Understanding the Policy Process – H.R.1195 – Workplace Violence Prevention for HealthCare and Social Service Workers Ac

tTable of Contents

1. Introduction 3
2. Purpose Statement 3
3. Description of the Policy Problem/Issue 4
4. Brief History of the Issue 4
5. Background of the Issue 5
6. Issue Statement 6
7. Legislator’s Contact Information 6
8. Stakeholders, Special Interest Groups (SIGs), and Grassroots Efforts 7
9. Policy Goals and Objectives 9
10. Role of the Nursing Disciplines as it Relates to the Policy Issue 9
11. Policy Options and Alternatives if the Bill is Not Passed 10
12. Conclusion 10
13. References 12

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1. Understanding the Policy Process – H.R.1195 – Workplace Violence Prevention for

Health Care and Social Service Workers Act

2. Introduction

Advocacy is one of the primary functions of healthcare professionals, especially DNP-
prepared nurses. Advocacy means championing the rights, well-being, and health of patients,
colleagues, organizations, communities, faculties, and professions in general (Anders, 2021;
Abbasinia et al., 2019). One of the ways nurses can meaningfully advocate for these rights is
through the policy process, a systematized approach through which laws are made in a
jurisdiction. Today, it is a prerequisite that nurses, at the very core, comprehensively understands
the policy process, including agenda setting, lobbying, formulation, adoption, implementation
and administration, and monitoring and review/evaluation (Masoumeh et al., 2020; Etowa et al.,
2023). They must know how a bill is drafted and becomes law, the critical role voting in
Congress plays, how lobbying occurs, how public hearings can potentially impact the process,
and what role they can play in the policy process. Ideally, DNPs can play an integral role in
influencing policies by participating in the policy process without seeking elective positions.

3. Purpose Statement

This paper describes the H.R.1195 (Workplace Violence Prevention for Health Care and
Social Service Workers Act) bill, including its history, background and current status, goals and
objectives, and the stakeholders, special interest groups, and grassroots efforts involved in the
successful enactment of the bill; identifies contact information of a legislator that might assist in
passing it; explores the role of the nursing discipline as it relates to the bill; and proposes policy
options/alternatives if the bill is not passed.

4. Description of the Policy Problem/Issue

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H.R.1195, or the Workplace Violence Prevention for Health Care and Social Service
Workers Act, is a bill that primarily seeks to protect healthcare workers and other social service
workers from workplace violence. This includes clinicians like nurses, physicians, pharmacists,
physiotherapists, paramedics, chiropractors, laboratory technologists, and other practitioners. It
also covers other individuals offering social services, including child and family, school, mental
health & substance abuse, geriatrics, community, and hospice & palliative care social workers.
Social workers form a critical segment of the US labor force; they essentially work to improve
the health, quality of life, and well-being of communities, groups, families, and individuals.
Despite assisting and empowering people and communities to overcome challenges and
championing social justice and equity causes, evidence suggests that clinicians and social
workers continuously and increasingly face acts of violence at their workplaces. Workplace
violence typically includes physical abuse (kicking, pushing, hitting, and assault), verbal abuse
(shouting, insulting, and intimidating), bullying, sexual harassment, emotional and psychological
abuse (stalking, threatening, humiliation, and criticizing), and cyberbullying or online
harassment. Workplace violence can be instigated by employers, senior employees, or
colleagues, often against inferior employees.

5. Brief History of the Bill (Policy Issue)

Bill H.R.1195 was introduced into the House of Representatives by Rep. Courtney Joe of
Connecticut’s Second District on 22 nd February 2021 (117 th Congress). The bill was co-sponsored
by 145 other congressmen and women, including Representatives Scott Rober, Bacon Don,
Adams Alman, Young Don, and many others. It was referred to the Committee on Education and
Labor, the Committee on Energy and Commerce, and the Committee on Ways and Means on 5 th
April 2021. It passed the House vote on 16 April 2021 (254 Yeas against 166 Nays) and referred

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to the Senate. The bill was received in the Senate and read twice on 19 April 2021 before being
sent to the Senate’s Committee on Health, Education, Labor, and Pensions for review
(Congress.gov, n.d.). It is currently waiting for Senate approval (vote) and will be referred to the
President to be signed into law if everything goes as planned.

