SAVE Act

I 118TH CONGRESS 1ST SESSION H. R. 2584 To protect hospital personnel from violence, and for other purposes. IN THE HOUSE OF REPRESENTATIVES APRIL 13, 2023 Mr. BUCSHON (for himself and Ms. DEAN of Pennsylvania) introduced the following bill; which was referred to the Committee on the Judiciary A BILL To protect hospital personnel from violence, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Safety From Violence 4 for Healthcare Employees Act’’ or the ‘‘SAVE Act’’. 5 SEC. 2. PREVENTION OF VIOLENCE AGAINST HOSPITAL 6 PERSONNEL. 7 (a) FINDINGS.—Congress makes the following find- 8 ings: 9 VerDate Sep 11 2014 23:41 Apr 14, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2584.IH H2584 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 2584 IH (1) The incidence of assault and intimidation 1 against hospital employees poses a serious national 2 problem. 3 (2) The problem of assault and intimidation 4 against hospital and health care employees preceded 5 the COVID–19 pandemic. According to an April 6 2020 Bureau of Labor Statistics report, the health 7 care and social service industries experienced the 8 highest rates of injuries caused by workplace vio- 9 lence and were 5 times as likely to suffer a work- 10 place violence injury than workers overall in 2018. 11 That report also found that the incidence rate for 12 workplace violence against health care workers had 13 steadily increased since 2011. The COVID–19 pan- 14 demic exacerbated this growing problem. 15 (3) Workplace violence in hospitals inhibits hos- 16 pital employees from performing their duties and 17 thereby disrupts the delivery of health care services 18 and leads to adverse patient outcomes. Violence to- 19 wards hospital workers also has been associated with 20 decreased productivity and quality of care, employee 21 absenteeism, and increased employee turnover. 22 (4) State and local authorities are now and will 23 continue to be responsible for prosecuting the over- 24 whelming majority of violent crimes in the United 25 VerDate Sep 11 2014 23:41 Apr 14, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2584.IH H2584 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 2584 IH States, including assault and intimidation against 1 hospital employees. These authorities can address 2 the problem of assault and intimidation against hos- 3 pital employees more effectively with greater Federal 4 law enforcement involvement. 5 (5) Existing Federal law is inadequate to ad- 6 dress this problem. 7 (6) Assault and intimidation against hospital 8 employees substantially affects interstate commerce 9 in many ways, including the following: 10 (A) Health care services are a significant 11 part of the national economy. In 2021, expendi- 12 tures on health care services accounted for 18.3 13 percent of the country’s gross domestic product 14 (or $4,300,000,000,000). Within health care, 15 hospitals and health systems are economic pil- 16 lars that create jobs and support economic 17 growth across State lines. In 2021, hospitals di- 18 rectly employed 6,350,000 individuals. More 19 broadly, hospitals supported 17,815,000 jobs 20 throughout the entire interstate economy—1 21 out of 8 jobs in the United States—and sup- 22 ported nearly $4,000,000,000 in overall eco- 23 nomic activity. 24 VerDate Sep 11 2014 23:41 Apr 14, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2584.IH H2584 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 2584 IH (B) The health care market, and hospitals 1 in particular, are heavily regulated by the Fed- 2 eral Government. 3 (C) Hospital revenue comes from interstate 4 or Federal sources, such as out-of-State insur- 5 ers or Medicare. 6 (D) Hospital employees who are victims of 7 assault or intimidation are prevented from pur- 8 chasing goods and services, obtaining or sus- 9 taining employment, or participating in other 10 commercial activity. 11 (E) Facilities and instrumentalities of 12 interstate commerce have been used in the com- 13 mission of assault and intimidation against hos- 14 pital employees. 15 (F) Assault and intimidation against hos- 16 pital employees has been committed using arti- 17 cles that have traveled in interstate commerce. 18 (7) In Summit Health, Ltd. v. Pinhas, 500 19 U.S. 322, 329–30 (1991), the Supreme Court of the 20 United States held that it is ‘‘clear’’ that hospitals 21 are ‘‘regularly’’ engaged in interstate commerce, per- 22 forming services for out-of-State patients and gener- 23 ating revenues from out-of-State sources. 24 VerDate Sep 11 2014 23:41 Apr 14, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2584.IH H2584 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 2584 IH (8) In Taylor v. United States, 579 1 U.S.lll(2016), the Supreme Court of the United 2 States ruled that activities that affect commerce 3 may be regulated so long as they substantially affect 4 interstate commerce in the aggregate, even if their 5 individual impact on interstate commerce is minimal. 