Senate Bill S2470B

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2470

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            January 21, 2011
                               ___________

Introduced  by  Sen. MAZIARZ -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law and the education law, in relation
  to a safe patient handling policy for health care facilities

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  This  act  shall  be  known and may be cited as the "safe
patient handling act".
  S 2. Article 29-D of the public health law is amended by adding a  new
title 4 to read as follows:
                                 TITLE 4
                      SAFE PATIENT HANDLING POLICY
SECTION 2999-G. LEGISLATIVE INTENT.
        2999-H. DEFINITIONS.
        2999-I. NEW YORK STATE SAFE PATIENT HANDLING TASK FORCE.
        2999-J. STATEWIDE SAFE PATIENT HANDLING POLICY.
        2999-K. HEALTH CARE FACILITY SAFE PATIENT HANDLING COMMITTEES.
        2999-L. ENFORCEMENT.
  S  2999-G.  LEGISLATIVE  INTENT.  THE  LEGISLATURE  HEREBY  FINDS  AND
DECLARES THAT IT IS IN THE PUBLIC INTEREST TO  ENACT  A  STATEWIDE  SAFE
PATIENT  HANDLING  POLICY  FOR HEALTH CARE FACILITIES IN NEW YORK STATE.
WITHOUT SAFE PATIENT HANDLING LEGISLATION,  IT  IS  PREDICTED  THAT  THE
DEMAND  FOR  NURSING  SERVICES  WILL  EXCEED THE SUPPLY BY NEARLY THIRTY
PERCENT BY THE YEAR TWO THOUSAND TWENTY THUS DECREASING THE  QUALITY  OF
HEALTH  CARE  IN  NEW  YORK STATE.   THERE ARE MANY BENEFITS THAT CAN BE
DERIVED FROM SAFE PATIENT HANDLING PROGRAMS.   PATIENTS BENEFIT  THROUGH
IMPROVED  QUALITY  OF  CARE  AND QUALITY OF LIFE BY REDUCING THE RISK OF
FALLS, BEING DROPPED, FRICTION BURNS, SKIN TEARS AND BRUISES. CAREGIVERS
BENEFIT FROM THE REDUCED RISK OF CAREER ENDING AND DEBILITATING INJURIES
LEADING TO INCREASED MORALE, IMPROVED JOB SATISFACTION AND LONGEVITY  IN
THE  PROFESSION.  HEALTH CARE FACILITIES REALIZE A QUICK RETURN ON THEIR

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04321-01-1
              

S. 2470                             2

INVESTMENT THROUGH REDUCED WORKERS' COMPENSATION MEDICAL  AND  INDEMNITY
COSTS,  REDUCED  LOST WORKDAYS AND IMPROVED RECRUITMENT AND RETENTION OF
CAREGIVERS. ALL OF THIS WILL LEAD TO FISCAL IMPROVEMENT IN  HEALTH  CARE
IN NEW YORK STATE.
  S 2999-H. DEFINITIONS. FOR THE PURPOSES OF THIS TITLE:
  1.  "HEALTH  CARE  FACILITY"  SHALL  MEAN ANY INDIVIDUAL, PARTNERSHIP,
ASSOCIATION, CORPORATION, LIMITED LIABILITY COMPANY  OR  ANY  PERSON  OR
GROUP  OF  PERSONS  ACTING DIRECTLY OR INDIRECTLY ON BEHALF OF OR IN THE
INTEREST OF THE EMPLOYER, WHICH  PROVIDES  HEALTH  CARE  SERVICES  IN  A
FACILITY  LICENSED OR OPERATED PURSUANT TO ARTICLE TWENTY-EIGHT, TWENTY-
EIGHT-A OR THIRTY-SIX OF THIS CHAPTER, OR THE MENTAL  HYGIENE  LAW,  THE
EDUCATION  LAW OR THE CORRECTION LAW, INCLUDING ANY FACILITY OPERATED BY
THE STATE, A POLITICAL SUBDIVISION OR A PUBLIC  BENEFIT  CORPORATION  AS
DEFINED BY SECTION SIXTY-SIX OF THE GENERAL CONSTRUCTION LAW.
  2.  "NURSE"  SHALL  MEAN A REGISTERED PROFESSIONAL NURSE OR A LICENSED
PRACTICAL NURSE AS DEFINED BY ARTICLE ONE  HUNDRED  THIRTY-NINE  OF  THE
EDUCATION LAW.
  3.  "DIRECT  CARE  WORKER"  SHALL  MEAN  ANY EMPLOYEE OF A HEALTH CARE
FACILITY THAT IS RESPONSIBLE FOR PATIENT HANDLING OR PATIENT  ASSESSMENT
AS  A  REGULAR  OR  INCIDENTAL  PART  OF THEIR EMPLOYMENT, INCLUDING ANY
LICENSED OR UNLICENSED HEALTH CARE WORKER.
  4. "EMPLOYEE REPRESENTATIVE" SHALL MEAN THE  RECOGNIZED  OR  CERTIFIED
COLLECTIVE  BARGAINING  AGENT  FOR  NURSES  OR  DIRECT CARE WORKERS OF A
HEALTH CARE FACILITY.
  5. "SAFE PATIENT HANDLING" SHALL MEAN THE USE OF ENGINEERING CONTROLS,
LIFTING AND TRANSFER AIDS, OR ASSISTIVE DEVICES,  BY  NURSES  OR  DIRECT
CARE  WORKERS, INSTEAD OF MANUAL LIFTING TO PERFORM THE ACTS OF LIFTING,
TRANSFERRING AND REPOSITIONING OF HEALTH CARE PATIENTS AND RESIDENTS.
  6. "SAFE PATIENT HANDLING PROGRAM" SHALL INCLUDE:
  (A) A WRITTEN POLICY STATEMENT; AND
  (B) MANAGEMENT COMMITMENT AND EMPLOYEE INVOLVEMENT; AND
  (C) COMMITTEES; AND
  (D) RISK ASSESSMENTS; AND
  (E) INCIDENT INVESTIGATION; AND
  (F) PROCUREMENT OF ENGINEERING CONTROLS, LIFTING AND TRANSFER AIDS  OR
ASSISTIVE DEVICES TO ENSURE SAFE PATIENT HANDLING; AND
  (G) EMPLOYEE TRAINING AND EDUCATION ON SAFE PATIENT HANDLING; AND
  (H) PROGRAM EVALUATION AND MODIFICATION.
  S  2999-I.  NEW  YORK STATE SAFE PATIENT HANDLING TASK FORCE. 1. A NEW
YORK STATE SAFE PATIENT HANDLING TASK FORCE IS HEREBY CREATED WITHIN THE
DEPARTMENT.  SUCH TASK FORCE SHALL CONSIST OF A TOTAL OF ELEVEN  MEMBERS
AND  SHALL  INCLUDE THE COMMISSIONER OR HIS OR HER DESIGNEE; THE COMMIS-
SIONER OF LABOR OR HIS OR HER DESIGNEE; THREE MEMBERS APPOINTED  BY  THE
GOVERNOR,  TWO  SUCH  MEMBERS  SHALL  BE  REPRESENTATIVES OF HEALTH CARE
ORGANIZATIONS, ONE SUCH MEMBER SHALL BE FROM  AN  EMPLOYEE  ORGANIZATION
REPRESENTING NURSES AND ONE SUCH MEMBER SHALL BE FROM AN EMPLOYEE ORGAN-
IZATION  REPRESENTING  DIRECT  CARE  WORKERS;  TWO SUCH MEMBERS SHALL BE
CERTIFIED ERGONOMIST EVALUATION SPECIALISTS; TWO MEMBERS TO BE APPOINTED
BY THE TEMPORARY PRESIDENT OF THE SENATE, WHO SHALL  HAVE  EXPERTISE  IN
FIELDS  OF  DISCIPLINE RELATED TO HEALTH CARE OR OCCUPATIONAL SAFETY AND
ONE SUCH APPOINTEE SHALL BE FROM AN ORGANIZATION REPRESENTING  EITHER  A
NURSE  OR DIRECT CARE WORKER; TWO MEMBERS TO BE APPOINTED BY THE SPEAKER
OF THE ASSEMBLY, WHO  SHALL  HAVE  EXPERTISE  IN  FIELDS  OF  DISCIPLINE
RELATED  TO  HEALTH  CARE  OR OCCUPATIONAL SAFETY AND ONE SUCH APPOINTEE
SHALL BE FROM AN ORGANIZATION REPRESENTING EITHER A NURSE OR DIRECT CARE
WORKER; ONE MEMBER TO BE APPOINTED BY THE MINORITY LEADER OF THE SENATE,

