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house Bill H.R. 1195

Should the Federal Gov’t Set & Enforce a Workplace Violence Safety Standard for Healthcare Settings?

Argument in favor

Workplace violence is a growing problem in the healthcare and social service industries that puts workers, healthcare outcomes, and healthcare facility security at risk. OSHA had previously agreed to rulemaking to address this problem, but progress on this issue has stalled even as workplace violence against healthcare workers has increased during the pandemic. In the absence of rulemaking momentum at OSHA, Congress needs to step in to legislate on this issue.

larubia's Opinion
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04/16/2021
Yes, I support standards for health & safety for healthcare workers. I want the same for educators. I can share stories that make my military husband cringe. I worked at an elementary school. No security guards there. Your lucky to get a call when the meth bust is happening 100 feet from the playground full of 5 year olds. Try a lockdown with an armed man with a semi-automatic weapon & 30 rounds at dismissal. How about parents coming into the office locked & loaded, drunk/abusive. Oh, then there are the divorcing parents, pedophiles lurking by the playground, or the random gang member who has it in for his brother’s friend. Not to mention the students coming armed to school. One 4th grader putting a handgun to the head of a second grader after tutoring. I, sadly, can go on. All of the above are true stories. All of the above I had to respond to as a principal, without a weapon, without campus security, often without my halftime or no time school counselor. Yes, please take care of healthcare workers. But, please do not forget those in schools that serve and protect the most precious humans. We need help, too.
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Joan's Opinion
···
04/16/2021
As a retired RN, I support this bill. I worked many years in emergency rooms and have seen workplace violence. Because emergency rooms have constant ambulance traffic opening doors to accept patients, anyone can walk through the doors when they open. The hospital did have “security”. One or two older obese men who moved like molasses in January. They were no help when a man with a gun entered through the ER ambulance door. After a scuffle, an off duty policeman who was there with his wife got the gun.
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Frank-001's Opinion
···
04/16/2021
I know several people working in healthcare. I visit one hospital regularly. I have been lead to believe little is being done to protect patients or caregivers from determined predators. It seems that most hospital security systems are pretty weak. It depends primarily on the public’s goodwill. I remember a while back that one hospital in the area was forced to beef up security in the maternity ward because babies were being stolen. Then another hospital security issue arose when laptops started disappearing. Then there are the instances of having personal items stolen. Looking around a hospital room patient security is not a priority. I've crept myself out thinking how easy getting past security is! Wonder how much never gets media attention in the name of “keeping people calm.” In the plus column: Entrance security has improved due to COVID. However, other weaknesses are still readily apparent. Not sure what the downside of better security beyond the needed increase of funds.
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Argument opposed

While no one denies that workplace violence against healthcare and social service workers is a problem, the process by which this bill has been drafted is flawed. The opposition of the American Hospital Association (AHA), which represents hospitals and healthcare networks and notes that hospitals already have stringent safety precautions in place, should give lawmakers pause as the AHA’s members are key stakeholders in this issue.

B.R.'s Opinion
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04/16/2021
In 2016, the GAO claimed that there was very little studies done to determine whether the violence prevention programs that already exist are effective which then serves the question: Why would we recommend to implement a program that will cost $35 million that hasn't been tested for effectiveness. This is the problem with programs like this. We blindly implement them, continue to fund them year after year without turning back to actually see if they are working. Enough of the stupidity.
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ManfromNebraska's Opinion
···
04/16/2021
Local issue it is not the federal government’s responsibility. There are already protections.
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Robert's Opinion
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04/16/2021
This should belong to the states. The federal government needs to stay out of the states laws!
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What is House Bill H.R. 1195?

This bill would direct the Occupational Safety and Health Administration (OSHA) to issue a federal workplace violence prevention standard requiring healthcare and social service employers to write and implement a workplace violence prevention plan to prevent and protect employees from violent incidents in the workplace. Compliance with the new standard would be required for hospitals and skilled nursing facilities as a condition of their Medicare provider agreements.

