BILL NUMBER: AB 1136	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 15, 2011
	AMENDED IN SENATE  JULY 5, 2011
	AMENDED IN SENATE  JUNE 20, 2011
	AMENDED IN ASSEMBLY  MAY 31, 2011
	AMENDED IN ASSEMBLY  APRIL 26, 2011
	AMENDED IN ASSEMBLY  APRIL 6, 2011

INTRODUCED BY   Assembly Member Swanson

                        FEBRUARY 18, 2011

   An act to add Section 6403.5 to the Labor Code, relating to
employment safety.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1136, as amended, Swanson. Employment safety: health
facilities.
   Existing law regulates the operation of health facilities.
   Existing law, the California Occupational Safety and Health Act of
1973, establishes certain safety and other responsibilities of
employers and employees, including the requirement that employers
provide safety devices and safeguards reasonably necessary to render
the employment safe. Willful or repeated violations are a crime.
   This bill would make findings and declarations concerning the
lifting, repositioning, and transfer of patients in acute care
hospitals and resulting injuries to hospital personnel.
   This bill would  amend the California Occupational Safety and
Health Act of 1973 to  require an employer to maintain a safe
patient handling policy, as defined, for patient care units, and to
provide trained lift teams, as defined, or staff trained in safe
lifting techniques in each general acute care hospital  , except
for specified hospitals  . The safe patient handling policy
would require the replacement of manual lifting and transferring of
patients with powered patient transfer devices, lifting devices, or
lift teams, as specified. As part of the injury and illness
prevention programs required by existing regulations, employers would
be required to adopt a patient protection and health care worker
back and musculoskeletal injury prevention plan, which shall include
a safe patient handling policy component, as specified, to protect
patients and health care workers  , as defined,  in health
care facilities. By changing the definition of a crime, this bill
would impose a state-mandated local program.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  This act shall be known and cited as the Hospital
Patient and Health Care Worker Injury Protection Act.
  SEC. 2.  The Legislature finds and declares the following:
   (a) In 2008, there were 36,130 occupational musculoskeletal
disorder (MSD) cases in private industry where the source of injury
or illness was a health care patient or resident of a health care
facility. This accounted for 11 percent of the 317,440 total cases of
MSDs that resulted in at least one lost day from work in 2008.
Almost all (98 percent) of the cases involving patient handling
occurred within the health care and social assistance industry,
composing 55 percent of the 64,300 total MSD cases in that industry.
   (b) For MSD cases involving patient handling, almost all (99
percent) were the result of overexertion. A sprain, strain, or tear
was the type of injury that was incurred in 84 percent of the MSD
cases involving patient handling.
   (c) Nursing aides, orderlies, and attendants incurred occupational
injuries or illnesses in 52 percent of the MSD cases involving
health care patients. Registered nurses accounted for 16 percent and
home health aides for another 6 percent. Other occupations with MSD
cases involving health care patients included licensed practical and
licensed vocational nurses, emergency medical technicians and
paramedics, personal and home care aides, health care support
workers, radiologic technologists and technicians, and medical and
health services managers.
   (d) Over 12 percent of the nursing workforce leaves the bedside
due to back injuries each year. California's nursing workforce is
aging at the same time patient acuity and obesity are 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 sixty thousand dollars
($60,000) and one hundred forty thousand dollars ($140,000) to train
and orient each new nurse, preventing turnover from injuries will
save hospitals money.
  SEC. 3.  Section 6403.5 is added to the Labor Code, to read:
   6403.5.   (a)     As part of the injury and
illness prevention programs required by Section 3203 of Title 8 of
the California Code of Regulations, or any successor law or
regulation, employers shall adopt a patient protection and health
care worker back and musculoskeletal injury prevention plan. The plan
shall include a safe patient handling policy component reflected in
professional occupational safety guidelines for the protection of
patients and health care workers in health care facilities. 

   (a) 
    (b)  An employer shall maintain a safe patient handling
policy at all times for all patient care units, and shall provide
trained lift teams or other support staff trained in safe lifting
techniques in each general acute care hospital. The employer shall
provide training to health care workers that includes, but is not
limited to, the following:
    (1) The appropriate use of lifting devices and equipment.
   (2) The five areas of body exposure: vertical, lateral, bariatric,
repositioning, and ambulation.
    (3) The use of lifting devices to handle patients safely.

   (b) 
    (c)  As the coordinator of care, the registered nurse
shall be responsible for the observation and direction of patient
lifts and mobilization, and shall participate as needed in patient
handling in accordance with the nurse's job description  and
professional judgment  . 
   (c) 
    (d)  For purposes of this section, "lift team" means
hospital employees specifically trained to handle patient lifts,
repositionings, and transfers using patient transfer, repositioning,
or lifting devices as appropriate for the specific patient. Lift team
members may perform other duties as assigned during their 
shift   shifts. A general acute care hospital shall not
be required by this section to hire new staff to comprise the lift
team so long as direct patient care assignments are not compromised
 . 
   (e) For purposes of this section, "health care worker" means a
lift team member or other staff responsible for assisting in lifting
patients who is a hospital employee specifically trained to handle
patient lifts, repositioning, and transfers using patient transfer,
repositioning, and lifting devices as appropriate for the specific
patient.  
   (d) 
    (f)  For the purposes of this section, "safe patient
handling policy" means a policy that requires replacement of manual
lifting and transferring of patients with powered patient transfer
devices, lifting devices, and lift teams, as appropriate for the
specific patient and consistent with the employer's safety policies
and the professional judgment and clinical assessment of the
registered nurse. 
   (e) As part of the injury and illness prevention programs required
by Section 3203 of Title 8 of the California Code of Regulations, or
any successor law or regulation, employers shall adopt a patient
protection and health care worker back and musculoskeletal injury
prevention plan. The plan shall include a safe patient handling
policy component reflected in professional occupational safety
guidelines for the protection of patients and health care workers in
health care facilities.  
   (f) 
    (g)  A health care worker who refuses to lift,
reposition, or transfer a patient due to concerns about patient or
worker safety or the lack of trained lift team personnel or equipment
shall not, based upon the refusal, be the subject of disciplinary
action by the hospital or any of its managers or employees. 
   (h) This section shall not apply to general acute care hospitals
within the Department of Corrections and Rehabilitation or the State
Department of Developmental Services. 
  SEC. 4.
   No reimbursement is required by this act pursuant to Section 6 of
Article XIII B of the California Constitution because the only costs
that may be incurred by a local agency or school district will be
incurred because this act creates a new crime or infraction,
eliminates a crime or infraction, or changes the penalty for a crime
or infraction, within the meaning of Section 17556 of the Government
Code, or changes the definition of a crime within the meaning of
Section 6 of Article XIII B of the California Constitution.