Legislative Updates

What you need to know about current and pending regulation

Dec 2017

ASPHP Commitment Statement on Clinical Well-Being

The mission of the Association of Safe Patient Handling Professionals (ASPHP) is to improve the safety of caregivers and their patients by advancing the science and practice of safe patient handling and mobility. Inherent in our mission statement is the close link between care giver and care recipient (patient) safety and well-being.

The Board of Directors, certificants and members of the ASPHP represent a multi-functional, inter-disciplinary team of healthcare professionals who are dedicated to the recognition of safety for patients and clinicians across all healthcare settings.

We are committed to providing support to the National Academy of Medicine Action Collaborative on Clinical Well-Being and Resilience in their efforts to reverse clinician (care giver) burnout and promote well-being. We hope to work together to bring about change, including legislation and best practice recommendations, that meets our mission and that of the Collaborative.  We would be honored to provide input whenever requested and/or warranted.

We attended the first public meeting of the collaborative on July 14, 2017 and provided resource materials prior to and since that meeting. Our website (www.asphp.org ) provides a great deal of information, demonstrating the link between patient and clinician safety and well-being, as well as information that identifies and quantifies the negative impact of care giver burnout. The Learning Center of our website contains a wealth of knowledge regarding these issues and is continually refreshed as new content becomes available.

We thank you for this opportunity and look forward to assisting the Collaborative in meeting their mission.

The National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience called for organizations to formally commit to supporting clinician well-being and combating burnout – and the response has been overwhelming. Over 130 organizations have issued statements pledging that they will work to reverse trends in clinician burnout.

Read the Organizational Commitment Statements

Dec 2017
NAM National Call for Commitment Statements on Clinical Burnout and Well-Being
The July 2017 ASPHP Member Newsletter started with a brief article discussing the National Academy of Medicine (NAM) Action Collaborative on Clinical Well-Being and Resilience. The ASPHP has been interacting with NAM since that time, providing them information regarding our association and its efforts to meet our mission to improve the safety of caregivers and their patients by advancing the science and practice of safe patient handling.

NAM recognizes that burnout affects the entire health care team and impacts our whole society. (link burnout among healthcare professionals discussion paper and photo). The collaborative focuses on physicians, nurses, nurse practitioners, physician assistants, pharmacists, dentists, etc. They are addressing mental and emotional well-being as well as physical health, addressing physical demands, fatigue, and violence in the workplace. By July this collaborative had grown to over 50 organizations (https://nam.edu/initiatives/clinician-resilience-and-well-being/) with a base working group of 20 organizations.

Read more…

A Theme Song for SPHM
One of our ASPHP Board Members has written some lyrics for a theme song for safe patient handling and mobility (SPHM), comparing the current conditions for healthcare workers to the plight of the coal workers in the 1940s. To read the lyrics and his commentary Click Here.
New York State SPHM Requirements Effective January, 1, 2017
New York state passed a funding bill on March 31, 2014 that addressed a number of healthcare related issues, including passing a Safe Patient Handling Act. The act requires hospitals, nursing homes, diagnostic treatment centers, treatment clinics and others listed to establish safe patient handling committees by January 1, 2016. The composition, purpose and duties of the committee are detailed in the act. The act also requires each covered facility to develop a policy by January 1, 2017. Details regarding this act are available in the documents below.NYS Section 20 Article 29D Safe Patient Handling 03312014
NYS SPH Act 03312014
SPH Summary AFLCIO 04032014

The New York State Department of Health Safe Patient Handling Work Group Report on Safe Patient Handling best practices and resources has been released. Click below to read the document.

NYS DOH SPH Work Group Report

Two states have recent SPHM legislative activity. In Florida FL-H-77/FL-S-486, Patient Lifting and Handling Practices died in committee on 3/11/2016. In Massachusetts MA-H-4039, Health Facility Safe Patient Handling (a new draft of MA-H-1914/MA-S-1124), was sent to the Joint Committee on Health Care Financing on 2/29/2016. For more detail click on the links below.FLORIDA 03-15-2016

MASSACHUSETTS 03-7-2016

The New York State Department of Health Safe Patient Handling Work Group Report on Safe Patient Handling best practices and resources has been released. Click below to read the document.