6. Background of the Policy Issue

Despite forming a significant part of the country’s labor force, rendering essential human
services, and playing the advocacy role, healthcare and social service workers face higher
workplace-related injuries than any other industry. In 2020, the US Bureau of Labor Statistics
reported that healthcare workers experience more than 75% of all workplace-related violence
nationally; they are also nearly four times more likely to get injured at work due to workplace
violence than employees in other work settings (Courtney, n.d.). The issue of workplace violence
in clinical settings is long and complex.
The journey to introduce comprehensive laws and standards that protect healthcare
workers and other social service employees started back in 2013 when Representative Courtney
asked GAO (Government Accountability Office) to conduct a comprehensive review of
workplace violence trends in the health sector and recommend to OSHA (Occupational Safety
and Health Administration) potential solutions to address it. Released in March 2016, the GAO
report shed light on a looming national crisis threatening to tear the healthcare and social service
industries. GAO found that the number of nonfatal workplace violence incidents in hospitals and
other healthcare facilities ranged from 22,250 and 80,710 in 2011, with beating, kicking, and
hitting ranking high (GAO, 2016). In response to this report, Congressman Courtney and other
members requested OSHA to create an overarching workplace safety standard to safeguard
clinicians from the rising incidences of workplace violence (Courtney, n.d.).

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7. Policy Issue Statement

This policy compels the US Department of Labor to address and prevent workplace
violence in social service, healthcare, and other related industries by issuing an occupational
health and safety standard that mandates employers to protect employees from workplace
violence and establish whistleblower protection for employers that report violence in their
workplaces.

8. Legislator’s Contact Information

70-year-old Senator Kathleen Passidomo (district office: 3299 East Tamiami Trail, Suite
203 Naples, FL 34112; phone contact 239-417-6205) was contacted and interviewed about bill
H.R.1195 that is presently in the Senate’s Committee on Health, Education, Labor, and Pensions
and awaiting the Senate’s vote. A request for a potential meet-up was emailed to the Senator’s
district office in Naples on 15 th May 2023 and followed by a phone call two days later; the
Senator agreed to an interview but through Skype or any other videoconference platform. A 30-
minute Skype interview was conducted on 20 th May 2023, focusing primarily on the potential
fate of the Workplace Violence Prevention for Health Care and Social Service Workers Act and
what its passage might mean to employees in the health and social work service in Florida and
nationally. The Senator was asked open-ended questions.
When asked to explain what she thinks about the motive behind the introduction of
H.R.1195 and its potential objectives and benefits, Senator Passidomo quoted the 2018 statistics
from the US Department of Labor and the Bureau of Labor Statistics. She said, “In 2019, the rate
of injuries due to workplace violence among Americans working in the healthcare and social
service industries was five times higher than the overall rate for all workers nationally” (US
Bureau of Labor Statistics, n.d.). Further, she reported that workplace violence could reduce

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employee morale and teamwork, cause mental issues, lower productivity, and increase workplace
dissatisfaction and turnover rates. For the healthcare industry, especially the nursing profession,
which is already facing severe shortages due to the aging population and lower pay, increased
turnovers can be catastrophic and derail the country’s goal of achieving healthcare equity, quality,
and safety.
Senator Passidomo also admitted that protecting health and social workers from potential
violence, intimidation, and harassment must be prioritized by the 118 th Congress and future
administrations. She was optimistic about the bill passing the upcoming Senate vote, although
the date is yet to be set. As a woman, long-standing civil servant, and now a lawmaker,
Passidomo indicated understanding the issues women and minority employees, especially people
of color, face in the labor market, from intimidation, harassment, discrimination, ridicule, and
limited employment benefit and career growth opportunities. To her, the Workplace Violence
Prevention for Health Care and Social Service Workers Act is a significant step towards
achieving equality and improving workplace safety for marginalized groups. The conversation
ended with the Senator promising to follow up on the bill and establish its status. No follow-up
has been made so far, although she promised to return soon.

9. Stakeholders, Special Interest Groups (SIGs), and Grassroots Efforts
   Since being introduced into the House, the Workplace Violence Prevention for Health
   Care and Social Service Workers Act has, over the years, received support from different
   stakeholders, special interest groups (SIGs), and grassroots advocates, including the National
   Nurses United (NNU), National Association of Social Workers (NASW), the American
   Industrial Hygiene Association, (AIHA), American Nurses Association (ANA), American
   Speech-Language-Hearing Association, American College of Occupational and Environmental

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Medicine (ACOEM), American College of Emergency Physicians (ACEP), and several other
factions.
For example, National Nurses United President Deborah Burger has reiterated the critical
role the Workplace Violence Prevention for Health Care and Social Service Workers Act can play
in holding employers in the healthcare and social service industries accountable, via federal
OSHA, for implementing a mitigation plan to prevent and altogether stop workplace violence.
President Deborah appreciated Representative Courtney and Senator Baldwin for introducing the
bill to protect nurses and other social workers from potential injuries and harm while caring for
patients, their families, and their communities.
Through its CEO, Anthony Estreet, the National Association of Social Workers has also
supported the introduction of the Workplace Violence Prevention for Health Care and Social
Service Workers Act and its potential passage. In a statement, Estreet said, “Social workers
provide essential services to individuals, families, and communities, at times at risk to their own
safety. We need to do all that we can to prevent workplace violence and protect our healthcare
and social services workforce” (Courtney, n.d.). American Industrial Hygiene Association CEO
Lawrence Sloan has gone a step further to request members of the Congress to support the
critical bipartisan bill terming it “an opportunity for Congress reduce workplace violence”
(Courtney, n.d.).

