H.R. 2531

[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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