This bill would also set minimum requirements for a workplace safety standard and for employers’ workplace violence prevention plans. Those requirements would include: unit-specific assessments and implementation of prevention measures, including physical changes to the environment; staffing for patient care and security; employee involvement in all steps of the plan; hands-on training; robust recordkeeping requirements, including a violent incident log; and protections for employees who report workplace violence to their employer and law enforcement. 

An amendment made to this bill during its committee markup made two major changes to it: 

  • For facilities with multiple employers operating in them, it would require procedures for determining which employer (or employers) is/are responsible for implementing and complying with this bill’s provisions.
  • To create flexibility in the provision of annual training (after initial training), the amendment would allow employers to use live video-conference in cases when in-person training is not practicable, and recognizes that many employees covered by this bill — especially social services workers — don’t routinely visit a centralized workplace.

This legislation would cover a wide variety of workplaces, including: hospitals, residential treatment facilities, non-residential treatment settings, medical treatment or social service settings in correctional or detention facilities, psychiatric treatment facilities, substance use disorder treatment centers, community care settings such as group homes and mental health clinics, and federal healthcare facilities such as those operated by the Veterans Administration (VA) and the Indian Health Service (IHS). It would also cover field work settings, such as home care and home-based hospice, and emergency services and transport services.

For the purposes of this bill, “workplace violence” means the threat or use of physical force against an employee, regardless of whether an injury is sustained.

Impact

Workplace violence; workplace safety; workers; healthcare and social services workers; healthcare facilities; OSHA; VA; IHS; and federal standard-setting with regard to workplace violence and employers’ responsibility to keep workers safe.

Cost of House Bill H.R. 1195

$35.00 Million
The CBO estimates that this bill would cost $35 million over the 2020-2024 period, and $60 million over the 2020-2029 period.

More Information

In-DepthSponsoring Rep. Joe Courtney (D-CT) reintroduced this bill from the 115th and 116th Congresses to address rising rates of workplace violence against healthcare and social service employees such as nurses, physicians, emergency responders, medical assistants, and social workers: 

“Health care and social workers have been waiting for years, long before COVID, to have their safety taken seriously while they’re working hard to ensure everyone else’s,” said Congressman Courtney. “This workforce faces more on-the-job violence than any other sector in the American economy and the rates have been on the rise for years, even during the COVID-19 crisis. These incidents are predictable and preventable, and it’s time we ensure workplaces take the steps we know work to avoid them. This is an extremely flexible and bipartisan proposal, and it’s driven by the very workers who are most at risk. I’m grateful for the support of our bipartisan coalition, and especially for the support of nurses, doctors, EMTs, social service workers, and others who have helped us drive this bill farther and farther ahead.”

House Committee on Education and Labor Chairman Bobby Scott (D-VA) adds:

“Health care and social service workers are routinely subjected to threats, assaults, and injury from foreseeable and preventable acts of workplace violence at rates that significantly exceed all other professions. This bill strengthens protections for these frontline workers by requiring that the Occupational Safety and Health Administration issue an enforceable standard within 42 months of enactment that ensures employers adopt plans to address preventable acts of workplace violence.”

In the 116th Congress, original cosponsor Rep. Alma Adams (D-NC) added that thousands of workers are killed or injured on the job each year

“Every year, more than 850 workers are killed on the job and another 28,000 suffer serious injury. The Workplace Violence Prevention and Social Services Workers Act sends the message that ‘enough is enough’ — setting a national standard that forces employers to take seriously the health and safety of American workers. I am proud to stand with Rep. Courtney and Chairman Scott in support of this effort, and look forward to its consideration by the House.”

During this bill’s committee hearing in the 116th Congress, Reps. Phil Roe (R-TN) and Virginia Foxx (R-NC) raised concerns about circumventing OSHA’s normal rulemaking process. Rep. Roe shared an American Hospital Association (AHA) statement opposing this bill. In its statement, the AHA cited concerns about this bill potentially creating duplicate anti-workplace violence measures for health care facilities that already have such measures in place and allowing only limited opportunity for the public and stakeholders to review and comment on this bill. In a June 10, 2019 letter, AHA Executive Vice President Thomas P. Nickels wrote:

“America’s hospitals and health systems are committed to a culture of safety for every worker, patient and family member who enters our facilities. However, because hospitals have already implemented specifically tailored policies and programs to address workplace violence, we do not believe that the OSHA standards required by H.R. 1309 are warranted, nor do we support an expedited approach that would deny the public the opportunity to review and comment on proposed regulations.” 

