,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #bdhj  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,june #be1 #bjac ,mr4 
,cony]s 7= himself & ,mr4 ,george ,mill]
 ( ,cali=nia7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on         
,education & ! ,work=ce1 & 9 addition to
 ! ,committees on ,en]gy & ,comm]ce &   
,ways & ,means1 = a p]iod to be         
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to direct !        
,secret>y ( ,labor to issue an          
occupational safety & heal? /&>d to     
r$uce injuries to pati5ts1 nurses1 & all
 o!r heal? c>e work]s by e/abli%+ a safe
 pati5t h&l+1 mobility1 & injury        
prev5tion /&>d1 & = o!r purposes4  #a4  
,%ort title2 f9d+s2 table ( cont5ts  7a7
 ,%ort ,title ,?is ,act may be cit$ z ! 
,nurse & ,heal? ,c>e ,work] ,protection 
,act ( #bjac4  7b7 ,f9d+s ,congress f9ds
 ! foll[+3  7#a7 ,9 #bjaa1 regi/]$      
nurses rank$ fif? among all occupations 

= ! numb] ( cases ( musculoskeletal     
disord]s result+ 9 days away f "w1 )    
#aa1hhj total cases4 ,9 #bjaa1 nurs+    
assi/ants report$ #be1jaj cases--!      
highe/ ( all occupations4 ,! lead+ cause
 ( ^! heal? c>e employees' injuries is  
pati5t lift+1 transf]r+1 & reposition+  
injuries1 :i* con/itute a significant   
risk to ! heal? & welf>e ( ^? employees4
  7#b7 ,! physical dem&s ( ! nurs+      
pr(ession lead _m nurses to leave !     
pr(ession4 ,fifty-two p]c5t ( nurses    
compla9 ( *ronic back pa9 & #ch p]c5t   
suff] f pa9 sev]e en\gh to require leave
 f "w4 ,_m nurses & o!r heal? c>e work]s
 suff]+ back injury d n return to "w4   
,^! consequ5ces con/itute a mat]ial     
impairm5t ( heal? = ^! employees4  7#c7 
,pati5ts are n at optimum levels (      
safety :ile be+ lift$1 transf]r$1 or    
reposition$ manually4 ,me*anical & o!r  
appropriate lift programs c sub/antially
 r$uce sk9 te>s & pressure ulc]s suff]$ 
by pati5ts & ! frequ5cy ( pati5ts be+   
dropp$1 ?us all[+ pati5ts a saf] means  

to progress ?r\gh _! c>e4  7#d7 ,!      
developm5t ( assi/ive pati5t h&l+       
te*nology1 equipm5t1 & devices has      
ess5tially r5d]$ ! act ( /rict manual   
pati5t h&l+ outdat$ & typically         
unnecess>y z a function ( nurs+ c>e4    
7#e7 ,a gr[+ numb] ( heal? c>e          
facilities t h incorporat$ pati5t h&l+  
te*nology & practices h report$ positive
 results4 ,injuries among nurs+ /aff &  
heal? c>e work]s h dramatically decl9$  
at heal? c>e facilities implem5t+ safe  
pati5t h&l+ te*nology1 equipm5t1        
devices1 & practices4 ,z a result1 !    
numb] ( lo/ "w days due to injury & /aff
 turnov] has decl9$4 ,/udies h also %[n 
t assi/ive pati5t h&l+ te*nology        
successfully r$uces work]s' comp5sation 
co/s = musculoskeletal disord]s4  7#f7  
,a numb] ( ,/ates h implem5t$ safe      
pati5t h&l+1 mobility & injury prev5tion
 /&>ds4 ,! success ( ^! programs at !   
facility & ,/ate level demon/rates !    
feasibility ( su* /&>ds4  7#g7 ,e/abli%+
 a safe pati5t h&l+1 mobility1 & injury 

