rates from workplace violence are widely recognized to be higher than reported levels. (6) Violence in health care settings has adverse impacts on workers and patients, compromising quality of care. (7) Studies have demonstrated that workplace violence prevention programs tailored to the needs of specific work areas and State-based workplace violence prevention legislation are strongly associated with reductions in workplace violence. (8) Studies have found that proper staff training, appropriate staffing levels, sufficient resources, and the use of evidence based interventions (such as effective communication with patients using de-escalation techniques and noncoercive use of medications) can reduce the risks to the safety of both patients and staff, using least-restrictive measures. (9) The Occupational Safety and Health Administration has issued Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers , however, this guidance is not enforceable. Absent an enforceable standard, employers lack mandatory requirements to implement an effective and ongoing violence prevention program that provides protection of workers from workplace violence. (10) Nine States have mandated that certain types of health care facilities implement workplace violence prevention programs. On April 1, 2018, the Division of Occupational Safety and Health of the State of California issued a comprehensive standard ( Workplace Violence Prevention in Health Care ) that requires health care facilities to implement a workplace violence prevention plan. (11) Employer organizations have challenged the Occupational Safety and Health Administration’s authority to utilize the General Duty Clause of the Occupational Safety and Health Act of 1970 to enforce against workplace violence hazards, arguing that Congress did not intend to cover workplace violence under such clause when the Act was enacted in 1970. (12) The Occupational Safety and Health Administration (OSHA) received two petitions for rulemaking in July of