[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.
____________________