NYS DOH SPH Work Group Report

FL H 77/FL S 486, Patient Lifting and Handling Practices

The subject set of bills continue to move through the Florida legislature. They would require hospitals to establish a policy concerning safe handling of patients, establishing a committee to do so. On 1/12/2016 it was referred to House Health and Human Services. Learn more at this link.
FLORIDA legislative update

Nurses and Healthcare Worker Protection Act of 2015

It’s back! This is the 3rd iteration (Will the third time be the charm?) of the subject bill, first introduced in 2009 and re-introduced in 2013. Since its initial introduction more states have adopted and/or strengthened SPHM standards. There has been a groundswell of support for this legislation in the past few years, but getting our US legislature to agree on anything and solve problems has seemed to be a major problem in recent years.

The ASPHP continues to support the need for federal SPHM legislation. Click documents below to read and learn.

Nurse and Health Care Worker Protection Act of 2015
Executive Summary of Nurse and Health Care Worker Protection Act of 2015
One Page Notice

The document below provides a summary of enacted standards, regulations or other directives at the state level in the United States as of February 22, 2015
Review Legislation Update

There are some changes taking place in the UK to improve minimum standards for Health Care Assistants working in health and social care. These changes are to be implemented and resulted from the Francis Report and then the Cavendish Review.

Read CareCertificate Framework
Read Cavendish Review

Following recruitment all Health Care Assistants (HCAs) will need to attain the Health Care Certificate within a period of 12 weeks. Schemes are currently being piloted to see how this will be managed, who will assess them, it will create a significant amount of work immediately following recruitment and does not lead to a formal qualification.

Compliance will also be monitored by the CQC (Care Quality Commission). There is not a standard specifically for safe patient handling but is does get encompassed within Standard 13 Health & Safety.

Cal/OSHA AB 1136, Healthcare Worker Back and Musculoskeletal Injury Prevention RegulationsThe subject regulations, which have gone through the comment period and public hearing process, were passed on June 19, 2014. They and other support materials are available at the following link: http://www.dir.ca.gov/oshsb/safe_patient_handling.html. The ASPHP board and general members have been heavily involved in the coment and review process, offering a significant number of suggestions and being involved in discussions. We are happy to see that there are meaningful efforts being made to address the patient handling exposure, seeking to reduce harm to both care providers and care recipients.

On April 16, 2014 Cal/OSHA issued modifications and response to the 45-day comment period to their Title 8, New Section of the General Industry Safety Orders Safe Patient Handling Standard suggested language. That document may be found below. Selected comments by the ASPHP and their responses appear on pages 23-24. While a number of other comments were made by the ASPHP they were not replied to individually.

Modifications and Response to Comments

New York state passed a funding bill on March 31, 2014 that addressed a number of healthcare related issues, including passing a Safe Patient Handling Act. The act requires hospitals, nursing homes, diagnostic treatment centers, treatment clinics and others listed to establish safe patient handling committees by January 1, 2016. The composition, purpose and duties of the committee are detailed in the act. The act also requires each covered facility to develop a policy by January 1, 2017. Details regarding this act are available in the documents below.

NYS Section 20 Article 29D Safe Patient Handling 03312014
NYS SPH Act 03312014
SPH Summary AFLCIO 04032014

The document below provides a summary of recent safe patient handling and mobility legislative activity at the state level as of December 5, 2013.

SPHM State Update 12042013

On July 31, 2013 the Occupational Safety and Health Standards Board (OSHSB) of the State of California posted the following documents relative to their Title 8, General Industry Safety Orders, Title 8, Division 1, Chapter 4, Subchapter 7, Article 106, New Section 5120 Safe Patient Handling:

  • Notice/Information Digest
  • Proposed Regulation
  • Initial Statement of Reasons

These documents, available at the link below, are offered for public review and comment for the period from August 2, 2013 – September 19, 2013. Written comments must be submitted so that they are received no later than September 13, 2013. The official record of the rulemaking proceedings will be closed at the conclusion of the public hearing on September 19, 2013.

These efforts were made pursuant to the enactment of the State of California AB 1136, the Hospital Patient and Health Care Worker Protection Act in 2011. The Association of Safe Patient Handling Professionals (ASPHP) has been and will continue to be involved in offering comments regarding these proposed regulations, helping to satisfy the mission of the Association, namely “To improve the safety of caregivers and their patients by advancing the science and practice of safe patient handling.”

Read Documents

H.R. 2480 Nurse and Health Care Worker Protection Act of 2013

The subject bill was introduced in the U.S. House of Representatives on June 25, 2013 co-sponsored by Congressman John Conyers from Michigan and Congressman George Miller from California. The ASPHP will review and be offering comments regarding the bill.

