual might be physically injured; and
       (B) 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, without regard to 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 
     individuals 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

[[Page H9138]]

     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 experience confusion or 
     disorientation, be non-responsive to instruction, behave 
     unpredictably, or engage in disruptive, threatening, or 
     violent behavior.
       (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--
       (i) assigning and placing sufficient numbers of staff to 
     reduce patient-specific Type 2 workplace violence hazards;
       (ii) provision of dedicated and available safety personnel 
     such as security guards;
       (iii) employee training on workplace violence prevention 
     methods and techniques to de-escalate and minimize violent 
     behavior; and
       (iv) 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 Workplace Violence Prevention for Health 
     Care and Social Service Workers Act).''; 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.

  The CHAIR. No further amendment to the bill, as amended, shall be in 
order except those printed in part B of the report. Each such further 
amendment may be offered only in the order printed in the report, by a 
Member designated in the report, shall be considered read, shall be 
debatable for the time specified in the report equally divided and 
controlled by the proponent and an opponent, shall not be subject to 
amendment, and shall not be subject to a demand for division of the 
question.


                Amendment No. 1 Offered by Mr. Hastings

  The CHAIR. It is now in order to consider amendment No. 1 printed in 
part B of House Report 116-302.
  Mr. HASTINGS. Madam Chair, I have an amendment at the desk.
  The CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 13, beginning on line 6, amend subparagraph (C) to 
     read as follows:
       (C) Availability of plan.--
       (i) In general.--Each Plan shall be--

       (I) made available at all times to the covered employees 
     who are covered under such Plan; and
       (II) to the extent possible, emailed to each such employee 
     upon completion of the employee's annual training under 
     paragraph (3)(A).

       (ii) Rule of construction.--Nothing in this subparagraph 
     shall be construed to serve in lieu of training or any other 
     requirements under this Act.

  The CHAIR. Pursuant to House Resolution 713, the gentleman from 
Florida (Mr. Hastings) and a Member opposed each will control 5 
minutes.
  The Chair recognizes the gentleman from Florida.
  Mr. HASTINGS. Madam Chair, my amendment No. 1 requires employers 
covered by the Workplace Violence Prevention for Health Care and Social 
Service Workers Act to make their organization's workplace violence 
prevention plans available to their employees through email and other 
methods.
  Before I proceed, I want to thank Mr. Courtney for bringing this 
matter to our attention. What I didn't say to Mr. Courtney before now 
is that, 27 years ago, I came to this institution as a Member of the 
House of Representatives. Either the second or third measure that I 
proposed dealt with workplace violence, and it is this long that we are 
finally addressing this in a meaningful way.
  This is a short and simple amendment that will help employees covered 
under the legislation stay familiar and comfortable with their 
organization's plans for preventing workplace violence.
  H.R. 1309 requires the Department of Labor to promulgate an 
occupational safety and health standard for certain employers in the 
healthcare and social service sectors.
  The standard requires them to develop and implement comprehensive 
plans for protecting their employees from workplace violence. These 
plans are specifically tailored to workplaces and their employees on a 
case-by-case basis and are important tools for identifying and 
mitigating risks.
  As a part of the requirements for these plans, H.R. 1309 requires 
employers to provide comprehensive training on these plans to employees 
and to make their workplace violence prevention plans available to 
their employees at all times.
  My amendment, which is cosponsored by my good friend and colleague, 
Congressman DeSaulnier, expands on this specific requirement and 
requires employers to share their plans with their employees through 
email and other methods, following the completion of their annual 
training.
  Doing so would ensure that, in addition to the other training and 
guidance provided by their employers, employees have access to their 
own digital copies of their organization's violence prevention plans. 
Having this access will permit them greater flexibility to access and 
review these important documents as they feel necessary.
  This is a commonsense amendment that will make it easier for covered 
employees to feel comfortable with their organization's workplace 
violence prevention plans.
  Madam Chair, I urge my colleagues to support this amendment, and I 
reserve the balance of my time.
  Ms. FOXX of North Carolina. Madam Chair, I claim the time in 
opposition to the amendment.
  The CHAIR. The gentlewoman from North Carolina is recognized for 5 
minutes.
  Ms. FOXX of North Carolina. Madam Chair, this amendment is 
unnecessary. The underlying bill already mandates that each workplace 
violation prevention plan required by the bill ``be made available at 
all times'' to covered employees. This amendment adds yet another 
overly prescriptive requirement on healthcare establishments.
  OSHA, as it proceeds with its rulemaking, should have the ability to 
determine the specific elements required of each employer after 
analyzing their effectiveness and potential cost.
  Ultimately, H.R. 1309 circumvents the longstanding, established OSHA 
rulemaking process, which is intended to research thoroughly the 
underlying circumstances that may merit a health and safety regulation 
and gather meaningful stakeholder input in order to create the most 
feasible and protective safety and health standard possible.