For himself, Rep. Roe said:

“No one is more interested in having a safe workplace more than the hospitals. What’s the hurry? Why don’t we do this in a bipartisan way? We could have the American Hospital Association in to testify and see what their issues are. That’s what I would recommend.”

Rep. Foxx added that this bill is a “rush to judgment”: 

“Health care workers are familiar with the Hippocratic Oath: ‘First do no harm.’ In its rush to judgment, H.R. 1309 does great harm by short-circuiting the public input process and prescribing a specific end result from the beginning.”

Numerous labor and professional organizations representing workers in the healthcare and social services industries support this legislation. They include the American Federation of Teachers (AFT), AFSCME, AFL-CIO, American Federation of Government Employees, National Nurses United, American Nurses Association, American Psychiatric Nurses Association, and others. 

This legislation has 145 House cosponsors, including 139 Democrats and six Republicans, in the 117th Congress.

In the previous session of Congress, this legislation passed the House on a bipartisan 251-158 vote with the support of 228 bipartisan House cosponsors, including 220 Democrats and eight Republicans, but was not voted on by the Senate. Its Senate companion, sponsored by Sen. Tammy Baldwin (D-WI), had 31 Senate cosponsors, including 30 Democrats and one Republican, and did not receive a committee vote.

In the 115th Congress, this legislation had 23 Democratic House cosponsors and didn’t receive a committee vote. It didn’t have a Senate companion in the 115th Congress. 


Of NoteBureau of Labor Statistics data shows that up to 30% of hospital workers have been assaulted at work. Employees in psychiatric hospitals have a dramatically higher rate of assault: nearly 50% of emergency room physicians have been physically assaulted at work, and 80% report that this violence has a negative impact on patient care.

According to a 2016 Government Accountability Office (GAO) report, rates of violence against healthcare workers are up to 12 times higher than rates of violence against workers overall. Additionally, in 2016, 70% of nonfatal workplace assaults were against workers in the health care and social assistance sectors. In 2016, a comprehensive review published in the New England Journal of Medicine, “Workplace Violence Against Health Care Workers in the United States,” found that although healthcare and social service sector workers account for only 12.2% of the workforce, they account for nearly 75% of workplace assaults.

The COVID-19 pandemic has exacerbated workplace violence issues in healthcare settings. In November 2020, National Nurses United’s nationwide survey of over 15,000 registered nurses found over 20% of nurses reporting increased workplace on the violence. The nurses attributed the increased violence to decreasing staffing levels, changes in the patient population, and visitor restrictions. Even prior to the pandemic, there was an almost 60% increase in violent incidents in health care and social service workplaces that led to employees being away from work.

Bureau of Labor Statistics (BLS) data also showed an increase in serious injuries due to workplace violence among healthcare workers over the period 2016-2017. In 2016, 13.3 out of every 10,000 health care and social assistance workers work due to nonfatal occupational injuries and illnesses that required them to take time off work; in 2017, that figure rose to 13.7 out of 10,000 full-time workers in the industry. Both the 2016 and 2017 figures for the healthcare and social assistance industry were much higher than the rates for all industries (2.8 days away from work per 10,000 full-time workers in 2016 and 2.7 days away from work per 10,000 full-time workers in 2017).

According to the U.S. Bureau of Labor Statistics Census of Fatal Occupational Injuries, at least 58 hospital workers died due to workplace violence over the period 2011-2016. Workplace violence is the fourth leading cause of workplace deaths overall, according to the National Safety Council.

In its 2016 report, the GAO observed that because relatively few studies on workplace violence prevention programs’ effectiveness have been conducted, it’s hard to know how effective they are. However, in a literature review of five studies, the GAO found that four of the five studies suggested that workplace violence prevention programs can contribute to reduced rates of assault.

