[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4266 Introduced in House (IH)]

<DOC>






114th CONGRESS
  1st Session
                                H. R. 4266

 To direct the Secretary of Labor to issue an occupational safety and 
 health standard to reduce injuries to patients, nurses, and all other 
health care workers by establishing a safe patient handling, mobility, 
        and injury prevention standard, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           December 16, 2015

Mr. Conyers (for himself, Mr. Scott of Virginia, Ms. Wilson of Florida, 
 Mr. Clay, Mr. Brendan F. Boyle of Pennsylvania, Mr. Danny K. Davis of 
 Illinois, Mrs. Beatty, and Ms. Graham) introduced the following bill; 
which was referred to the Committee on Education and the Workforce, and 
   in addition to the Committees on Energy and Commerce and Ways and 
 Means, 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 direct the Secretary of Labor to issue an occupational safety and 
 health standard to reduce injuries to patients, nurses, and all other 
health care workers by establishing a safe patient handling, mobility, 
        and injury prevention standard, and for other purposes.

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

SECTION 1. SHORT TITLE; FINDINGS; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Nurse and Health 
Care Worker Protection Act of 2015''.
    (b) Findings.--Congress finds the following:
            (1) In 2014, registered nurses ranked sixth among all 
        occupations for the number of cases of musculoskeletal 
        disorders resulting in days away from work, with 11,360 total 
        cases. Nursing assistants reported 20,020 cases in 2014, the 
        second highest of any profession. The leading cause of these 
        health care employees' injuries is patient lifting, 
        transferring, and repositioning injuries, which constitute a 
        significant risk to the health and welfare of those employees 
        under the Occupational Safety and Health Act of 1970.
            (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 workers suffering back injury do not return 
        to work. These consequences constitute a material impairment of 
        health for these employees under the Occupational Safety and 
        Health Act of 1970.
            (3) Patients are not at optimum levels of safety while 
        being lifted, transferred, or repositioned manually. 
        Appropriate mechanical lifts can substantially reduce skin 
        tears and pressure ulcers suffered by patients and the 
        frequency of patients being dropped, thus allowing patients a 
        safer means to progress through their care and avoid disabling 
        injuries due to unsafe practices.
            (4) The development of assistive patient handling 
        technology, equipment, and devices has essentially rendered the 
        act of strict manual patient handling outdated and typically 
        unnecessary as a function of nursing care.
            (5) A growing number of health care facilities that have 
        incorporated patient handling technology and practices have 
        reported positive results. Injuries among nursing staff and 
        health care workers have dramatically declined at health care 
        facilities implementing safe patient handling technology, 
        equipment, devices, and practices. As a result, the number of 
        lost work days due to injury and staff turnover has declined. 
        Studies have also shown that assistive patient handling 
        technology successfully reduces workers' compensation costs for 
        musculoskeletal disorders.
            (6) A number of States have implemented safe patient 
        handling, mobility and injury prevention standards. The success 
        of these programs at the facility and State level demonstrates 
        the technological and economical feasibility of such standards.
            (7) Establishing a safe patient handling, mobility, and 
        injury prevention standard for direct-care registered nurses 
        and other health care workers is a critical component 
        reasonably necessary for protecting the health and safety of 
        nurses and other health care workers, addressing the nursing 
        shortage, and increasing patient safety.
    (c) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; findings; table of contents.
Sec. 2. Safe patient handling, mobility, and injury prevention 
                            standard.
Sec. 3. Application of safe patient handling, mobility, and injury 
                            prevention standard to facilities receiving 
                            Medicare and Medicaid funds.
Sec. 4. Nonpreemption.
Sec. 5. Definitions.

SEC. 2. SAFE PATIENT HANDLING, MOBILITY, AND INJURY PREVENTION 
              STANDARD.

