,,ii #aafth ,,congress #ast ,session ,s4 #hea ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #ad1 #bjai,ms4 ,baldwin 7for herself1 ,ms4 ,warren1 ,mr4 ,schatz1 ,mrs4 ,gillibrand1 ,mr4 ,brown1 and ,mr4 ,blumenthal7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,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 plan1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,workplace ,violence ,prevention for ,health ,care and ,social ,service ,workers ,act4 #b4 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title4,sec4 #b4 ,table of contents4,title ,i--,workplace ,violence ,prevention ,standard,sec4 #aja4 ,workplace violence prevention standard4,sec4 #ajb4 ,scope and application4,sec4 #ajc4 ,requirements for workplace violence prevention standard4,sec4 #ajd4 ,rules of construction4,sec4 #aje4 ,other definitions4,title ,,ii--,amendments to the ,social ,security ,act,sec4 #bja4 ,application of the workplace violence prevention standard to certain facilities receiving ,medicare funds4 ,i ,workplace ,violence ,prevention ,standard #aja4 ,workplace violence prevention standard 7a7 ,interim final standard 7#a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,secretary of ,labor shall promulgate an interim final standard on workplace violence prevention-- 7,a7 to require certain employers in the health care and social service sectors1 and certain employers in sectors that conduct activities similar to the activities in the health care and social service sectors1 to develop and implement a comprehensive workplace violence prevention plan to protect health care workers1 social service workers1 and other personnel from workplace violence2 and 7,b7 that shall1 at a minimum1 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 #bjae and adhere to the requirements of this title4 7#b7 ,applicability of other statutory requirements ,the following shall not apply to the promulgation of the interim final standard under this subsection3 7,a7 ,the requirements applicable to occupational safety and health standards under section #f7;b7 of the ,occupational ,safety and ,health ,act of #aigj 7#bi ,u4,s4,c4 #fee7;b774 7,b7 ,the requirements of chapters #e and #f of title #e1 ,united ,states ,code1 and titles #b and #db1 ,united ,states ,code4 7#c7 ,notice and comment ,notwithstanding paragraph 7#b77;,b71 the ,secretary shall1 prior to promulgating the interim final standard under this subsection1 provide notice of the interim final standard and a #cj-;day opportunity for public comment4 7#d7 ,effective date of interim standard ,the interim final standard shall-- 7,a7 take effect on a date that is not later than #cj days after promulgation1 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 date2 7,b7 be enforced in the same manner and to the same extent as any standard promulgated under section #f7;b7 of the ,occupational ,safety and ,health ,act of #aigj 7#bi ,u4,s4,c4 #fee7;b772 and 7,c7 be in effect until the final standard described in subsection 7b7 becomes effective and enforceable4 7#e7 ,failure to promulgate ,if an interim final standard described in paragraph 7#a7 is not promulgated not later than #a year of the date of enactment of this ,act1 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 #f7;b7 of the ,occupational ,safety and ,health ,act of #aigj 7#bi ,u4,s4,c4 #fee7;b77 until such provisions are superseded in whole by an interim final standard promulgated by the ,secretary that meets the requirements of paragraph 7#a74 7b7 ,final standard 7#a7 ,proposed final standard ,not later than #b years after the date of enactment of this ,act1 the ,secretary of ,labor shall1 pursuant to section #f of the ,occupational ,safety and ,health ,act of #aigj 7#bi ,u4,s4,c4 #fee71 promulgate a proposed final standard on workplace violence prevention-- 7,a7 for the purposes described in subsection 7a77#a77;,a72 and 7,b7 that shall include1 at a minimum1 the elements contained in the interim final standard promulgated under subsection 7a74 7#b7 ,final standard ,not later than #db months after the date of enactment of this ,act1 the ,secretary shall promulgate a final standard on such proposed standard that shall-- 7,a7 provide no less protection than any workplace violence standard adopted by a ,state plan that has been approved by the ,secretary under section #ah of the ,occupational ,safety and ,health ,act of #aigj 7#bi ,u4,s4,c4 #ffg72 and 7,b7 be effective and enforceable in the same manner and to the same extent as any standard promulgated under section #f7;b7 of the ,occupational ,safety and ,health ,act of #aigj 7#bi ,u4,s4,c4 #fee7;b774 #ajb4 ,scope and application ,in this title3 7#a7 ,covered facility ,the term covered facility includes the following3 7,a7 ,any hospital1 including any specialty hospital1 in-patient or outpatient setting1 or clinic operating within a hospital license1 or any setting that provides outpatient services4 7,b7 ,any residential treatment facility1 including any nursing home1 skilled nursing facility1 hospice facility1 and long-term care facility4 7,c7 ,any non-residential treatment or service setting4 7,d7 ,any medical treatment or social service setting or clinic at a correctional or detention facility4 7,e7 ,any community care setting1 including a community-based residential facility1 group home1 and mental health clinic4 7,f7 ,any psychiatric treatment facility4 7,g7 ,any drug abuse or substance use disorder treatment center4 7,h7 ,any independent freestanding emergency centers4 7,i7 ,any facility described in subparagraphs 7,a7 through 7,h7 operated by a ,federal ,government agency and required to comply with occupational safety and health standards pursuant to part #aifj of title #bi1 ,code of ,federal ,regulations 7or any corresponding similar regulations or rulings74 7,j7 ,any other facility the ,secretary determines should be covered under the standards promulgated under section #aja4 7#b7 ,covered services ,the term covered service includes the following services and operations3 7,a7 ,any services and operations provided in any field work setting1 including home health care1 home-based hospice1 and home-based social work4 7,b7 ,any emergency services and transport1 including such services provided by firefighters and emergency responders4 7,c7 ,any services described in subparagraphs 7,a7 and 7,b7 performed by a ,federal ,government agency and required to comply with occupational safety and health standards pursuant to part #aifj of title #bi1 ,code of ,federal ,regulations 7or any corresponding similar regulations or rulings74 7,d7 ,any other services and operations the ,secretary determines should be covered under the standards promulgated under section #aja4 7#c7 ,covered employer 7,a7 ,in general ,the term covered employer includes a person 7including a contractor1 subcontractor1 a temporary service firm1 or an employee leasing entity7 that employs an individual to work at a covered facility or to perform covered services4 7,b7 ,exclusion ,the term covered employer does not include an individual who privately employs1 in the individual's residence1 a person to perform covered services for the individual or a family member of the individual4 7#d7 ,covered employee ,the term covered employee includes an individual employed by a covered employer to work at a covered facility or to perform covered services4 #ajc4 ,requirements for workplace violence prevention standard ,each standard described in section #aja shall include1 at a minimum1 the following requirements3 7#a7 ,workplace violence prevention plan ,not later than #f months after the date of promulgation of the interim final standard under section #aja7;a71 a covered employer shall develop1 implement1 and maintain an effective written workplace violence prevention plan 7referred to in this section as a ,plan7 for covered employees at each covered facility and for covered employees performing a covered service on behalf of such employer1 which meets the following3 7,a7 ,plan development ,each ,plan shall-- 7i7 be developed and implemented with the meaningful participation of direct care employees and1 where applicable1 employee representatives and collective bargaining representatives1 for all aspects of the ,plan2 7ii7 be tailored and specific to conditions and hazards for the covered facility or the covered service1 including patient-specific risk factors and risk factors specific to each work area or unit2 and 7iii7 be suitable for the size1 complexity1 and type of operations at the covered facility or for the covered service1 and remain in effect at all times4 7,b7 ,plan content ,each ,plan shall include procedures and methods for the following3 7i7 ,identification of the individual responsible for implementation of the ,plan4 7ii7 ,with respect to each work area and unit at the covered facility or while covered employees are performing the covered service1 risk assessment and identification of workplace violence risks and hazards to employees exposed to such risks and hazards 7including environmental risk factors and patient-specific risk