October 4, 2008
Dear WING USA friends,
WING USA Legislative Update 10-4-08:
Governor Schwarzenegger Vetoes Safe Patient Handling for the Fifth Time
On September 28, 2008, for the fifth time in as many years, Governor Arnold Schwarzenegger vetoed legislation for the safe handling of healthcare patients in California. See within below for Governor Schwarzenegger’s veto message of Senate Bill 1151, Hospitals: lift teams, “Hospital Patient and Health Care Worker Injury Protection Act.” Every year since 2004, Governor Schwarzenegger has vetoed legislation which would protect hospital patients and nurses and other healthcare workers from needless injuries directly caused by manual lifting and moving.
CA SB 1151 cites U.S. Bureau of Labor Statistics 2006 data with California leading the nation in work-related musculoskeletal disorders. With nurses aging at the same time that patient acuity and obesity are rising, SB 1151 states, “It is imperative that we protect our registered nurses and other health care workers from injury, and provide patients with safe and appropriate care.”
SB 1151 continues to say, “At a cost of between forty thousand dollars ($40,000) and sixty thousand dollars ($60,000) to train and orient each new nurse, preventing turnover from injuries will save hospitals money.”
Though the nurse shortage continues, and preventing injuries is proven to save money, Governor Schwarzenegger’s veto means that California nurses and other healthcare workers may still be required to lift back-breaking loads which can lead to devastating injuries and disabilities. And, California patients remain vulnerable to needless injuries which sometimes occur with manual lifting and moving, including pain, bruising, skin tears and abrasions, dislodgement of tubes, dislocations, fractures, being dropped, and other injuries.
Where safe patient lifting equipment is not available, healthcare workers are obligated to lift manually if dependent patients are to be moved at all. Injuries from placing such hazardous loads on the backs of nursing staff cannot rightfully be called “accidents” but are the predictable outcome of lifting dangerous amounts of weight in awkward postures. Such lifting has been proven to cause microfractures by exceeding tolerance limits of spinal structures. “None of the [manual patient] lifting techniques would be considered safe.” (William S. Marras et al. 1999. “A Comprehensive Analysis of Low-Back Disorder Risk and Spinal Loading During the Transferring and Repositioning of Patients Using Different Techniques.” Ergonomics. 42(7), 915).
From SB 1151 Bill Analysis, Senate Committee on Labor and Industrial Relations, date of hearing March 26, 2008, at http://info.sen.ca.gov/pub/07-08/bill/sen/sb_1151-1200/sb_1151_cfa_20080325_110047_sen_comm.html:
SUPPORT for SB 1151:
California Nurses Association (CNA) - Sponsor
American Federation of State, County and Municipal Employees, AFL-CIO
California Applicants' Attorneys Association (CAAA)
California Labor Federation, AFL-CIO
United Nurses Association of California/Union of Health Care Professionals (UNAC/UHCP)
OPPOSITION against SB 1151:
California Hospital Association (CHA)
From the same website, wording from the governor’s veto messages over the past five years:
Governor Schwarzenegger’s SPH veto messages 2004 to 2008:
September 22, 2004, AB 2532 (Hancock) vetoed. AB 2532 would have required general acute care hospitals, except rural ones, to provide lift teams to assist healthcare workers with patient lifting. Governor Schwarzenegger’s veto message stated, "Because I am concerned about the financial burden hospitals are already under, I cannot support the costly mandate imposed on them by AB 2532."
September 29, 2005, SB 363 (Perata) vetoed. SB 363 would have required general acute care hospitals, except rural ones, to provide lift teams to assist healthcare workers with patient lifting. Governor Schwarzenegger’s veto message stated that the bill, "imposes a one-size-fits-all mandate on hospitals to establish a zero lift policy requiring teams and the use of equipment to lift patients.” And, “If hospitals do not initiate these measures on their own, I will consider legislation next year that imposes the mandate."
September 29, 2006, SB 1204 (Perata) vetoed. SB 1204 would have required general acute care hospitals to establish a health care worker back injury prevention plan. Governor Schwarzenegger’s veto message stated, "Since my veto message of last year, hospitals of all sizes from throughout the state have reported on progress made in implementing lift policies. I applaud their efforts and encourage the continued development of these policies. I believe this is proof that allowing hospitals the flexibility to implement lift policies that meet their individual needs is far more effective than imposing a rigid one-size-fits-all mandate on every hospital in California."
October 13, 2007, SB 171 (Perata) vetoed. SB 171 would have required acute care hospitals to establish a patient protection and health care worker back injury prevention plan. Governor Schwarzenegger’s veto message stated, "This bill, which imposes a one-size fits all mandate on hospitals to establish a ‘zero lift’ patient handling policy, is similar to measures I have vetoed the last three years. While I continue to support the goal of reducing workplace injuries, I remain convinced that this inflexible mandate is a poor alternative to giving hospitals the flexibility needed to achieve this goal in the manner that most efficiently addresses each hospital's needs and resources."
September 28, 2008, SB 1151 (Perata) vetoed. SB 115 would have required general acute care hospitals “to use lift teams or lift, repositioning, and transfer devices when there is a risk of injury to a patient or a health care worker, except in emergency situations.” “A safe patient handling policy does not require the use of patient lift, repositioning, or transfer devices if the individual hospital’s own needs assessment indicates that it is safe for the patient and the employee to utilize techniques not requiring the use of those devices.”
SB 1151 veto message:
http://gov.ca.gov/pdf/press/SB_1151_Perata_Veto_Message.pdf.
“To the Members of the California State Senate:
”I am returning Senate Bill 1151 without my signature.
“This bill would require all general acute care hospitals to adopt, as part of their Injury and Illness Prevention Programs, a patient protection and health care worker back injury prevention plan that includes a ‘safe patient handling policy.’
“SB 1151 is similar to measures that I have vetoed over the last four years. This bill is unnecessary as current laws and regulations are in place to address the workplace health and safety needs of health care workers. Existing statutes are flexible and allow employers to exercise discretion in determining what combination of lift teams and equipment is necessary to have an effective Injury and Illness Prevention Program.
“For these reasons, I am returning this bill without my signature.
“Sincerely,
“Arnold Schwarzenegger”
SB 1151: Links to wording and complete history. The veto message should also be added soon through the “Veto Message” link: http://www.leginfo.ca.gov/cgi-bin/postquery?bill_number=sb_1151&sess=CUR&house=B&search_type=email.
Governor Schwarzenegger says safe patient handling legislation is unnecessary, that current law and regulations address the safety needs of healthcare workers, and that flexible statutes allow employers to determine what they need for injury prevention.
With healthcare workers remaining among top occupations in the nation for work-related musculoskeletal injuries, it is clear that volunteerism by the healthcare industry to adequately protect against lifting injuries has not worked on a large scale.
Onward we go in the national struggle for nearly 18,000 nursing homes and 6,000 hospitals to implement effective protection for healthcare workers and patients and residents against preventable injuries caused by manual lifting and moving.
Best wishes to all…Anne
Anne Hudson, RN, BSN
October 4, 2008
Founder, Work Injured Nurses’ Group USA
Coos Bay, Oregon
anne@wingusa.org
www.wingusa.org
September 26, 2008
Dear WING USA friends,
Legislative Update on Safe Patient Handling September 26, 2008
HR 378 Nurse and Patient Safety and Protection Act Remains in Committee
The national bill HR 378 “Nurse and Patient Safety and Protection Act of 2007” remains in committee. The bill for safe patient handling was originally introduced two years ago on September 26, 2006, as HR 6182 “Nurse and Patient Safety and Protection Act of 2006,” by U.S. Representative John Conyers, Jr., Democrat, Michigan District 14, calling for an amendment of the Occupational Safety and Health Act of 1970 to reduce injuries to patients, nurses, and other health care providers with a safe patient handling standard.
Representative John Conyers, Jr., re-introduced the bill as HR 378 “Nurse and Patient Safety and Protection Act of 2007” on January 10, 2007. HR 378 would "direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard."
If HR 378 is successful, a Federal Safe Patient Handling Standard, calling for “all health care facilities” to comply, will be enacted “to prevent musculoskeletal disorders for direct-care registered nurses and other health care providers working in health care facilities. This standard shall require the elimination of manual lifting of patients by direct-care registered nurses and other health care providers, through the use of mechanical devices, except during a declared state of emergency.”
The last action on HR 378 was over a year ago. HR 378 was referred on May 9, 2007, by two House Committees, the Committee on Education and Labor and the Committee on Workforce Protections, to the House Subcommittee on Workforce Protections. As of this date, September 26, 2008, HR 378 remains in the Subcommittee on Workforce Protections where it has not yet had a hearing, and no hearing is scheduled.
There is one co-sponsor to date of the Nurse and Patient Safety and Protection Act. On June 3, 2008, U.S. Representative Joe Sestak, Democrat, Pennsylvania District 7, (202) 225-2011, joined Representative John Conyers, Jr., to co-sponsor HR 378 for the protection of healthcare workers and dependent persons in their care against devastating injuries directly caused by manual patient lifting..
From a call this date, September 26, 2008, to the House Education and Labor Committee office, (202) 225-3725, the Subcommittee on Workforce Protections has not acted on HR 378. And, with Congress looking to adjourn for this session, the Nurse and Patient Safety and Protection Act is not likely to be acted on this year. The date for Congress to re-convene will be per call of the Chair.
Legislators wanting to co-sponsor HR 378 Nurse and Patient Safety and Protection Act, or others wishing to express support, can contact Representative John Conyers, Jr., (202) 225-5126, John.Conyers@mail.house.gov, and Mr. Joel Segal, Legislative Assistant on Health Policy, (202) 225-5126, Joel.Segal@mail.house.gov.
For links to the status, complete history, and text of HR 378, go to http://thomas.loc.gov.
California Legislature Passes Safe Patient Handling Fifth Time –
Will Governor Schwarzenegger Sign or Veto, Again?
Legislation for the safe handling of patients in California is on the desk of Governor Arnold Schwarzenegger – again. For the fifth year in a row, the California State Legislature has passed legislation to protect patients and healthcare workers from painful injuries caused by lifting and moving dependent persons. But, every year, for the past four years, Governor Schwarzenegger has chosen to veto. The question is whether he will sign the fifth time around in 2008.
