BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 1136
                                                                  Page  1

          ASSEMBLY THIRD READING
          AB 1136 (Swanson) 
          As Amended  May 31, 2011
          Majority vote 

           LABOR & EMPLOYMENT     5-1                                      
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          |     |                          |     |                          |
          |Ayes:|Swanson, Alejo, Allen,    |     |                          |
          |     |Furutani, Yamada          |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Morrell                   |     |                          |
          |     |                          |     |                          |
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            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
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            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 








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          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 


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