prev5tion /&>d = direct-c>e regi/]$     
nurses & o!r heal? c>e work]s is a      
critical compon5t reasonably necess>y = 
protect+ ! heal? & safety ( nurses & o!r
 heal? c>e work]s1 address+ ! nurs+     
%ortage1 & increas+ pati5t safety4  7c7 
,table ( cont5ts ,! table ( cont5ts (   
?is ,act is z foll[s3  ,sec4 #a4 ,%ort  
title2 f9d+s2 table ( cont5ts4 ,sec4 #b4
 ,safe pati5t h&l+1 mobility1 & injury  
prev5tion /&>d4 ,sec4 #c4 ,application (
 safe pati5t h&l+1 mobility1 & injury   
prev5tion /&>d to facilities receiv+    
,m$ic>e & ,m$icaid funds4 ,sec4 #d4     
,nonpreemption4 ,sec4 #e4 ,def9itions4  
#b4 ,safe pati5t h&l+1 mobility1 &      
injury prev5tion /&>d  7a7 ,rulemak+    
,not)/&+ any o!r provision ( law1 n lat]
 ?an #a ye> aft] ! date ( enactm5t ( ?is
 ,act1 ! ,secret>y ( ,labor %all1       
pursuant to section #f ( ! ,occupational
 ,safety & ,heal? ,act ( #aigj 7#bi     
,u4,s4,c4 #fee71 promulgate an int]im   
f9al /&>d on safe pati5t h&l+1 mobility1
 & injury prev5tion 79 ?is section su*  

/&>d is ref]r$ to z ! safe pati5t h&l+1 
mobility1 & injury prev5tion /&>d7 to   
prev5t musculoskeletal disord]s =       
direct-c>e regi/]$ nurses & all o!r     
heal? c>e work]s h&l+ pati5ts4 ,a f9al  
safe pati5t h&l+1 mobility1 & injury    
prev5tion /&>d %all be promulgat$ n lat]
 ?an #b ye>s aft] ! date ( enactm5t (   
?is ,act4  7b7 ,requirem5ts ,! safe     
pati5t h&l+1 mobility1 & injury         
prev5tion /&>d %all require ! use (     
eng9e]+ & safety controls to p]=m h&l+ (
 pati5ts & ! elim9ation ( injuries f    
manual h&l+ ( pati5ts by direct-c>e     
regi/]$ nurses & all o!r heal? c>e      
work]s1 ?r\gh ! developm5t ( a          
compreh5sive program1 to include ! use (
 me*anical te*nology & devices to !     
greate/ degree feasible4 ,:]e ! use (   
me*anical te*nology & devices is n      
feasible1 ! /&>ds %all require ! use (  
alt]native controls & measures1 includ+ 
tra9$1 designat$ lift teams1 to m9imize 
! risk ( injury to nurses & heal? c>e   
work]s result+ f ! manual h&l+ (        

pati5ts4 ,! /&>d %all apply to all heal?
 c>e employ]s1 %all g5]ally align )     
int]pr(essional national safe pati5t    
h&l+1 mobility1 & injury prev5tion      
/&>ds1 & %all include ! foll[+3  7#a7   
,program developm5t ,a requirem5t t ea* 
heal? c>e employ] %all develop &        
implem5t a safe pati5t h&l+1 mobility1 &
 injury prev5tion program )9 #f mon?s ( 
! date ( promulgation ( ! f9al /&>d1 :i*
 program %all include haz>d             
id5tification1 risk assessm5ts1 &       
control measures 9 relation to pati5t   
c>e duties & pati5t h&l+4  7#b7         
,te*nology & equipm5t pur*ase &         
managem5t ,a requirem5t t1 )9 #b ye>s ( 
! date ( promulgation ( ! f9al /&>d1 ea*
 heal? c>e employ] %all pur*ase1 use1   
ma9ta91 & make accessible to heal? c>e  
work]s1 su* safe pati5t h&l+ equipm5t1  
te*nology1 & accessories z ! ,secret>y  
det]m9es appropriate4  7#c7 ,heal? c>e  
work] p>ticipation ,a requirem5t t ea*  
heal? c>e employ] %all obta9 input f    
heal? c>e work]s1 to include direct c>e 

regi/]$ nurses1 heal? c>e work]s1 _!    
repres5tatives1 & _! collective b>ga9+  
ag5ts1 9 develop+ & implem5t+ ! safe    
pati5t h&l+1 mobility1 & injury         
prev5tion program1 includ+ ! pur*ase (  
te*nology & equipm5t & necess>y         
accessories4  7#d7 ,data track+ & review
 ,a requirem5t t ea* heal? c>e employ]  
%all e/abli% a review program to analyze
 data relevant to ! implem5tation ( !   
employ]s' safe pati5t h&l+1 mobility1 & 
injury prev5tion program1 & %all acc\nt 
= circum/ances :]e safe pati5t h&l+     
te*nology & equipm5t1 or tra9$1         
designat$ lift teams1 7 n utiliz$ 9     
accordance ) ! heal? c>e employ]s safe  
pati5t h&l+1 mobility1 & injury         
prev5tion /&>d4 ,ea* heal? c>e employ]  
%all ^u reque/1 make available _! f9d+s 
& data us$ 9 su* review1 to heal? c>e   
work]s1 _! repres5tatives1 _! collective
 b>ga9+ ag5ts1 & ! ,secret>y or o!r     
,f$]al ag5cy4  7#e7 ,incorporation (    
,te*nology into ,facilities ,a          
requirem5t t ea* heal? c>e employ] %all 

