Nurse and Health Care Worker Protection Act of 2013 - Requires the Secretary of Labor to promulgate an interim final standard on safe patient handling, mobility, and injury prevention to prevent musculoskeletal disorders for direct-care registered nurses and all other health care workers that requires the use of engineering and safety controls to handle patients through the use of mechanical technology and devices where feasible. Requires, however, the use of alternative controls and measures, including trained, designated lift teams, where such technology and devices are not feasible, in order to minimize the risk of injury to nurses and health care workers.
Includes among the requirements of a final standard that health care employers: (1) develop and implement a safe patient handling, mobility, and injury prevention program; (2) train their workers on safe patient handling, mobility, and injury prevention; and (3) post a uniform notice that explains the standard, procedures to report patient handling-related injuries, and workers' rights under this Act. Requires the Secretary to conduct unscheduled inspections to ensure compliance with the standard.
Amends title XVIII (Medicare) of the Social Security Act to apply the safe patient handling, mobility, and injury prevention standard to hospitals receiving Medicare funds.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2480 Introduced in House (IH)]
113th CONGRESS
1st Session
H. R. 2480
To direct the Secretary of Labor to issue an occupational safety and
health standard to reduce injuries to patients, nurses, and all other
health care workers by establishing a safe patient handling, mobility,
and injury prevention standard, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 25, 2013
Mr. Conyers (for himself and Mr. George Miller of California)
introduced the following bill; which was referred to the Committee on
Education and the Workforce, and in addition to the Committees on
Energy and Commerce and Ways and Means, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To direct the Secretary of Labor to issue an occupational safety and
health standard to reduce injuries to patients, nurses, and all other
health care workers by establishing a safe patient handling, mobility,
and injury prevention standard, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; FINDINGS; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Nurse and Health
Care Worker Protection Act of 2013''.
(b) Findings.--Congress finds the following:
(1) In 2011, registered nurses ranked fifth among all
occupations for the number of cases of musculoskeletal
disorders resulting in days away from work, with 11,880 total
cases. In 2011, nursing assistants reported 25,010 cases--the
highest of all occupations. The leading cause of these health
care employees' injuries is patient lifting, transferring, and
repositioning injuries, which constitute a significant risk to
the health and welfare of those employees.
(2) The physical demands of the nursing profession lead
many nurses to leave the profession. Fifty-two percent of
nurses complain of chronic back pain and 38 percent suffer from
pain severe enough to require leave from work. Many nurses and
other health care workers suffering back injury do not return
to work. These consequences constitute a material impairment of
health for these employees.
(3) Patients are not at optimum levels of safety while
being lifted, transferred, or repositioned manually. Mechanical
and other appropriate lift programs can substantially reduce
skin tears and pressure ulcers suffered by patients and the
frequency of patients being dropped, thus allowing patients a
safer means to progress through their care.
(4) The development of assistive patient handling
technology, equipment, and devices has essentially rendered the
act of strict manual patient handling outdated and typically
unnecessary as a function of nursing care.
(5) A growing number of health care facilities that have
incorporated patient handling technology and practices have
reported positive results. Injuries among nursing staff and
health care workers have dramatically declined at health care
facilities implementing safe patient handling technology,
equipment, devices, and practices. As a result, the number of
lost work days due to injury and staff turnover has declined.
Studies have also shown that assistive patient handling
technology successfully reduces workers' compensation costs for
musculoskeletal disorders.
(6) A number of States have implemented safe patient
handling, mobility and injury prevention standards. The success
of these programs at the facility and State level demonstrates
the feasibility of such standards.
(7) Establishing a safe patient handling, mobility, and
injury prevention standard for direct-care registered nurses
and other health care workers is a critical component
reasonably necessary for protecting the health and safety of
nurses and other health care workers, addressing the nursing
shortage, and increasing patient safety.
(c) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; findings; table of contents.
Sec. 2. Safe patient handling, mobility, and injury prevention
standard.
Sec. 3. Application of safe patient handling, mobility, and injury
prevention standard to facilities receiving
Medicare and Medicaid funds.
Sec. 4. Nonpreemption.
Sec. 5. Definitions.
SEC. 2. SAFE PATIENT HANDLING, MOBILITY, AND INJURY PREVENTION
STANDARD.