                              {time}  1015

  By dodging the established regulatory process, H.R. 1309 is 
foreclosing other potential solutions. H.R. 1309 will require OSHA to 
enforce an interim final standard in healthcare and social service 
settings within a year. The legislation does not allow OSHA to consider 
important information, such as the experience of California which has a 
brand-new standard in place, the views of experts in the field, and the 
input of workers who have invaluable workplace experience.
  H.R. 1309 discounts the complexity of the underlying issue and the 
importance of the knowledge and experience stakeholders can offer that 
will help create a workable and effective solution.

[[Page H9139]]

  Madam Chair, I yield back the balance of my time.
  Mr. HASTINGS. Madam Chair, I close by reiterating that this amendment 
is a short and uncontentious proposal to help covered employees feel 
comfortable with their organization's workplace violence prevention 
plans.
  By requiring employers to make their organization's workplace 
violence prevention plans available through email and other methods, 
this amendment would ensure that employees have access to their own 
digital copies of their organization's plans. Having this access will 
permit employees greater flexibility to access and review these 
important documents as they feel necessary.
  Madam Chair, I urge my colleagues to support this amendment, and I 
yield back the balance of my time.
  The CHAIR. The question is on the amendment offered by the gentleman 
from Florida (Mr. Hastings).
  The amendment was agreed to.


               Amendment No. 2 Offered by Mr. DeSaulnier

  The CHAIR. It is now in order to consider amendment No. 2 printed in 
part B of House Report 116-302.
  Mr. DeSAULNIER. Madam Chair, I have an amendment at the desk.
  The CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 11, line 23, strike ``and''.
       Page 11, line 25, strike the period and insert ``; and''.
       Page 11, after line 25, insert the following:

       (V) to provide employees with information about available 
     trauma and related counseling.