OSHA — the federal agency responsible for protecting workers’ health and safety — currently doesn’t require employers to implement workplace violence prevention programs. However, it does provide voluntary guidelines, and can cite employers for failing to provide a workplace free from recognized serious harms. In recent years, OSHA has agreed to undergo rulemaking on healthcare workplace violence. However, action on this stalled under the Trump administration.


Media:

Summary by Lorelei Yang

(Photo Credit: iStockphoto.com / sturti)

AKA

Workplace Violence Prevention for Health Care and Social Service Workers Act

Official Title

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.

bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
      senate Committees
      Committee on Health, Education, Labor, and Pensions
  • The house Passed April 16th, 2021
    Roll Call Vote 254 Yea / 166 Nay
      house Committees
      Committee on Education and Labor
      Health
      Committee on Energy and Commerce
      Committee on Ways and Means
    IntroducedFebruary 22nd, 2021

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    Yes, I support standards for health & safety for healthcare workers. I want the same for educators. I can share stories that make my military husband cringe. I worked at an elementary school. No security guards there. Your lucky to get a call when the meth bust is happening 100 feet from the playground full of 5 year olds. Try a lockdown with an armed man with a semi-automatic weapon & 30 rounds at dismissal. How about parents coming into the office locked & loaded, drunk/abusive. Oh, then there are the divorcing parents, pedophiles lurking by the playground, or the random gang member who has it in for his brother’s friend. Not to mention the students coming armed to school. One 4th grader putting a handgun to the head of a second grader after tutoring. I, sadly, can go on. All of the above are true stories. All of the above I had to respond to as a principal, without a weapon, without campus security, often without my halftime or no time school counselor. Yes, please take care of healthcare workers. But, please do not forget those in schools that serve and protect the most precious humans. We need help, too.
    Like (38)
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    In 2016, the GAO claimed that there was very little studies done to determine whether the violence prevention programs that already exist are effective which then serves the question: Why would we recommend to implement a program that will cost $35 million that hasn't been tested for effectiveness. This is the problem with programs like this. We blindly implement them, continue to fund them year after year without turning back to actually see if they are working. Enough of the stupidity.
    Like (13)
    Follow
    Share
    As a retired RN, I support this bill. I worked many years in emergency rooms and have seen workplace violence. Because emergency rooms have constant ambulance traffic opening doors to accept patients, anyone can walk through the doors when they open. The hospital did have “security”. One or two older obese men who moved like molasses in January. They were no help when a man with a gun entered through the ER ambulance door. After a scuffle, an off duty policeman who was there with his wife got the gun.
    Like (23)
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    I know several people working in healthcare. I visit one hospital regularly. I have been lead to believe little is being done to protect patients or caregivers from determined predators. It seems that most hospital security systems are pretty weak. It depends primarily on the public’s goodwill. I remember a while back that one hospital in the area was forced to beef up security in the maternity ward because babies were being stolen. Then another hospital security issue arose when laptops started disappearing. Then there are the instances of having personal items stolen. Looking around a hospital room patient security is not a priority. I've crept myself out thinking how easy getting past security is! Wonder how much never gets media attention in the name of “keeping people calm.” In the plus column: Entrance security has improved due to COVID. However, other weaknesses are still readily apparent. Not sure what the downside of better security beyond the needed increase of funds.
    Like (21)
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    We must protect our healthcare workers on the job, no matter the facility or setting. I think during a time of increasing domestic and workplace violence this seems like a good effort towards making sure these vital workers will be safe on the job.