(a) Rulemaking.--Notwithstanding any other provision of law, not
later than 1 year after the date of enactment of this Act, the
Secretary of Labor shall, pursuant to section 6 of the Occupational
Safety and Health Act of 1970 (29 U.S.C. 655), promulgate an interim
final standard on safe patient handling, mobility, and injury
prevention (in this section such standard is referred to as the ``safe
patient handling, mobility, and injury prevention standard'') to
prevent musculoskeletal disorders for direct-care registered nurses and
all other health care workers handling patients. A final safe patient
handling, mobility, and injury prevention standard shall be promulgated
not later than 2 years after the date of enactment of this Act.
(b) Requirements.--The safe patient handling, mobility, and injury
prevention standard shall require the use of engineering and safety
controls to perform handling of patients and the elimination of
injuries from manual handling of patients by direct-care registered
nurses and all other health care workers, through the development of a
comprehensive program, to include the use of mechanical technology and
devices to the greatest degree feasible. Where the use of mechanical
technology and devices is not feasible, the standards shall require the
use of alternative controls and measures, including trained, designated
lift teams, to minimize the risk of injury to nurses and health care
workers resulting from the manual handling of patients. The standard
shall apply to all health care employers, shall generally align with
interprofessional national safe patient handling, mobility, and injury
prevention standards, and shall include the following:
(1) Program development.--A requirement that each health
care employer shall develop and implement a safe patient
handling, mobility, and injury prevention program within 6
months of the date of promulgation of the final standard, which
program shall include hazard identification, risk assessments,
and control measures in relation to patient care duties and
patient handling.
(2) Technology and equipment purchase and management.--A
requirement that, within 2 years of the date of promulgation of
the final standard, each health care employer shall purchase,
use, maintain, and make accessible to health care workers, such
safe patient handling equipment, technology, and accessories as
the Secretary determines appropriate.
(3) Health care worker participation.--A requirement that
each health care employer shall obtain input from health care
workers, to include direct care registered nurses, health care
workers, their representatives, and their collective bargaining
agents, in developing and implementing the safe patient
handling, mobility, and injury prevention program, including
the purchase of technology and equipment and necessary
accessories.
(4) Data tracking and review.--A requirement that each
health care employer shall establish a review program to
analyze data relevant to the implementation of the employers'
safe patient handling, mobility, and injury prevention program,
and shall account for circumstances where safe patient handling
technology and equipment, or trained, designated lift teams,
were not utilized in accordance with the health care employers
safe patient handling, mobility, and injury prevention
standard. Each health care employer shall upon request, make
available their findings and data used in such review, to
health care workers, their representatives, their collective
bargaining agents, and the Secretary or other Federal agency.
(5) Incorporation of technology into facilities.--A
requirement that each health care employer shall consider the
feasibility of incorporating safe patient handling technology
as part of process of new facility design and construction, or
facility remodeling.
(6) Education and training.--A requirement that each health
care employer shall train health care workers on safe patient
handling, mobility, and injury prevention policies, technology,
equipment, and devices, initially, and on a continuing annual
basis, and as necessary. Such training shall prepare health
care workers, including designated lift teams, to identify,
assess, and control musculoskeletal hazards of a general
nature, and those specific to particular patient care areas,
and shall be conducted by an individual with knowledge in the
subject matter, and delivered, at least in part, in an
interactive simulated point-of-care training and hands-on
format that reflects the specific demands of a health care
workers' duties.
(7) Notice of safe patient handling and rights under this
act.--A requirement that each health care employer shall post a
uniform notice in a form specified by the Secretary that--
(A) explains the safe patient handling, mobility,
and injury prevention standard;
(B) includes information regarding safe patient
handling, mobility, and injury prevention policies and
training;
(C) explains procedures to report patient handling-
related injuries; and
(D) explains health care workers' rights under this
Act.
(8) Annual evaluation.--A requirement that each health care
employer shall conduct an annual written evaluation of the
implementation of the safe patient handling, mobility, and
injury prevention program, including handling procedures,
selection of technology, equipment, and engineering controls,
assessment of injuries, and new safe patient handling,
mobility, and injury prevention technology and devices that
have been developed. The evaluation shall be conducted with the
involvement of nurses, other health care workers, their
representatives, and their collective bargaining agents, and
their input shall be documented in the evaluation. Health care
employers shall take corrective action as recommended in the
written evaluation.