  The CHAIR. Pursuant to House Resolution 713, the gentleman from 
California (Mr. DeSaulnier) and a Member opposed each will control 5 
minutes.
  The Chair recognizes the gentleman from California.
  Mr. DeSAULNIER. Madam Chair, my amendment requires that healthcare 
workers and social service workers are provided with information on 
available mental health resources, trauma, and related counseling.
  It is appalling that those who dedicate their lives to caring for 
people in need suffer workplace violence at disproportionately high 
rates across the Nation. In 2018, healthcare and social service workers 
were four times as likely to suffer a serious workplace violence injury 
than workers overall.
  Between 2013 and 2016, one in four registered nurses and nursing 
students reported being physically assaulted at work by a patient or a 
patient's family member. And in 2017, State government healthcare and 
social service workers were almost 10 times more likely to be injured 
by an assault than private-sector healthcare workers.
  Some, tragically, do not survive these incidents. Yesterday, I spoke 
about a former constituent, Donna Kay Gross of Concord, California, who 
was a psychiatric technician at Napa State Hospital in California.
  She was brutally murdered by a patient outside the unit where she 
worked. She chose to go into this field and work as a technician 
because of a history of mental health in her family, and her mother was 
at Napa State Hospital.
  Her story, unfortunately, is not completely unique. A few years ago 
here in Washington, Mindy Blandon, a registered nurse, was working in 
the surgical oncology unit when a patient she was treating became 
agitated. As Mindy and another nurse approached the bedside, the 
patient became combative.
  At the end of an extended scuffle, the patient strangled Mindy with 
her own stethoscope. Luckily, Mindy survived with the support of her 
other staff, but the trauma she went through will forever affect her.
  Workplace violence has serious physical and emotional consequences 
for workers and employers alike. While H.R. 1309 includes provisions 
for workers' medical care as part of the underlying bill, we must also 
address the psychological effects of workplace violence. Survivors of 
workplace violence are at an increased risk of long-term emotional 
problems and post-traumatic stress disorders which can be debilitating, 
lead to lost days of work, deteriorate productivity and morale, and 
sometimes even end workers' careers.
  The high turnover that results weakens our Nation's healthcare 
workforce that is already stretched thin and discourages good people 
from entering these professions.
  I am proud that California has led the way in preventing and 
responding to workplace violence against healthcare workers, including 
requiring the mental health service information that this amendment 
provides.
  There is a clear need for these services. According to the Bureau of 
Labor Statistics, 18,400 workers in the private industry experienced 
trauma from nonfatal workplace violence in 2017. Of those victims who 
experience trauma from workplace violence, 71 percent worked in the 
healthcare and social assistance industry.
  This amendment would bring the Workplace Violence Prevention for 
Health Care and Social Service Workers Act in line with the California 
law by ensuring that healthcare and social service workers are provided 
with critical information on trauma and related counseling for 
employees after a violent incident.
  Madam Chair, I urge support for the amendment, and I reserve the 
balance of my time.
  Ms. FOXX of North Carolina. Madam Chair, I claim the time in 
opposition to the amendment.
  The CHAIR. The gentlewoman from North Carolina is recognized for 5 
minutes.
  Ms. FOXX of North Carolina. Madam Chair, I yield myself such time as 
I may consume.
  Madam Chair, this amendment adds yet another overly prescriptive 
regulatory requirement on healthcare providers, small and large, 
without going through the established rulemaking process.
  This amendment provides no opportunity for OSHA to examine whether 
the requirements listed in the amendment would be beneficial and 
useful. The provision in this amendment could be examined during a 
small business stakeholder panel and a public comment period if OSHA 
were permitted to engage in these important steps before issuing an 
interim final rule.
  We still need additional research and data to identify the best ways 
to mitigate and prevent workplace violence in healthcare and social 
service settings. There have been calls for additional research on the 
project, including from the Government Accountability Office and the 
Centers for Disease Control and Prevention.
  Democrat amendments to the bill, such as the one we are debating, do 
not change these basic facts. Democrat window-dressing amendments that 
add more red tape don't change the fact that H.R. 1309 fails to allow 
for the development of a workable, effective, and feasible workplace 
violence prevention standard.
  Madam Chair, I yield back the balance of my time.
  Mr. DeSAULNIER. Madam Chair, I yield 1 minute to the gentleman from 
Florida (Mr. Hastings), my distinguished friend.
  Mr. HASTINGS. Madam Chair, I am pleased to rise in support of my 
colleague, Mr. DeSaulnier's amendment to H.R. 1309.
  As my good friend knows, I was planning to introduce an amendment 
that was virtually identical to his, and so I was happy to make this a 
combined effort and support his amendment as a cosponsor.
  As has already been explained, this amendment would require employers 
to provide information about trauma and trauma-related counseling for 
employees in their reporting, incident response, and post-incident 
investigation procedures.
  Doing so would ensure that employees have access to this vital 
information in the wake of incidents involving workplace violence. I 
think this is an important consideration as we consider this 
legislation responding to high rates of workplace violence.
  Our Nation's caregivers, including nurses, social workers, and many 
others working in the healthcare and social service sectors, suffer 
workplace violence injuries at far higher rates than in any other 
profession.
  Mr. DeSAULNIER. Madam Chair, I urge my colleagues to support the 
amendment, and I yield back the balance of my time.
  The CHAIR. The question is on the amendment offered by the gentleman 
from California (Mr. DeSaulnier).
  The amendment was agreed to.

[[Page H9140]]

  



                  Amendment No. 3 Offered by Mr. Byrne

  The CHAIR. It is now in order to consider amendment No. 3 printed in 
part B of House Report 116-302.
  Mr. BYRNE. Madam Chair, I have an amendment at the desk.
  The CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Strike all after section 1 and insert the following:

     SECTION 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 estimated 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 Bureau of Labor Statistics reported 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.
       (3) The Bureau of Labor Statistics reports that health care 
     and social service workers suffered 71 percent of all 
     workplace violence injuries caused by persons in 2017 and are 
     more than 4 times as likely to suffer a workplace violence 
     injury than workers overall.
       (4) According to a September 2018 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.
       (6) Studies have found that proper staff education 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.
       (7) The Occupational Safety and Health Administration in 
     2015 updated its ``Guidelines for Preventing Workplace 
     Violence for Healthcare and Social Service Workers'', 
     however, this guidance is not enforceable.
       (8) 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.
       (9) 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 spring 2019 regulatory agenda listed a Small 
     Business Regulatory Enforcement Fairness Act Panel for 
     Prevention of Workplace Violence in Health Care and Social 
     Assistance.

     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. Final 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. FINAL STANDARD.