Read Bill Here

The Occupational Safety and Health Administration (OSHA) and the Centers for Medicare and Medicaid Services (CMS) signed an interagency agreement in August of 2012. They agreed to work together on the following three projects:

  1. Developing a Healthcare Injury and Illness Fact Book;
  2. Implementing safety and health management systems in hospitals; and
  3. Implementing safe patient handling/lifting programs in hospitals.

The goals in addressing the need to implement safe patient handling (SPH) programs are to offer guidance to include:

  1. Explanation of SPH principles & practices;
  2. Discussion of linkage between worker and patient safety;
  3. Roadmap to implementing SPH programs in hospitals;
  4. Emphasis on barriers to implementation and how to overcome them;
  5. Case studies of success stories and missteps from VPP hospitals and other facilities (real world worker and patient safety data) ; and
  6. Tools and other implementation resources.

Read here for more details

With federal and state elections having been completed recently, prior year bills making their way through the legislative process will frequently be eliminated at the end of the legislative session. Two states introducing new bills addressing safe patient handling are Masssachusetts and New York. To learn more about their status, please see below.

Read About Massachusetts
Read About New York

Pending Legislation
There continues to be legislative activity at the state level in the United States addressing safe patient handling (SPH). Illinois had IL S 680, Nursing Home Care Act sent to the Governor for signing on June 14, 2012. It amends the act to include a number of specific requirements regarding SPH. Massachusetts had MA H 1484, Safe Patient Handling Policy, passed from the first committee to the Joint Committee on Health Care Financing on June 14, 2012. The Bill provides that certain health facilities be directed to establish a safe patient handling program. New York introduced NY A 10715, Safe Patient Handling Act, on June 16, 2012 that requires the establishment a SPH policy for healthcare facilities. Mississippi enacted an urging resolution, MS HR 25, urging Mississippi’s business and industries to help protect the health, well-being, and investment made in the state’s workforce by implementing ergonomic practices and programs proven to prevent musculoskeletal disorders. To learn more about any of the actions, click on the appropriate links.

Read State of Illinois
Read State of Massachusetts
Read State of Mississippi
Read State of New York

Deborah Gold, Deputy Chief for Health and Technical Services at Cal/OSHA, will be making a presentation regarding the development of additional language regarding Cal/OSHA AB 1136 at the ASPHP Regional Networking Event in Oakland, CA on November 12, 2012. Suzy Harrington, Director of the American Nurses Association (ANA) Center for Health, Safety and Wellness will also be there making a presentation regarding the ANA-led working group that is in the process of developing SPH standards. This event and the related activities are also discussed elsewhere on our website.

ISO Technical Report Comments

ISO has published the technical report ISO/TR 1226:2012, “Ergonomics – Manual Handling of People in the Healthcare Sector.” It is available through ANSI at the following link http://webstore.ansi.org. The document is a technical report, not an ISO international standard. This publication was offered as a draft technical report on October 25, 2011. A group of ASPHP Board members reviewed the draft report and provided comments that may be viewed below:

Read ASPHP Comments

ArjoHuntleigh has published an edited summary report which is provided as the attached document.

Read Report Here

Moving and Handling People: The New Zealand Guidelines

The first version of the New Zealand Patient Handling Guidelines was published in 2003. Since then there have been numerous developments in moving and handling across the world. There are 14 sections in the Guidelines that cover five general topics relevant to moving and handling programmes:

Part A: Introduction (Sections 1-2)
Part B: Core skills and competencies (Sections 3-6)
Part C: Physical resources (Sections 7-9)
Part D: Organisational systems for moving and handling (Sections 10-13)
Part E: Emerging toics in moving and handling people (Section 14)

Each section has been written so it can be read independently of the other sections. For that reason, there is a small amount of overlap between some sections. In New Zealand Healthcare, the Health and Safety Employment Act (1992) states that it is the responsibility of both employers and employees to ensure workplaces provide a safe work environment through hazard identification and controls.

Access Guideline

April 2012 Legislative Update

1.Nursing and Residential Care Facilities OSHA National Emphasis Program, Directive Number CPL 03-00-016, Effective Date April 5, 2012. – The U.S. Department of Labor’s Occupational Safety and Health Administration today announced a new National Emphasis Program for Nursing and Residential Care Facilities to protect workers from serious safety and health hazards that are common in medical industries. OSHA develops national emphasis programs to focus outreach efforts and inspections on specific hazards in an industry for a three-year period. Through this NEP, OSHA will target nursing homes and residential care facilities in an effort to reduce occupational illnesses and injuries.