S. 2470                             3

WHO SHALL HAVE EXPERTISE IN FIELDS OF DISCIPLINE RELATED TO HEALTH  CARE
OR  OCCUPATIONAL SAFETY; AND ONE MEMBER APPOINTED BY THE MINORITY LEADER
OF THE ASSEMBLY, WHO  SHALL  HAVE  EXPERTISE  IN  FIELDS  OF  DISCIPLINE
RELATED TO HEALTH CARE OR OCCUPATIONAL SAFETY.
  2.  TASK  FORCE  MEMBERS  SHALL  RECEIVE  NO  COMPENSATION  FOR  THEIR
SERVICES, BUT SHALL BE REIMBURSED  FOR  ACTUAL  AND  NECESSARY  EXPENSES
INCURRED IN THE PERFORMANCE OF THEIR DUTIES.
  3.  THE  TASK  FORCE  SHALL BE APPOINTED NO LATER THAN JULY FIRST, TWO
THOUSAND THIRTEEN AND SHALL SERVE FOR A PERIOD OF TWO YEARS; ANY  VACAN-
CIES ON THE TASK FORCE SHALL BE FILLED IN THE MANNER PROVIDED FOR IN THE
INITIAL APPOINTMENT.
  4.  THE CHAIRPERSON OF THE TASK FORCE SHALL BE THE COMMISSIONER OR HIS
OR HER DESIGNEE.
  5. THE TASK FORCE SHALL MEET NO LESS THAN THREE TIMES A YEAR.
  6. NOTWITHSTANDING ANY OTHER PROVISION  OF  LAW,  A  MAJORITY  OF  THE
MEMBERS  OF  THE TASK FORCE THEN IN OFFICE SHALL CONSTITUTE A QUORUM FOR
THE TRANSACTION OF BUSINESS OR THE EXERCISE OF POWER OR FUNCTION OF  THE
TASK  FORCE.  AN  ACT,  DETERMINATION OR DECISION OF THE MAJORITY OF THE
MEMBERS OF THE TASK FORCE SHALL BE HELD TO BE THE ACT, DETERMINATION  OR
DECISION OF THE TASK FORCE.
  7. THE TASK FORCE SHALL:
  (A)  PREPARE A POLICY STATEMENT REQUIRING A COMPREHENSIVE SAFE PATIENT
HANDLING PROGRAM TO BE IMPLEMENTED AT ALL  HEALTH  CARE  FACILITIES,  AS
DEFINED  IN SUBDIVISION ONE OF SECTION TWENTY-NINE HUNDRED NINETY-NINE-H
OF THIS TITLE.  THE POLICY STATEMENT SHALL INCLUDE THE REQUIREMENTS  FOR
DEVELOPING  AND  IMPLEMENTING AN EFFECTIVE SAFE PATIENT HANDLING PROGRAM
THAT SHALL INCLUDE ALL ELEMENTS SPECIFIED IN SUBDIVISION SIX OF  SECTION
TWENTY-NINE HUNDRED NINETY-NINE-H OF THIS TITLE;
  (B)  REVIEW  EXISTING  SAFE  PATIENT  HANDLING  PROGRAMS  OR POLICIES,
INCLUDING DEMONSTRATION PROGRAMS PREVIOUSLY AUTHORIZED BY CHAPTER  SEVEN
HUNDRED THIRTY-EIGHT OF THE LAWS OF TWO THOUSAND FIVE;
  (C)  CONSULT  WITH  ANY  ORGANIZATION,  EDUCATIONAL INSTITUTION, OTHER
GOVERNMENT ENTITY OR AGENCY OR PERSON;
  (D) CONDUCT PUBLIC HEARINGS, AS IT DEEMS NECESSARY;
  (E) IDENTIFY OR DEVELOP TRAINING MATERIALS AND PROCEDURES WITH  REGARD
TO THE EQUIPMENT OR TECHNOLOGY REQUIRED BY THE STATEWIDE POLICY;
  (F) REVIEW RULES AND REGULATIONS PRIOR TO ADOPTION BY THE DEPARTMENT;
  (G) REVIEW AND UPDATE THE POLICY STATEMENT ON A BI-ANNUAL BASIS; AND
  (H)  SUBMIT  A  REPORT TO THE COMMISSIONER BY JULY FIRST, TWO THOUSAND
FOURTEEN IDENTIFYING SAFE PATIENT HANDLING PROGRAM ELEMENTS  AND  RECOM-
MENDATIONS OF SAFE PATIENT LIFTING EQUIPMENT, TECHNIQUES OR DEVICES.
  8. ALL STATE DEPARTMENTS, COMMISSIONS, AGENCIES AND PUBLIC AUTHORITIES
SHALL PROVIDE THE TASK FORCE WITH ANY REASONABLY REQUESTED ASSISTANCE OF
ADVICE IN A TIMELY MANNER.
  S 2999-J. STATEWIDE SAFE PATIENT HANDLING POLICY. 1. THE COMMISSIONER,
IN  CONSULTATION  WITH  THE TASK FORCE, SHALL PROMULGATE RULES AND REGU-
LATIONS FOR A STATEWIDE SAFE PATIENT HANDLING  POLICY  FOR  HEALTH  CARE
FACILITIES COVERED BY THIS TITLE. SUCH POLICY SHALL BE MADE AVAILABLE TO
ALL  FACILITIES  COVERED  BY  THIS TITLE ON OR BEFORE JANUARY FIRST, TWO
THOUSAND FIFTEEN.
  2. THE STATEWIDE SAFE PATIENT HANDLING POLICY SHALL INCLUDE  STANDARDS
WITH REGARD TO:
  (A)  THE  EQUIPMENT,  DEVICES  OR  TECHNOLOGY TO BE USED BY A NURSE OR
DIRECT CARE WORKER WHO IS ENGAGED IN PATIENT HANDLING;
  (B) THE RATIO OF SUCH EQUIPMENT OR TECHNOLOGY BASED UPON THE  TYPE  OF
FACILITY,  THE  NUMBER OF BEDS IN A FACILITY, THE NUMBER OF PATIENT-HAN-