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    I think violence in America is generally growing, although I admit that I haven’t researched the data on single violent events covering violence from the verbal to the physical and domestic to stranger-on-stranger violence. It’s the reason I support background checks and banning certain kinds of weapons or weapon parts. I know the argument that only criminals will have guns. Nonetheless, I haven’t heard anyone say guns in general should be banned, so people would still be able to buy guns to protect themselves, their families, and their property. Many people are angry and afraid in part due to income inequality and job insecurity. In the last 5 years, in a society where we are all too prone to look for anyone or anything else to blame but our own choices, behaviors, and the unknowable random variables that influence fate we have been encouraged to blame other people - especially non-white groups. Reuters published this article which supports my impression that violence with guns is increasing: - DAYTON, Aug. 4, 2019 - A gunman dressed in body armor opened fire in downtown Dayton, Ohio, killing nine people including his sister and wounding 27 others. Police killed the shooter. - VIRGINIA BEACH, May 31, 2019 - A disgruntled public utility employee opened fire with a handgun on co-workers at a municipal building in Virginia, killing 12 people and wounding at least four before he was fatally shot by police. - THOUSAND OAKS, Nov. 7, 2018 - A former Marine combat veteran killed 12 people in a bar in Thousand Oaks, California, a suburb of Los Angeles. He then killed himself. - TREE OF LIFE, Oct. 27, 2018 - A gunman burst into the Tree of Life synagogue near Pittsburgh with a semi-automatic rifle and three handguns as he fired on congregants gathered for a Sabbath service, killing 11. - SANTA FE, Texas, May 18, 2018 - A 17-year-old student dressed in a trench coat and armed with a shotgun and pistol opened fire at his high school outside Houston, killing nine students and a teacher, before surrendering to officers. - PARKLAND, Feb. 14, 2018 - A former student at Marjory Stoneman Douglas High School in Parkland, Florida, opened fire with an assault-style rifle, killing 17 students and educators. - SUTHERLAND SPRINGS, Nov. 5, 2017 - A man thrown out of the U.S. Air Force for beating his wife and child shot 26 people fatally at a rural Texas church where his in-laws worshipped before killing himself. - LAS VEGAS, Oct. 1, 2017 - A gunman opened fire on a country music festival from a 32nd-floor hotel suite, killing 58 people and wounding 564 others before taking his own life. - ORLANDO, June 12, 2016 - A gunman fatally shot 49 people at Pulse, a gay nightclub, before he was shot dead by police. - SAN BERNARDINO, Dec. 2, 2015 - A husband and wife killed 14 people at a workplace holiday party in San Bernardino in Southern California before dying in a shootout with police. - ROSEBURG, Oct 1, 2015 - A gunman stalked onto an Oregon college campus and opened fire, killing nine people and wounding seven before police shot him to death. - CHARLESTON, June 17, 2015 - A White supremacist killed nine Black churchgoers at a church in Charleston, South Carolina. He was sentenced to death. - WASHINGTON, D.C., Sept. 16, 2013 - A former Navy reservist working as a government contractor killed 12 people at the Washington Navy Yard. He was shot dead by police. - NEWTOWN, Dec. 14, 2012 - A heavily armed gunman killed 26 people, including 20 children from five- to 10-years old, in a rampage at Sandy Hook Elementary School in Connecticut. - AURORA, July 20, 2012 - A masked gunman killed 12 people and wounded 70 others at a cinema in Aurora, Colorado. He received multiple life sentences. - FORT HOOD, Nov. 5, 2009 - An army major and psychiatrist opened fire at Fort Hood, a U.S. Army base in Texas, killing 13 people. https://www.reuters.com/world/us/major-mass-shootings-united-states-2021-03-23/
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    I can't even imagine the hell that our health care workers have experienced over the past year and are continuing to experience now that we have yet another Covid surge here in Michigan......and with all the heart ache, suffering and death they have faced EVERY freaking day.....they have to worry about violence against them as well.....they should be protected and supported as much as humanly possible.
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    Local issue it is not the federal government’s responsibility. There are already protections.
    Like (8)
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    Important to standardize...this issue is bigger than you think actually 1 in 4 nurses are abused in the workplace that’s more often than prison guards or police. Patients seem to be more aggressive especially those who exhibit long Covid and the frontline staff needs these basic protections in place.
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    This should belong to the states. The federal government needs to stay out of the states laws!