California Senate Bill 1151, Hospitals: lift teams, “Hospital Patient and Health Care Worker Injury Protection Act,” was introduced on February 6, 2008, by Senator Don Perata, Democrat, (510) 286-1333, Senator.Perata@sen.ca.gov. Senator Perata has introduced, and successfully carried a bill through the California Legislature, every year since 2004 to protect California healthcare workers and patients from injuries caused by manual lifting.
SB 1151 passed the California Assembly 45 to 29 on August 14, 2008, and passed the Senate 22 to 15 on August 30, 2008. The bill was enrolled and delivered to the Governor on September 17, 2008.
Per call this date, September 26, 2008, to Governor Schwarzenegger’s office, (916) 445-2841, the “Hospital Patient and Health Care Worker Injury Protection Act” is on the Governor’s desk. Per governor’s office staff, Governor Schwarzenegger has until September 30th to sign or veto; if he neither signs nor vetoes, SB 1151 will become law without his signature.
SB 1151 cites U.S. Bureau of Labor Statistics 2006 data showing California to lead the nation in musculoskeletal disorders suffered by workers. “California’s nursing workforce is aging at the same time patient acuity and obesity is rising. It is imperative that we protect our registered nurses and other health care workers from injury, and provide patients with safe and appropriate care. At a cost of between forty thousand dollars ($40,000) and sixty thousand dollars ($60,000) to train and orient each new nurse, preventing turnover from injuries will save hospitals money.”
SB 1151 cites California’s Occupational Safety and Health Act of 1973 which requires employers to provide safety devices or safeguards reasonably necessary to render employment safe. If signed into law, SB 1151 would require general acute care hospitals “to establish a patient protection and health care worker back injury prevention plan,” requiring hospitals to conduct a needs assessment to identify patients needing lift teams, and lift, repositioning, or transfer devices.
"The bill would require a general acute care hospital to use lift teams or lift, repositioning, and transfer devices when there is a risk of injury to a patient or a health care worker, except in emergency situations.” “A safe patient handling policy does not require the use of patient lift, repositioning, or transfer devices if
the individual hospital’s own needs assessment indicates that it is safe for the patient and the employee to utilize techniques not requiring the use of those devices.”
For links to the wording, complete history, and current status of CA SB 1151: http://www.leginfo.ca.gov/cgi-bin/postquery?bill_number=sb_1151&sess=CUR&house=B&search_type=email.
For notification of when Governor Schwarzenegger signs or vetoes, you can subscribe to receive email notification of legislative action on SB 1151 at www.leginfo.ca.gov.
With best wishes to all…Anne
Anne Hudson, RN, BSN
September 26, 2008
Founder, Work Injured Nurses’ Group USA
Coos Bay, Oregon
anne@wingusa.org
www.wingusa.org
WING USA SPH Legislative Update 4-29-08
April 29, 2008
Dear WING USA Friends,
To clarify differences among the nine states which have passed legislation related to safe patient handling, as reported in WING USA’s Legislative Update of March 31, 2008:
Nine States with Laws Related to Safe Patient Handling: Three States Supportive, Six States Require Safe Patient Handling Policy, Program, or Lift Equipment
Yes, nine states have passed legislation pertaining in some way to safe patient and/or resident handling, with three states lending support to efforts for safe patient and/or resident handling, and six states directly requiring development of safe patient handling policies, and/or implementation of safe patient handling programs, and/or use of mechanical patient lifting equipment, with variations in the scope and strength of requirements imposed by each state.
Inclusion of all nine states in the previous update was not meant to confuse, or to detract from the importance of the six states with laws mandating safe patient and/or resident handling policies and/or programs and/or lift equipment, but was in celebration of each state’s contribution on our country’s journey to a national standard for the safe handling of all patients and residents.
To differentiate among the nine states which have passed legislation:
Three states, Ohio, New York, and Hawaii, have passed legislation which does not directly require, but is supportive of, safe patient and/or resident handling – Ohio with interest-free loans to nursing homes wishing to implement lift equipment, New York with a demonstration project on safe patient handling, and Hawaii with adopting a resolution supporting American Nurses Association’s “Handle With Care” program (more details on each state below).
Six states, Texas, Washington, Rhode Island, Maryland, Minnesota, and New Jersey, have passed legislation requiring safe patient and /or resident handling policies, and/or programs, and/or lifting equipment, with much variation in scope and strength among the different state laws (more details on each state below).
Links to wording of legislation enacted by the nine states are provided below, so comparisons can be made among state laws providing support for, and state laws mandating implementation of, safe patient handling policies, and/or programs, and/or provision and use of patient lift equipment.
Of keen interest is the difference among states in addressing the safe handling of either or both hospital patients and/or nursing home residents. As more states draft legislation, ideally they will cover the safe handling of dependent persons across all settings by all healthcare workers.
With nearly 6,000 hospitals and 18,000 nursing homes, there are three nursing homes for every hospital in America. The US Bureau of Labor Statistics regularly reports three to four times as many work-related musculoskeletal injuries among nurse aides, orderlies, and attendants as among registered nurses. Efforts must be ramped up for the safe handling of dependent persons across all healthcare settings, and to other settings as well including correctional facilities, schools, etc., and for insurance coverage of home lift equipment, including ceiling-mounted lifts, to allow dependent persons to remain in their own home.
Efforts also need to move forward to assure permanent light duty nursing positions, to allow nurses disabled by lifting to remain with their employer in other non-lifting nursing work. Retaining back-disabled nurses, instead of continuing the widespread practice of terminating nurses when they can no longer lift, would help ease the nurse shortage by retaining some of our most experienced nurses.
Workers’ compensation carriers could save greatly on time loss payments and retraining costs if they would develop programs to assist employers to retain their injured nurses. It is time to move beyond the old paradigm of using nurses to lift until they’re broken and discarding them, and to acknowledge the contributions of nurses beyond lifting by continuing their employment. Yet, helping nurses back-disabled by lifting people to remain with their employer is a strategy missing in most discussions by thought leaders on easing the nurse shortage.
In addition to the nine states which have passed legislation related to safe patient handling, several other states have introduced (see the previous Update of 3-31-08), and others are reportedly considering introducing. Pressing toward a national standard for safe patient handling, HR 378 “Nurse and Patient Safety and Protection Act of 2007,” apparently remains in committee.
The importance of working to stop injuries to nursing staff and patients and residents caused by manual lifting cannot be overstated. With every day’s delay in implementing modern lift equipment, supported by the strongest safe patient and resident handling policies and programs possible, more nursing staff and dependent patients and residents suffer needless pain and injuries.
Research has proven that there are no safe methods of manual patient lifting. Injuries from lifting patients and residents cannot rightfully be called accidents. Nursing staff injuries from lifting, turning, and repositioning patients and residents are the predictable result of lifting and handling hazardous amounts of weight, compounded by forward bending in the awkward postures required to manually handle people.
Fortunately, equipment exists today which even eliminates the manual turning previously required to place the sling under the patient to use lift equipment. Other equipment eliminates lifting wheelchair patients from wheelchair up onto the exam table in the office. Large economical slide sheets extending head to foot are available to slide the patient’s whole body, and could be incorporated into the budget of almost any facility. When learning how slide sheets reduce friction to eliminate dragging the patient, I was instructed to stop saying “draw sheet” and to call the standard item what it is – a “drag sheet.” Low tech hand blocks and spring-loaded seat cushions could eliminate manually lifting patients who need only a small boost up to their feet.
Equipment available for safely handling patients and residents ranges from low-tech to extremely sophisticated. Yet, availability of such an array of modern equipment and devices has not convinced many facilities to remove dangerous loads from the backs of their nursing staff. With nursing assistants and nurses combined far surpassing any other occupation year after year for work-related musculoskeletal injuries, volunteerism clearly has not worked in large measure to stop injuries directly caused by lifting people.
Here’s a quick comparison of the nine states which have passed legislation, first the three supportive states, then the six states requiring safe patient and/or resident handling policies, and/or programs, and/or lift equipment. See wording at the links provided for details on requirements of each state’s legislation.
Three states which have passed legislation supportive of, but not requiring, safe patient and/or resident handling:
1. Ohio HB 67. March 21, 2005. First state to pass any kind of legislation in U.S.A. related to safe patient or resident handling. Created a workers’ compensation fund for interest-free loans to nursing homes wishing to purchase lift equipment for implementation of “No Manual Lifting of Residents” policies. Note: Does not require nursing homes to purchase and implement lift equipment or to develop safe patient handling policies and programs. Offers interest-free loans for lift equipment to nursing homes. Does not offer same loans to hospitals. Text: Scroll down to Sec. 4121.48. http://www.legislature.state.oh.us/bills.cfm?ID=126_HB_67_EN.
2. New York A 7641 and S 4929. October 18, 2005. Created a two-year “Safe Patient Handling Demonstration Program” to establish safe patient handling programs and collect data on nursing staff and patient injury with patient handling, manual versus lift equipment, in order to describe best practices for health and safety of healthcare workers and patients. Note: Does not require health care facilities to implement safe patient handling policies and programs. See: http://assembly.state.ny.us/ and http://www.senate.state.ny.us
New York A 7836. July 3, 2007. Extends demonstration program for two years to research the effect of safe patient handling programs, to build upon existing evidence-based data, with the goal of designing best practices for safe patient handling in health care facilities. Also establishes specifications for safe patient handling programs. Note: Does not require implementation of safe patient handling policies and programs. Summary text: http://assembly.state.ny.us/leg/?bn=A07836.
3. Hawaii HCR 16. April 24, 2006. Resolution calls for safeguards in health care facilities to minimize musculoskeletal injuries by nurses and for the State Legislature to support policies in American Nurses Association’s “Handle With Care” Campaign. HCR 16 states that in 2005, the Council of State Governments’ Health Capacity Task Force adopted and supported the policies contained in American Nurses Association’s “Handle With Care” campaign, and asked member states to also support the campaign. Recognizing that musculoskeletal disorders are the leading occupational health problem plaguing nurses, HCR 16 says, “Be it resolved…that the Legislature of the State of Hawaii supports the policies contained in the American Nurses Association's “Handle With Care” campaign.” Note: Does not require safe patient handling policy or program or use of patient lift equipment. Text: http://www.capitol.hawaii.gov/session2006/Bills/HCR16_.pdf.