S. 2470                             4

DLING TASKS, TYPES OF CARE UNITS, PATIENT POPULATIONS, AND PATIENT  CARE
AREAS;
  (C)  THE  MINIMUM  NUMBER  OF  DEVICES TO ENSURE THAT CURRENT ASSESSED
HAZARDS ARE ELIMINATED OR MITIGATED;
  (D) ESTABLISHING  PROCEDURES  FOR  THE  SUBMISSION  AND  REPORTING  OF
COMPLIANCE BY EACH HEALTH CARE FACILITY COVERED BY THIS TITLE; AND
  (E)  ESTABLISHING  PROCEDURES  FOR COMPLAINTS OR VIOLATIONS, INCLUDING
THE FILING PROCESS, REVIEW, AND EVALUATION AND CORRECTIVE ACTION OF SUCH
COMPLAINTS.
  3. EACH HEALTH CARE FACILITY SHALL FILE WITH THE  DEPARTMENT  BY  JULY
FIRST,  TWO  THOUSAND  THIRTEEN A DETAILED PLAN TO COMPLY WITH THE RULES
AND REGULATIONS OF THE  STATEWIDE  SAFE  PATIENT  HANDLING  POLICY.  THE
DEPARTMENT SHALL ACCEPT SUCH PLAN BY JULY FIRST, TWO THOUSAND SIXTEEN.
  S  2999-K.  HEALTH  CARE FACILITY SAFE PATIENT HANDLING COMMITTEES. 1.
EACH HEALTH CARE  FACILITY  SHALL  ESTABLISH  A  SAFE  PATIENT  HANDLING
COMMITTEE EITHER BY CREATING A NEW COMMITTEE OR ASSIGNING THE POWERS AND
DUTIES  TO  AN EXISTING COMMITTEE.   AT LEAST ONE-HALF OF THE MEMBERS OF
THE SAFE PATIENT HANDLING COMMITTEE SHALL  BE  FRONTLINE  NON-MANAGERIAL
NURSES OR DIRECT CARE WORKERS. AT LEAST ONE NON-MANAGERIAL NURSE AND ONE
NON-MANAGERIAL  DIRECT CARE WORKER SHALL BE ON THE SAFE PATIENT HANDLING
COMMITTEE. THE COMMITTEE SHALL HAVE TWO CO-CHAIRS WITH ONE FROM  MANAGE-
MENT AND ONE FRONTLINE NON-MANAGERIAL NURSE OR DIRECT CARE WORKER.
  2.  THE  SAFE  PATIENT  HANDLING COMMITTEE SHALL: (A) SET CRITERIA FOR
EVALUATION OF PATIENTS AND/OR RESIDENTS TO DETERMINE WHICH  LIFT  AND/OR
REPOSITIONING  EQUIPMENT,  DEVICES OR TECHNOLOGY ARE TO BE USED; AND FOR
PERFORMANCE OF RISK  ASSESSMENTS  OF  THE  ENVIRONMENT,  JOB  TASKS  AND
PATIENT NEEDS;
  (B)  ENSURE  LIFT  AND/OR  REPOSITIONING EQUIPMENT IS SET UP, USED AND
MAINTAINED ACCORDING TO MANUFACTURER'S INSTRUCTIONS;
  (C) PROVIDE INITIAL AND ON-GOING YEARLY TRAINING AND EDUCATION ON SAFE
PATIENT HANDLING FOR CURRENT EMPLOYEES AND NEW HIRES,  AND  ENSURE  THAT
RETRAINING FOR THOSE FOUND TO BE DEFICIENT IS PROVIDED AS NEEDED WITHOUT
IMPACT TO THE EMPLOYMENT STATUS OF THE RETRAINED EMPLOYEES;
  (D)  SET UP AND UTILIZE A PROCESS FOR INCIDENT INVESTIGATION AND POST-
INVESTIGATION REVIEW WHICH INCLUDES A PLAN OF CORRECTION AND IMPLEMENTA-
TION OF CONTROLS;
  (E) MAKE RECOMMENDATIONS FOR THE ACQUISITION OF  EQUIPMENT  OR  PROCE-
DURES BEYOND THE MINIMUM STATE RECOMMENDATIONS; AND
  (F) PERFORM, AT MINIMUM, AN ANNUAL PROGRAM ASSESSMENT AND EVALUATION.
  S  2999-L. ENFORCEMENT. 1. ANY NURSE OR DIRECT CARE WORKER OR EMPLOYEE
REPRESENTATIVE WHO BELIEVES THE HEALTH CARE FACILITY  HAS  NOT  MET  THE
STANDARDS  SET  FORTH IN THIS TITLE SHALL BRING THE MATTER TO THE ATTEN-
TION OF THE HEALTH CARE FACILITY IN THE FORM OF  A  WRITTEN  NOTICE  AND
SHALL  AFFORD  THE  HEALTH  CARE  FACILITY  A  REASONABLE OPPORTUNITY TO
CORRECT SUCH  DEFICIENCIES,  PROVIDED  THAT  SUCH  NOTICE  NEED  NOT  BE
PROVIDED  WHERE  THE  NURSE  OR DIRECT WORKER OR EMPLOYEE REPRESENTATIVE
REASONABLY BELIEVES THAT THE FAILURE TO MEET STANDARDS PRESENTS AN IMMI-
NENT THREAT TO THE SAFETY OF A SPECIFIC NURSE OR DIRECT CARE WORKER,  OR
TO  THE  GENERAL  HEALTH  OF  A SPECIFIC PATIENT, AND REPORTING WILL NOT
RESULT IN CORRECTIVE ACTION.
  2. IN THE EVENT THAT THE HEALTH CARE FACILITY RECEIVING NOTICE  PURSU-
ANT  TO  SUBDIVISION ONE OF THIS SECTION DOES NOT TAKE CORRECTIVE ACTION
WITHIN SIXTY DAYS, OR IN THE EVENT THAT NOTICE  OF  A  FAILURE  TO  MEET
STANDARDS IS NOT REQUIRED PURSUANT TO SUBDIVISION ONE OF THIS SECTION, A
NURSE  OR DIRECT CARE WORKER SHALL HAVE THE RIGHT TO REFUSE TO ENGAGE IN
PATIENT HANDLING UNTIL THE HEALTH CARE FACILITY HAS ADEQUATELY ADDRESSED

S. 2470                             5

THE SPECIFIC FAILURE TO MEET STANDARDS.   UPON REFUSAL,  SUCH  NURSE  OR
DIRECT  CARE  WORKER OR HIS OR HER REPRESENTATIVE SHALL FILE A COMPLAINT
TO THE DEPARTMENT IN THE MANNER SET FORTH IN THE STATEWIDE SAFE  PATIENT
HANDLING POLICY.
  3.  NO  EMPLOYER  SHALL  TAKE  RETALIATORY ACTION AGAINST ANY NURSE OR
DIRECT CARE WORKER FOR RAISING CONCERNS OR ISSUES REGARDING SAFE PATIENT
HANDLING, FILING A COMPLAINT OR REFUSING TO ENGAGE IN PATIENT HANDLING.
  4. NURSES AND DIRECT CARE WORKERS, AS DEFINED IN  SECTION  TWENTY-NINE
HUNDRED  NINETY-NINE-H  OF  THIS TITLE SHALL BE CONSIDERED EMPLOYEES FOR
THE PURPOSES OF SECTION SEVEN HUNDRED FORTY-ONE OF THE LABOR LAW.
  5. THE DEPARTMENT AND THE DEPARTMENT OF LABOR SHALL PUBLISH  AND  MAKE
PUBLIC WHICH HEALTH CARE FACILITIES ARE IN COMPLIANCE WITH THE STATEWIDE
SAFE PATIENT HANDLING POLICY.
  S  3.  The  education law is amended by adding a new section 6510-f to
read as follows:
  S 6510-F. STATE SAFE PATIENT HANDLING POLICY.   1. THE  REFUSAL  OF  A
LICENSED  PRACTICAL  NURSE  OR  A  REGISTERED NURSE TO ENGAGE IN PATIENT
HANDLING SHALL NOT CONSTITUTE PATIENT ABANDONMENT  OR  NEGLECT  IF  SUCH
NURSE  HAS,  IN  A  MANNER  CONSISTENT WITH ARTICLE TWENTY-NINE-D OF THE
PUBLIC HEALTH LAW AND THE RULES AND REGULATIONS PROMULGATED PURSUANT  TO
SUCH  ARTICLE,  REFUSED  A  PATIENT  HANDLING  ASSIGNMENT  AND  FILED  A
COMPLAINT WITH THE DEPARTMENT OF HEALTH.
  2. THE REFUSAL OF A LICENSED  OR  UNLICENSED  HEALTH  CARE  WORKER  TO
ENGAGE  IN  PATIENT  HANDLING NOT CONSISTENT WITH THE STATE SAFE PATIENT
HANDLING POLICY OR A FACILITY'S SAFE PATIENT HANDLING POLICY  SHALL  NOT
BE  CONSIDERED  PROFESSIONAL  MISCONDUCT.  THE  REFUSAL OF A LICENSED OR
UNLICENSED HEALTH CARE WORKER TO ENGAGE IN PATIENT  HANDLING  SHALL  NOT
CONSTITUTE  PATIENT  ABANDONMENT  OR  NEGLECT  IF  SUCH WORKER HAS, IN A
MANNER CONSISTENT WITH ARTICLE TWENTY-NINE-D OF THE  PUBLIC  HEALTH  LAW
AND  THE  RULES  AND  REGULATIONS  PROMULGATED PURSUANT TO SUCH ARTICLE,
REFUSED A PATIENT HANDLING ASSIGNMENT AND FILED  A  COMPLAINT  WITH  THE
DEPARTMENT OF HEALTH.
  S 4. This act shall take effect on the one hundred twentieth day after
it shall have become a law.