       (a) In General.--The Secretary of Labor shall promulgate a 
     final standard on workplace violence prevention--
       (1) 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
       (2) that may 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.
       (b) Effective Date of Standard.--The final standard shall--
       (1) take effect on a date that is not later than 60 days 
     after promulgation, except that such final standard may 
     include a reasonable phase-in period for the implementation 
     of required engineering controls that take effect after such 
     date; and
       (2) 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)).
       (c) Educational Outreach.--
       (1) During rulemaking.--During the period beginning on the 
     date the Secretary commences rulemaking under this section 
     and ending on the effective date of the final standard 
     promulgated under this section, the Secretary of Labor shall 
     engage in an educational campaign for covered employees and 
     covered employers regarding workplace violence prevention in 
     health care and social service industries on the materials of 
     the Occupational Safety and Health Administration on 
     workplace violence prevention for such industries.
       (2) Requirements of final standard.--Beginning on the date 
     on which the final standard is promulgated under this 
     section, the Secretary shall engage in an educational 
     campaign for covered employees and covered employers on the 
     requirements of such final standard.

     SEC. 102. SCOPE AND APPLICATION.

       In this title:
       (1) Covered facility.--The term ``covered facility'' means 
     a facility with respect to which the Secretary determines 
     that requirements of the final standard promulgated under 
     section 101(a) would be reasonably necessary or appropriate, 
     and which may include:
       (A) Any hospital, including any specialty hospital.
       (B) Any residential treatment facility, including any 
     nursing home, skilled nursing facility, hospice facility, and 
     long-term care facility.
       (C) Any medical treatment or social service setting or 
     clinic at a correctional or detention facility.
       (D) Any community-based residential facility, group home, 
     and mental health clinic.
       (E) Any psychiatric treatment facility.
       (F) Any drug abuse or substance use disorder treatment 
     center.
       (G) Any independent freestanding emergency centers.
       (H) Any facility described in subparagraphs (A) through (G) 
     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 (as 
     such section is in effect on the date of enactment of this 
     Act).
       (2) Covered services.--The term ``covered service'' 
     includes the following services and operations:
       (A) Any services and operations provided in home health 
     care, home-based hospice, and home-based social work.
       (B) Any emergency medical services and transport, including 
     such services when 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 (as 
     such section is in effect on the date of enactment of this 
     Act).
       (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, or a temporary 
     service firm) 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 a person to 
     perform covered services for the individual or a friend or 
     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 may include the 
     following requirements:
       (1) Workplace violence prevention plan.--Not later than 6 
     months after the date of promulgation of the final standard 
     under section 101(a), a covered employer shall develop, 
     implement, and maintain a 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) subject to subparagraph (D), be developed and 
     implemented with the meaningful participation of direct care 
     employees and, where applicable, employee representatives, 
     for all aspects of the Plan;

[[Page H9141]]

       (ii) be applicable 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 each individual or the job title of 
     each 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 may be--

       (I) informed by past violent incidents specific to such 
     covered facility or such covered service; and
       (II) conducted with--

       (aa) representative 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 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 to the employer 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 educating 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 ensuring the 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.
       (D) Clarification.--The requirement under subparagraph 
     (A)(i) shall not be construed to require that all direct care 
     employees and employee representatives participate in the 
     development and implementation of the Plan.
       (2) Violent incident investigation.--
       (A) In general.--As soon as practicable after a workplace 
     violence incident, of which a covered employer has knowledge, 
     the employer shall conduct an investigation of such incident, 
     under which the employer shall--
       (i) review the circumstances of the incident 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, 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) Education.--With respect to the covered employees 
     covered under a Plan of a covered employer, the employer 
     shall provide education to such employees who may be exposed 
     to workplace violence hazards and risks, which meet the 
     following requirements:
       (A) Annual 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 education 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 education for each such covered employee 
     whose job circumstances has changed, within a reasonable 
     timeframe after such change.
       (D) Applicable new employee education prior to employee's 
     job assignment.
       (E) All education provides such employees opportunities to 
     ask questions, give feedback on such education, and request 
     additional instruction, clarification, or other followup.
       (F) All education is provided in-person or online and by an 
     individual with knowledge of workplace violence prevention 
     and of the Plan.
       (G) All education 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 records related to each Plan of 
     the employer, including workplace violence risk and hazard 
     assessments, and identification, evaluation, correction, and 
     education procedures;
       (ii) maintain for a minimum of 5 years--

       (I) a violent incident log described in subparagraph (B) 
     for recording all workplace violence incidents; and
       (II) records of all incident investigations as required 
     under paragraph (2)(B); and

       (iii) 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 (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 part), 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, 
     client, or other individual 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--
       (i) shall 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) may be based on a template developed by the Secretary 
     not later than 1 year after the date of promulgation of the 
     standards under section 101(a);
       (iii) may include 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, resident, or customer of a covered 
     employer;
       (bb) a family or friend of a patient, client, resident, or 
     customer of a covered employer;
       (cc) a stranger;
       (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 addressed;