Six states which have passed legislation requiring safe patient and/or resident handling policies, and/or programs, and/or patient lifting equipment:
1. Texas SB 1525. June 17, 2005. First state to require both hospitals and nursing homes to establish a policy for safe patient handling and movement, to control the risk of injury to patients and nurses; to evaluate alternative methods from manual lifting, including equipment and patient care environment; to restrict, to the extent feasible with existing equipment, manual handling of all or most of a patient’s weight to emergency, life-threatening, or exceptional circumstances; and provides for nurses to refuse to perform patient handling tasks believed in good faith to involve unacceptable risks of injury to a patient or nurse. Note: Covers both hospitals and nursing homes. Requires safe patient handling policy only. Does not require safe patient handling program or provision and use of lift equipment. Specifies nurses. Does not cover nurse assistants. Enrolled text:
http://www.capitol.state.tx.us/tlodocs/79R/billtext/html/SB01525F.htm.
2. Washington HB 1672. March 22, 2006. First state to mandate provision of lift equipment by hospitals and to offer financial assistance with implementation by tax credits and reduced workers’ compensation premiums. Hospitals must establish a safe patient handling committee with at least half of the members frontline non-managerial employees providing direct patient care, a safe patient handling program, and policy for all shifts and units. Hospitals may choose either one readily-available lift per acute care unit on the same floor, one lift for every ten acute care inpatient beds, or lift equipment for use by specially-trained lift teams. Employees may refuse without fear of reprisal patient handling activities believed in good faith to impose an unacceptable risk of injury to an employee or patient. With hospital construction or remodeling, feasibility of incorporating patient handling equipment is to be considered, or of designing to incorporate at a later date. Note: Covers hospitals only. Does not cover nursing homes. Provides financial assistance to implement lift equipment and programs. Covers “employees,” which would include nurse assistants and other healthcare workers, not limited to nurses only. Enrolled text: http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bills/House%20Passed%20Legislature/1672-S.PL.pdf.
3. Rhode Island H 7386 and S 2760. July 7, 2006. Requires hospitals and nursing facilities to achieve maximum reasonable reduction of manual lifting, transferring, and repositioning of patients and residents except in emergency, life-threatening, or exceptional circumstances. As a condition of licensure, health care facilities shall establish a safe patient handling committee chaired by a professional nurse with at least half the members non-managerial employees providing direct patient care, a safe patient handling program, and policy for all shifts and units. An employee may report, without fear of discipline or adverse consequences, being required to perform patient handling believed in good faith to expose the patient and/or employee to an unacceptable risk of injury. These reportable incidents shall be included in the facility's annual performance evaluation. Availability and use of safe patient handling equipment in new space or renovation is to be considered, with input from the community to be served. Legislative findings include that safe patient handling can reduce patient skin tears threefold. Note: Covers both hospitals and nursing facilities. Covers “employees,” not limited to nurses only. RI H 7386 text: http://www.rilin.state.ri.us/Billtext/BillText06/HouseText06/H7386Aaa.pdf and RI S 2760 text: http://www.rilin.state.ri.us/Billtext/BillText06/SenateText06/S2760A.pdf.
4. Maryland HB 1137 and SB 879. April 10, 2007. Defines “safe patient lifting” as “use of mechanical lifting devices by hospital employees, instead of manual lifting, to lift, transfer, and reposition patients.” Hospitals required to develop a safe patient lifting committee with an equal number of managers and employees, and a safe patient lifting policy to reduce employee injuries with patient lifting. Consideration is to be given to patient handling hazard assessment; enhanced use of mechanical lifting devices; development of specialized lift teams; training programs for safe patient lifting; incorporating space and construction design for mechanical lifting devices in architectural plans; and evaluating effectiveness of the safe lifting policy. Note: Covers only hospitals. Does not cover nursing homes. Covers “hospital employees,” not limited to nurses only. MD HB 1137 text: http://mlis.state.md.us/2007RS/chapters_noln/Ch_57_hb1137T.pdf. MD SB 879 text: http://mlis.state.md.us/2007RS/chapters_noln/Ch_56_sb0879T.pdf.
5. Minnesota HF 712 and SF 828 passed within HF 122. May 25, 2007. Requires a safe patient handling program by every licensed health care facility, including hospitals, outpatient surgical centers, and nursing homes; a safe patient handling committee; and policy to minimize manual lifting of patients by nurses and other direct patient care workers by utilizing safe patient handling equipment, rather than people, to transfer, move, and reposition patients and residents in all health care facilities. The program will address acquiring adequate, appropriate, safe patient handling equipment; training; remodeling and construction consistent with program goals; and evaluations of the program. Financial assistance will include matching grants and development of on-going funding sources to acquire and train on safe patient handling equipment, including low interest loans, interest free loans, and federal, state, or county grants, plus a special workers' compensation fund of $500,000 for safe patient handling grants. The MN State Council on Disability shall convene a work group to study use of safe patient handling equipment in unlicensed outpatient clinics, physician offices, and dental settings. Note: Covers hospitals, surgical centers, and nursing homes. Covers nurses and “other direct patient care workers,” not limited to nurses only. Link to text within MN HF 122: http://www.leg.state.mn.us/leg/legis.asp. Language in three areas: 1. Grant funding Art 1, Sec 6, Sub 3, pp 25-26; 2. main body of wording Art 2, Sec 23. 182.6551 to Sec 25. 182.6553, pp 48-51; and 3. study ways for workers' comp insurers to recognize compliance in premiums and for on-going funding Art 2, Sec 36, and work groups on safe patient handling and equipment Sec 37, pp 58-59.
6. New Jersey SB 1758 and AB 3028. January 3, 2008. Covers general and special hospitals, nursing homes, state developmental centers, and state and county psychiatric hospitals. To establish a safe patient handling committee, with at least 50% of the members health care workers representing disciplines employed by the facility. Requires a safe patient handling program and policy on all units and all shifts; a plan for prompt access to patient handling equipment; posting the policy in a location easily visible to staff, patients, and visitors, which minimizes unassisted patient handling, and includes a statement on the right of a patient to refuse assisted patient handling. “Assisted patient handling” means use of mechanical patient handling equipment, including, but not limited to, electric beds, portable base and ceiling track-mounted full body sling lifts, stand assist lifts, and mechanized lateral transfer aids; and patient handling aids, including, but not limited to, gait belts with handles, sliding boards and surface friction-reducing devices. There shall be no retaliatory action against any health care worker who refuses a patient handling task due to reasonable concern about worker or patient safety, or the lack of appropriate and available patient handling equipment. Includes recommendations for a capital plan to purchase equipment necessary to carry out the policy, which takes into account financial constraints of the facility. Note: Covers hospitals, nursing homes, developmental centers, and psychiatric hospitals. Covers “health care workers,” not limited to nurses only. NJ SPH Act text: http://www.njleg.state.nj.us/2006/Bills/PL07/225_.PDF.
With best wishes to all,
Anne Hudson, RN, BSN
April 29, 2008
Founder, Work Injured Nurses’ Group USA
Coos Bay, Oregon
anne@wingusa.org
www.wingusa.org
March 31, 2008
Dear WING USA friends,
WING USA Legislative Update on Safe Patient Handling:
Nine States Passed, Nine Other States Introduced, National Bill Continues
As of March 31, 2008, nine states are known to have passed industry-specific legislation related to the safe handling of patients and residents including Ohio, New York, Texas, Washington, Hawaii, Rhode Island, Maryland, Minnesota, and New Jersey.
Nine other states are known to have introduced or re-introduced legislation on safe patient handling including Massachusetts, California, Iowa, Nevada, Michigan, Florida, Vermont, Missouri, and Illinois, with seven of the nine continuing in their state legislature. It is unknown if Iowa and Nevada are re-introducing after being unsuccessful (see below). Information follows on legislative activity known at this time, though other state activity may have occurred.
National Bill for Safe Patient Handling Continues:
HR 378, “Nurse and Patient Safety and Protection Act of 2007,” was re-introduced on January 10, 2007, by Representative John Conyers (D-MI), phone 202-225-5126, email John.Conyers@mail.house.gov. Legislative Assistant on Health Policy is Joel Segal, phone 202-225-5126, email Joel.Segal@mail.house.gov.
HR 378 is currently in two House subcommittees. On February 2, 2007, the House Committee on Energy and Commerce referred HR 378 to the Subcommittee on Health. The last action was on May 9, 2007, when the House Committee on Education and Labor referred HR 378 to the Subcommittee on Workforce Protections.
If HR 378 is passed into law: "Nurse and Patient Safety and Protection Act of 2007 requires the Secretary of Labor, acting through the Director of Occupational Safety and Health Administration, to establish a Federal Safe Patient Handling Standard to prevent musculoskeletal disorders for direct-care registered nurses and other health care providers working in health care facilities by requiring the elimination of manual lifting of patients through the use of mechanical devices, except during a declared state of emergency.”
HR 378 links to text, status, actions: http://thomas.loc.gov/cgi-bin/bdquery/z?d110:h378:
Nine States which have Introduced or Re-introduced Legislation related to Safe Patient Handling: Massachusetts, California, Iowa, Nevada, Michigan, Florida, Vermont, Missouri, and Illinois.
1. Massachusetts has pursued legislation for safe patient handling since first introducing in December 2004 and continues with re-introduction of companion bills.
Senate Number 1294, “An Act to Require the Use of Evidence-Based Practices for Safe Patient Handling and Movement,” was introduced on January 10, 2007, by Senator Richard T. Moore (D), phone 617-722-1420, email Richard.Moore@state.ma.us.
House Number 2052, “An Act Relating to Safe Patient Handling in Certain Health Care Facilities,” was introduced on February 19, 2007, by Representative Jennifer M. Callahan (D), phone 617-722-2130, email Rep.JenniferCallahan@hou.state.ma.us, and 33 co-sponsors.
On February 28, 2008, SN 1294 was attached to HB 2052. The two bills were referred to the Joint Committee on Health Care Financing with further action pending.
MA SN 1294 history: http://www.mass.gov/legis/185history/s01294.htm.
MA SN 1294 text: http://www.mass.gov/legis/bills/senate/185/st01/st01294.htm.
MA HN 2052 history: http://www.mass.gov/legis/185history/h02052.htm.
MA HN 2052 text: http://www.mass.gov/legis/bills/house/185/ht02pdf/ht02052.pdf.