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 2470--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            January 21, 2011
                               ___________

Introduced  by  Sen. MAZIARZ -- read twice and ordered printed, and when
  printed to be committed  to  the  Committee  on  Health  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN ACT to amend the public health law and the education law, in relation
  to a safe patient handling policy for health care facilities

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. This act shall be known and  may  be  cited  as  the  "safe
patient handling act".
  S  2. Article 29-D of the public health law is amended by adding a new
title 4 to read as follows:
                                 TITLE 4
                      SAFE PATIENT HANDLING POLICY
SECTION 2999-G. LEGISLATIVE INTENT.
        2999-H. DEFINITIONS.
        2999-I. NEW YORK STATE SAFE PATIENT HANDLING TASK FORCE.
        2999-J. STATEWIDE SAFE PATIENT HANDLING POLICY.
        2999-K. HEALTH CARE FACILITY SAFE PATIENT HANDLING COMMITTEES.
        2999-L. ENFORCEMENT.
  S  2999-G.  LEGISLATIVE  INTENT.  THE  LEGISLATURE  HEREBY  FINDS  AND
DECLARES  THAT  IT  IS  IN THE PUBLIC INTEREST TO ENACT A STATEWIDE SAFE
PATIENT HANDLING POLICY FOR HEALTH CARE FACILITIES IN  NEW  YORK  STATE.
WITHOUT  SAFE  PATIENT  HANDLING  LEGISLATION,  IT IS PREDICTED THAT THE
DEMAND FOR NURSING SERVICES WILL EXCEED  THE  SUPPLY  BY  NEARLY  THIRTY
PERCENT  BY  THE YEAR TWO THOUSAND TWENTY THUS DECREASING THE QUALITY OF
HEALTH CARE IN NEW YORK STATE.   THERE ARE MANY  BENEFITS  THAT  CAN  BE
DERIVED  FROM  SAFE PATIENT HANDLING PROGRAMS.  PATIENTS BENEFIT THROUGH
IMPROVED QUALITY OF CARE AND QUALITY OF LIFE BY  REDUCING  THE  RISK  OF
FALLS, BEING DROPPED, FRICTION BURNS, SKIN TEARS AND BRUISES. CAREGIVERS
BENEFIT FROM THE REDUCED RISK OF CAREER ENDING AND DEBILITATING INJURIES

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04321-03-1
              

S. 2470--A                          2

LEADING  TO INCREASED MORALE, IMPROVED JOB SATISFACTION AND LONGEVITY IN
THE PROFESSION. HEALTH CARE FACILITIES REALIZE A QUICK RETURN  ON  THEIR
INVESTMENT  THROUGH  REDUCED WORKERS' COMPENSATION MEDICAL AND INDEMNITY
COSTS,  REDUCED  LOST WORKDAYS AND IMPROVED RECRUITMENT AND RETENTION OF
CAREGIVERS. ALL OF THIS WILL LEAD TO FISCAL IMPROVEMENT IN  HEALTH  CARE
IN NEW YORK STATE.
  S 2999-H. DEFINITIONS. FOR THE PURPOSES OF THIS TITLE:
  1.  "HEALTH  CARE  FACILITY"  SHALL  MEAN ANY INDIVIDUAL, PARTNERSHIP,
ASSOCIATION, CORPORATION, LIMITED LIABILITY COMPANY  OR  ANY  PERSON  OR
GROUP  OF  PERSONS  ACTING DIRECTLY OR INDIRECTLY ON BEHALF OF OR IN THE
INTEREST OF THE EMPLOYER, WHICH  PROVIDES  HEALTH  CARE  SERVICES  IN  A
FACILITY  LICENSED OR OPERATED PURSUANT TO ARTICLE TWENTY-EIGHT, TWENTY-
EIGHT-A OR THIRTY-SIX OF THIS CHAPTER, OR THE MENTAL  HYGIENE  LAW,  THE
EDUCATION  LAW OR THE CORRECTION LAW, INCLUDING ANY FACILITY OPERATED BY
THE STATE, A POLITICAL SUBDIVISION OR A PUBLIC  BENEFIT  CORPORATION  AS
DEFINED BY SECTION SIXTY-SIX OF THE GENERAL CONSTRUCTION LAW.
  2.  "NURSE"  SHALL  MEAN A REGISTERED PROFESSIONAL NURSE OR A LICENSED
PRACTICAL NURSE AS DEFINED BY ARTICLE ONE  HUNDRED  THIRTY-NINE  OF  THE
EDUCATION LAW.
  3.  "DIRECT  CARE  WORKER"  SHALL  MEAN  ANY EMPLOYEE OF A HEALTH CARE
FACILITY THAT IS RESPONSIBLE FOR PATIENT HANDLING OR PATIENT  ASSESSMENT
AS  A  REGULAR  OR  INCIDENTAL  PART  OF THEIR EMPLOYMENT, INCLUDING ANY
LICENSED OR UNLICENSED HEALTH CARE WORKER.
  4. "EMPLOYEE REPRESENTATIVE" SHALL MEAN THE  RECOGNIZED  OR  CERTIFIED
COLLECTIVE  BARGAINING  AGENT  FOR  NURSES  OR  DIRECT CARE WORKERS OF A
HEALTH CARE FACILITY.
  5. "SAFE PATIENT HANDLING" SHALL MEAN THE USE OF ENGINEERING CONTROLS,
LIFTING AND TRANSFER AIDS, OR ASSISTIVE DEVICES,  BY  NURSES  OR  DIRECT
CARE  WORKERS, INSTEAD OF MANUAL LIFTING TO PERFORM THE ACTS OF LIFTING,
TRANSFERRING AND REPOSITIONING OF HEALTH CARE PATIENTS AND RESIDENTS.
  6. "SAFE PATIENT HANDLING PROGRAM" SHALL INCLUDE:
  (A) A WRITTEN POLICY STATEMENT; AND
  (B) MANAGEMENT COMMITMENT AND EMPLOYEE INVOLVEMENT; AND
  (C) COMMITTEES; AND
  (D) RISK ASSESSMENTS; AND
  (E) INCIDENT INVESTIGATION; AND
  (F) PROCUREMENT OF ENGINEERING CONTROLS, LIFTING AND TRANSFER AIDS  OR
ASSISTIVE DEVICES TO ENSURE SAFE PATIENT HANDLING; AND
  (G) EMPLOYEE TRAINING AND EDUCATION ON SAFE PATIENT HANDLING; AND
  (H) PROGRAM EVALUATION AND MODIFICATION.
  S  2999-I.  NEW  YORK STATE SAFE PATIENT HANDLING TASK FORCE. 1. A NEW
YORK STATE SAFE PATIENT HANDLING TASK FORCE IS HEREBY CREATED WITHIN THE
DEPARTMENT.  SUCH TASK FORCE SHALL CONSIST OF A TOTAL OF ELEVEN  MEMBERS
AND  SHALL  INCLUDE THE COMMISSIONER OR HIS OR HER DESIGNEE; THE COMMIS-
SIONER OF LABOR OR HIS OR HER DESIGNEE; THREE MEMBERS APPOINTED  BY  THE
GOVERNOR,  TWO  SUCH  MEMBERS  SHALL  BE  REPRESENTATIVES OF HEALTH CARE
ORGANIZATIONS, ONE SUCH MEMBER SHALL BE FROM  AN  EMPLOYEE  ORGANIZATION
REPRESENTING NURSES AND ONE SUCH MEMBER SHALL BE FROM AN EMPLOYEE ORGAN-
IZATION  REPRESENTING  DIRECT  CARE  WORKERS;  TWO SUCH MEMBERS SHALL BE
CERTIFIED ERGONOMIST EVALUATION SPECIALISTS; TWO MEMBERS TO BE APPOINTED
BY THE TEMPORARY PRESIDENT OF THE SENATE, WHO SHALL  HAVE  EXPERTISE  IN
FIELDS  OF  DISCIPLINE RELATED TO HEALTH CARE OR OCCUPATIONAL SAFETY AND
ONE SUCH APPOINTEE SHALL BE FROM AN ORGANIZATION REPRESENTING  EITHER  A
NURSE  OR DIRECT CARE WORKER; TWO MEMBERS TO BE APPOINTED BY THE SPEAKER
OF THE ASSEMBLY, WHO  SHALL  HAVE  EXPERTISE  IN  FIELDS  OF  DISCIPLINE
RELATED  TO  HEALTH  CARE  OR OCCUPATIONAL SAFETY AND ONE SUCH APPOINTEE