       (iv) not later than 7 days, depending on the availability 
     or condition of the witness, after the employer learns of 
     such incident, shall contain a record of each violent 
     incident, which is updated to ensure completeness of such 
     record;
       (v) shall be maintained for not less than 5 years; and
       (vi) in the case of a violent incident involving a privacy 
     concern case as defined in section 1904.29(b)(7) of title 29, 
     Code of Federal Regulations (as such section is in effect on 
     the date of enactment of this Act), shall protect the 
     identity of employees in a manner consistent with that 
     section.
       (C) Annual summary.--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 (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 employees are customarily posted; and
       (v) not be altered, defaced, or covered by other material 
     by the employer.

[[Page H9142]]

       (5) 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 education required by each standard 
     described in section 101, and specified in the Plan.
       (6) 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) Enforcement.--Each violation of the policy shall be 
     enforced in the same manner and to the same extent as a 
     violation of section 11(c) of the Occupational Safety and 
     Health Act (29 U.S.C. 660(c)) is enforced.

     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, 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 lawful acts of defense 
     of others.
       (C) Inclusions.--The term ``workplace violence'' includes 
     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.
       (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) Alarm.--The term ``alarm'' means a mechanical, 
     electrical, or electronic device that can alert others but 
     does not rely upon an employee's vocalization in order to 
     alert others.
       (7) Engineering controls.--
       (A) In general.--The term ``engineering controls'' means an 
     aspect of the built space or a device that removes or 
     minimizes 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.
       (8) 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 
     individuals and persons at risk of committing workplace 
     violence.
       (9) 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 known or recorded 
     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.
       (10) Secretary.--The term ``Secretary'' means the Secretary 
     of Labor.
       (11) 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 Workplace Violence Prevention for Health 
     Care and Social Service Workers Act).''; 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 final standard on workplace violence 
     prevention required under section 101.

  The CHAIR. Pursuant to House Resolution 713, the gentleman from 
Alabama (Mr. Byrne) and a Member opposed each will control 5 minutes.
  The Chair recognizes the gentleman from Alabama.
  Mr. BYRNE. Madam Chair, I yield myself such time as I may consume.
  Let me be clear: protecting workers from workplace violence is a 
policy priority that Republicans and Democrats see eye to eye on. 
American workers should be kept out of harm's way on the job so they 
can return home to their families every day healthy and safe.
  Republicans and Democrats appreciate the hard work and empathy that 
healthcare workers and community caregivers demonstrate every single 
day on the job. Their dedication to caring for the most vulnerable 
members of our communities is extraordinary. And these workers deserve 
our gratitude, our respect, and our commitment to ensuring that they 
are safe on the job.
  Today, we can do right by them by working together to address the 
critical need for protection and the prevention of violence in the 
workplace. Impactful legislation is possible in an effective and 
bipartisan manner, but I echo Ranking Member Foxx's observation that 
this bill is simply the wrong approach.
  While H.R. 1309 stands no chance of becoming law, I believe we have a 
real opportunity here to advance legislation that could be enacted and 
provide the protections for workers we all desire.
  The amendment that I am proposing today recognizes that OSHA, having 
noted the hazards and risks that exist with healthcare workers, is 
currently advancing the rulemaking process to address this important 
issue.

[[Page H9143]]