2. California has re-introduced legislation for the fifth time on the safe handling of patients, following passage by the legislature, and vetoes by Governor Arnold Schwarzenegger (R), for the past four years running.
Senate Bill 1151, Hospitals: Lift Teams, “Hospital Patient and Health Care Worker Injury Protection Act,” was introduced on February 6, 2008, by Senator Don Perata (D), phone 510-286-1333, email Senator.Perata@sen.ca.gov. SB 1151 was heard by the Senate Committee on Labor and Industrial Relations on March 26, 2008, and was referred to the Senate Appropriations Committee with a hearing date set for April 14, 2008.
Assembly Bill 371, Health Facilities, “An Act Relating to Health Facility Financing and Making an Appropriation Therefor,” was introduced by Assemblyman Jared Huffman (D), phone 916-319-2006, and Assemblywoman Sally Lieber (D), phone 916-319-2022, on February 14, 2007. A two-year bill, AB 371 was amended and passed by the Senate on September 7, 2007, and was returned to the Assembly on January 7, 2008. With concurrence, AB 371 is waiting to be heard and voted on for passage by the Assembly.
CA SB 1151 links to wording, history, and status: www.leginfo.ca.gov.
CA AB 371 links to wording, history, and status: www.leginfo.ca.gov.
3. Iowa introduced House File 635, “An Act Relating to Manual Patient Handling by Nurses in a Hospital Setting,” on March 8, 2005, by Representative Mary J. Mascher (D), phone 319-351-2826, email Mary.Mascher@legis.state.ia.us.
HF 635 passed the first reading and was referred to the House Committee on Human Resources where the bill was apparently unsuccessful. It is unknown if Iowa has re-introduced or has plans to re-introduce.
IA HF 635, in Archives, link to history and summary: http://coolice.legis.state.ia.us/Cool-ICE/default.asp?Category=BillInfo&Service=DspHistory&key=0671C&ga=81
4. Nevada introduced Assembly Bill 577, “Requires Certain Medical Facilities to Establish a Program for Safe Handling of Patients,” on March 26, 2007. AB 577 was introduced by Health and Human Services with no individual Assemblyperson’s name listed at the Nevada Legislature website as the bill’s sponsor.
On April 23, 2007, AB 577 was amended by the Assembly Committee on Health and Human Services, was declared an emergency measure under the Constitution, and passed the Assembly 34 to 8. AB 577 was read the first time in the Senate, and passed the Senate Committee on Human Resources and Education, but was unsuccessful after the second reading in the Senate.
Nevada’s two-year legislature is scheduled to reconvene in February 2009. It is unknown if there are plans to re-introduce a bill for safe patient handling in Nevada. Assemblywoman Sheila Leslie, Chair of the Committee on Health, may be able to provide more info, phone 775-333-6564, or email sleslie@asm.state.nv.us.
NV AB 577 history: https://www.leg.state.nv.us/74th/Reports/history.cfm?DocumentType=1&BillNo=577.
NV AB 577 text with amendments April 23, 2007: https://www.leg.state.nv.us/74th/Bills/AB/AB577_R1.pdf
5. Michigan introduced Senate Bill 377 on March 27, 2007, to amend “Public Health Code” regarding each hospital’s establishment of a safe patient handling committee and implementation of a safe patient handling program.
SB 377 was introduced by Senator Dennis Olshove (D), phone 517-373-8360; with co-sponsor Senator Gilda Jacobs (D), phone 517-373-7888; and four other co-sponsors: Senators Raymond Basham (D), Liz Brater (D), Deborah Cherry (D), and Bruce Patterson (R). SB 377 is currently in the Senate Health Policy Committee.
MI SB 377 history: http://www.legislature.mi.gov/(S(bj3n1c2yhuxae3b5wvdzer45))/mileg.aspx?page=getObject&objectName=2007-SB-0377.
MI SB 377 text http://www.legislature.mi.gov/documents/2007-2008/billintroduced/Senate/pdf/2007-SIB-0377.pdf
6. Florida re-introduced companion bills “Relating to Hospitalized Patients/Safe Lifting Policies.”
Senate Bill 508, “An Act Relating to the Safe Lifting of Hospitalized Patients,” was introduced on October 15, 2007, by Senator Mike Fasano (R), phone 727-848-5885; and co-sponsors Senator J. Alex Villalobos (R), phone 850-487-5130, email villalobos.alex.web@flsenate.gov; and Senator Evelyn J. Lynn (R), phone 850-487-5033, email lynn.evelyn.web@flsenate.gov.
Significantly, SB 508 passed the Senate as amended 39 to 0 on March 13, 2008, with announcement of the Senate passing SB 508 made during the 8th Annual Safe Patient Handling and Movement Conference in Orlando, Florida (see http://www.cme.hsc.usf.edu/sphm/). Following passage by the Senate, SB 508 was sent to the House and was referred to the House Joint Healthcare Council and the Policy and Budget Council with further action pending.
House Bill 471, “Patient Lifting and Handling Practices,” was introduced on January 7, 2008, by Representative Jimmy Patronis (R), phone 850-914-6300; and co-sponsors Representative Yolly Roberson (D), phone 850-488-7088; and Representative Juan C. Zapata (R), phone 850-488-9550. HB 471 passed the first reading, has been amended in committee, and is presently in the House Joint Healthcare Council pending further action.
FL SB 508 links to history and text: http://www.flsenate.gov.
FL HB 471 links to history and text: http://www.myfloridahouse.gov
7. Vermont introduced companion bills in February 2007, both titled “An Act Relating to Safe Patient Handling.”
Senate Bill 141 was introduced on February 27, 2007, by Senator Virginia V. “Ginny” Lyons (D), email vlyons@leg.state.vt.us; and Senator Richard T. Mazza (D), phone 802-863-1067. SB 141 was referred to the Senate Committee on Health and Welfare with further action pending.
House Bill 421 was introduced on February 28, 2007, by Representative Johannah Leddy Donovan (D), email jdonovan@leg.state.vt.us; co-sponsored by Representative Sarah R. Edwards (Progressive), phone 802-828-2231, email sedwards@leg.state.vt.us; and seven other co-sponsors: Representatives Peter Hunt, Tim Jerman, Patricia McDonald, Alice Miller, Betty Nuovo, Christopher Pearson, and Kathy Pellett. HB 421 was referred to the House Committee on Human Services with further action pending.
VT SB 141 status: http://www.leg.state.vt.us/database/status/summary.cfm. VT VT SB 141 text: http://www.leg.state.vt.us/docs/legdoc.cfm?URL=/docs/2008/bills/intro/S-141.HTM.
VT HB 421 status: http://www.leg.state.vt.us/database/status/summary.cfm.
VT HB 421 text: http://www.leg.state.vt.us/docs/legdoc.cfm?URL=/docs/2008/bills/intro/H-421.HTM.
8. Missouri introduced House Bill 1940, “Hospital Patient Safety,” on January 31, 2008, by Representative Sam Page (D), phone 573-751-9762, email Sam.Page@house.mo.gov; co-sponsored by Representative Robert Schaaf (R), phone 573-751-2183, email rob.schaaf@house.mo.gov; and 14 other co-sponsors: Representatives Meadows, Frame, Komo, Talboy, McClanahan, Norr, Onder, Cooper, Threlkeld, Baker, Bland, Hughes, Skaggs, and Holsman. HB 1940 was heard in the House Special Committee on Healthcare Transformation on March 26, 2008, and is pending further action.
MO HB 1940 status and link to actions: http://house.mo.gov/billtracking/bills081/bills/hb1940.htm.
MO HB 1940 text: http://www.house.mo.gov/billtracking/bills081/biltxt/intro/HB1940I.htm.
9. Illinois re-introduced House Bill 5274, “Safe Patient Handling Act,” on February 14, 2008, by Representative Elizabeth Coulson (R), phone 217-782-4194. HB 5274 was read for the first time and was referred to the House Rules Committee on February 14, 2008, with further action pending.
Links to status, history, and text which contains only a short title provision: http://www.ilga.gov/legislation/BillStatus.asp?DocNum=5274&GAID=9&DocTypeID=HB&LegId=36524&SessionID=51&GA=95.
Nine States which have Passed Legislation related to Safe Patient Handling: Ohio, New York, Texas, Washington, Hawaii, Rhode Island, Maryland, Minnesota, and New Jersey.
1. Ohio House Bill 67 was signed into law on March 21, 2005, by Governor Bob Taft (R), with Section 4121.48 creating a workers’ compensation fund for interest-free loans to nursing homes for lift equipment and for implementation of “No Manual Lifting of Residents” policies.
The law stipulates creation in the state treasury of the long-term care loan fund to be operated by the bureau of workers’ compensation “to make loans without interest to employers that are nursing homes for the purpose of allowing those employers to purchase, improve, install, or erect sit-to-stand floor lifts, ceiling lifts, other lifts, and fast electric beds, and to pay for the education and training of personnel, in order to implement a facility policy of no manual lifting of residents by employees.”
OH HB 67 text as enrolled, scroll down to Section 4121.48: http://www.legislature.state.oh.us/bills.cfm?ID=126_HB_67_EN.
2. New York companion bills, Assembly Bill 7641 and Senate Bill 4929, were introduced in April 2005, and were signed into law on October 18, 2005, by Governor George Pataki (R). The law created a two-year “Safe Patient Handling Demonstration Program” to establish safe patient handling programs and collect data on the incidence of nursing staff and patient injury with patient handling, manual versus lift equipment, with results used to describe best practices for improving health and safety of healthcare workers and patients during patient handling.
NY AB 7641 links to history and text: http://assembly.state.ny.us/.
NY SB 4929 links to history and text: http://www.senate.state.ny.us.
In April 2007, New York introduced identical bills, A 7836 by Assembly Member Richard N. Gottfried (D) and S 5116 by Senator Kemp Hannon (R), “An act to amend chapter 738 of the laws of 2005, relating to establishing a safe patient handling demonstration program, in relation to the effectiveness thereof.” In June 2007, S 5116 was substituted by A 7836 which was signed into law on July 3, 2007, by Governor Eliot Spitzer (D), extending the safe patient handling demonstration program for two years to research the effect of safe patient handling programs in health care facilities, to build upon existing evidence-based data, with the ultimate goal of designing "best practices" for safe patient handling in New York State health care facilities. The bill also establishes specifications for safe patient handling programs.