factors71 which shall be-- 7,i7 informed by past violent incidents specific to such covered facility or such covered service2 and 7,,ii7 conducted with1 at a minimum-- 7aa7 direct care employees2 7bb7 where applicable1 the representatives of such employees2 and 7cc7 the employer4 7iii7 ,hazard prevention1 engineering controls1 or work practice controls to correct hazards in a timely manner1 applying industrial hygiene principles of the hierarchy of controls1 which-- 7,i7 may include security and alarm systems1 adequate exit routes1 monitoring systems1 barrier protection1 established areas for patients and clients1 lighting1 entry procedures1 staffing and working in teams1 and systems to identify and flag clients with a history of violence2 and 7,,ii7 shall ensure that employers correct1 in a timely manner1 hazards identified in the annual report described in paragraph 7#e74 7iv7 ,reporting1 incident response1 and post-incident investigation procedures1 including procedures-- 7,i7 for employees to report workplace violence risks1 hazards1 and incidents2 7,,ii7 for employers to respond to reports of workplace violence2 7,,iii7 for employers to perform a post-incident investigation and debriefing of all reports of workplace violence with the participation of employees and their representatives2 and 7,,iv7 to provide medical care or first aid to affected employees4 7v7 ,procedures for emergency response1 including procedures for threats of mass casualties and procedures for incidents involving a firearm or a dangerous weapon4 7vi7 ,procedures for communicating with and training of covered employees on workplace violence hazards1 threats1 and work practice controls1 the ,plan1 and procedures for confronting1 responding to1 and reporting workplace violence threats1 incidents1 and concerns1 and employee rights4 7vii7 ,procedures for determining which covered employer or employers shall be responsible for implementing and complying with the provisions of the standard applicable to the working conditions over which such employers have control1 and ensuring the coordination of risk assessment efforts1 ,plan development1 and implementation of the ,plan with other employers who have employees who work at the covered facility or who are performing the covered service4 7viii7 ,procedures for conducting the annual evaluation under paragraph 7#f74 7,c7 ,availability of ,plan ,each ,plan shall be made available at all times to the covered employees who are covered under such ,plan4 7#b7 ,violent incident investigation 7,a7 ,in general ,as soon as practicable after a workplace violence incident1 risk1 or hazard of which a covered employer has knowledge1 the employer shall conduct an investigation of such incident1 risk1 or hazard under which the employer shall-- 7i7 review the circumstances of the incident1 risk1 or hazard1 and whether any controls or measures implemented pursuant to the ,plan of the employer were effective2 and 7ii7 solicit input from involved employees1 their representatives1 and supervisors1 about the cause of the incident1 risk1 or hazard1 and whether further corrective measures 7including system-level factors7 could have prevented the incident1 risk1 or hazard4 7,b7 ,documentation ,a covered employer shall document the findings1 recommendations1 and corrective measures taken for each investigation conducted under this paragraph4 7#c7 ,training and education ,with respect to the covered employees covered under a ,plan of a covered employer1 the employer shall provide training and education to such employees who may be exposed to workplace violence hazards and risks1 which meet the following requirements3 7,a7 ,annual training and education includes information on the ,plan1 including identified workplace violence hazards1 work practice control measures1 reporting procedures1 record keeping requirements1 response procedures1 and employee rights4 7,b7 ,additional hazard recognition training for supervisors and managers to ensure they can recognize high-risk situations and do not assign employees to situations that predictably compromise their safety4 7,c7 ,additional training for each such covered employee whose job circumstances has changed1 within a reasonable timeframe after such change4 7,d7 ,new employee training prior to assignment4 7,e7 ,all training provides such employees opportunities to ask questions1 give feedback on such training1 and request additional instruction1 clarification1 or other follow up4 7,f7 ,all training is provided in-person and by an individual with