  This amendment would ensure that the regulated community has an 
opportunity to provide meaningful comments on a workplace violence 
prevention standard which will inform an effective and workable final 
regulation before the agency begins enforcement, and it calls on OSHA 
to convene the already planned Small Business Regulatory Enforcement 
Fairness Act panel before proceeding with the rulemaking process to 
allow small businesses the opportunity to comment on regulatory text.
  Finally, the amendment would require OSHA to conduct an educational 
campaign on workplace violence prevention in the healthcare and social 
service industries.
  This commonsense amendment acknowledges and supports the work already 
underway and protects this progress so that they can further propel 
solutions to workplace violence.
  Addressing workplace violence prevention is crucial. The Obama 
administration delayed action on this issue and first made moves to 
initiate a rulemaking process in the final year of President's Obama's 
8-year tenure.
  Meanwhile, the Department of Labor is working on workplace violence 
prevention rulemaking as we speak, and as I said, has initiated the 
panel scheduled for January.
  We agree there is work to be done, but H.R. 1309 is not the answer. I 
ask my colleagues to support my amendment so we can make real, 
meaningful steps toward protecting American workers in this industry, 
and I reserve the balance of my time.
  Mr. COURTNEY. Madam Chair, I rise in opposition to the amendment.
  The CHAIR. The gentleman from Connecticut is recognized for 5 
minutes.
  Mr. COURTNEY. Madam Chair, again, I rise in opposition to the 
amendment, but certainly with great respect for the proponent. I 
actually supported making this amendment in order because I have such 
high regard for the gentleman.
  However, this amendment, essentially, Madam Chair, guts the bill.
  The essence of this bill is to say to the Occupational Safety and 
Health Administration, who has been studying this issue since the 1990s 
and has issued commonsense guidelines--that again, Ranking Member Foxx 
has touted as an example of how this isn't a real problem that we need 
to accelerate, but the fact of the matter is, we incorporate those 
guidelines in the underlying bill with a real deadline, 42 months. That 
has precedent.
  Congress has done this before. OSHA is an act of Congress, and we 
have accelerated deadlines for bloodborne pathogens back in the late 
1990s, gave them a 1-year deadline or a 6-month deadline to implement a 
standard, again, for HIV, hepatitis B, and C, in healthcare. And thank 
God. We are a safer country because Congress stepped in and set a 
deadline for OSHA to act.
  We did it for hazardous waste materials. We put a deadline to make 
them act. Without a deadline, what we are stuck with is OSHA's 
atrocious record of getting rules out in a timely fashion. Beryllium, 
18 years it took; silica, 19 years. If you inhale silica, you suffocate 
and get cancer; confined spaces in construction, working in trenches, 
22 years.
  And, yes, yesterday, the Trump administration, for the third time, 
scheduled a preliminary panel with the SBREFA panel, having canceled 
the prior two. We are 3 years into this administration, and still, to 
this date, nothing actually has happened other than notices, which so 
far have just been canceled over and over again.

                              {time}  1030

  Madam Chair, while we were here on the floor, one of the most 
credible voices on this issue, which is the American College of 
Emergency Physicians--when these unruly, agitated patients with the 
heroin and opioid crises and behavioral health crises are coming 
through the doors, they are the ones who are really at the front line, 
along with the nurses and their assistants. They urge legislators to 
oppose the Byrne amendment that would eliminate the deadline for OSHA 
to issue a standard.
  The reason they give is that, in 2018, they did a survey of emergency 
physicians all across America who reported being physically assaulted 
while at work, with 60 percent of those assaults occurring within the 
previous year. This is happening in real time, and it is accelerating. 
The trajectory is something that we cannot wait for OSHA to basically 
go back and reinvent the wheel that they have already issued in terms 
of guidelines about how to reduce risk in workplaces.
  That is why, in addition to other issues in this amendment that 
eliminate the whistleblower protection, as well as the interim final 
standard, which, again, incorporates OSHA's already preexisting rules, 
that I rise in strong opposition to this amendment.
  Let's move forward, and let's do it in a timely fashion for America's 
healthcare and social services workforce.
  Madam Chair, I reserve the balance of my time.
  Mr. BYRNE. Madam Chair, I return the gentleman's respect, and I know 
that he has worked long and hard on this. I agree with him that this is 
a real problem that is getting worse, but we are not going to make it 
better if we pass something in this House that will not get up on the 
floor of the Senate and won't be signed by the President. We know it 
won't.
  I would suggest to the gentleman that this vehicle is how we actually 
get something passed and do something for the workers that we care so 
much about.
  Madam Chair, I reserve the balance of my time.
  Mr. COURTNEY. Madam Chair, I yield myself the balance of my time.
  Madam Chair, the gentleman is absolutely right. The Obama 
administration took too long to move on this. Again, I, along with 
George Miller, requested the GAO study back in 2013. The results came 
in, in 2016. He is right. The first regulatory step didn't take place 
until January 2017, on the way out the door.
  But we are 3 years into this administration, and they are not setting 
the world on fire in terms of addressing this issue. That panel, which 
you described, to call it a baby step is an overstatement. It is a baby 
crawl, in terms of this process. Again, we have seen the track record--
22 years, 19 years, 17 years--to get a standard out.
  Our healthcare workforce cannot wait that long. That is why H.R. 1309 
should proceed without the Byrne amendment.
  Madam Chair, I yield back the balance of my time.
  Mr. BYRNE. Madam Chair, I yield myself the balance of my time.
  I close by saying this. We need to do something. If we don't enact my 
amendment, we are going to end up doing nothing, and I think something 
is better than nothing.
  Madam Chair, I yield back the balance of my time.
  The CHAIR. The question is on the amendment offered by the gentleman 
from Alabama (Mr. Byrne).
  The question was taken; and the Chair announced that the noes 
appeared to have it.
  Mr. BYRNE. Madam Chair, I demand a recorded vote.
  The CHAIR. Pursuant to clause 6 of rule XVIII, further proceedings on 
the amendment offered by the gentleman from Alabama will be postponed.