    (a) Rulemaking.--Notwithstanding any other provision of law, not 
later than 1 year after the date of enactment of this Act, the 
Secretary of Labor shall, pursuant to section 6 of the Occupational 
Safety and Health Act of 1970 (29 U.S.C. 655), promulgate an interim 
final standard on safe patient handling, mobility, and injury 
prevention (in this section such standard is referred to as the ``safe 
patient handling, mobility, and injury prevention standard'') to 
prevent musculoskeletal disorders for direct-care registered nurses and 
all other health care workers handling patients. The interim final 
standard shall remain in effect until it is replaced by a final safe 
patient handling, mobility, and injury prevention standard.
    (b) Requirements.--The safe patient handling, mobility, and injury 
prevention standard shall require the use of engineering and safety 
controls to perform handling of patients and to reduce the incidence of 
injuries from manual handling of patients by direct-care registered 
nurses and all other health care workers, through the development of a 
comprehensive program, to include the use of mechanical technology and 
devices to the greatest degree feasible. Where the use of mechanical 
technology and devices is not feasible, the standards shall require the 
use of alternative controls and measures to minimize the risk of injury 
to nurses and health care workers resulting from the manual handling of 
patients. The standard shall apply to all health care employers, shall 
generally align with interprofessional national safe patient handling, 
mobility, and injury prevention standards, and shall include the 
following:
            (1) Program development.--A requirement that each health 
        care employer shall develop and implement a safe patient 
        handling, mobility, and injury prevention program within 6 
        months of the date of promulgation of the interim final 
        standard, which program shall include hazard identification, 
        risk assessments, and control measures in relation to patient 
        care duties and patient handling.
            (2) Technology and equipment purchase and management.--A 
        requirement that, within 2 years of the date of issuance by the 
        Secretary of an interim final standard, each health care 
        employer shall purchase, use, maintain, and make accessible to 
        health care workers, such safe patient handling equipment, 
        technology, and accessories as the Secretary determines 
        appropriate.
            (3) Health care worker participation.--A requirement that 
        each health care employer shall obtain input from health care 
        workers, to include direct care registered nurses, health care 
        workers, their representatives, and their collective bargaining 
        agents, in developing and implementing the safe patient 
        handling, mobility, and injury prevention program, including 
        training and education and the purchase of technology and 
        equipment and necessary accessories.
            (4) Data tracking and review.--A requirement that each 
        health care employer shall establish a review program to 
        analyze data relevant to the implementation of the employers' 
        safe patient handling, mobility, and injury prevention program, 
        and shall account for circumstances where safe patient handling 
        technology or equipment were not utilized in accordance with 
        the health care employers' safe patient handling, mobility, and 
        injury prevention standard. Each health care employer shall 
        upon request, make available their findings and data used in 
        such review, to health care workers, their representatives, 
        their collective bargaining agents, and the Secretary or other 
        Federal agency. Each health care employer shall maintain the 
        data and findings from their review for at least 5 years
            (5) Incorporation of technology into facilities.--A 
        requirement that each health care employer shall consider the 
        feasibility of incorporating safe patient handling technology 
        as part of process of new facility design and construction, or 
        facility remodeling.
            (6) Education and training.--A requirement that each health 
        care employer shall train health care workers on safe patient 
        handling, mobility, and injury prevention policies, technology, 
        equipment, and devices, initially, and on a continuing annual 
        basis, and as necessary. Such training shall prepare health 
        care workers, to identify, assess, and control musculoskeletal 
        hazards of a general nature, and those specific to particular 
        patient care areas, and shall be conducted by an individual 
        with knowledge in the subject matter, and delivered, at least 
        in part, in an interactive simulated point-of-care training and 
        hands-on format that reflects the specific demands of a health 
        care workers' duties.
            (7) Notice of safe patient handling and rights under this 
        act.--A requirement that each health care employer shall post a 
        uniform notice in a form specified by the Secretary that--
                    (A) explains the safe patient handling, mobility, 
                and injury prevention standard;
                    (B) includes information regarding safe patient 
                handling, mobility, and injury prevention policies and 
                training;
                    (C) explains procedures to report patient handling-
                related injuries; and
                    (D) explains health care workers' rights under this 
                Act, including any whistleblower protections.
            (8) Annual evaluation.--A requirement that each health care 
        employer shall conduct an annual written evaluation of the 
        implementation of the safe patient handling, mobility, and 
        injury prevention program, including handling procedures, 
        selection of technology, equipment, and engineering controls, 
        assessment of injuries, and new safe patient handling, 
        mobility, and injury prevention technology and devices that 
        have been developed. The evaluation shall be conducted with the 
        involvement of nurses, other health care workers, their 
        representatives, and their collective bargaining agents, and 
        their input shall be documented in the evaluation. Health care 
        employers shall take corrective action as recommended in the 
        written evaluation.
            (9) Right to refuse unsafe assignment.--A requirement that 
        each health care employer shall provide procedures under which 
        a health care worker or employee may refuse to perform the 
        employee's duties if the employee has a reasonable apprehension 
        that performing such duties would violate the safe patient 
        handling, mobility, and injury prevention standard, and would 
        result in injury or impairment of health to the health care 
        worker, other health care workers, or patients. Where 
        practicable, the health care worker must have communicated the 
        health or safety concern to the health care employer and have 
        not been able to obtain a correction of the violation.
    (c) Inspections.--The Secretary of Labor shall conduct unscheduled 
inspections under section 8 of the Occupational Safety and Health Act 
of 1970 (29 U.S.C. 657) to ensure implementation of and compliance with 
the safe patient handling, mobility, and injury prevention standard.