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    All I needed to see was that the American Hospital Association is against this bill. If anyone tells you that most hospitals are Not-For-Profit Corporations and they should be given the benefit of doubt, they are lying to you. Hospitals and Hospital Systems and their CEO's are just as bad as any other corporation. Officially, they may be non-profit, but they are no less greedy and penny-pinching. Their CEO's take salaries that are at least has high and sometimes higher than CEO's of For-Profit corporations. They nickel and dime their employees--doctors, nurse, aides, housekeeping, tech services, cafeteria workers, security, etc. They chase down and hound patients who are late paying their bills. They hide their actual costs AND their pricing schedules to prevent patients from comparing different hospitals/hospital systems. SO, I TAKE THE SIDE OF THOSE WHO ACTUALLY DO ALL THE WORK INSIDE THE HOSPITAL AND WHO ARE AT RISK! ----------------PROTECT THE HEALTHCARE WORKERS!
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    This is a State jurisdiction! Allowing States and local governments to regulate this situation is better suited for local citizens and their needs. No need for federal involvement here.
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    Keep the SALT and recognize Republicans for who they are. “A close examination of the care work sector, however, reveals that the market isn’t working particularly well at all. As of May 2020, the median wage for a home health aide was $13.02 an hour. Many caregivers work informally; they are caring for their relatives. One in six caregivers live in poverty, as Fortune recently reported. Their circumstances say nothing about the importance of their work. The elderly require care and so do people with certain disabilities. Care workers are necessary, but they are simply undervalued and underpaid. This is an old problem, which rests on top of other old problems; it’s not a coincidence that care workers in the U.S. are mostly women, and women of color at that. The Biden bill only does so much for them: It calls for higher wages, but unless moderate Democrats change their minds about the filibuster, a $15 minimum wage will remain a rallying cry instead of reality. Republicans, however, seem determined to do nothing. The party has no plan to protect care work at all. And that’s the point. The GOP doesn’t have a plan because it doesn’t think care work matters. They don’t value the people who perform it. When members of the party rail against the elites, and fashion themselves champions of the worker, they aren’t talking about low-income Black women who take care of the elderly. They aren’t even referring to the archetypal white man in a hard hat. That man has a family, and that family has needs. They’re thinking of themselves, and their own families, because they have the means to pay for care. Most Americans aren’t so fortunate. The GOP’s barebones America would leave millions behind, and that’s the way they like it.” -Sarah Jones
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    We need more guns! Every man woman and child should carry one even two with high cap magazines.
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    This is not the federal government’s job.
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    What a freaking joke.... Our lawmakers couldn't prevent the insurrection that occurred on Jan. 6th, which was incited by the disgraced twice impeached lowlife that formerly resided in the White House. So, tell me how the hell are they going to prevent violence in other work places????? Case in point, https://www.huffpost.com/entry/brandon-hole-police-chief-red-flag-laws-two-semiautomatic_n_607ba489e4b09614f9b700c1 THE FBI COULDN'T PREVENT THE PIECE OF GARBAGE THAT WENT ON A RAMPAGE AT FEDEX. THEY DIDN'T PREVENT THIS PIECE OF GARBAGE FROM PURCHASING TWO RIFLES, IN SPITE OF THE "RED FLAG WARNING".... How about enforcing the current laws instead of creating more you can't even enforce???? How about closing the loopholes that allow scum like this from getting their hands on guns???? The FBI was warned a year ago by his mother that he was dangerous, but did anyone listen or care???? We have so many laws on the books that aren't enforced and every day more and more mass shootings are occurring. When is it going to stop?????
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    Yet another frivolous way to spend the people’s money on something that cannot help anyone.
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    No, this should be in the oversight of the state and city where the business is. The federal government has too much to keep up with and many issues would never get the appropriate attention needed in a timely manner.
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    I believe violence in the workplace should be illegal with serious consequences for it taking place...oh wait, it IS illegal already. Seriously, do we need to waste valuable legislative time on something that is already protected? This isn't as much about disagreeing with the sentiment of the bill as it is to state that there are FAR more important and pressing issues that we should be prioritizing.
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    Will this include installation of an escalator to board Air Force One?
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