S. 2470--A                          3

SHALL BE FROM AN ORGANIZATION REPRESENTING EITHER A NURSE OR DIRECT CARE
WORKER; ONE MEMBER TO BE APPOINTED BY THE MINORITY LEADER OF THE SENATE,
WHO SHALL HAVE EXPERTISE IN FIELDS OF DISCIPLINE RELATED TO HEALTH  CARE
OR  OCCUPATIONAL SAFETY; AND ONE MEMBER APPOINTED BY THE MINORITY LEADER
OF THE ASSEMBLY, WHO  SHALL  HAVE  EXPERTISE  IN  FIELDS  OF  DISCIPLINE
RELATED TO HEALTH CARE OR OCCUPATIONAL SAFETY.
  2.  TASK  FORCE  MEMBERS  SHALL  RECEIVE  NO  COMPENSATION  FOR  THEIR
SERVICES, BUT SHALL BE REIMBURSED  FOR  ACTUAL  AND  NECESSARY  EXPENSES
INCURRED IN THE PERFORMANCE OF THEIR DUTIES.
  3.  THE  TASK  FORCE  SHALL BE APPOINTED NO LATER THAN JULY FIRST, TWO
THOUSAND THIRTEEN AND SHALL SERVE FOR A PERIOD OF TWO YEARS; ANY  VACAN-
CIES ON THE TASK FORCE SHALL BE FILLED IN THE MANNER PROVIDED FOR IN THE
INITIAL APPOINTMENT.
  4.  THE CHAIRPERSON OF THE TASK FORCE SHALL BE THE COMMISSIONER OR HIS
OR HER DESIGNEE.
  5. THE TASK FORCE SHALL MEET NO LESS THAN THREE TIMES A YEAR.
  6. NOTWITHSTANDING ANY OTHER PROVISION  OF  LAW,  A  MAJORITY  OF  THE
MEMBERS  OF  THE TASK FORCE THEN IN OFFICE SHALL CONSTITUTE A QUORUM FOR
THE TRANSACTION OF BUSINESS OR THE EXERCISE OF POWER OR FUNCTION OF  THE
TASK  FORCE.  AN  ACT,  DETERMINATION OR DECISION OF THE MAJORITY OF THE
MEMBERS OF THE TASK FORCE SHALL BE HELD TO BE THE ACT, DETERMINATION  OR
DECISION OF THE TASK FORCE.
  7. THE TASK FORCE SHALL:
  (A)  PREPARE A POLICY STATEMENT REQUIRING A COMPREHENSIVE SAFE PATIENT
HANDLING PROGRAM TO BE IMPLEMENTED AT ALL  HEALTH  CARE  FACILITIES,  AS
DEFINED  IN SUBDIVISION ONE OF SECTION TWENTY-NINE HUNDRED NINETY-NINE-H
OF THIS TITLE.  THE POLICY STATEMENT SHALL INCLUDE THE REQUIREMENTS  FOR
DEVELOPING  AND  IMPLEMENTING AN EFFECTIVE SAFE PATIENT HANDLING PROGRAM
THAT SHALL INCLUDE ALL ELEMENTS SPECIFIED IN SUBDIVISION SIX OF  SECTION
TWENTY-NINE HUNDRED NINETY-NINE-H OF THIS TITLE;
  (B)  REVIEW  EXISTING  SAFE  PATIENT  HANDLING  PROGRAMS  OR POLICIES,
INCLUDING DEMONSTRATION PROGRAMS PREVIOUSLY AUTHORIZED BY CHAPTER  SEVEN
HUNDRED THIRTY-EIGHT OF THE LAWS OF TWO THOUSAND FIVE;
  (C)  CONSULT  WITH  ANY  ORGANIZATION,  EDUCATIONAL INSTITUTION, OTHER
GOVERNMENT ENTITY OR AGENCY OR PERSON;
  (D) CONDUCT PUBLIC HEARINGS, AS IT DEEMS NECESSARY;
  (E) IDENTIFY OR DEVELOP TRAINING MATERIALS AND PROCEDURES WITH  REGARD
TO THE EQUIPMENT OR TECHNOLOGY REQUIRED BY THE STATEWIDE POLICY;
  (F) REVIEW RULES AND REGULATIONS PRIOR TO ADOPTION BY THE DEPARTMENT;
  (G) REVIEW AND UPDATE THE POLICY STATEMENT ON A BI-ANNUAL BASIS; AND
  (H)  SUBMIT  A  REPORT TO THE COMMISSIONER BY JULY FIRST, TWO THOUSAND
FOURTEEN IDENTIFYING SAFE PATIENT HANDLING PROGRAM ELEMENTS  AND  RECOM-
MENDATIONS OF SAFE PATIENT LIFTING EQUIPMENT, TECHNIQUES OR DEVICES.
  8. ALL STATE DEPARTMENTS, COMMISSIONS, AGENCIES AND PUBLIC AUTHORITIES
SHALL PROVIDE THE TASK FORCE WITH ANY REASONABLY REQUESTED ASSISTANCE OF
ADVICE IN A TIMELY MANNER.
  S 2999-J. STATEWIDE SAFE PATIENT HANDLING POLICY. 1. THE COMMISSIONER,
IN  CONSULTATION  WITH  THE TASK FORCE, SHALL PROMULGATE RULES AND REGU-
LATIONS FOR A STATEWIDE SAFE PATIENT HANDLING  POLICY  FOR  HEALTH  CARE
FACILITIES COVERED BY THIS TITLE. SUCH POLICY SHALL BE MADE AVAILABLE TO
ALL  FACILITIES  COVERED  BY  THIS TITLE ON OR BEFORE JANUARY FIRST, TWO
THOUSAND FIFTEEN.
  2. THE STATEWIDE SAFE PATIENT HANDLING POLICY SHALL INCLUDE  STANDARDS
WITH REGARD TO:
  (A)  THE  EQUIPMENT,  DEVICES  OR  TECHNOLOGY TO BE USED BY A NURSE OR
DIRECT CARE WORKER WHO IS ENGAGED IN PATIENT HANDLING;

