119-hr2531

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2531 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 2531

 To direct the Secretary of Labor to issue an occupational safety and 
health standard that requires covered employers within the health care 
and social service industries to develop and implement a comprehensive 
 workplace violence prevention plan, and for other purposes.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 April 1, 2025

 Mr. Courtney (for himself, Mr. Bacon, Mr. Scott of Virginia, Mr. 
 Fitzpatrick, Ms. Omar, and Ms. Adams) introduced the following bill; 
which was referred to the Committee on Education and Workforce, and in 
addition to the Committees on Energy and Commerce, and Ways and Means, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of 
 the committee concerned

_______________________________________________________________________

 A BILL

 To direct the Secretary of Labor to issue an occupational safety and 
health standard that requires covered employers within the health care 
and social service industries to develop and implement a comprehensive 
 workplace violence prevention plan, and for other purposes.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Workplace Violence Prevention for 
Health Care and Social Service Workers Act''.

SEC. 2. TABLE OF CONTENTS.

 The table of contents for this Act is as follows:

Sec. 1. Short title.

Sec. 2. Table of contents.
 TITLE I--WORKPLACE VIOLENCE PREVENTION STANDARD

Sec. 101. Workplace violence prevention standard.

Sec. 102. Scope and application.

Sec. 103. Requirements for workplace violence prevention standard.

Sec. 104. Rules of construction.

Sec. 105. Other definitions.
 TITLE II--AMENDMENTS TO THE SOCIAL SECURITY ACT

Sec. 201. Application of the workplace violence prevention standard to 
 certain facilities receiving Medicare 
 funds.

 TITLE I--WORKPLACE VIOLENCE PREVENTION STANDARD

SEC. 101. WORKPLACE VIOLENCE PREVENTION STANDARD.

    (a) Interim Final Standard.--

    (1) In general.--Not later than 1 year after the date of 
 enactment of this Act, the Secretary of Labor shall issue an 
 interim final standard on 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 and carry out other 
 activities or requirements described in 

section 103 to 
 protect health care workers, social service workers, 
 and other personnel from workplace violence;
        (B) that shall, at a minimum, be based on the 
 Guidelines for Preventing Workplace 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; and
            (C) that provides for a period determined 
 appropriate by the Secretary, not to exceed 1 year, 
 during which the Secretary shall prioritize technical 
 assistance and advice consistent with 

section 21
            (d) of 
 the Occupational Safety and Health Act of 1970 (29 
 U.S.C. 670
            (d) ) to employers subject to the standard 
 with respect to compliance with the standard.

    (2) Inapplicable provisions of law and executive order.--
 The following provisions of law and Executive orders shall not 
 apply to the issuance of the interim final standard under this 
 subsection:
        (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.
            (C) Subchapter I of chapter 35 of title 44, United 
 States Code (commonly referred to as the ``Paperwork 
 Reduction Act'').
            (D) Executive Order No. 12866 (58 Fed. Reg. 51735; 
 relating to regulatory planning and review), as 
 amended.

    (3) Notice and comment.--Notwithstanding paragraph

    (2)
        (B) , 
 the Secretary shall, prior to issuing 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 issuance, 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 issued 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 issued by the Secretary that meets the 
 requirements of paragraph

    (1) .

    (b) Final Standard.--

    (1) Proposed standard.--Not later than 2 years after the 
 date of enactment of this Act, the Secretary of Labor shall, 
 pursuant to 

section 6 of the Occupational Safety and Health Act 
 (29 U.S.C. 655), promulgate a proposed standard on workplace 
 violence prevention--
        (A) for the purposes described in subsection

    (a)

    (1)
        (A) ; and
        (B) that shall include, at a minimum, requirements 
 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 issue 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), provided the Secretary finds that the final 
 standard is feasible on the basis of the best available 
 evidence; and
        (B) be effective and enforceable in the same manner 
 and to the same extent as any standard promulgated 
 under 

section 6

    (b) of the Occupational Safety and 
 Health Act of 1970 (29 U.S.C. 655

    (b) ).