          Amendment No. 4 Offered by Mr. Harder of California

  The CHAIR. It is now in order to consider amendment No. 4 printed in 
part B of House Report 116-302.
  Mr. HARDER of California. Madam Chair, I have an amendment at the 
desk.
  The CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 23, line 23, strike ``and''.
       Page 24, line 2, strike the period and insert a semicolon.
       Page 24, after line 2, insert the following:
       (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.

  The CHAIR. Pursuant to House Resolution 713, the gentleman from 
California (Mr. Harder) and a Member opposed each will control 5 
minutes.
  The Chair recognizes the gentleman from California.
  Mr. HARDER of California. Madam Chair, I yield myself such time as I 
may consume.
  Madam Chair, my amendment is going to ensure that nothing in this act

[[Page H9144]]

shall be construed to limit or prevent healthcare workers from 
reporting violent incidents to appropriate law enforcement.
  This is really critical because, obviously, this amendment is going 
to really put some new restrictions on workplace violence. It is so 
critical to ensure we do that. But we also want to make sure that there 
are safeguards in place to make sure that reporting is not only going 
to the law enforcement agencies but also around the rest of the 
community. That is why our amendment is so critical here.
  Madam Chair, I reserve the balance of my time.
  Ms. FOXX of North Carolina. Madam Chair, I claim the time in 
opposition, although I am not opposed to the amendment.
  The CHAIR. Without objection, the gentlewoman from North Carolina is 
recognized for 5 minutes.
  There was no objection.
  Ms. FOXX of North Carolina. Madam Chair, this amendment underscores 
two obvious points: first, that healthcare and social service workers 
should be free to report workplace violence incidents to law 
enforcement; and second, that this bill was drafted poorly.
  Such a commonsense provision should not need to be added to the 
underlying legislation. But in the Democrats' rush to force OSHA to 
promulgate workplace violence prevention standards, they are bypassing 
key elements of the established rulemaking process that would ensure a 
provision such as this amendment, if needed, is in the regulatory text.
  H.R. 1309 circumvents the longstanding, established OSHA rulemaking 
process, which is intended to gather information on the underlying 
circumstances that may merit a health and safety regulation and to 
receive meaningful stakeholder input in order to create the most 
feasible and protective safety and health standard possible.
  By dodging the established regulatory process, the Democrats are 
ignoring or unaware of many key issues like the ones addressed in this 
amendment.
  Madam Chair, I will support the amendment, and I yield back the 
balance of my time.
  Mr. HARDER of California. Madam Chair, I yield 1 minute to the 
gentleman from Connecticut (Mr. Courtney).
  Mr. COURTNEY. Madam Chair, I thank the gentleman from California (Mr. 
Harder) for yielding.
  Again, I want to salute his amendment. For the record, there is no 
prohibition built into OSHA that you can't have dual jurisdiction, in 
terms of criminal investigations or prosecutions from injuries in any 
setting that OSHA covers. However, I still applaud the Member for just 
sort of foot-stomping this point to make sure that because so many of 
these incidents involve assault, there is absolutely a clear signal 
that there is no hindrance or obstacle.
  Again, for that purpose, I certainly strongly support the amendment 
and urge its adoption.
  Mr. HARDER of California. Madam Chair, I yield back the balance of my 
time.
  The CHAIR. The question is on the amendment offered by the gentleman 
from California (Mr. Harder).
  The question was taken; and the Chair announced that the ayes 
appeared to have it.
  Mr. HARDER of California. Madam Chair, I demand a recorded vote.
  The CHAIR. Pursuant to clause 6 of rule XVIII, further proceedings on 
the amendment offered by the gentleman from California will be 
postponed.


            Amendment No. 5 Offered by Mr. Levin of Michigan

  The CHAIR. It is now in order to consider amendment No. 5 printed in 
part B of House Report 116-302.
  Mr. LEVIN of Michigan. Madam Chair, I have an amendment at the desk.
  The CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 14, line 19, insert ``anti-retaliation policies,'' 
     after ``response procedures,''.

