BILL ANALYSIS Ó AB 1136 Page 1 ASSEMBLY THIRD READING AB 1136 (Swanson) As Amended May 31, 2011 Majority vote LABOR & EMPLOYMENT 5-1 ----------------------------------------------------------------- | | | | | |Ayes:|Swanson, Alejo, Allen, | | | | |Furutani, Yamada | | | | | | | | |-----+--------------------------+-----+--------------------------| |Nays:|Morrell | | | | | | | | ----------------------------------------------------------------- SUMMARY : Establishes the Hospital Patient and Health Care Worker Injury Protection Act (Act) to require hospitals to adopt a safe patient handling policy. Specifically, this bill : 1)Establishes the Act to require all general acute care hospitals (hospitals) to do the following: a) Maintain a safe patient handling policy at all times for all patient care units; b) Provide trained life teams or other support staff trained in safe lifting techniques; and, c) Provide training to health care workers on the appropriate use of lifting devices and equipment to handle patients safely and the five areas of body exposure: vertical, lateral, bariatric, repositioning, and ambulation. 2)Requires all hospitals to develop a written safe patient handling policy by January 1, 2013. 3)Requires a registered nurse, as the coordinator of care, to be responsible for the observation and direction of patient lifts and mobilization and participate as needed in patient handling in accordance with the nurse's job description. 4)Defines "lift team" as hospital employees specifically trained to handle patient lifts, repositioning, and transfers using patient transfer, repositioning or lifting devices as AB 1136 Page 2 appropriate for the specific patient. 5)Adds to the definition of "lift team" allowing lift team members to perform other assigned duties during their shift. 6)Defines "safe patient handling policy" as a policy that requires replacement of manual lifting and transferring of patients with powered patient transfer devices, lifting devices, or lift teams, as appropriate for the specific patient and consistent with the employer's safety policies and the professional judgment and clinical assessment of a registered nurse. 7)Requires employers to adopt a patient protection and health care worker back and musculoskeletal injury prevention plan as part of their injury and illness prevention program. 8)Prohibits a hospital from taking disciplinary action against a health care worker who refuses to lift, reposition, or transfer a patient due to the worker's concerns about his or her patient's safety and his or her own personal safety and the lack of available trained lift team personnel or appropriate lifting equipment. FISCAL EFFECT : Unknown COMMENTS : According to the author, registered nurses (RNs) manually lift an estimated 1.8 tons, or 3,600 pounds, per shift. Each time an RN lifts a patient, the RN has a 75% chance of injuring his or her back. The author notes that nursing surveys reveal that 83% of RNs work in spite of back pain, while 52% report chronic back pain. The author states that, when RNs leave, their employers spend $40,000 to $60,000 to train and orient their replacements. According to 2009 data from the federal Bureau of Labor Statistics (BLS), in the private industry, 18% (172,820 cases) of all occupational injuries and illnesses occurred in health care and social assistance industries at a higher incidence rate than all other private industry occupations. In addition, BLS data show that the most common injuries suffered by nurses include musculoskeletal disorders (MSDs) and overexertion. Six states - Maryland, Minnesota, New Jersey, Rhode Island, Texas and Washington - have laws that mandate a form of safe AB 1136 Page 3 patient handling or the use of lifting equipment. In 2005, Texas became the first state to require both hospitals and nursing homes to establish a policy for safe patient handling and movement. In 2006, Washington became the first state to mandate the use of lift equipment by hospitals. Washington uses tax credits and reduced workers' compensation premiums to financially assist hospitals with the purchasing of lift equipment. The California Nurses Association (CNA) states that over 12% of the nursing workforce leaves the occupation because of back injuries each year. They note that this bill is a triple win policy; it safely cares for patients, saves the state's nursing workforce and saves hospitals money. The Association of California Healthcare Districts (ACHD) states that patient transfers are the number one loss driver for hospitals through workers' compensation claims. ACHD asserts that preventing turnover from lift related injuries will save hospitals money in the long run and this bill will help prevent work related injuries in district hospitals. In a letter that expresses their oppose unless amended position, the California Hospital Association (CHA) writes that several key provisions of this bill are ambiguous and, if interpreted narrowly, would prove problematic and potentially interfere with hospitals' ability to provide quality patient care. The California Children's Hospital Association (CCHA), writes that this bill does not allow any flexibility and its one-size-fits-all approach is problematic for children's hospitals because it fails to recognize that much of the lifting done in children's hospitals include that of newborns, infants and young children. Analysis Prepared by : Shannon McKinley / L. & E. / (916) 319-2091 FN: 0000980