NY A 7836 summary text: http://assembly.state.ny.us/leg/?bn=A07836.
3. Texas Senate Bill 1525, “An Act Relating to Safe Patient Handling and Movement Practices of Nurses in Hospitals and Nursing Homes,” introduced March 10, 2005, by author Senator Judith Zaffirini (D) and Sponsor Representative Dianne Delisi (R), was signed into law by Governor Rick Perry (R) on June 17, 2005, and became effective January 1, 2006.
With passage of SB 1525, Texas became the first state to mandate implementation of policy for safe patient handling and movement programs by hospitals and nursing homes (“Texas Passes First Law for Safe Patient Handling in America: Landmark Legislation Protects Healthcare Workers and Patients from Injury Related to Manual Patient Lifting.” Mary Anne Hudson. September/October 2005. Journal of Long-Term Effects of Medical Implants. 15(5): 559-566).
The Texas law requires hospitals and nursing homes to establish a policy to identify, assess, and develop methods of controlling the risk of injury to patients and nurses associated with lifting, transferring, repositioning, and movement of patients; to evaluate alternative methods from manual lifting to reduce the risk of injury from patient lifting, including equipment and patient care environment; to restrict, to the extent feasible with existing equipment, manual handling of all or most of a patient’s weight to emergency, life-threatening, or exceptional circumstances; and to provide for refusal to perform patient handling tasks believed in good faith to involve unacceptable risks of injury to a patient or nurse.
TX SB 1525 enrolled text: http://www.capitol.state.tx.us/tlodocs/79R/billtext/html/SB01525F.htm.
4. Washington House Bill 1672, “An Act Relating to Reducing Injuries among Patients and Health Care Workers,” was initially introduced on February 1, 2005, sponsored by Representatives Steve Conway (D), Zack Hudgins (D), Tami Green (D), Eileen Cody (D), Sherry Appleton (D), Dawn Morrell (D), Alex Wood (D), John McCoy (D), Phyllis Kenney (D), Jim Moeller (D), and Maralyn Chase (D). After being stalled in the House Committee on Commerce and Labor in 2005, HB 1672 was reintroduced on January 8, 2006. HB 1672 passed the House 85 to 13 on March 7, 2006, and passed the Senate 48 to zero on March 8, 2006. Washington State’s safe patient handling law was signed by Governor Christine Gregoire (D) on March 22, 2006, and went into effect June 7, 2006.
With passage of HB 1672, Washington became the first state to require hospitals to provide mechanical patient lift equipment as part of their policy for safe patient handling, and to offer financial assistance, with tax credits and reduced workers’ compensation premiums, for implementation of lift equipment to reduce injuries related to lifting and moving patients (“The Need to Legislate the Healthcare Industry in the State of Washington to Protect Healthcare Workers from Back Injury.” William Charney. September/October 2005. Journal of Long-Term Effects of Medical Implants. 15(5): 567-571).
On a timeline, Washington hospitals must establish a safe patient handling committee, a safe patient handling program, and implement a safe patient handling policy for all shifts and units. Hospitals may choose among three options for implementation of lift equipment, either one readily-available lift per acute care unit on the same floor, one lift for every ten acute care inpatient beds, or lift equipment for use by specially-trained lift teams. Provision is made for employees to refuse without fear of reprisal patient handling activities believed in good faith to impose an unacceptable risk of injury to an employee or patient. With hospital construction or remodeling, feasibility is to be considered of incorporating patient handling equipment, or of designing to incorporate at a later date.
Significantly, Washington State’s safe patient handling law was passed during National Patient Safety Awareness Week, March 5-11, 2006. HB 1672 states, “Patients are not at optimum levels of safety while being lifted, transferred, or repositioned manually. Mechanical lift programs can reduce skin tears suffered by patients by threefold. Nurses, thirty-eight percent of whom have previous back injuries, can drop patients if their pain thresholds are triggered.” The Bureau of Labor Statistics reports that the injury rate of hospital employees in Washington State exceeds that of construction, agriculture, manufacturing, and transportation. With passage of HB 1672, Washington hospital patients and healthcare workers will be protected from unintentional pain and injuries related to manual patient lifting and moving.
WA HB 1672 enrolled text: http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bills/House%20Passed%20Legislature/1672-S.PL.pdf.
5. Hawaii House Concurrent Resolution Number 16, “Requesting Appropriate Safeguards be Instituted in Health Care Facilities to Minimize the Occurrence of Musculoskeletal Injuries Suffered by Nurses,” was introduced on February 3, 2006, by Representatives Marilyn B. Lee (D), Rida Cabanilla (D), Cindy Evans (D), Maile S. L. Shimabukuro (D), Roy M. Takumi (D), Clift Tsuji (D), Kirk Caldwell (D), Josh Green, MD (D), Robert N. Herkes (D), Ezra Kanoho (D), Bertha C. Kawakami (D), Bob Nakasone (D), Brian Schatz (D), Joseph M. Souki (D), Dwight Y. Takamine (D), and Kameo Tanaka (D). HCR 16 was adopted on April 24, 2006, calling for safeguards in health care facilities to minimize musculoskeletal injuries by nurses and for the State Legislature to support policies in American Nurses Association’s “Handle With Care” Campaign.
The report associated with HCR 16 is titled “American Nurses Association's ‘Handle With Care’ Campaign Support.” HCR 16 recognizes that musculoskeletal disorders are the leading occupational health problem plaguing nurses; that of primary concern are back injuries, which can be severely debilitating to nurses; that nursing personnel are among the highest at risk for musculoskeletal disorders; that work days lost to back injuries are twice as great for nursing home workers as for truck drivers; that nursing home and hospital workers incur more lost work days due to back injuries than construction workers, miners, and agriculture workers.
HCR 16 recognizes that musculoskeletal injury to nurses is particularly distressing in context of the current nurse shortage; and that injuries to nurses from patient handling compound factors such as the aging nurse workforce, declining retention and recruitment rates, and lowering the social value of nursing to worsen the shortage.
Hawaii’s resolution states that in 2005 the Council of State Governments’ Health Capacity Task Force adopted and supported the policies contained in American Nurses Association’s “Handle With Care” campaign, and asked member states to also support the campaign. With adoption of HCR 16, Hawaii says, “Be it resolved…that the Legislature of the State of Hawaii supports the policies contained in the American Nurses Association's “Handle With Care” campaign” (see ANA “Handle With Care brochure: http://nursingworld.org/MainMenuCategories/OccupationalandEnvironmental/occupationalhealth/handlewithcare/Resources/hwc.aspx.)
HI HCR 16 text: http://www.capitol.hawaii.gov/session2006/Bills/HCR16_.pdf.
6. Rhode Island’s “Safe Patient Handling Act of 2006” became law on July 7, 2006, “To Promote the Safe Handling of Patients in Health Care Facilities.” Companion bills, Senate Bill 2760 and House Bill 7386, both entitled “An Act Relating to Health and Safety – Safe Patient Handling Legislation,” were introduced in February 2006. SB 2760 was introduced on February 14, 2006, by Senators V. Susan Sosnowski (D), Beatrice A. Lanzi (D), Rhoda E. Perry (D), M. Teresa Paiva-Weed (D), and Juan M. Pichardo (D). HB 7386 was introduced on February 16, 2006, by Representatives Grace Diaz (D), Paul E. Moura (D), Amy G. Rice (D), Edith H. Ajello (D), and Raymond J. Sullivan, Jr. (D).
The bills were transmitted on June 29, 2006, to Governor Donald L. Carcieri (R), and became law on July 7, 2006, without Governor Carcieri’s signature. Rhode Island’s Safe Patient Handling Act took effect on January 1, 2007, requiring hospitals and nursing facilities to achieve maximum reasonable reduction of manual lifting, transferring, and repositioning of patients and residents except in emergency, life-threatening, or exceptional circumstances.
As a condition of licensure, health care facilities shall establish a safe patient handling committee, and a safe patient handling program, including implementation of a safe patient handling policy for all shifts and units by July 1, 2008. Protocols shall be established for an employee to report, without fear of discipline or adverse consequences, to the committee being required to perform patient handling believed in good faith to expose the patient and/or employee to an unacceptable risk of injury. These reportable incidents shall be included in the facility's annual performance evaluation.
The health services council shall consider the proposed availability and use of safe patient handling equipment in new or renovated space to be constructed, and input from the community to be served by the proposed equipment and services. Legislative findings listed in the law include greater risk of patient injury with manual lifting and moving, and that safe patient handling can reduce skin tears suffered by patients by threefold and can significantly reduce other injuries to patients as well.
RI H 7386 text: http://www.rilin.state.ri.us/Billtext/BillText06/HouseText06/H7386Aaa.pdf
RI S 2760 text: http://www.rilin.state.ri.us/Billtext/BillText06/SenateText06/S2760A.pdf.
7. Maryland passed identical companion bills for safe patient handling, House Bill 1137 and Senate Bill 879, on April 10, 2007, with Maryland’s “Act concerning Hospitals – Safe Patient Lifting” taking effect on October 1, 2007.
HB 1137, “Health Care Facilities and Regulation,” was introduced on February 19, 2007, by Delegates Joseline Pena-Melnyk (D), Aisha N. Braveboy (D), Melony G. Griffith (D), Jolene Ivey (E), and Kris Valderrama (D). SB 879, “Hospitals – Safe Patient Lifting,” was introduced on February 21, 2007, by Senator Paul G. Pinsky (D). HB 1137 and SB 879 were approved by Governor Martin O’Malley (D) on April 10, 2007.
HB 1137 and SB 879 define “safe patient lifting” as “use of mechanical lifting devices by hospital employees, instead of manual lifting, to lift, transfer, and reposition patients.” The new laws require Maryland hospitals to develop a safe patient lifting committee, with equal numbers of managers and employees by December 1, 2007, and a safe patient lifting policy to reduce employee injuries with patient lifting by July 1, 2008.
Consideration is to be given to patient handling hazard assessment; enhanced use of mechanical lifting devices; development of specialized lift teams; training programs for safe patient lifting; incorporating space and construction design for mechanical lifting devices in architectural plans; and evaluating effectiveness of the safe lifting policy.
MD HB 1137 history: http://mlis.state.md.us/2007rs/billfile/HB1137.htm.
MD HB 1137 text: http://mlis.state.md.us/2007RS/chapters_noln/Ch_57_hb1137T.pdf.