  The CHAIR. Pursuant to House Resolution 713, the gentleman from 
Michigan (Mr. Levin) and a Member opposed each will control 5 minutes.
  The Chair recognizes the gentleman from Michigan.
  Mr. LEVIN of Michigan. Madam Chair, my amendment ensures that our 
incredible healthcare and social service workers are aware that they 
are legally protected from retaliation by their employers.
  I begin by thanking my colleague, Congressman   Joe Courtney, for his 
hard work on this outstanding bill, and Chairman Scott for leading this 
issue and bringing the bill to the floor today.
  Healthcare and social service workers are some of this country's most 
precious workers, taking care of us and our loved ones, sometimes under 
some of the most trying conditions imaginable.
  H.R. 1309 will help protect these workers by requiring employers in 
the healthcare and social service sectors to develop workplace violence 
prevention plans. My amendment will require that mandatory violence 
prevention plan trainings include the critical information that these 
workers, when faced with any violent or unwanted behavior in the 
workplace, can safely report the incident without fear of retaliation.
  Bureau of Labor Statistics data tell us that private-sector injury 
rates from workplace violence in healthcare and social service sectors 
increased 63 percent between 2006 and 2016, in just a decade. And due 
to underreporting, injury rates and workplace violence are widely 
assumed to be higher than the reported levels.
  This is a huge problem for workers but also for those they care for, 
as violence in healthcare settings compromises quality of care. We 
cannot expect healthcare and social service workers to be able to 
deliver essential lifesaving services under the threat of violence and 
assault and fear of repercussions for reporting any incident that may 
occur.
  The same goes for social service workers. A safe and violence-free 
workplace is essential to a functioning social service system that will 
help our communities thrive. We cannot expect workers to come forward 
with reports of violence if they fear retribution.
  My straightforward amendment aims to ensure that healthcare and 
social service workers covered by this bill are aware of their right to 
come forward and report any incident of violence at work without fear 
of retribution.
  Madam Chair, let me add that this is really personal for me. I don't 
want to reveal my age, but I started organizing healthcare workers for 
SEIU in 1983, and I remember my very first campaign at Shore Haven 
Nursing Home in Grand Haven, Michigan.
  Some of the workers in the nursing home did face violence on the job, 
and they really had no way to handle it. So Mr. Courtney's bill, his 
leadership on this, is so essential for all the health and social 
service workers of the country.
  Madam Chair, I urge my colleagues to support this amendment, and I 
reserve the balance of my time.
  Ms. FOXX of North Carolina. Madam Chair, I rise in opposition to the 
amendment.
  The CHAIR. The gentlewoman from North Carolina is recognized for 5 
minutes.
  Ms. FOXX of North Carolina. Madam Chair, this amendment is yet 
another example of Democrats assuming bad motives on the part of 
American employers and handcuffing them with additional, overly 
prescriptive micromanagement from Washington.
  The vast majority of employers in America follow the laws, take good 
care of their employees, respect their rights in the workplace, and do 
not need more red tape imposed on them. Yet this amendment adds 
additional requirements on America's small businesses without receiving 
any meaningful input from them or other stakeholders.
  Democratic amendments, such as the one we are debating, do not change 
the basic fact that H.R. 1309 is already overly prescriptive and 
forecloses important input from knowledgeable stakeholders.
  H.R. 1309 will require OSHA to enforce an interim final standard in 
healthcare and social service settings within a year. This legislation 
does not allow OSHA to consider important information, including the 
experience of California, which has a brand-new standard in place; the 
views of experts in the field; and the input of workers who have 
invaluable workplace experience. This data and evidence and the

[[Page H9145]]

views of stakeholders may very well not align with the bill's 
requirements.
  Adopting H.R. 1309 discounts the complexity of the underlying issue 
and the importance of the knowledge and experience stakeholders can 
offer.
  Madam Chair, I yield back the balance of my time.
  Mr. LEVIN of Michigan. Madam Chair, I am sure we can all agree that 
retribution for people reporting violence in the workplace is something 
that is important, that people should not face retribution, that they 
should not fear reporting when they personally or their coworkers face 
violence on the job. So I hope that we will have broad support for this 
amendment.
  Madam Chair, I yield back the balance of my time.

                              {time}  1045

  The CHAIR. The question is on the amendment offered by the gentleman 
from Michigan (Mr. Levin).
  The amendment was agreed to.
  Mr. COURTNEY. Madam Chair, I move that the Committee do now rise.
  The motion was agreed to.
  Accordingly, the Committee rose; and the Speaker pro tempore (Mr. 
Brown of Maryland) having assumed the chair, Ms. Jackson Lee, Chair of 
the Committee of the Whole House on the state of the Union, reported 
that that Committee, having had under consideration the bill (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, had come to no resolution thereon.

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