[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6182 Introduced in House (IH)]








109th CONGRESS
  2d Session
                                H. R. 6182

   To amend the Occupational Safety and Health Act of 1970 to reduce 
 injuries to patients, direct-care registered nurses, and other health 
    care providers by establishing a safe patient handling standard.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 26, 2006

 Mr. Conyers introduced the following bill; which was referred to the 
   Committee on Education and the Workforce, and in addition to the 
   Committee on Energy and Commerce, for a period to be subsequently 
   determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
   To amend the Occupational Safety and Health Act of 1970 to reduce 
 injuries to patients, direct-care registered nurses, and other health 
    care providers by establishing a safe patient handling standard.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; FINDINGS.

    (a) Short Title.--This Act may be cited as the ``Nurse And Patient 
Safety & Protection Act of 2006''.
    (b) Findings.--Congress finds the following:
            (1) Direct-care registered nurses rank 10th among all 
        occupations for musculoskeletal disorders, sustaining injuries 
        at a higher rate than laborers, movers, and truck drivers. In 
        2004, nurses sustained 8,800 musculoskeletal disorders, most of 
        which (over 7,000) were back injuries. The leading cause of 
        these injuries in health care are the result of patient 
        lifting, transferring, and repositioning injuries.
            (2) The physical demands of the nursing profession lead 
        many nurses to leave the profession. Fifty two percent of 
        nurses complain of chronic back pain and 38 percent suffer from 
        pain severe enough to require leave from work. Many nurses and 
        other health care providers suffering back injury do not return 
        to work.
            (3) Patients are not at optimum levels of safety while 
        being lifted, transferred, or repositioned manually. Mechanical 
        lift programs can substantially reduce skin tears suffered by 
        patients, allowing patients a safer means to progress through 
        their care.
            (4) The development of assistive patient handling equipment 
        and devices has essentially rendered the act of strict manual 
        patient handling unnecessary as a function of nursing care.
            (5) Application of assistive patient handling technology 
        fulfills an ergonomic approach within the nursing practice by 
        designing and fitting the job or workplace to match the 
        capabilities and limitations of the human body.
            (6) A growing number of health care facilities have 
        incorporated patient handling technology and have reported 
        positive results. Injuries among nursing staff have 
        dramatically declined since implementing patient handling 
        equipment and devices. As a result, the number of lost work 
        days due to injury and staff turnover has declined. Cost-
        benefit analyses have also shown that assistive patient 
        handling technology successfully reduces workers' compensation 
        costs for musculoskeletal disorders.
            (7) Establishing a safe patient handling standard for 
        direct-care registered nurses and other health care providers 
        is a critical component in increasing patient safety, 
        protecting nurses, and addressing the nursing shortage.

SEC. 2. FEDERAL SAFE PATIENT HANDLING STANDARD.

    Not later than 1 year after the date of the enactment of this 
title, the Secretary of Labor, acting through the Director of 
Occupational Safety and Health Administration, shall 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. 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 
standard shall include a musculoskeletal injury prevention plan, which 
will include hazard identification and risk assessments in relation to 
patient care duties and patient handling. The standard shall require:
            (1) all health care facilities comply with the standard;
            (2) health care facilities to purchase, use, and maintain 
        safe lift mechanical devices;
            (3) input from direct-care registered nurses and 
        organizations representing direct-care registered nurses in 
        implementing the standard;
            (4) a program to identify problems and solutions regarding 
        safe patient handling;
            (5) a system to report, track, and analyze trends in 
        injuries, as well as make injury data available to the public;
            (6) training for staff on safe patient handling policies, 
        equipment, and devices at least on an annual basis. Training 
        will also include hazard identification, assessment and control 
        of musculoskeletal hazards in patient care areas, this would 
        include interactive classroom based and hands on training by a 
        knowledgeable person or staff; and
            (7) annual evaluations of safe patient handling efforts, as 
        well as new technology, handling procedures, and engineering 
        controls. Documentation of this process shall include equipment 
        selection and evaluation.