knowledge of workplace violence prevention and of the ,plan4 7,g7 ,all training is appropriate in content and vocabulary to the language1 educational level1 and literacy of such covered employees4 7#d7 ,recordkeeping and access to plan records 7,a7 ,in general ,each covered employer shall-- 7i7 maintain at all times-- 7,i7 records related to each ,plan of the employer1 including workplace violence risk and hazard assessments1 and identification1 evaluation1 correction1 and training procedures2 7,,ii7 a violent incident log described in subparagraph 7,b7 for recording all workplace violence incidents2 and 7,,iii7 records of all incident investigations as required under paragraph 7#b77;,b72 and 7ii7 make such records and logs available1 upon request1 to covered employees and their representatives for examination and copying in accordance with section #aiaj4ajbj of title #bi1 ,code of ,federal ,regulations 7or any corresponding similar regulation or ruling71 and in a manner consistent with ,,hipaa privacy regulations 7defined in section #aahj7;b77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;d-#i7;b77#c777 and part #b of title #db1 ,code of ,federal ,regulations 7or any corresponding similar regulations or rulings74 7,b7 ,violent incident log description ,each violent incident log shall-- 7i7 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 employer2 7ii7 be based on a template developed by the ,secretary not later than #a year after the date of enactment of this ,act2 7iii7 include1 at a minimum1 a description of-- 7,i7 the violent incident 7including environmental risk factors present at the time of the incident72 7,,ii7 the date1 time1 and location of the incident1 and the names and job titles of involved employees2 7,,iii7 the nature and extent of injuries to covered employees2 7,,iv7 a classification of the perpetrator who committed the violence1 including whether the perpetrator was-- 7aa7 a patient1 client1 or customer of a covered employer2 7bb7 a family or friend of a patient1 client1 or customer of a covered employer2 7cc7 a stranger with criminal intent2 7dd7 a coworker1 supervisor1 or manager of a covered employee2 7ee7 a partner1 spouse1 parent1 or relative of a covered employee2 or 7ff7 any other appropriate classification2 7,v7 the type of violent incident 7such as type #a violence1 type #b violence1 type #c violence1 or type #d violence72 and 7,,vi7 how the incident was abated2 7iv7 omit any element of personal identifying information sufficient to allow identification of any patient1 resident or client alleged to have committed a violent incident 7including the person's name1 address1 electronic mail address1 telephone number1 or social security number1 or other information that1 alone or in combination with other publicly available information1 reveals such person's identity72 7v7 not later than #g days after the employer learns of such incident1 contain a record of each violent incident1 which is updated to ensure completeness of such record2 7vi7 be maintained for not less than #e years2 and 7vii7 in the case of a violent incident involving a privacy concern case1 protect the identity of employees in a manner consistent with section #aijd4bi7;b7 of title #bi1 ,code of ,federal ,regulations 7or any corresponding similar regulation or ruling74 7,c7 ,annual summary 7i7 ,covered employers ,each covered employer shall prepare an annual summary of each violent incident log for the preceding calendar year that shall-- 7,i7 with respect to each covered facility1 and each covered service1 for which such a log has been maintained1 include the total number of violent incidents1 the number of recordable injuries related to such incidents1 and the total number of hours worked by the covered employees for such preceding year2 7,,ii7 be completed on a form provided by the ,secretary2 7,,iii7 be posted for three months beginning ,february #a of each year in a manner consistent with the requirements of part #aijd of title #bi1 ,code of ,federal ,regulations 7or any corresponding similar regulations or rulings71 relating to the posting of summaries of injury and illness logs2 7,,iv7 be located in a conspicuous place or places where notices to employees are customarily posted2 and 7,v7 not be altered1 defaced1 or covered by other material4 7ii7 ,secretary ,not later than #a year after the promulgation of the interim final standard under section #aja7;a71 the ,secretary shall make available a platform for the electronic submission of annual summaries required under this