S. 2470--A                          4

  (B) THE RATIO OF SUCH EQUIPMENT OR TECHNOLOGY BASED UPON THE  TYPE  OF
FACILITY,  THE  NUMBER OF BEDS IN A FACILITY, THE NUMBER OF PATIENT-HAN-
DLING TASKS, TYPES OF CARE UNITS, PATIENT POPULATIONS, AND PATIENT  CARE
AREAS;
  (C)  THE  MINIMUM  NUMBER  OF  DEVICES TO ENSURE THAT CURRENT ASSESSED
HAZARDS ARE ELIMINATED OR MITIGATED;
  (D) ESTABLISHING  PROCEDURES  FOR  THE  SUBMISSION  AND  REPORTING  OF
COMPLIANCE BY EACH HEALTH CARE FACILITY COVERED BY THIS TITLE; AND
  (E)  ESTABLISHING  PROCEDURES  FOR COMPLAINTS OR VIOLATIONS, INCLUDING
THE FILING PROCESS, REVIEW, AND EVALUATION AND CORRECTIVE ACTION OF SUCH
COMPLAINTS.
  3. EACH HEALTH CARE FACILITY SHALL FILE WITH THE  DEPARTMENT  BY  JULY
FIRST, TWO THOUSAND FIFTEEN A DETAILED PLAN TO COMPLY WITH THE RULES AND
REGULATIONS  OF  THE STATEWIDE SAFE PATIENT HANDLING POLICY. THE DEPART-
MENT SHALL ACCEPT SUCH PLAN BY JULY FIRST, TWO THOUSAND SIXTEEN.
  S 2999-K. HEALTH CARE FACILITY SAFE PATIENT  HANDLING  COMMITTEES.  1.
EACH  HEALTH  CARE  FACILITY  SHALL  ESTABLISH  A  SAFE PATIENT HANDLING
COMMITTEE EITHER BY CREATING A NEW COMMITTEE OR ASSIGNING THE POWERS AND
DUTIES TO AN EXISTING COMMITTEE.  AT LEAST ONE-HALF OF  THE  MEMBERS  OF
THE  SAFE  PATIENT  HANDLING COMMITTEE SHALL BE FRONTLINE NON-MANAGERIAL
NURSES OR DIRECT CARE WORKERS. AT LEAST ONE NON-MANAGERIAL NURSE AND ONE
NON-MANAGERIAL DIRECT CARE WORKER SHALL BE ON THE SAFE PATIENT  HANDLING
COMMITTEE.  THE COMMITTEE SHALL HAVE TWO CO-CHAIRS WITH ONE FROM MANAGE-
MENT AND ONE FRONTLINE NON-MANAGERIAL NURSE OR DIRECT CARE WORKER.
  2. THE SAFE PATIENT HANDLING COMMITTEE SHALL:  (A)  SET  CRITERIA  FOR
EVALUATION  OF  PATIENTS AND/OR RESIDENTS TO DETERMINE WHICH LIFT AND/OR
REPOSITIONING EQUIPMENT, DEVICES OR TECHNOLOGY ARE TO BE USED;  AND  FOR
PERFORMANCE  OF  RISK  ASSESSMENTS  OF  THE  ENVIRONMENT,  JOB TASKS AND
PATIENT NEEDS;
  (B) ENSURE LIFT AND/OR REPOSITIONING EQUIPMENT IS  SET  UP,  USED  AND
MAINTAINED ACCORDING TO MANUFACTURER'S INSTRUCTIONS;
  (C) PROVIDE INITIAL AND ON-GOING YEARLY TRAINING AND EDUCATION ON SAFE
PATIENT  HANDLING  FOR  CURRENT EMPLOYEES AND NEW HIRES, AND ENSURE THAT
RETRAINING FOR THOSE FOUND TO BE DEFICIENT IS PROVIDED AS NEEDED WITHOUT
IMPACT TO THE EMPLOYMENT STATUS OF THE RETRAINED EMPLOYEES;
  (D) SET UP AND UTILIZE A PROCESS FOR INCIDENT INVESTIGATION AND  POST-
INVESTIGATION REVIEW WHICH INCLUDES A PLAN OF CORRECTION AND IMPLEMENTA-
TION OF CONTROLS;
  (E)  MAKE  RECOMMENDATIONS  FOR THE ACQUISITION OF EQUIPMENT OR PROCE-
DURES BEYOND THE MINIMUM STATE RECOMMENDATIONS; AND
  (F) PERFORM, AT MINIMUM, AN ANNUAL PROGRAM ASSESSMENT AND EVALUATION.
  S 2999-L. ENFORCEMENT. 1. ANY NURSE OR DIRECT CARE WORKER OR  EMPLOYEE
REPRESENTATIVE  WHO  BELIEVES  THE  HEALTH CARE FACILITY HAS NOT MET THE
STANDARDS SET FORTH IN THIS TITLE SHALL BRING THE MATTER TO  THE  ATTEN-
TION  OF  THE  HEALTH  CARE FACILITY IN THE FORM OF A WRITTEN NOTICE AND
SHALL AFFORD THE  HEALTH  CARE  FACILITY  A  REASONABLE  OPPORTUNITY  TO
CORRECT  SUCH  DEFICIENCIES,  PROVIDED  THAT  SUCH  NOTICE  NEED  NOT BE
PROVIDED WHERE THE NURSE OR DIRECT  WORKER  OR  EMPLOYEE  REPRESENTATIVE
REASONABLY BELIEVES THAT THE FAILURE TO MEET STANDARDS PRESENTS AN IMMI-
NENT  THREAT TO THE SAFETY OF A SPECIFIC NURSE OR DIRECT CARE WORKER, OR
TO THE GENERAL HEALTH OF A SPECIFIC  PATIENT,  AND  REPORTING  WILL  NOT
RESULT IN CORRECTIVE ACTION.
  2.  IN THE EVENT THAT THE HEALTH CARE FACILITY RECEIVING NOTICE PURSU-
ANT TO SUBDIVISION ONE OF THIS SECTION DOES NOT TAKE  CORRECTIVE  ACTION
WITHIN  SIXTY  DAYS,  OR  IN  THE EVENT THAT NOTICE OF A FAILURE TO MEET
STANDARDS IS NOT REQUIRED PURSUANT TO SUBDIVISION ONE OF THIS SECTION, A