SEC. 3. REQUIREMENT FOR HEALTH CARE FACILITIES.

    (a) Safe Patient Handling Plan.--In accordance with the standard 
required under section 2, and not later than 6 months after such 
standard is published, health care facilities shall develop and 
implement a safe patient handling plan that--
            (1) provides adequate, appropriate, and quality delivery of 
        health care services that protects patient safety and prevents 
        musculoskeletal disorders for direct-care registered nurses and 
        other health care providers;
            (2) is consistent with the requirements of the Federal Safe 
        Patient Handling Standard (as established in section 2);
            (3) provides for input by direct-care registered nurses and 
        organizations representing direct-care registered nurses in 
        implementing the plan; and
            (4) ensures that safe lifting mechanical devices shall only 
        be used by direct care registered nurses and other health care 
        providers.
    (b) Posting, Records, and Auditing.--
            (1) Posting requirements.--Not later than 6 months after 
        the standard required under section 2 is published, a health 
        care facility shall post, in each unit of the facility, a 
        uniform notice in a form specified by the Secretary in 
        regulation that--
                    (A) explains the Federal Safe Patient Handling 
                Standard issued under section 2;
                    (B) includes information regarding safe patient 
                handling polices and training; and
                    (C) explains procedure to report patient handling-
                related injuries.
            (2) Audits.--The Secretary shall require the Occupational 
        Safety and Health Administration to conduct unscheduled audits 
        to ensure--
                    (A) implementation of the safe patient handling 
                plan in accordance with this title; and
                    (B) compliance with reporting and reviewing 
                findings for continual improvements to the safe patient 
                handling plan.

SEC. 4. PROTECTION OF DIRECT-CARE REGISTERED NURSES AND OTHER 
              INDIVIDUALS.

    (a) Refusal of Assignment.--A direct-care registered nurse or other 
health care provider may refuse to accept an assignment in a health 
care facility if--
            (1) the assignment would violate the standard establish 
        under section 2; or
            (2) the direct-care registered nurse or other health care 
        provider is not prepared by education, training, or experience 
        to fulfill the assignment without compromising the safety of 
        any patient or jeopardizing the license of the nurse.
    (b) Retaliation for Refusal of Assignment Barred.--
            (1) No discharge, discrimination, or retaliation.--No 
        health care facility shall discharge, discriminate, or 
        retaliate in any manner with respect to any aspect of 
        employment, including discharge, promotion, compensation, or 
        terms, conditions, or privileges of employment, against a 
        direct-care registered nurse or other health care provider 
        based on his or her refusal of a work assignment under 
        subsection (a).
            (2) No filing of complaint.--No health care facility shall 
        file a complaint or a report against a direct-care registered 
        nurse or other health care provider with the appropriate State 
        professional disciplinary agency because of his or her refusal 
        of a work assignment under subsection (a).
    (c) Complaint to Secretary.--A direct-care registered nurse, health 
care provider, or other individual may file a complaint with the 
Secretary against a health care facility that violates this Act or a 
standard established under this Act. For any complaint filed, the 
Secretary shall--
            (1) receive and investigate the complaint;
            (2) determine whether a violation of this Act as alleged in 
        the complaint has occurred; and
            (3) if such a violation has occurred, issue an order that 
        the complaining direct-care registered nurse, health care 
        provider, or other individual shall not suffer any retaliation 
        under subsection (b) or under subsection (d).
    (d) Whistleblower Protection.--
            (1) Retaliation barred.--A health care facility shall not 
        discriminate or retaliate in any manner with respect to any 
        aspect of employment, including hiring, discharge, promotion, 
        compensation, or terms, conditions, or privileges of employment 
        against any individual who in good faith, individually or in 
        conjunction with another person or persons--
                    (A) reports a violation or a suspected violation of 
                this Act or the standard established under this Act to 
                the Secretary, a public regulatory agency, a private 
                accreditation body, or the management personnel of the 
                health care facility;
                    (B) initiates, cooperates, or otherwise 
                participates in an investigation or proceeding brought 
                by the Secretary, a public regulatory agency, or a 
                private accreditation body concerning matters covered 
                by this Act; or
                    (C) informs or discusses with other individuals or 
                with representatives of health care facility employees 
                a violation or suspected violation of this Act.
            (2) Good faith defined.--For purposes of this subsection, 
        an individual shall be deemed to be acting in good faith if the 
        individual reasonably believes--
                    (A) the information reported or disclosed is true; 
                and
                    (B) a violation of this Act or the standard 
                established under this Act has occurred or may occur.
    (e) Cause of Action.--Any direct-care registered nurse or other 
health care provider who has been discharged, discriminated, or 
retaliated against in violation of subsection (b)(1) or (d), or against 
whom a complaint has been filed in violation of subsection (b)(2), may 
bring a cause of action in a United States district court. A direct-
care registered nurse or other health care provider who prevails on the 
cause of action shall be entitled to one or more of the following:
            (1) Reinstatement.
            (2) Reimbursement of lost wages, compensation, and 
        benefits.
            (3) Attorneys' fees.
            (4) Court costs.
            (5) Other damages.
    (f) Notice.--A health care facility shall include in the notice 
required under section 3(b) an explanation of the rights of direct-care 
registered nurses, health care providers, and other individuals under 
this section and a statement that a direct-care registered nurse, 
health care provider, or other individual may file a complaint with the 
Secretary against a health care facility that violates the standard 
issued under section 2, including instructions for how to file such a 
complaint.