In 2010, according to the department’s Bureau of Labor Statistics, nursing and residential care facilities experienced one of the highest rates of lost workdays due to injuries and illnesses of all major American industries. The incidence rate for cases involving days away from work in the nursing and residential care sector was 2.3 times higher than that of all private industry as a whole, despite the availability of feasible controls to address hazards. The data further indicate that an overwhelming proportion of the injuries within this sector were attributed to overexertion as well as to slips, trips and falls. Taken together, these two categories accounted for 62.5 percent of cases involving days away from work within this industry in 2010. For this NEP, OSHA will target facilities with a days-away-from-work rate of 10 or higher per 100 full-time workers.

“These are people who have dedicated their lives to caring for our loved ones when they are not well. It is not acceptable that they continue to get hurt at such high rates,” said Dr. David Michaels, assistant secretary of labor for occupational safety and health. “Our new emphasis program for inspecting these facilities will strengthen protections for society’s caretakers.”

Health care workers face numerous serious safety and health hazards, and the NEP will provide guidance to OSHA compliance staff on the policies and procedures for targeting and conducting inspections specifically focused on the hazards associated with nursing and residential care. These hazards include exposure to blood and other potentially infectious material; exposure to other communicable diseases such as tuberculosis; ergonomic stressors related to lifting patients; workplace violence; and slips, trips and falls. Workers also may be exposed to hazardous chemicals and drugs. OSHA Compliance Directive

2. Illinois Nursing Home Care Act, Amendment 1. Passed the Senate on 3/28/2012, passed the House on 3/29/2012. Amends the Nursing Home Care Act; provides, in provisions concerning a facility’s safe patient handling policy, for the addition of definitions; requires training of nurses and other direct care providers on safe lifting policies and techniques and current lifting equipment; requires that a facility’s policy includes a process for fostering and maintaining resident safety, dignity, self-determination and choice; provides that safe lifting teams must receive certain specialized, in depth training. Click Here for Details

Cal/OSHA AB 1136, Safe Patient Handling Comments – May 14, 2012ASPHP submitted additional comments regarding AB 1136

Read ASPHP Comments Here

Cal/OSHA AB 1136, Safe Patient Handling Stakeholders Meeting – March 29, 2012

A second advisory meeting to discuss AB 1136 was held on March 29, 2012. The ASPHP submitted comments for discussion.

Read ASPHP Statement Here

Cal/OSHA AB 1136, Safe Patient Handling Stakeholders Meeting – January 24, 2012On January 24, 2012 Cal/OSHA held an advisory meeting to discuss AB 1136, Safe Patient Handling legislation that became effective on January 1, 2012. This legislation is now incorporated into the California Labor Code as Section 6403.5 and regulated as part of the Injury and Illness Prevention Program (IIPP) requirements. The meeting was considered a pre-regulation meeting. Cal/OSHA is looking for content from stakeholders to help with clarification of the language to include definitions, processes, training, policies, etc. associated with safe patient handling (SPH) programs. A second stakeholders meeting is planned for late March or Early April.

Linked in this section are documents that were made available at that meeting. Also linked is a position statement that the ASPHP offered in support of this legislation. We stand ready to provide support to Cal/OSHA, helping to meet our mission, “to improve the safety of caregivers and their patients by advancing the science and practice of safe patient handling”.

Cal/OSHA AB 1136 SPH FAQ

Cal/OSHA AB 1136 Implementation Policy

Cal/OSHA AB 1136 SPH Proposed Standard

ASPHP Statement Cal OSHA January 2012

Snapshot of Enacted Safe Patient Handling Legislation

Enacted US SPH Legislation February 2012

OSHA November 9, 2011 Statement Regarding a New National Emphasis Program for Nursing Home Facilities

OSHA Released this statement in response to a 6% increase in the incidence rate in non-fatal occupational injuries and illnesses for healthcare workers. The rate of MSD cases with days away from work for nursing aides, orderlies, and assistants increased 10%. Read Here

2012

Missouri 19 CSR 30-20.097 Safe Patient Handling and Movement in Hospitals

RNs Praise Signing of Landmark Lift Bill to Protect Patients, Nurses
The California Nurses Association/National Nurses United today praised the decision by California Gov. Jerry Brown to sign an important workplace safety bill to protect registered nurses and other healthcare employees from disabling injuries and safeguard patients from preventable falls… Read More