MD SB 879 history: http://mlis.state.md.us/2007rs/billfile/SB0879.htm.
MD SB 879 text: http://mlis.state.md.us/2007RS/chapters_noln/Ch_56_sb0879T.pdf.
8. Minnesota’s “Safe Patient Handling Act” was passed by inclusion of companion bills on safe patient handling, House File 712 and Senate File 828, within the second engrossment of a large omnibus bill, House File No. 122.
HF 712, “Safe Patient Handling Act,” introduced on February 8, 2007, by Representatives Patti Fritz (D), Erin Murphy (D), Maria Ruud (D), Karen Clark (D), Jim Abeler (R), and David Bly (D); and SF 828, “Safe Patient Handling Act,” introduced on February 15, 2007, by Senators Linda Higgins (D), Sharon L. Erickson Ropes (D), Kathy Sheran (D), Paul E. Koering (R), and John Marty (D), passed within HF 122 which was approved by Governor Tim Pawlenty (R) on May 25, 2007.
Minnesota’s Safe Patient Handling Act requires implementation of a safe patient handling program by every licensed health care facility in the state, including hospitals, outpatient surgical centers, and nursing homes. On a timeline, a safe patient handling committee will be established; and a safe patient handling policy will be adopted to minimize manual lifting of patients by nurses and other direct patient care workers by utilizing safe patient handling equipment, rather than people, to transfer, move, and reposition patients and residents in all health care facilities.
The safe patient handling program will address the assessment of hazards with patient handling, acquisition of an adequate supply of appropriate safe patient handling equipment, initial and ongoing training on use of the equipment, procedures to ensure that remodeling and construction are consistent with program goals, and periodic evaluations of the safe patient handling program.
Provisions are included for financial assistance with matching grants and development of on-going funding sources for health care facilities to acquire and train on safe patient handling equipment. Such sources may include low interest loans, interest free loans, and federal, state, or county grants. A special workers' compensation fund provided $500,000 for safe patient handling grants.
The Minnesota State Council on Disability shall convene a work group representing clinics, disability advocates, and direct care workers, to study issues around use of safe patient handling equipment in unlicensed outpatient clinics, physician offices, and dental settings.
On passage of Minnesota’s Safe Patient Handling Statute, Elizabeth (Bettye) Shogren, RN, Health and Safety Specialist, Minnesota Nurses Association, stated, “We had many supporters in the community and a comprehensive strategic plan to advance the bill. Over-preparation and realistic expectations made this a success.”
On January 17, 2008, the Minnesota Department of Labor and Industry announced awarding 67 grants totaling $500,000 to health care facilities to help purchase patient-lifting equipment in complying with the new state patient-handling regulations. For a list of the facilities in Minnesota receiving patient-handling grants see http://www.doli.state.mn.us/pdf/sph_approv_grants.pdf.
Omnibus bill HF 122 is over 130 pages, with language on safe patient handling in three separate areas: 1. Initial grant funding in Article 1, Section 6, Subdivision 3, on pages 25-26; 2. Main body of wording for safe patient handling in Article 2, Section 23. 182.6551 to Section 25. 182.6553, on pages 48-51; and 3. Study of ways to require workers' compensation insurers to recognize compliance in premiums and for on-going funding in Article 2, Section 36, and work groups on safe patient handling and equipment in Section 37 on pages 58-59.
MN HF 122 text: http://www.leg.state.mn.us/leg/legis.asp.
MN SF 828 and MN HF 712 links to history and text: http://www.leg.state.mn.us/leg/legis.asp.
9. New Jersey appears to be the most recent state to pass legislation. The “Safe Patient Handling Act” was signed into law by Governor Jon Corzine (D) on January 3, 2008, following passage of identical bills titled “Safe Patient Handling Act”: Senate Bill 1758, introduced on March 21, 2006, by primary sponsors Senators Joseph F. Vitale (D) and Loretta Weinberg (D) and co-sponsors Senators John H. Adler (D), Fred H. Madden, Jr. (D), Ronald L. Rice (D), and Barbara Buono (D); and Assembly Bill 3028, introduced on May 15, 2006, by primary sponsors Assemblymen Herb Conaway, Jr. (D), Vincent Prieto (D), and Gary S. Schaer (D), and Assemblywoman Joan M. Voss (D), with co-sponsors Assemblywomen Linda R. Greenstein (D) and Valerie Vainieri Huttle (D), and Assemblymen Patrick J. Diegnan, Jr. (D), Robert M. Gordon (D), and Thomas P. Giblin (D).
On December 13, 2007, A 3028 was substituted by S 1758 which passed the New Jersey Senate 37 to 0 and the Assembly 77 to 3. The Safe Patient Handling Act went into effect immediately upon signing on January 3, 2008, covering general and special hospitals, nursing homes, state developmental centers, and state and county psychiatric hospitals.
Covered facilities are to establish a safe patient handling committee for development and implementation of a safe patient handling program and a safe patient handling policy on all units and for all shifts. Assessment of the handling requirements of each patient are to be Included, with a plan for prompt access to patient handling equipment and handling aids. The safe patient handling policy shall be posted in a location easily visible to staff, patients, and visitors, which minimizes unassisted patient handling, and includes a statement concerning the right of a patient to refuse the use of assisted patient handling.
“Assisted patient handling” means use of mechanical patient handling equipment, including, but not limited to, electric beds, portable base and ceiling track-mounted full body sling lifts, stand assist lifts, and mechanized lateral transfer aids; and patient handling aids, including, but not limited to, gait belts with handles, sliding boards and surface friction-reducing devices.
There shall be no retaliatory action against any health care worker who refuses a patient handling task due to reasonable concern about worker or patient safety, or the lack of appropriate and available patient handling equipment.
Recommendations shall be included for a three-year capital plan to purchase safe patient handling equipment and patient handling aids necessary to carry out the safe patient handling policy, which is to take into account the financial constraints of the facility.
NJ Safe Patient Handling Act text: http://www.njleg.state.nj.us/2006/Bills/PL07/225_.PDF.
With best wishes to all,
Anne Hudson, RN, BSN
Founder, Work Injured Nurses’ Group USA
March 31, 2008
anne@wingusa.org
www.wingusa.org
October 21, 2007
Dear WING USA:
Fourth Veto on Safe Patient Handling for California
For the fourth year running, California Governor Arnold Schwarzenegger (R) has once more vetoed legislation to protect patients and healthcare workers from painful injuries with lifting and moving dependent persons.
Senate Bill 171 "Hospital Patient and Health Care Worker Injury Protection Act," introduced by Senator Don Perata (D), passed the California Senate June 4, 2007, and the Assembly September 6, 2007, but was vetoed on October 13, 2007, by Governor Schwarzenegger. The bill would have become effective on July 1, 2008, providing legal protection against preventable injuries from manual patient handling.
Citing California's Occupational Safety and Health Act of 1973, which requires employers to provide safety devices or safeguards for safe employment, SB 171 would have required all acute care hospitals to establish a "patient protection and health care worker back injury prevention plan," requiring "hospitals to use lift teams, and lift, repositioning, and transfer devices, and to train health care workers on the appropriate use of lift, repositioning, and transfer devices."
SB 171 cites Bureau of Labor Statistics (BLS) data showing that certified nurse assistants, registered nurses, and licensed practical nurses together, 95% of whom are women, consistently lead the nation in work-related musculoskeletal disorders (MSD's).
SB 171 further cites 2006 BLS data showing that California leads the nation in MSD's suffered by its workers, and points out that the risk of patient handling injury escalates with an aging nursing workforce and with rising patient acuity and obesity.
With the cost of replacing a single registered nurse between $40,000 and $60,000, SB 171 shows that preventing turnover of nurses due to patient handling injuries would save hospitals money, and states, "It is imperative that we protect our registered nurses and other health care workers from injury, and provide patients with safe and appropriate care."
Yet, it appears that Governor Schwarzenegger and most state governments to date lack the resolve to take measures necessary to protect healthcare workers and dependent persons from preventable lifting injuries.
With MSD's from the manual lifting of patients and residents possibly the single-largest cause of disabling work injury in America, and possibly the single-largest cause of the nurse shortage, injuries from lifting people is clearly a national healthcare crisis which deserves, but has not yet achieved, top priority. One can only wonder why. Being lifted or moved by others will touch each one of us, literally, physically, at some point, either ourselves or a loved one. With each passing moment, more patients, residents, and healthcare workers are unnecessarily injured by manual lifting.
A recent example of injury to a dependent person being moved is "Ms. Maggy," who finds herself in a nursing home following a hip fracture. Six weeks after successful hip pinning surgery, during a wheelchair-to-bed pivot transfer, Ms. Maggy was apparently rapidly turned on her operated leg, wrenching her knee. When she refused to have the same nurse aide for the next transfer, another nurse aide apparently again performed a rapid pivot transfer on her operated leg, wrenching the same knee again.
X-rays showed no fracture to Ms. Maggy's knee, but weeks later, she still has much pain in that knee, further limiting her mobility. If a "sit-stand" lift had been available, the wrenching injury to Ms. Maggy's knee could have been avoided. Directives for use of safe lift and transfer equipment could avoid many such painful debilitating injuries. It has been stated that safe patient-lift equipment should be considered just as essential as hospital and nursing home beds, for prevention of injuries to healthcare workers, patients, and residents alike.
In fact, "With availability of gentle repositioning, lift, and transfer equipment, which reduces risk of pain and injury to patients, manual handling without assistive equipment may become considered malpractice" ("Devastating Injuries in Healthcare Workers: Description of the Crisis and Legislative Solution to the Epidemic of Back Injury from Patient Lifting." Richard F. Edlich, MD, PhD, Mary Anne Hudson, RN, BSN, Ralph M. Buschbacher, MD, et al. March/April 2005. Journal of Long-Term Effects of Medical Implants. 15(2): 225-241).
Volunteerism to protect healthcare workers, patients, and residents against lifting injuries, within the massive system of nearly 6,000 hospitals and 18,000 nursing homes, is not realistic and clearly is not working. Thus far, about one quarter of the states have passed legislation for, or related to, safe patient handling. Governor Schwarzenegger's fourth veto of protection against patient handling injuries for Californians underscores the profound need for a national standard to unify the states on safe patient handling.