consid] ! feasibility ( incorporat+ safe
 pati5t h&l+ te*nology z "p ( process ( 
new facility design & con/ruction1 or   
facility remodel+4  7#f7 ,education &   
tra9+ ,a requirem5t t ea* heal? c>e     
employ] %all tra9 heal? c>e work]s on   
safe pati5t h&l+1 mobility1 & injury    
prev5tion policies1 te*nology1 equipm5t1
 & devices1 initially1 & on a cont9u+   
annual basis1 & z necess>y4 ,su* tra9+  
%all prep>e heal? c>e work]s1 includ+   
designat$ lift teams1 to id5tify1       
assess1 & control musculoskeletal haz>ds
 ( a g5]al nature1 & ^? specific to     
p>ticul> pati5t c>e areas1 & %all be    
conduct$ by an individual ) k 9 !       
subject matt]1 & deliv]$1 at lea/ 9 "p1 
9 an int]active simulat$ po9t-(-c>e     
tra9+ & h&s-on =mat t reflects !        
specific dem&s ( a heal? c>e work]s'    
duties4  7#g7 ,notice ( safe pati5t h&l+
 & rights "u ?is ,act ,a requirem5t t   
ea* heal? c>e employ] %all po/ a uni=m  
notice 9 a =m specifi$ by ! ,secret>y   
t--  7,a7 expla9s ! safe pati5t h&l+1   

mobility1 & injury prev5tion /&>d2  7,b7
 includes in=mation reg>d+ safe pati5t  
h&l+1 mobility1 & injury prev5tion      
policies & tra9+2  7,c7 expla9s         
proc$ures to report pati5t h&l+-relat$  
injuries2 &  7,d7 expla9s heal? c>e     
work]s' rights "u ?is ,act4  7#h7       
,annual evaluation ,a requirem5t t ea*  
heal? c>e employ] %all conduct an annual
 writt5 evaluation ( ! implem5tation ( !
 safe pati5t h&l+1 mobility1 & injury   
prev5tion program1 includ+ h&l+         
proc$ures1 selection ( te*nology1       
equipm5t1 & eng9e]+ controls1 assessm5t 
( injuries1 & new safe pati5t h&l+1     
mobility1 & injury prev5tion te*nology &
 devices t h be5 develop$4 ,! evaluation
 %all be conduct$ ) ! involvem5t (      
nurses1 o!r heal? c>e work]s1 _!        
repres5tatives1 & _! collective b>ga9+  
ag5ts1 & _! input %all be docum5t$ 9 !  
evaluation4 ,heal? c>e employ]s %all    
take corrective action z recomm5d$ 9 !  
writt5 evaluation4  7#i7 ,"r to ,refuse 
,unsafe ,assignm5t ,a requirem5t t ea*  

heal? c>e employ] %all provide proc$ures
 "u :i* a heal? c>e work] or employee   
may refuse to p]=m ! employee's duties  
if ! employee has a reasonable          
appreh5sion t p]=m+ su* duties w\ld     
violate ! safe pati5t h&l+1 mobility1 & 
injury prev5tion /&>d1 & w\ld result 9  
injury or impairm5t ( heal? to ! heal?  
c>e work]1 o!r heal? c>e work]s1 or     
pati5ts4 ,:]e practicable1 ! heal? c>e  
work] mu/ h communicat$ ! heal? or      
safety conc]n to ! heal? c>e employ] & h
 n be5 able to obta9 a correction ( !   
violation4  7c7 ,inspections ,!         
,secret>y ( ,labor %all conduct uns*$ul$
 inspections "u section #h ( !          
,occupational ,safety & ,heal? ,act (   
#aigj 7#bi ,u4,s4,c4 #feg7 to ensure    
implem5tation ( & compliance ) ! safe   
pati5t h&l+1 mobility1 & injury         
prev5tion /&>d4  #c4 ,application ( safe
 pati5t h&l+1 mobility1 & injury        
prev5tion /&>d to facilities receiv+    
,m$ic>e & ,m$icaid funds  7a7 ,9 g5]al  
,section #ahff ( ! ,social ,security    