(9) Right to refuse unsafe assignment.--A requirement that
each health care employer shall provide procedures under which
a health care worker or employee may refuse to perform the
employee's duties if the employee has a reasonable apprehension
that performing such duties would violate the safe patient
handling, mobility, and injury prevention standard, and would
result in injury or impairment of health to the health care
worker, other health care workers, or patients. Where
practicable, the health care worker must have communicated the
health or safety concern to the health care employer and have
not been able to obtain a correction of the violation.
(c) Inspections.--The Secretary of Labor shall conduct unscheduled
inspections under section 8 of the Occupational Safety and Health Act
of 1970 (29 U.S.C. 657) to ensure implementation of and compliance with
the safe patient handling, mobility, and injury prevention standard.
SEC. 3. APPLICATION OF SAFE PATIENT HANDLING, MOBILITY, AND INJURY
PREVENTION STANDARD TO FACILITIES RECEIVING MEDICARE AND
MEDICAID FUNDS.
(a) In General.--Section 1866 of the Social Security Act (42 U.S.C.
1395cc) is amended--
(1) in subsection (a)(1)(V), by inserting ``and safe
patient handling, mobility, and injury prevention standard (as
initially promulgated under section 2 of the Nurse and Health
Care Worker Protection Act of 2009)'' before the period at the
end; and
(2) in subsection (b)(4)--
(A) in subparagraph (A), inserting ``and the safe
patient handling, mobility, and injury prevention
standard'' after ``Bloodborne Pathogens standard''; and
(B) in subparagraph (B), inserting ``or the safe
patient handling, mobility, and injury prevention
standard'' after ``Bloodborne Pathogens standard''.
(b) Effective Date.--The amendments made by subsection (a) shall
apply to health care facilities 1 year after date of issuance of the
final safe patient handling, mobility, and injury prevention standard
required under section 2.
SEC. 4. NONPREEMPTION.
(a) Effect on Other Laws.--Nothing in this Act shall be construed
to--
(1) preempt any law, rule, or regulation of a State or
political subdivision of a State, unless such law, rule, or
regulation is in conflict with this Act or a regulation or
order issued under this Act; or
(2) impair or diminish in any way the authority of any
State to enact and enforce any law which provides equivalent or
greater protections for employees engaging in conduct protected
under this Act.
(b) Rights Retained by Health Care Workers.--Nothing in this Act
shall be construed to diminish the rights, privileges, or remedies of
any health care worker or employee under any Federal or State law, or
under any collective bargaining agreement.
SEC. 5. DEFINITIONS.
For purposes of this Act:
(1) Direct-care registered nurse.--The term ``direct-care
registered nurse'' means an individual who has been granted a
license by at least one State to practice as a registered nurse
and who provides bedside care or outpatient services for one or
more patients or residents.
(2) Employee.--The term ``employee'' means any individual
employed by a health care employer, to include health care
workers, as well as employees who do not qualify as health care
workers, including independent contractors.
(3) Employment.--The term ``employment'' includes the
provision of services under a contract or other arrangement.
(4) Handling.--The term ``handling'' includes actions such
as lifting, transferring, repositioning, mobilizing, moving, or
any other action involving the physical movement, manipulation,
or support of a patient by a health care worker, or any direct
patient care action which presents a risk of musculoskeletal
injury.
(5) Health care employer.--The term ``health care
employer'' means an outpatient health care facility, hospital,
nursing home, home health care agency, social assistance
facility or program, hospice, federally qualified health
center, nurse managed health center, rural health clinic, or
any similar health care facility that employs direct-care
registered nurses or other health care workers.
(6) Health care worker.--The term ``health care worker''
means an individual who has been assigned by a health care
employer to engage in patient handling, including direct-care
registered nurses, independent contractors, or individuals who
perform the duties of health care workers.
(7) Lift team.--The term ``lift team'' means health care
workers with specialized training and knowledge of safe patient
handling, mobility, and injury prevention practices and
technology.
<all>
Introduced in House
Introduced in House
Sponsor introductory remarks on measure. (CR E963-964)
Referred to the Committee on Education and the Workforce, and in addition to the Committees on Energy and Commerce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Education and the Workforce, and in addition to the Committees on Energy and Commerce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Education and the Workforce, and in addition to the Committees on Energy and Commerce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Workforce Protections.
Referred to the Subcommittee on Health.
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