SEC. 3. APPLICATION OF SAFE PATIENT HANDLING, MOBILITY, AND INJURY 
              PREVENTION STANDARD TO FACILITIES RECEIVING MEDICARE AND 
              MEDICAID FUNDS.

    (a) In General.--Section 1866 of the Social Security Act (42 U.S.C. 
1395cc) is amended--
            (1) in subsection (a)(1)(V), by inserting ``and safe 
        patient handling, mobility, and injury prevention standard (as 
        initially promulgated under section 2 of the Nurse and Health 
        Care Worker Protection Act of 2015)'' before the period at the 
        end; and
            (2) in subsection (b)(4)--
                    (A) in subparagraph (A), by inserting ``and the 
                safe patient handling, mobility, and injury prevention 
                standard'' after ``Bloodborne Pathogens standard''; and
                    (B) in subparagraph (B), by inserting ``or the safe 
                patient handling, mobility, and injury prevention 
                standard'' after ``Bloodborne Pathogens standard''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to health care facilities 1 year after date of issuance of the 
final safe patient handling, mobility, and injury prevention standard 
required under section 2.

SEC. 4. NONPREEMPTION.

    (a) Effect on Other Laws.--Nothing in this Act shall be construed 
to--
            (1) preempt any law, rule, or regulation of a State or 
        political subdivision of a State, unless such law, rule, or 
        regulation is in conflict with this Act or a regulation or 
        order issued under this Act;
            (2) impair or diminish in any way the authority of any 
        State to enact and enforce any law which provides equivalent or 
        greater protections for employees engaging in conduct protected 
        under this Act;
            (3) curtail or limit in any way the right of people with 
        disabilities under the Americans with Disabilities Act (42 
        12101 et seq.) or section 504 of the Rehabilitation Act of 1973 
        (29 U.S.C. 794) to those reasonable modifications needed to 
        receive equal access to health care, including the requirement 
        that health care employees give priority consideration to the 
        lifting, movement, or transfer needs and preferences of people 
        with disabilities; or
            (4) curtail or limit in any way consideration as an 
        expenditure to acquire or modify equipment for use by or to 
        benefit individuals with disabilities that is specified in 
        section 44 of the Internal Revenue Code of 1986, which is 
        available to eligible small businesses.
    (b) Rights Retained by Health Care Workers.--Nothing in this Act 
shall be construed to diminish the rights, privileges, or remedies of 
any health care worker or employee under any Federal or State law, or 
under any collective bargaining agreement.

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 one State to practice as a registered nurse 
        and who provides bedside care or outpatient services for one or 
        more patients or residents.
            (2) Employee.--The term ``employee'' means any individual 
        employed by a health care employer, to include health care 
        workers, as well as employees who do not qualify as health care 
        workers, including independent contractors.
            (3) Employment.--The term ``employment'' includes the 
        provision of services under a contract or other arrangement.
            (4) Handling.--The term ``handling'' includes actions such 
        as lifting, transferring, repositioning, mobilizing, moving, or 
        any other action involving the physical movement, manipulation, 
        or support of a patient by a health care worker, or any direct 
        patient care action which presents a risk of musculoskeletal 
        injury.
            (5) Health care employer.--The term ``health care 
        employer'' means an outpatient health care facility, hospital, 
        nursing home, home health care agency, social assistance 
        facility or program, hospice, federally qualified health 
        center, nurse managed health center, rural health clinic or 
        rehabilitative center, or any similar health care facility that 
        employs direct-care registered nurses or other health care 
        workers.
            (6) Health care worker.--The term ``health care worker'' 
        means an individual who has been assigned by a health care 
        employer to engage in patient handling, including direct-care 
        registered nurses, independent contractors, or individuals who 
        perform the duties of health care workers.
                                 <all>