,act 7#db ,u4,s4,c4 #acie;cc7 is am5d$--
  7#a7 9 subsection 7a77#a77,v71 by     
ins]t+ & safe pati5t h&l+1 mobility1 &  
injury prev5tion /&>d 7z initially      
promulgat$ "u section #b ( ! ,nurse &   
,heal? ,c>e ,work] ,protection ,act (   
#bjji7 be=e ! p]iod at ! end2 &  7#b7 9 
subsection 7b77#d7--  7,a7 9 subp>agraph
 7,a71 ins]t+ & ! safe pati5t h&l+1     
mobility1 & injury prev5tion /&>d aft]  
,bloodborne ,pa?og5s /&>d2 &  7,b7 9    
subp>agraph 7,b71 ins]t+ or ! safe      
pati5t h&l+1 mobility1 & injury         
prev5tion /&>d aft] ,bloodborne ,pa?og5s
 /&>d4  7b7 ,effective date ,! am5dm5ts 
made by subsection 7a7 %all apply to    
heal? c>e facilities #a ye> aft] date ( 
issuance ( ! f9al safe pati5t h&l+1     
mobility1 & injury prev5tion /&>d       
requir$ "u section #b4  #d4             
,nonpreemption  7a7 ,effect on o!r laws 
,no?+ 9 ?is ,act %all be con/ru$ to--   
7#a7 preempt any law1 rule1 or          
regulation ( a ,/ate or political       
subdivision ( a ,/ate1 unless su* law1  

rule1 or regulation is 9 conflict ) ?is 
,act or a regulation or ord] issu$ "u   
?is ,act2 or  7#b7 impair or dim9i% 9   
any way ! au?ority ( any ,/ate to enact 
& en=ce any law :i* provides equival5t  
or great] protections = employees engag+
 9 conduct protect$ "u ?is ,act4  7b7   
,rights ,reta9$ by ,heal? ,c>e ,work]s  
,no?+ 9 ?is ,act %all be con/ru$ to     
dim9i% ! rights1 privileges1 or rem$ies 
( any heal? c>e work] or employee "u any
 ,f$]al or ,/ate law1 or "u any         
collective b>ga9+ agreem5t4  #e4        
,def9itions ,= purposes ( ?is ,act3     
7#a7 ,direct-c>e regi/]$ nurse ,! t]m   
direct-c>e regi/]$ nurse means an       
individual :o has be5 grant$ a lic5se by
 at lea/ "o ,/ate to practice z a       
regi/]$ nurse & :o provides b$side c>e  
or outpati5t s]vices = "o or m pati5ts  
or resid5ts4  7#b7 ,employee ,! t]m     
employee means any individual employ$ by
 a heal? c>e employ]1 to include heal?  
c>e work]s1 z well z employees :o d n   
qualify z heal? c>e work]s1 includ+     

indep5d5t contractors4  7#c7 ,employm5t 
,! t]m employm5t includes ! provision ( 
s]vices "u a contract or o!r arrangem5t4
  7#d7 ,h&l+ ,! t]m h&l+ includes       
actions su* z lift+1 transf]r+1         
reposition+1 mobiliz+1 mov+1 or any o!r 
action involv+ ! physical movem5t1      
manipulation1 or support ( a pati5t by a
 heal? c>e work]1 or any direct pati5t  
c>e action :i* pres5ts a risk (         
musculoskeletal injury4  7#e7 ,heal? c>e
 employ] ,! t]m heal? c>e employ] means 
an outpati5t heal? c>e facility1        
hospital1 nurs+ home1 home heal? c>e    
ag5cy1 social assi/ance facility or     
program1 hospice1 f$]ally qualifi$ heal?
 c5t]1 nurse manag$ heal? c5t]1 rural   
heal? cl9ic1 or any simil> heal? c>e    
facility t employs direct-c>e regi/]$   
nurses or o!r heal? c>e work]s4  7#f7   
,heal? c>e work] ,! t]m heal? c>e work] 
means an individual :o has be5 assign$  
by a heal? c>e employ] to engage 9      
pati5t h&l+1 includ+ direct-c>e regi/]$ 
nurses1 indep5d5t contractors1 or       

individuals :o p]=m ! duties ( heal? c>e
 work]s4  7#g7 ,lift team ,! t]m lift   
team means heal? c>e work]s ) specializ$
 tra9+ & k ( safe pati5t h&l+1 mobility1
 & injury prev5tion practices &         
te*nology4