SEC. 102. SCOPE AND APPLICATION.

 In this title:

    (1) Covered facility.--
        (A) In general.--The term ``covered 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, Alzheimer's and 
 memory care facility, and long-term care 
 facility.
            (iii) Any non-residential treatment or 
 service setting.
            (iv) Any medical treatment or social 
 service setting or clinic at a correctional or 
 detention facility.
            (v) Any community care setting, 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 (in this section referred to as the 
 ``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--
            (i) shall be developed and implemented with 
 the meaningful participation of direct care 
 employees, other employees, and employee 
 representatives, for all aspects of the Plan;
            (ii) shall 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;
            (iii) shall 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; and
            (iv) may be in consultation with 
 stakeholders or experts who specialize in 
 workplace violence prevention, emergency 
 response, or other related areas of expertise 
 for all relevant aspects of the Plan.
        (B) Plan content.--Each Plan shall include 
 procedures and methods for the following:
            (i) Identification of the individual and 
 the individual's position 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;
            (IV) to provide medical care or 
 first aid to affected employees; and
            (V) to provide employees with 
 information about available trauma and 
 related counseling.
            (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, anti-retaliation policies, and 
 employee rights.
        (B) Additional hazard recognition training shall be 
 provided for supervisors and managers to ensure they--
            (i) can recognize high-risk situations; and
            (ii) do not assign employees to 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) Additional training shall be provided for each 
 such covered employee whose job circumstances require 
 working with victims of torture, trafficking, or 
 domestic violence.
        (E) Applicable training shall be provided under 
 this paragraph for each new covered employee prior to 
 the employee's job assignment.
        (F) All training shall provide such employees 
 opportunities to ask questions, give feedback on 
 training, and request additional instruction, 
 clarification, or other followup.
        (G) 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.
        (H) 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 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 member 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 and submit to the 
 Secretary 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--

    (aa) the total number of 
 violent incidents;

    (bb) the number of 
 recordable injuries related to 
 such incidents; and
            (cc) 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 3 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 subparagraph.

    (5) Annual report.--
        (A) Report to secretary.--Not later than February 
 15 of each year, each covered employer shall report to 
 the Secretary, on a form provided by the Secretary, the 
 frequency, quantity, and severity of workplace 
 violence, and any incident response and post-incident 
 investigation (including abatement measures) for the 
 incidents set forth in the annual summary of the 
 violent incident log described in paragraph

    (4)
            (C) . The 
 contents of the report of the Secretary to Congress 
 shall not disclose any confidential information.
        (B) Report to congress.--Not later than 6 months 
 after February 15 of each year, the Secretary shall 
 submit to Congress a summary of the reports received 
 under subparagraph
        (A) .

    (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) Plan updates.--Each covered employer shall incorporate 
 changes to the Plan, in a manner consistent with paragraph

    (1)
        (A)
            (i) and based on findings from the most recent annual 
 evaluation conducted under paragraph

    (6) , as appropriate.

    (8) Anti-retaliation.--
        (A) === Policy ===
-Each covered employer shall adopt a 
 policy prohibiting any person (including an agent of 
 the employer) from the discrimination or retaliation 
 described in subparagraph
        (B) .
        (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;

    (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;

    (3) nothing in this Act shall be construed to limit or 
 prevent health care workers, social service workers, and other 
 personnel from reporting violent incidents to appropriate law 
 enforcement; and

    (4) nothing in this Act shall be construed to limit or 
 diminish any protections in relevant Federal, State, or local 
 law related to--
        (A) domestic violence;
        (B) stalking;
            (C) dating violence; and
            (D) sexual assault.

SEC. 105. OTHER DEFINITIONS.

 In this title:

    (1) Workplace violence.--
        (A) In general.--The term ``workplace violence'' 
 means any act of violence or threat of violence, 
 without regard to intent, that occurs at a covered 
 facility or while a covered employee performs a covered 
 service.
        (B) Exclusions.--The term ``workplace violence'' 
 does not include lawful acts of self-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 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 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 the period at 
 the end 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.
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