6 In addition, as the United States Court of Appeals 7 for the Fourth Circuit recognized in United States 8 v. Hill, 927 F.3d 188 (4th Cir. 2019), Taylor and 9 other Supreme Court decisions establish that when 10 Congress may regulate an economic or commercial 11 activity—as it may with respect to hospitals—it also 12 may regulate violent conduct that interferes with or 13 affects that activity. Accordingly, if individuals are 14 engaged in ongoing economic or commercial activity 15 subject to congressional regulation—as hospital em- 16 ployees are—then Congress also may prohibit violent 17 crime that interferes with or affects such individuals’ 18 ongoing economic or commercial activity. 19 (9) Federal jurisdiction over certain violent 20 crimes against hospital employees enables Federal, 21 State, and local authorities to work together as part- 22 ners in the investigation and prosecution of such 23 crimes. 24 VerDate Sep 11 2014 23:41 Apr 14, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2584.IH H2584 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 2584 IH (10) The problem of assault and intimidation 1 against hospital employees is serious, widespread, 2 and interstate in nature as to warrant Federal as- 3 sistance to hospitals to combat that activity. 4 (b) PROHIBITION ON INTERFERENCE WITH HOS- 5 PITAL PERSONNEL IN THE PERFORMANCE OF DUTIES.— 6 (1) IN GENERAL.—Chapter 7 of title 18, United 7 States Code, is amended by adding at the end the 8 following: 9 ‘‘§ 120. Interference with performance of duties of 10 hospital personnel 11 ‘‘(a) IN GENERAL.—Whoever knowingly assaults or 12 intimidates an individual employed by a hospital, or an 13 entity contracting with a hospital or other medical facility, 14 during the course of the performance of the duties of such 15 individual, and, as a result, interferes with the perform- 16 ance of the duties of such individual or limits the ability 17 of such individual to perform such duties, shall be fined 18 under this title, imprisoned not more than 10 years, or 19 both. 20 ‘‘(b) ENHANCED PENALTIES.— 21 ‘‘(1) ACTS INVOLVING DANGEROUS WEAPONS 22 OR ACTS THAT RESULT IN BODILY INJURY.—Who- 23 ever, in the commission of any act described in sub- 24 section (a), uses a deadly or dangerous weapon or 25 VerDate Sep 11 2014 23:41 Apr 14, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2584.IH H2584 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 2584 IH inflicts bodily injury, shall be fined under this title 1 or imprisoned not more than 20 years, or both. 2 ‘‘(2) ACTS COMMITTED DURING EMERGENCY 3 DECLARATIONS.—Whoever commits any act de- 4 scribed in subsection (a) during the period of a dec- 5 laration of a public emergency for the area in which 6 the act is committed shall be fined under this title 7 or imprisoned not more than 20 years, or both. 8 ‘‘(c) DEFENSE.—It shall be a defense to a prosecu- 9 tion under this section that— 10 ‘‘(1) the defendant is a person with a physical, 11 mental, or intellectual disability; and 12 ‘‘(2) the conduct of the defendant was a clear 13 and direct manifestation of such disability. 14 ‘‘(d) DEFINITIONS.—In this section: 15 ‘‘(1) HOSPITAL.—The term ‘hospital’ means 16 any of the following medical facilities: 17 ‘‘(A) A hospital (as defined in section 18 1861(e) of the Social Security Act (42 U.S.C. 19 1395x(e))). 20 ‘‘(B) A long-term care hospital (as defined 21 in section 1861(ccc) of such Act (42 U.S.C. 22 1395x(ccc))). 23 VerDate Sep 11 2014 23:41 Apr 14, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2584.IH H2584 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 2584 IH ‘‘(C) A rehabilitation facility (as defined in 1 section 1886(j)(1)(A) of such Act (42 U.S.C. 2 1395ww(j)(1)(A))). 3 ‘‘(D) A cancer hospital (as described in 4 section 1886(d)(1)(B)(iii) of such Act (42 5 U.S.C. 1395ww(d)(1)(B)(iii))). 6 ‘‘(E) A children’s hospital (as described in 7 section 1886(d)(1)(B)(v) of such Act (42 8 U.S.C. 1395ww(d)(1)(B)(v))). 9 ‘‘(F) A critical access hospital (as defined 10 in section 1861(mm)(1) of such Act (42 U.S.C. 11 1395x(mm)(1))). 12 ‘‘(G) A rural emergency hospital (as de- 13 fined in section 1861(kkk)(2) of such Act (42 14 U.S.C. 1395x(kkk)(2))). 15 ‘‘(2) DECLARATION OF A PUBLIC EMER- 16 GENCY.—The term ‘declaration of a public emer- 17 gency’ means any of the following: 18 ‘‘(A) A public health emergency declared 19 by the Secretary of Health and Human Services 20 under section 319 of the Public Health Service 21 Act. 22 ‘‘(B) An emergency or disaster declared by 23 the President pursuant to the Robert T. Staf- 24 VerDate Sep 11 2014 23:41 Apr 14, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2584.IH H2584 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 2584 IH ford Disaster Relief and Emergency Assistance 1 Act.’’