paragraph4 7#e7 ,annual report ,not later than ,february #ae of each year1 each covered employer shall report to the ,secretary1 the frequency1 quantity1 and severity of workplace violence1 and any incident response and post-incident investigation 7including abatement measures for the incidents7 set forth in the annual summary of the violent incident log described in paragraph 7#d77;,c74 7#f7 ,annual evaluation ,each covered employer shall conduct an annual written evaluation1 conducted with the full1 active participation of covered employees and employee representatives1 of-- 7,a7 the implementation and effectiveness of the ,plan1 including a review of the violent incident log2 and 7,b7 compliance with training required by each standard described in section #aja1 and specified in the ,plan4 7#g7 ,anti-retaliation 7,a7 ,policy ,each covered employer shall adopt a policy prohibiting any person 7including an agent of the employer7 from discriminating or retaliating against any employee for reporting1 or seeking assistance or intervention from1 a workplace violence incident1 threat1 or concern to the employer1 law enforcement1 local emergency services1 or a government agency1 or participating in an incident investigation4 7,b7 ,prohibition ,no covered employer shall discriminate or retaliate against any employee for reporting1 or seeking assistance or intervention from1 a workplace violence incident1 threat1 or concern to the employer1 law enforcement1 local emergency services1 or a government agency1 or for exercising any other rights under this paragraph4 7,c7 ,enforcement ,this paragraph shall be enforced in the same manner and to the same extent as any standard promulgated under section #f7;b7 of the ,occupational ,safety and ,health ,act of #aigj 7#bi ,u4,s4,c4 #fee7;b774 #ajd4 ,rules of construction ,notwithstanding section #ah of the ,occupational ,safety and ,health ,act of #aigj 7#bi ,u4,s4,c4 #ffg7-- 7#a7 nothing in this title shall be construed to curtail or limit authority of the ,secretary under any other provision of the law2 and 7#b7 the rights1 privileges1 or remedies of covered employees shall be in addition to the rights1 privileges1 or remedies provided under any ,federal or ,state law1 or any collective bargaining agreement4 #aje4 ,other definitions ,in this title3 7#a7 ,workplace ,violence 7,a7 ,in general ,the term workplace violence means any act of violence or threat of violence1 without regard to intent1 that occurs at a covered facility or while a covered employee performs a covered service4 7,b7 ,exclusions ,the term workplace violence does not include lawful acts of self-defense or defense of others4 7,c7 ,inclusions ,the term workplace violence includes-- 7i7 the threat or use of physical force against a covered employee that results in or has a high likelihood of resulting in injury1 psychological trauma1 or stress1 without regard to whether the covered employee sustains an injury1 psychological trauma1 or stress2 and 7ii7 an incident involving the threat or use of a firearm or a dangerous weapon1 including the use of common objects as weapons1 without regard to whether the employee sustains an injury1 psychological trauma1 or stress4 7#b7 ,type #a violence ,the term type #a violence-- 7,a7 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 service2 and 7,b7 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 crime4 7#c7 ,type #b violence ,the term type #b violence means workplace violence directed at a covered employee by customers1 clients1 patients1 students1 inmates1 or any individual for whom a covered facility provides services or for whom the employee performs covered services4 7#d7 ,type #c violence ,the term type #c violence means workplace violence directed at a covered employee by a present or former employee1 supervisor1 or manager4 7#e7 ,type #d violence ,the term type #d violence means workplace violence directed at a covered employee by an individual who is not an employee1 but has or is known to have had a personal relationship with such employee4 7#f7 ,threat of ,violence ,the term threat of violence means a statement or conduct that causes a person to fear for his or her safety because there is a reasonable possibility the person might be physically injured1 and that serves no legitimate purpose4 7#g7 ,alarm ,the term alarm means a mechanical1 electrical1 or electronic device that does not rely upon an employee's vocalization in order to alert others4 7#h7 ,dangerous weapon ,the term dangerous weapon means an instrument capable