S. 1232 — Workplace Violence Prevention for Health Care and Social Service Workers Act

This section requires the Secretary of Labor to issue, not later than one year after enactment, an interim final occupational safety and health standard on workplace violence prevention for employers in health care and social service sectors and sectors conducting similar activities (e.g., requiring comprehensive prevention plans and other measures under section 103 to protect relevant workers). The interim standard, based at minimum on 2015 OSHA Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, bypasses OSH Act section 6(b) procedures (29 U.S.C. 655(b)), Administrative Procedure Act chapters 5 and 6, the Paperwork Reduction Act, and Executive Order 12866 (with a 30-day Federal Register comment period); it takes effect within 30 days (with possible phase-in for engineering controls), is enforced like a section 6(b) standard, prioritizes technical assistance for up to one year, and remains effective until a final standard supersedes it. (Thus, if not issued within one year, this title's provisions apply and are enforced as a section 6(b) standard.) Not later than two years after enactment, the Secretary must issue a proposed final standard pursuant to OSH Act section 6 (29 U.S.C. 655) containing at minimum the interim standard's requirements; not later than 42 months after enactment, the Secretary must issue the final standard, enforced like a section 6(b) standard and providing no less protection than any OSHA-approved state plan standard if feasible based on the best available evidence.

This section defines four terms for purposes of this title: (1) *Covered facility*, which includes hospitals (including outpatient settings), residential treatment facilities (e.g., nursing homes, long-term care facilities), non-residential treatment settings, correctional or detention facility clinics, community care settings (e.g., group homes, mental health clinics), psychiatric facilities, substance use disorder treatment centers, freestanding emergency centers, certain federal facilities subject to 29 CFR 1960, and others designated by the Secretary (excluding independent offices of physicians, dentists, or other practitioners); (2) *Covered service*, which includes home-based services (e.g., health care, hospice, social work), emergency services and transport (including by firefighters), certain federal services subject to 29 CFR 1960, and others designated by the Secretary (excluding child day care); (3) *Covered employer*, which includes any person (e.g., contractors, temporary firms) employing individuals at a covered facility or to perform covered services (excluding individuals privately employing in their residence); and (4) *Covered employee*, which includes individuals employed by a covered employer at a covered facility or to perform covered services.

This section establishes minimum requirements for workplace violence prevention standards promulgated under section 101, including a written workplace violence prevention plan (Plan) that covered employers must develop, implement, and maintain within six months of standard promulgation for covered employees at covered facilities or performing covered services. The Plan must be developed with meaningful participation of direct care employees, other employees, and representatives; be tailored to facility- or service-specific risks (including patient-specific factors); identify a responsible individual; include risk assessments informed by past incidents; apply hierarchy-of-controls hazard corrections (e.g., security systems, lighting, staffing); provide reporting, incident response, post-incident investigation and debriefing, emergency response, training communication, multi-employer coordination, and annual evaluation procedures; and be available to covered employees at all times. This section further requires covered employers to investigate workplace violence incidents, risks, or hazards as soon as practicable—with employee input, effectiveness review of Plan measures, and documentation of findings and corrections—and to provide annual training for covered employees on the Plan, hazards, controls, reporting, response procedures, anti-retaliation policies, and employee rights (with additional hazard recognition training for supervisors).

This section provides rules of construction notwithstanding section 18 of the Occupational Safety and Health Act of 1970 (i.e., approved state plans to develop and enforce occupational safety and health standards at least as effective as federal standards), as follows: (1) nothing in this title curtails or limits the Secretary's authority under any other provision of law; (2) rights, privileges, or remedies of covered employees are in addition to those provided under any federal or state law or collective bargaining agreement; (3) nothing in this Act limits or prevents health care workers, social service workers, and other personnel from reporting violent incidents to law enforcement; and (4) nothing in this Act limits or diminishes protections under relevant federal, state, or local law related to domestic violence, stalking, dating violence, or sexual assault.

This section defines terms used in this title, including "workplace violence" (any act or threat of violence at a covered facility or during covered services, excluding lawful self-defense, and including physical force or use of firearms/weapons likely to cause injury, trauma, or stress); categorizes it into four types—(1) Type 1 violence by individuals without legitimate business there (e.g., criminals entering to commit crimes), (2) Type 2 violence by customers, clients, patients, students, or inmates, (3) Type 3 violence by present/former coworkers or supervisors, and (4) Type 4 violence by non-employees with personal relationships to the employee or service recipients; "threat of violence" (statements/conduct causing reasonable fear of injury with no legitimate purpose); "dangerous weapon" (any instrument capable of death or serious injury); "engineering controls" (built-in hazard barriers/removals, e.g., weapon detectors, locked doors, CCTV); "work practice controls" (procedures to reduce hazards, e.g., adequate staffing, security guards, de-escalation training); "environmental risk factors" (e.g., isolation, poor lighting); "patient-specific risk factors" (e.g., history of violence, confusion-causing conditions); "alarm" (non-vocal alert device); and "Secretary" (Secretary of Labor).

This section requires Medicare-participating hospitals and skilled nursing facilities not subject to the Occupational Safety and Health Act of 1970 (or an approved 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) as a condition of their provider agreement. It further specifies that noncompliance with this standard is grounds for termination of the agreement (similar to noncompliance with the Bloodborne Pathogens standard). The amendments apply beginning one year after issuance of the required interim final standard.