The national bill, HR 378 Nurse and Patient Safety and Protection Act of 2007, re-introduced January 10, 2007, by US Representative John Conyers (D-MI), remains in committee. HR 378 would "direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and other health care providers by establishing a safe patient handling standard." If HR 378 passes, a federal standard for safe patient handling will be established in our country, covering nurses, other healthcare workers, and dependent persons in their care.
To express support of HR 378 Nurse and Patient Safety and Protection Act of 2007, contact Representative John Conyers, John.Conyers@mail.house.gov, (202) 225-5126, and Mr. Joel Segal, Legislative Assistant on Health Policy, Joel.Segal@mail.house.gov, (202) 225-5126. For links to the history and text of HR 378, go to http://thomas.loc.gov.
For the complete history of SB 171, California's "Hospital Patient and Health Care Worker Injury Protection Act," the fourth legislation for safe patient handling vetoed by Governor Schwarzenegger, go to http://www.leginfo.ca.gov/. Click the "Bill Information" box. Select "Bill Number" and enter "SB 171" in the box and click "Search." Click "SB 171" where you can select "Status," "History," "Bill Text," etc., or scroll to the bottom and select "Veto Message" for Governor Schwarzenegger's statement, which follows.
Best wishes to all…Anne
Anne Hudson, RN, BSN
October 21, 2007
Founder, Work Injured Nurses' Group USA
anne@wingusa.org
www.wingusa.org
"To the Members of the California State Senate:
"I am returning Senate Bill 171 without my signature.
"This bill, which imposes a one-size fits all mandate on hospitals to establish a "zero lift" patient handling policy, is similar to measures I have vetoed the last three years. While I continue to support the goal of reducing workplace injuries, I remain convinced that this inflexible mandate is a poor alternative to giving hospitals the flexibility needed to achieve this goal in the manner that most efficiently addresses each hospital's needs and resources.
"For this reason, I am returning this bill without my signature.
"Sincerely,
"Arnold Schwarzenegger"
Reprinted with permission from: XtraWise: a publication for the medical community.
Summer 2007. Vol 9.2. Sizewise Rentals, LLC. www.sizewise.net.
Back Injured Nurses: 1st Person Account
Anne Hudson, RN, BSN
"Research has shown for many years that there is no safe way to manually lift patients."
I always thought of an injured nurse as someone who was put in a difficult situation where an accident occurred and caused the injury. I never realized that injuries are occurring on a daily basis from our basic patient handling tasks. And then the pain went stabbing through my back and the doctor announced "cumulative trauma injury to the lumbar discs." In my case, this cumulative injury resulted in more than just pain; ultimately nursing as I knew it was taken from me.
Many nurses do not know how the workers' compensation system operates or what to expect if they get injured while lifting patients. At my
hospital, patient handling injury was never discussed at any unit meeting, hospital employee meeting, or nurses' union meeting. Injury from lifting patients was simply never addressed as an issue among nurses but was left up to the hospital to handle. Sadly, through my experience, I learned that hospitals generally deny workers' compensation claims, requiring the injured nurse to appeal the denial and appear in court to prove they were injured at work. I also learned that many hospitals do not retain injured nurses in other non-lifting nursing work if they are unable to return to lifting patients.
Nurses need to educate themselves on how and why patient lifting causes spinal injury. It has long been said that for nurses "back injury is part of the job" without clearly defining "back injury." Nurses need to know that manually lifting patients places them at tremendous risk of permanent spinal disability, not just at risk of muscle strain which would be expected to heal in a matter of days or weeks.
Learning how degenerative disc disease develops from repetitive micro-fractures to spinal structures with lifting hazardous amounts of weight often creates "champions" for a no lifting policy. Due to the fact that there are no pain receptors in the center of discs and vertebral endplates where injury typically begins, much insidious damage can occur to the spine without pain; knowing this is a powerful motivator for use of lift equipment.
I would tell other nurses to learn about the great variety of lifting, transferring, and turning equipment and friction-reducing devices available, and to then campaign for their hospital to provide the equipment. Hospital administrators need to recognize that preventing injuries with appropriate lift equipment and friction-reducing devices is always less costly than allowing injuries and replacing nurses. Research has shown for many years that there is no safe way to manually lift patients. Forces are exerted which exceed tolerance limits of the spine, so that injuries from patient lifting cannot rightly be called "accidents." Injury is the predictable outcome from performing such hazardous lifting.
Anne Hudson, RN, BSN, of Coos Bay, Oregon, is a Public Health Nurse with the Coos County Public Health Department. Since losing her
previous hospital nursing career to a spinal injury from lifting patients, she has become a voice for back-injured nurses and an activist for preventing injuries to nurses and patients related to manual patient lifting. Anne Hudson founded Work Injured Nurses' Group USA (WING USA) at www.wingusa.org for information, mutual support, and advocacy for back-injured nurses. She has spoken around the country and in Australia on the high cost of avoidable injuries from patient lifting, and endorses "Safe Patient Handling – No Manual Lift" legislation to mandate use of safe lift equipment for dependent persons across all healthcare settings. Anne Hudson has published articles and co-edited with William Charney the book Back Injury Among Healthcare Workers: Causes, Solutions, and Impacts.
Read full issue (pdf) XtraWise: a publication for the medical community. Summer 2007 Volume 9.2
September 8, 2007
Dear WING USA Friends,
Legislative Update September 2007
Minnesota Latest to Pass Legislation for Safe Patient Handling
Minnesota appears to be the most recent state to pass legislation for the safe handling of dependent health care patients and residents. Legislative activity in other states may have occurred of which I am unaware.
Minnesota’s "Safe Patient Handling Act," introduced as companion bills Senate File 828 and House File 712 in February 2007, was passed on May 20, 2007, within the second engrossment of a large omnibus bill, House File No. 122. HF 122 was approved by Governor Tim Pawlenty (R) on May 25, 2007.
Minnesota’s new Safe Patient Handling law requires all licensed health care facilities, including hospitals, outpatient surgical centers, and nursing homes, to establish a safe patient handling committee and a safe patient handling program, to minimize manual lifting by nurses and other direct patient care workers, by utilizing safe patient handling equipment rather than people, to transfer, move, and reposition patients and residents in all health care facilities.
A special workers' compensation fund was to provide $500,000 the first year and $500,000 the second year for safe patient handling grants, but a line item veto reduced funding to $500,000 one time. Provisions for development of on-going funding for safe patient handling programs and equipment are included in Minnesota’s Safe Patient Handling Act.
Omnibus bill HF 122 is very large, over 130 pages, with language pertinent to safe patient handling in three separate areas of the bill regarding 1. Initial grant funding, 2. The main body of wording for safe patient handling, and 3. Study of ways to require workers' compensation insurers to recognize compliance in premiums and for on-going funding, and work groups on safe patient handling and equipment.
Funding for safe patient handling grants is outlined in HF 122 Article 1 “Jobs, Economic Development, Housing and Minnesota Heritage Appropriations Summary,” Section 6 “Labor and Industry,” Subdivision 3 “Safety Codes and Services” on pages 25-26 (see below).
Provisions for studying ways to require workers' compensation insurers to recognize compliance in premiums of health care facilities, and for on-going funding sources, are in HF 122 Article 2 “Employment and Development-Related Provisions,” Section 36 “Study; Safe Patient Handling," with requirements for work groups on safe patient handling and equipment in Section 37 “Work Group; Safe Patient Handling” on pages 58-59 (see below).
Wording of Minnesota's Safe Patient Handling Act is in HF 122 Article 2 “Employment and Development-Related Provisions,” Section 23. 182.6551 to Section 25. 182.6553, on pages 48-51.
Wording of Minnesota's Safe Patient Handling Act follows below and may also be read online at the Minnesota State Legislature website. Go to http://www.leg.state.mn.us/leg/legis.asp. Enter "HF 122" in the House of Representatives “Enter Bill number” search box and click “go.” Click "Status of Bill in the House" for the bill's history. Under “Bill Name: HF 122,” click "Bill Text.” Under “Bill Engrossments,” click "H.F.122, 2nd Engrossment" posted on May 21, 2007.
Elizabeth (Bettye) Shogren, RN, Health and Safety Specialist, Minnesota Nurses Association, email Bettye.Shogren@mnnurses.org, gave the following report June 11, 2007, on Minnesota’s new Safe Patient Handling Statute:
“The language is pretty much what we had proposed initially, but the grant funding is significantly reduced. The legislature was a hard sell on that and the governor exercised a line item veto on the funding except for $500,000, but there is a requirement to get back to the legislature with some funding ideas especially for Long Term Care. In Minnesota, that group of employers has significant restrictions on what they can get as far as reimbursement. There is one other state that has a similar problem so there will be continued work on that issue. We really need that federal law so we don't have so much difference state to state.
“We are all so pleased that the bill got through largely intact. The Minnesota Hospital Association testified in support of the bill. The Long Term Care Associations opposed the bill due to financial issues not principle issues.
“We had many supporters in the community and a comprehensive strategic plan to advance the bill that has worked better than we had anticipated. Over-preparation and realistic expectations made this a success.
“If you are among the supporters, please accept my deepest thanks in helping Minnesota Nurses Association (MNA) achieve a victory for direct patient care staff. We will definitely be celebrating and hope you will be able to join us when we do--in spirit if not by being present. Bettye”
Congratulations to Minnesota on their new Safe Patient Handling Act for the safe handling of patients and residents! (See wording following.) Other states and the nation press on to secure legislation for the safe lifting and moving of dependent persons across all health care settings.
Best wishes to all…Anne
Anne Hudson, RN, BSN
September 8, 2007
Founder, Work Injured Nurses’ Group USA
Coos Bay, Oregon
anne@wingusa.org
www.wingusa.org
Note: Funding outlined in Article 1, Section 6, Subdivision 3 (immediately following) was reduced by a line item veto to $500,000 one time.
http://www.leg.state.mn.us/leg/legis.asp
MINNESOTA HOUSE FILE No. 122, 2nd ENGROSSMENT – 85th LEGISLATIVE SESSION (2007-2008) Posted on May 21, 2007
Article 1
JOBS, ECONOMIC DEVELOPMENT, HOUSING AND MINNESOTA HERITAGE APPROPRIATIONS SUMMARY
Section 6. LABOR AND INDUSTRY
Subdivision 3. Safety Codes and Services
This appropriation is from the workers' compensation fund. $500,000 the first year and $500,000 the second year are from the workers' compensation fund for patient safe handling grants under Minnesota Statutes, section 182.6553. This is a onetime appropriation and is available until expended.”