S. 2470--A                          5

NURSE OR DIRECT CARE WORKER SHALL HAVE THE RIGHT TO REFUSE TO ENGAGE  IN
PATIENT HANDLING UNTIL THE HEALTH CARE FACILITY HAS ADEQUATELY ADDRESSED
THE  SPECIFIC  FAILURE  TO MEET STANDARDS.   UPON REFUSAL, SUCH NURSE OR
DIRECT  CARE  WORKER OR HIS OR HER REPRESENTATIVE SHALL FILE A COMPLAINT
TO THE DEPARTMENT IN THE MANNER SET FORTH IN THE STATEWIDE SAFE  PATIENT
HANDLING POLICY.
  3.  NO  EMPLOYER  SHALL  TAKE  RETALIATORY ACTION AGAINST ANY NURSE OR
DIRECT CARE WORKER FOR RAISING CONCERNS OR ISSUES REGARDING SAFE PATIENT
HANDLING, FILING A COMPLAINT OR REFUSING TO ENGAGE IN PATIENT HANDLING.
  4. NURSES AND DIRECT CARE WORKERS, AS DEFINED IN  SECTION  TWENTY-NINE
HUNDRED  NINETY-NINE-H  OF  THIS TITLE SHALL BE CONSIDERED EMPLOYEES FOR
THE PURPOSES OF SECTION SEVEN HUNDRED FORTY-ONE OF THE LABOR LAW.
  5. THE DEPARTMENT AND THE DEPARTMENT OF LABOR SHALL PUBLISH  AND  MAKE
PUBLIC WHICH HEALTH CARE FACILITIES ARE IN COMPLIANCE WITH THE STATEWIDE
SAFE PATIENT HANDLING POLICY.
  S  3.  The  education law is amended by adding a new section 6510-f to
read as follows:
  S 6510-F. STATE SAFE PATIENT HANDLING POLICY.   1. THE  REFUSAL  OF  A
LICENSED  PRACTICAL  NURSE  OR  A  REGISTERED NURSE TO ENGAGE IN PATIENT
HANDLING SHALL NOT CONSTITUTE PATIENT ABANDONMENT  OR  NEGLECT  IF  SUCH
NURSE  HAS,  IN  A  MANNER  CONSISTENT WITH ARTICLE TWENTY-NINE-D OF THE
PUBLIC HEALTH LAW AND THE RULES AND REGULATIONS PROMULGATED PURSUANT  TO
SUCH  ARTICLE,  REFUSED  A  PATIENT  HANDLING  ASSIGNMENT  AND  FILED  A
COMPLAINT WITH THE DEPARTMENT OF HEALTH.
  2. THE REFUSAL OF A LICENSED  OR  UNLICENSED  HEALTH  CARE  WORKER  TO
ENGAGE  IN  PATIENT  HANDLING NOT CONSISTENT WITH THE STATE SAFE PATIENT
HANDLING POLICY OR A FACILITY'S SAFE PATIENT HANDLING POLICY  SHALL  NOT
BE  CONSIDERED  PROFESSIONAL  MISCONDUCT.  THE  REFUSAL OF A LICENSED OR
UNLICENSED HEALTH CARE WORKER TO ENGAGE IN PATIENT  HANDLING  SHALL  NOT
CONSTITUTE  PATIENT  ABANDONMENT  OR  NEGLECT  IF  SUCH WORKER HAS, IN A
MANNER CONSISTENT WITH ARTICLE TWENTY-NINE-D OF THE  PUBLIC  HEALTH  LAW
AND  THE  RULES  AND  REGULATIONS  PROMULGATED PURSUANT TO SUCH ARTICLE,
REFUSED A PATIENT HANDLING ASSIGNMENT AND FILED  A  COMPLAINT  WITH  THE
DEPARTMENT OF HEALTH.
  S 4. This act shall take effect on the one hundred twentieth day after
it shall have become a law.

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 2470--C

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            January 21, 2011
                               ___________

Introduced  by  Sens.  MAZIARZ, ADAMS, ADDABBO, AVELLA, CARLUCCI, DILAN,
  GOLDEN,  GRISANTI,  HASSELL-THOMPSON,  JOHNSON,  LARKIN,   MONTGOMERY,
  OPPENHEIMER,  PARKER, PERALTA, SAVINO, STEWART-COUSINS, ZELDIN -- read
  twice and ordered printed, and when printed to  be  committed  to  the
  Committee  on  Health  --  committee discharged, bill amended, ordered
  reprinted as amended and recommitted to said committee --  recommitted
  to the Committee on Health in accordance with Senate Rule 6, sec. 8 --
  committee  discharged,  bill amended, ordered reprinted as amended and
  recommitted to said committee -- reported favorably from said  commit-
  tee  and commited to the Committee on Finance -- committee discharged,
  bill amended, ordered reprinted as amended  and  recommitted  to  said
  committee

AN ACT to amend the public health law and the education law, in relation
  to a safe patient handling policy for health care facilities

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. This act shall be known and  may  be  cited  as  the  "safe
patient handling act".
  S  2. Article 29-D of the public health law is amended by adding a new
title 1-A to read as follows:
                                TITLE 1-A
                      SAFE PATIENT HANDLING POLICY
SECTION 2997-G. LEGISLATIVE INTENT.
        2997-H. DEFINITIONS.
        2997-I. NEW YORK STATE SAFE PATIENT HANDLING TASK FORCE.
        2997-J. STATEWIDE SAFE PATIENT HANDLING POLICY.
        2997-K. HEALTH CARE FACILITY SAFE PATIENT HANDLING COMMITTEES.
        2997-L. ENFORCEMENT.
  S  2997-G.  LEGISLATIVE  INTENT.  THE  LEGISLATURE  HEREBY  FINDS  AND
DECLARES  THAT  IT  IS  IN THE PUBLIC INTEREST TO ENACT A STATEWIDE SAFE
PATIENT HANDLING POLICY FOR HEALTH CARE FACILITIES IN  NEW  YORK  STATE.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04321-07-2
              