. 2 (2) CLERICAL AMENDMENT.—The table of sec- 3 tions for chapter 7 of title 18, United States Code, 4 is amended by adding at the end the following: 5 ‘‘120. Interference with performance of duties of hospital personnel.’’. (c) GRANTS FOR THE PROTECTION OF THE HOS- 6 PITAL WORKFORCE AGAINST VIOLENCE.—Title I of the 7 Omnibus Crime Control and Safe Streets Act of 1968 (34 8 U.S.C. 10101 et seq.) is amended by inserting after part 9 OO the following: 10 ‘‘PART PP—GRANT PROGRAM FOR HOSPITAL 11 WORKFORCE SAFETY AND SECURITY 12 ‘‘SEC. 3061. GRANT AUTHORIZATION. 13 ‘‘(a) IN GENERAL.—The Attorney General may make 14 grants under this part to hospitals for the purpose of car- 15 rying out programs to reduce the incidence of violence at 16 hospitals, including violence or intimidation against hos- 17 pital personnel in the performance of their duties. 18 ‘‘(b) USE OF FUNDS.—A grant awarded under this 19 part shall be used to reduce the incidence of violence at 20 hospitals through programs that may include one or more 21 of the following: 22 ‘‘(1) Training hospital personnel to prevent vio- 23 lence or intimidation against others or themselves, 24 VerDate Sep 11 2014 23:41 Apr 14, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2584.IH H2584 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 2584 IH including de-escalation training and specialized 1 training in responding to mental health crises. 2 ‘‘(2) Coordination with State and local law en- 3 forcement. 4 ‘‘(3) Placement and use of hospital access con- 5 trol technologies, video surveillance, metal detection, 6 panic buttons, status alert systems, restricted access 7 capabilities, and safe patient and staff rooms, and 8 other violence-prevention tools or measures. 9 ‘‘(4) Any other measures that the Attorney 10 General determines may provide a significant im- 11 provement in— 12 ‘‘(A) training for violence prevention at 13 hospitals; and 14 ‘‘(B) protection against violence and in- 15 timidation of hospital personnel. 16 ‘‘(c) PREFERENTIAL CONSIDERATION IN AWARDING 17 GRANTS.—In awarding grants under this part, the Attor- 18 ney General shall give preferential consideration, if fea- 19 sible, to an application from a hospital that— 20 ‘‘(1) has a demonstrated need for improved se- 21 curity; 22 ‘‘(2) has a demonstrated need for financial as- 23 sistance; and 24 VerDate Sep 11 2014 23:41 Apr 14, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2584.IH H2584 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 2584 IH ‘‘(3) has evidenced the ability to make the im- 1 provements for which the grant amounts are sought. 2 ‘‘(d) EQUITABLE DISTRIBUTION OF GRANT 3 FUNDS.—In awarding grants under this part, the Attor- 4 ney General shall ensure, to the extent practicable, an eq- 5 uitable geographic distribution among the regions of the 6 United States and among urban, suburban, and rural 7 areas. 8 ‘‘(e) ADMINISTRATIVE COSTS.—Not more than 2 per- 9 cent of a grant made under this part may be used for 10 costs incurred to administer such grant. 11 ‘‘SEC. 3062. APPLICATIONS. 12 ‘‘(a) IN GENERAL.—To request a grant under this 13 part, the chief executive of a hospital shall submit an ap- 14 plication to the Attorney General at such time, in such 15 form, and containing such information as the Attorney 16 General may reasonably require. 17 ‘‘(b) REQUIREMENTS.—Each application under this 18 section shall include— 19 ‘‘(1) a detailed explanation of— 20 ‘‘(A) the intended uses of funds provided 21 under the grant; and 22 ‘‘(B) how the activities funded under the 23 grant will satisfy the purpose of this part; 24 VerDate Sep 11 2014 23:41 Apr 14, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H2584.IH H2584 kjohnson on DSK79L0C42PROD with BILLS 12 •HR 2584 IH ‘‘(2) an assurance that the applicant shall 1 maintain and report such programmatic and finan- 2 cial data, records, and information as the Attorney 3 General may reasonably require; and 4 ‘‘(3) a certification, made in a form acceptable 5 to the Attorney General, that— 6 ‘‘(A) the programs to be funded by the 7 grant meet all the requirements of this part; 8 ‘‘(B) all the information contained in the 9 application is correct; and 10 ‘‘(C) the applicant will comply with all pro- 11 visions of this part and all other applicable Fed- 12 eral laws. 13 ‘‘(c) GUIDELINES.—Not later than 90 days after the 14 date of the enactment of this part, the Attorney General 15 shall promulgate guidelines to implement this section. 16 ‘‘SEC. 3063. ANNUAL REPORT TO CONGRESS; GRANT AC- 17 COUNTABILITY. 18 ‘‘(a) ANNUAL REPORT.—Not later than 90 days after 19 the end of the fiscal year for which funding for grants 20 under this part is made available, the Attorney General [Text truncated for display. Full text available on Congress.gov.]