ARTICLE 2
EMPLOYMENT AND DEVELOPMENT-RELATED PROVISIONS
MINNESOTA SAFE PATIENT HANDLING ACT
Section 23. [182.6551] CITATION.
Sections 182.6551 to 182.6553 may be cited as the "Safe Patient Handling Act."
Section 24. [182.6552] DEFINITIONS.
Subdivision 1. Direct patient care worker. "Direct patient care worker" means an individual doing the job of directly providing physical care to patients including nurses, as defined by section 148.171, who provide physical care to patients.
Subd. 2. Health care facility. "Health care facility" means a hospital as defined in section 144.50, subdivision 2; an outpatient surgical center as defined in section 144.55, subdivision 2; and a nursing home as defined in section 144A.01, subdivision 5.
Subd. 3. Safe patient handling. "Safe patient handling" means a process, based on scientific evidence on causes of injuries, that uses safe patient handling equipment rather than people to transfer, move, and reposition patients in all health care facilities to reduce workplace injuries. This process also reduces the risk of injury to patients.
Subd. 4. Safe patient handling equipment. "Safe patient handling equipment" means engineering controls, lifting and transfer aids, or mechanical assistive devices used by nurses and other direct patient care workers instead of manual lifting to perform the acts of lifting, transferring, and repositioning health care facility patients and residents.
Section 25. [182.6553] SAFE PATIENT HANDLING PROGRAM.
Subdivision 1. Safe patient handling program required.
(a) By July 1, 2008, every licensed health care facility in the state shall adopt a written safe patient handling policy establishing the facility's plan to achieve by January 1, 2011, the goal of minimizing manual lifting of patients by nurses and other direct patient care workers by utilizing safe patient handling equipment.
(b) The program shall address:
(1) assessment of hazards with regard to patient handling;
(2) the acquisition of an adequate supply of appropriate safe patient handling
equipment;
(3) initial and ongoing training of nurses and other direct patient care workers on the use of this equipment;
(4) procedures to ensure that physical plant modifications and major construction projects are consistent with program goals; and
(5) periodic evaluations of the safe patient handling program.
Subd. 2. Safe patient handling committee.
(a) By July 1, 2008, every licensed health care facility in the state shall establish a safe patient handling committee either by creating a new committee or assigning the functions of a safe patient handling committee to an existing committee.
(b) Membership of a safe patient handling committee or an existing committee must meet the following requirements:
(1) at least half the members shall be non-managerial nurses and other direct patient care workers; and
(2) in a health care facility where nurses and other direct patient care workers
are covered by a collective bargaining agreement, the union shall select the committee members proportionate to its representation of non-managerial workers, nurses, and other direct patient care workers.
(c) A health care organization with more than one covered health care facility may establish a committee at each facility or one committee to serve this function for all the facilities. If the organization chooses to have one overall committee for multiple facilities, at least half of the members of the overall committee must be non-managerial nurses and other direct patient care workers and each facility must be represented on the committee.
(d) Employees who serve on a safe patient handling committee must be compensated by their employer for all hours spent on committee business.
Subd. 3. Facilities with existing programs. A facility that has already adopted a safe patient handling policy that satisfies the requirements of subdivision 1, and established a safe patient handling committee by July 1, 2008, is considered to be in compliance with those requirements. The committee must continue to satisfy the requirements of subdivision 2, paragraph (b), on an ongoing basis.
Subd. 4. Committee duties. A safe patient handling committee shall:
(1) complete a patient handling hazard assessment that:
(i) considers patient handling tasks, types of nursing units, patient populations, and the physical environment of patient care areas;
(ii) identifies problems and solutions;
(iii) identifies areas of highest risk for lifting injuries; and
(iv) recommends a mechanism to report, track, and analyze injury trends;
(2) make recommendations on the purchase, use, and maintenance of an adequate supply of appropriate safe patient handling equipment;
(3) make recommendations on training of nurses and other direct patient care
workers on use of safe patient handling equipment, initially when the equipment arrives at the facility and periodically afterwards;
(4) conduct annual evaluations of the safe patient handling implementation plan and progress toward goals established in the safe patient handling policy; and
(5) recommend procedures to ensure that, when remodeling of patient care areas occurs, the plans incorporate safe patient handling equipment or the physical space and construction design needed to accommodate safe patient handling equipment at a later date.
Subd. 5. Training materials. The commissioner shall make training materials on implementation of this section available to all health care facilities at no cost as part of the training and education duties of the commissioner under section 182.673.
Subd. 6. Enforcement. This section shall be enforced by the commissioner under section 182.661. A violation of this section is subject to the penalties provided under section 182.666.
Subd. 7. Grant program. The commissioner may make grants to health care
facilities to acquire safe patient handling equipment and for training on safe patient handling and safe patient handling equipment. Grants to any one facility may not exceed $40,000. A grant must be matched on a dollar-for-dollar basis by the grantee. The commissioner shall establish a grant application process. The commissioner may give priority for grants to facilities that demonstrate that acquiring safe patient handling equipment will impose a financial hardship on the facility. For health care facilities that provide evidence of hardship, the commissioner may waive the 50 percent match requirement and may grant such a facility more than $40,000. Health care facilities that the commissioner determines are experiencing hardship shall not be required to meet the safe patient handling requirements until July 1, 2012.
Section 36. STUDY; SAFE PATIENT HANDLING.
(a) The commissioner of labor and industry shall study ways to require workers' compensation insurers to recognize compliance with Minnesota Statutes, section 182.6553, in the workers' compensation premiums of health care and long-term care facilities. The commissioner shall report by January 15, 2008, the results of the study to the chairs of the policy committees of the legislature with primary jurisdiction over workers' compensation issues.
(b) By January 15, 2008, the commissioner must make recommendations to the legislature regarding funding sources available to health care facilities for safe patient handling programs and equipment, including, but not limited to, low interest loans, interest free loans, and federal, state, or county grants.
Section 37. WORK GROUP; SAFE PATIENT HANDLING.
The Minnesota State Council on Disability shall convene a work group comprised of representatives from the Minnesota Medical Association and other organizations representing clinics, disability advocates, and direct care workers, to do the following:
(1) Assess the current options for and use of safe patient handling equipment in unlicensed outpatient clinics, physician offices, and dental settings;
(2) Identify barriers to the use of safe patient handling equipment in these settings; and
(3) Define clinical settings that move patients to determine applicability of the Safe Patient Handling Act.
The work group must report to the legislature by January 15, 2008, including reports to the chairs of the Senate and House of Representatives Committees on Workforce Development.
May 13, 2007
Dear WING USA Friends,
Safe Patient Handling Legislative Update May 2007
Legislative activity continues for the safe handling of patients and residents in America. Maryland has most recently passed legislation and several more states have introduced legislation calling for the use of modern technology rather than the backs of healthcare workers for lifting and moving dependent persons.
At this writing, at least 15 states have passed or introduced legislation for or related to safe patient handling. With passage of companion bills in April 2007, Maryland joined the growing list of states which are acting to curtail the epidemic of injuries caused by the unsafe manual lifting of people by other people. This report includes a summary of known state activity. Other states besides those listed may have passed or introduced, while certain other states are reported to be considering introducing.
Notably, the national bill, HR 378 Nurse and Patient Safety and Protection Act of 2007, introduced January 10, 2007, by Representative John Conyers, Jr, (D MI-14), continues in the US House of Representatives. HR 378 was referred to the Committee on Education and Labor and, also, to the Committee on Energy and Commerce where it was subsequently referred, on February 2, 2007, to the Subcommittee on Health. If HR 378 passes, the United States will have a federal standard for the safe handling of patients in our country.
To express support of HR 378 Nurse and Patient Safety and Protection Act of 2007, contact Representative John Conyers, John.Conyers@mail.house.gov, (202) 225-5126, and Mr. Joel Segal, Legislative Assistant on Health Policy, Joel.Segal@mail.house.gov, (202) 225-5126. For links to the history and text of HR 378, go to http://thomas.loc.gov.
The following summarizes state activity for safe patient handling which is known at this time.
Maryland passed identical companion bills HB 1137 and SB 879 for safe patient handling on April 10, 2007.
HB 1137 “Health Care Facilities and Regulation,” sponsored by Delegates Joseline Pena-Melnyk (D), Aisha N. Braveboy (D), Melony G. Griffith (D), Jolene Ivey (E), and Kris Valderrama (D), was introduced February 19, 2007. After passing the House and Senate on March 21, 2007, and April 1, 2007, respectively, HB 1137 was approved by Democratic Governor Marin O’Malley on April 10, 2007.
SB 879 “Hospitals - Safe Patient Lifting,” sponsored by Senator Paul G. Pinsky (D), was introduced on February 21, 2007. SB 879 passed the Senate on March 24, 2007, the House on March 29, 2007, and was approved by Democratic Governor Martin O’Malley on April 10, 2007.
HB 1137 and SB 879 define “safe patient lifting” as “use of mechanical lifting devices by hospital employees, instead of manual lifting, to lift, transfer, and reposition patients.” The new laws require Maryland hospitals to develop a safe patient lifting committee, with equal numbers of managers and employees by December 1, 2007, and a safe patient lifting policy to reduce employee injuries with patient lifting by July 1, 2008. Consideration is to be given to patient handling hazard assessment; enhanced use of mechanical lifting devices; development of specialized lift teams; training programs for safe patient lifting; incorporating space and construction design for mechanical lifting devices in architectural plans; and evaluating effectiveness of the safe lifting policy which is to take effect October 1, 2007.
MD HB 1137 history and text: http://mlis.state.md.us/2007rs/billfile/HB1137.htm.
MD SB 879 history and text: http://mlis.state.md.us/2007rs/billfile/SB0879.htm.
Maryland joins these six states which have enacted legislation for or related to safe patient handling: Texas, Washington, Hawaii, Rhode Island, Ohio, and New York.
Texas, with passage of SB 1525 on June 17, 2005, became the first state to mandate implementation of policy for safe patient handling and movement programs by hospitals and nursing homes. Enrolled text: http://www.capitol.state.tx.us/tlodocs/79R/billtext/html/SB01525F.htm.
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