10. Policy Goals and Objectives

Bill H.R.1195 is to address workplace violence in the social service, healthcare, and other
related industries by requiring the Department of Labor’s Occupational Safety and Health
Administration (OSHA) to issue federal occupational health and safety standards that compel
employers to take actions to safeguard healthcare and social service workers from potential

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violence in their work environments (Congress.gov, n.d.). The proposed standards would
mandate employers to create and roll out comprehensive violence mitigation plans, evaluate and
avert risks, offer education and training to workers, and guarantee investigation protocols and
incident reporting are implemented. The bill also aims to create protections for “whistleblowers”
who report workplace violence and related incidences and mandates the Occupational Safety and
Health Administration to launch inspections and investigations when complaints are raised.

11. Role of the Nursing Disciplines as it Relates to the Policy Issue
    Whether acting individually or leveraging their collective power as nursing associations,
    nurses have a critical role in passing bill H.R.1195. One of these roles is advocacy or lobbying
    (Chiu et al., 2021). Since the bill is currently in the Senate, nurses can directly contact Senators
    to persuade them to pass it to promote a safe working environment for social service and
    healthcare employees. Nurses can also leverage their collective voice through unions like ANA
    and NNU to persuade legislators to vote for the bill by raising awareness of its importance (Chiu
    et al., 2021). Another possible way of influencing the policy is by participating in committee
    hearings, whereby nurses can raise concerns, ask questions, engage in dialogue, submit
    testimonies, and evaluate the policy. They can also call on the President to sign the bill into law
    after it passes the Senate.
    Besides impacting the policy process, nurses can also play a huge role in implementing
    the policy once the President has signed it into law (Hajizadeh et al., 2021; Inayat et al., 2023).
    Since workplace violence directly impacts nurses because they are at the forefront of delivering
    patient care, they have a significant role in implementing the legislation’s provisions. They can
    do so by helping identify potential workplace violence risks, reporting incidences to their
    organizations and relevant authorities like OSHA, working closely with interdisciplinary leaders

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to guarantee compliance with the safety rules and guidelines, and taking part in workplace
prevention programs and plans implemented by their organizations, including education and
training.

12. Policy Options and Alternatives if the Bill is Not Passed

If bill H.R.1195 fails to pass the Senate vote or the President vetoes it, the only option is to
direct more efforts to similar bills, including S.4182 (Workplace Violence Prevention for Health
Care and Social Service Workers Act) introduced into the Senate by Wisconsin Senator Tammy
Suzanne Baldwin on 11 th May 2022 (GovInfo.gov, n.d.). The bill is currently undergoing
hearings at the Committee on Jurisdiction and serves the same purpose as H.R.1195: compel the
Secretary of Labor to issue a standard that necessitates covered employers within the social
service and healthcare industries to design and roll out comprehensive workplace violence
mitigation plans (Kaine.Senate.gov, n.d.).

13. Conclusion

Nurses can play a critical role in the policy process, from when a bill is drafted and
introduced into the House or Senate to when it is referred to public hearings and respective
legislators vote it to the last moment the President signs it into law. Typically, at every stage,
nurses can root for and voice their concerns and support for the bills by directly contacting
legislators and persuading them to either support or shoot them down. This can be done at an
individual level or through labor unions. At the same time, nurses have a significant role in
implementing provisions stipulated in bills after they become laws.

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References

Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2019). Patient advocacy in nursing: A concept
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Anders, R. L. (2021). Engaging nurses in health policy in the era of COVID-19. Nursing Forum,
56(1), 89-94. doi: 10.1111/nuf.12514
Bureau of Labor Statistics. (n.d.). Injuries, illnesses, and fatalities.
https://www.bls.gov/iif/home.htm
Chiu, P., Cummings, G. G., Thorne, S., & Schick-Makaroff, K. (2021). Policy advocacy and
nursing organizations: A scoping review. Policy, Politics & Nursing Practice, 22(4), 271-

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     GAO. (2016). Report to Congressional requesters – Workplace safety and health. United States
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GovInfo.gov. (n.d.). S. 4182 (IS) – Workplace Violence Prevention for Health Care and Social
Service Workers Act. https://www.govinfo.gov/app/details/BILLS-117s4182is
Hajizadeh, A., Zamanzadeh, V., Kakemann, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021).
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