of inflicting death or serious bodily injury1 regardless of whether such instrument was designed for that purpose4 7#i7 ,engineering controls 7,a7 ,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 hazard4 7,b7 ,inclusions ,for purposes of reducing workplace violence hazards1 the term engineering controls includes electronic access controls to employee occupied areas1 weapon detectors 7installed or handheld71 enclosed workstations with shatter-resistant glass1 deep service counters1 separate rooms or areas for high-risk patients1 locks on doors1 removing access to or securing items that could be used as weapons1 furniture affixed to the floor1 opaque glass in patient rooms 7which protects privacy1 but allows the health care provider to see where the patient is before entering the room71 closed-circuit television monitoring and video recording1 sight-aids1 and personal alarm devices4 7#aj7 ,environmental risk factors 7,a7 ,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 incident4 7,b7 ,clarification ,environmental risk factors may be associated with the specific task being performed or the work area1 such as working in an isolated area1 poor illumination or blocked visibility1 and lack of physical barriers between employees and persons at risk of committing workplace violence4 7#aa7 ,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 incident1 including-- 7,a7 a patient's history of violence and use of drugs or alcohol2 and 7,b7 any conditions or disease processes of the patient that may cause the patient to experience confusion or disorientation1 to be non-responsive to instruction1 to behave unpredictably1 or to engage in disruptive1 threatening1 or violent behavior4 7#ab7 ,secretary ,the term ,secretary means the ,secretary of ,labor4 7#ac7 ,work practice controls 7,a7 ,in general ,the term work practice controls means procedures and rules that are used to effectively reduce workplace violence hazards4 7,b7 ,inclusions ,the term work practice controls includes assigning and placing sufficient numbers of staff to reduce patient-specific ,type #b workplace violence hazards1 provision of dedicated and available safety personnel such as security guards1 employee training on workplace violence prevention method and techniques to de-escalate and minimize violent behavior1 and employee training on procedures for response in the event of a workplace violence incident and for post-incident response4 ,,ii ,amendments to the ,social ,security ,act #bja4 ,application of the workplace violence prevention standard to certain facilities receiving ,medicare funds 7a7 ,in general ,section #ahff of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7 is amended-- 7#a7 in subsection 7a77#a7-- 7,a7 by moving the indentation of subparagraph 7,w7 #b ems to the left2 7,b7 in subparagraph 7,x7-- 7i7 by moving the indentation #b ems to the left2 and 7ii7 by striking and at the end2 7,c7 in subparagraph 7,y71 by striking the period at the end and inserting 2 and2 and 7,d7 by inserting after subparagraph 7,y7 the following new subparagraph3 7,z7 in the case of hospitals that are not otherwise subject to the ,occupational ,safety and ,health ,act of #aigj 7or a ,state occupational safety and health plan that is approved under #ah7;b7 of such ,act7 and skilled nursing facilities that are not otherwise subject to such ,act 7or such a ,state occupational safety and health plan71 to comply with the ,workplace ,violence ,prevention ,standard 7as promulgated under section #aja of the ,workplace ,violence ,prevention for ,health ,care and ,social ,service ,workers ,act74 2 and 7#b7 in subsection 7b77#d7-- 7,a7 in subparagraph 7,a71 by inserting and a hospital or skilled nursing facility that fails to comply with the requirement of subsection 7a77#a77,z7 7relating to the ,workplace ,violence ,prevention ,standard7 after ,bloodborne ,pathogens standard72 and 7,b7 in subparagraph 7,b7-- 7i7 by striking 7a77#a77,u7 and inserting 7a77#a77,v72 and 7ii7 by inserting 7or1 in the case of a failure to comply with the requirement of subsection 7a77#a77,z71 for a violation of the ,workplace ,violence ,prevention standard referred to in such subsection by a hospital or skilled nursing facility1 as applicable1 that is subject to the provisions of such ,act7 before the period at the end4 7b7 ,effective date ,the amendments made by subsection 7a7 shall apply beginning on the date that is #a year after the date of issuance of the interim final standard on workplace violence prevention required under section #aja4