SEC. 5. DEFINITIONS.

    For purposes of this Act:
            (1) Direct-care registered nurse.--The term ``direct care 
        registered nurse'' means an individual who has been granted a 
        license by at least 1 State to practice as a registered nurse 
        and who provides bedside care or outpatient services for 1 or 
        more patients.
            (2) Health care provider.--The term ``health care 
        provider'' means any person required by State or Federal laws 
        or regulations to be licensed, registered, or certified to 
        provide health care services, and being either so licensed, 
        registered, or certified, or exempted from such requirement by 
        other statute or regulation.
            (3) Employment.--The term ``employment'' includes the 
        provision of services under a contract or other arrangement.
            (4) Health care facility.--The term ``health care 
        facility'' means an outpatient health care facility, hospital, 
        nursing home, home health care agency, hospice, federally 
        qualified health center, nurse managed health center, rural 
        health clinic, or any similar healthcare facility that employs 
        direct-care registered nurses.
            (5) Declared state of emergency.--The term ``declared state 
        of emergency'' means an officially designated state of 
        emergency that has been declared by the Federal Government or 
        the head of the appropriate State or local governmental agency 
        having authority to declare that the State, county, 
        municipality, or locality is in a state of emergency, but does 
        not include a state of emergency that results from a labor 
        dispute in the health care industry or consistent under 
        staffing.

SEC. 6. FINANCIAL ASSISTANCE TO NEEDY HEALTH CARE FACILITIES IN THE 
              PURCHASE OF SAFE PATIENT HANDLING EQUIPMENT.

    (a) In General.--The Secretary of Health and Human Services shall 
establish a grant program that provides financial assistance to cover 
some or all of the costs of purchasing safe patient handling equipment 
for health care facilities, such as hospitals, nursing facilities, and 
outpatient facilities, that--
            (1) require the use of such equipment in order to comply 
        with the standards established under section 2; but
            (2) demonstrate the financial inability to otherwise afford 
        the purchase of such equipment are provided grants for some or 
        all of the cost of purchasing such equipment.
    (b) Application.--No financial assistance shall be provided under 
this section except pursuant to an application made to the Secretary in 
such form and manner as the Secretary shall specify. The Secretary 
shall establish a fair standard whereby the facility must clearly 
demonstrate true financial need in order to establish eligibility for 
the grant program.
    (c) Authorization of Appropriations.--There are authorized to be 
appropriated for financial assistance under this section $50,000,000, 
which shall remain available until expended.
                                 <all>