S. 2470--C                          2

WITHOUT  SAFE  PATIENT  HANDLING  LEGISLATION,  IT IS PREDICTED THAT THE
DEMAND FOR NURSING SERVICES WILL EXCEED  THE  SUPPLY  BY  NEARLY  THIRTY
PERCENT  BY  THE YEAR TWO THOUSAND TWENTY THUS DECREASING THE QUALITY OF
HEALTH  CARE  IN  NEW  YORK STATE.   THERE ARE MANY BENEFITS THAT CAN BE
DERIVED FROM SAFE PATIENT HANDLING PROGRAMS.   PATIENTS BENEFIT  THROUGH
IMPROVED  QUALITY  OF  CARE  AND QUALITY OF LIFE BY REDUCING THE RISK OF
FALLS, BEING DROPPED, FRICTION BURNS, SKIN TEARS AND BRUISES. CAREGIVERS
BENEFIT FROM THE REDUCED RISK OF CAREER ENDING AND DEBILITATING INJURIES
LEADING TO INCREASED MORALE, IMPROVED JOB SATISFACTION AND LONGEVITY  IN
THE  PROFESSION.  HEALTH CARE FACILITIES REALIZE A QUICK RETURN ON THEIR
INVESTMENT THROUGH REDUCED WORKERS' COMPENSATION MEDICAL  AND  INDEMNITY
COSTS,  REDUCED  LOST WORKDAYS AND IMPROVED RECRUITMENT AND RETENTION OF
CAREGIVERS. ALL OF THIS WILL LEAD TO FISCAL IMPROVEMENT IN  HEALTH  CARE
IN NEW YORK STATE.
  S 2997-H. DEFINITIONS. FOR THE PURPOSES OF THIS TITLE:
  1.  "HEALTH  CARE  FACILITY"  SHALL  MEAN ANY INDIVIDUAL, PARTNERSHIP,
ASSOCIATION, CORPORATION, LIMITED LIABILITY COMPANY  OR  ANY  PERSON  OR
GROUP  OF  PERSONS  ACTING DIRECTLY OR INDIRECTLY ON BEHALF OF OR IN THE
INTEREST OF THE EMPLOYER, WHICH  PROVIDES  HEALTH  CARE  SERVICES  IN  A
FACILITY  LICENSED OR OPERATED PURSUANT TO ARTICLE TWENTY-EIGHT, TWENTY-
EIGHT-A OR THIRTY-SIX OF THIS CHAPTER, OR THE MENTAL  HYGIENE  LAW,  THE
EDUCATION  LAW OR THE CORRECTION LAW, INCLUDING ANY FACILITY OPERATED BY
THE STATE, A POLITICAL SUBDIVISION OR A PUBLIC  BENEFIT  CORPORATION  AS
DEFINED BY SECTION SIXTY-SIX OF THE GENERAL CONSTRUCTION LAW.
  2.  "NURSE"  SHALL  MEAN A REGISTERED PROFESSIONAL NURSE OR A LICENSED
PRACTICAL NURSE AS DEFINED BY ARTICLE ONE  HUNDRED  THIRTY-NINE  OF  THE
EDUCATION LAW.
  3.  "DIRECT  CARE  WORKER"  SHALL  MEAN  ANY EMPLOYEE OF A HEALTH CARE
FACILITY THAT IS RESPONSIBLE FOR PATIENT HANDLING OR PATIENT  ASSESSMENT
AS  A  REGULAR  OR  INCIDENTAL  PART  OF THEIR EMPLOYMENT, INCLUDING ANY
LICENSED OR UNLICENSED HEALTH CARE WORKER.
  4. "EMPLOYEE REPRESENTATIVE" SHALL MEAN THE  RECOGNIZED  OR  CERTIFIED
COLLECTIVE  BARGAINING  AGENT  FOR  NURSES  OR  DIRECT CARE WORKERS OF A
HEALTH CARE FACILITY.
  5. "SAFE PATIENT HANDLING" SHALL MEAN THE USE OF ENGINEERING CONTROLS,
LIFTING AND TRANSFER AIDS, OR ASSISTIVE DEVICES,  BY  NURSES  OR  DIRECT
CARE  WORKERS, INSTEAD OF MANUAL LIFTING TO PERFORM THE ACTS OF LIFTING,
TRANSFERRING AND REPOSITIONING OF HEALTH CARE PATIENTS AND RESIDENTS.
  6. "SAFE PATIENT HANDLING PROGRAM" SHALL INCLUDE:
  (A) A WRITTEN POLICY STATEMENT; AND
  (B) MANAGEMENT COMMITMENT AND EMPLOYEE INVOLVEMENT; AND
  (C) COMMITTEES; AND
  (D) RISK ASSESSMENTS; AND
  (E) INCIDENT INVESTIGATION; AND
  (F) PROCUREMENT OF ENGINEERING CONTROLS, LIFTING AND TRANSFER AIDS  OR
ASSISTIVE DEVICES TO ENSURE SAFE PATIENT HANDLING; AND
  (G) EMPLOYEE TRAINING AND EDUCATION ON SAFE PATIENT HANDLING; AND
  (H) PROGRAM EVALUATION AND MODIFICATION.
  S  2997-I.  NEW  YORK STATE SAFE PATIENT HANDLING TASK FORCE. 1. A NEW
YORK STATE SAFE PATIENT HANDLING TASK FORCE IS HEREBY CREATED WITHIN THE
DEPARTMENT.   SUCH TASK FORCE SHALL  CONSIST  OF  A  TOTAL  OF  THIRTEEN
MEMBERS  AND  SHALL INCLUDE THE COMMISSIONER OR HIS OR HER DESIGNEE; THE
COMMISSIONER OF LABOR OR HIS OR HER DESIGNEE; FIVE MEMBERS APPOINTED  BY
THE  GOVERNOR,  TWO SUCH MEMBERS SHALL BE REPRESENTATIVES OF HEALTH CARE
ORGANIZATIONS, ONE SUCH MEMBER SHALL BE FROM  AN  EMPLOYEE  ORGANIZATION
REPRESENTING NURSES AND ONE SUCH MEMBER SHALL BE FROM AN EMPLOYEE ORGAN-

S. 2470--C                          3

IZATION  REPRESENTING  DIRECT  CARE  WORKERS;  TWO SUCH MEMBERS SHALL BE
CERTIFIED ERGONOMIST EVALUATION SPECIALISTS; TWO MEMBERS TO BE APPOINTED
BY THE TEMPORARY PRESIDENT OF THE SENATE, WHO SHALL  HAVE  EXPERTISE  IN
FIELDS  OF  DISCIPLINE RELATED TO HEALTH CARE OR OCCUPATIONAL SAFETY AND
ONE SUCH APPOINTEE SHALL BE FROM AN ORGANIZATION REPRESENTING  EITHER  A
NURSE  OR DIRECT CARE WORKER; TWO MEMBERS TO BE APPOINTED BY THE SPEAKER
OF THE ASSEMBLY, WHO  SHALL  HAVE  EXPERTISE  IN  FIELDS  OF  DISCIPLINE
RELATED  TO  HEALTH  CARE  OR OCCUPATIONAL SAFETY AND ONE SUCH APPOINTEE
SHALL BE FROM AN ORGANIZATION REPRESENTING EITHER A NURSE OR DIRECT CARE
WORKER; ONE MEMBER TO BE APPOINTED BY THE MINORITY LEADER OF THE SENATE,
WHO SHALL HAVE EXPERTISE IN FIELDS OF DISCIPLINE RELATED TO HEALTH  CARE
OR  OCCUPATIONAL SAFETY; AND ONE MEMBER APPOINTED BY THE MINORITY LEADER
OF THE ASSEMBLY, WHO  SHALL  HAVE  EXPERTISE  IN  FIELDS  OF  DISCIPLINE
RELATED TO HEALTH CARE OR OCCUPATIONAL SAFETY.
  2.  TASK  FORCE  MEMBERS  SHALL  RECEIVE  NO  COMPENSATION  FOR  THEIR
SERVICES, BUT SHALL BE REIMBURSED  FOR  ACTUAL  AND  NECESSARY  EXPENSES
INCURRED IN THE PERFORMANCE OF THEIR DUTIES.
  3.  THE  TASK  FORCE  SHALL BE APPOINTED NO LATER THAN JULY FIRST, TWO
THOUSAND FOURTEEN AND SHALL SERVE FOR A PERIOD OF TWO YEARS; ANY  VACAN-
CIES ON THE TASK FORCE SHALL BE FILLED IN THE MANNER PROVIDED FOR IN THE
INITIAL APPOINTMENT.
  4.  THE CHAIRPERSON OF THE TASK FORCE SHALL BE THE COMMISSIONER OR HIS
OR HER DESIGNEE.
  5. THE TASK FORCE SHALL MEET NO LESS THAN THREE TIMES A YEAR.
  6. NOTWITHSTANDING ANY OTHER PROVISION  OF  LAW,  A  MAJORITY  OF  THE
MEMBERS  OF  THE TASK FORCE THEN IN OFFICE SHALL CONSTITUTE A QUORUM FOR
THE TRANSACTION OF BUSINESS OR THE EXERCISE OF POWER OR FUNCTION OF  THE
TASK  FORCE.  AN  ACT,  DETERMINATION OR DECISION OF THE MAJORITY OF THE
MEMBERS OF THE TASK FORCE SHALL BE HELD TO BE THE ACT, DETERMINATION  OR
DECISION OF THE TASK FORCE.
  7. THE TASK FORCE SHALL:
  (A)  PREPARE A POLICY STATEMENT REQUIRING A COMPREHENSIVE SAFE PATIENT
HANDLING PROGRAM TO BE IMPLEMENTED AT ALL  HEALTH  CARE  FACILITIES,  AS
DEFINED IN SUBDIVISION ONE OF SECTION TWENTY-NINE HUNDRED NINETY-SEVEN-H
OF  THIS TITLE.  THE POLICY STATEMENT SHALL INCLUDE THE REQUIREMENTS FOR
DEVELOPING AND IMPLEMENTING AN EFFECTIVE SAFE PATIENT  HANDLING  PROGRAM
THAT  SHALL INCLUDE ALL ELEMENTS SPECIFIED IN SUBDIVISION SIX OF SECTION
TWENTY-NINE HUNDRED NINETY-SEVEN-H OF THIS TITLE;
  (B) REVIEW  EXISTING  SAFE  PATIENT  HANDLING  PROGRAMS  OR  POLICIES,
INCLUDING  DEMONSTRATION PROGRAMS PREVIOUSLY AUTHORIZED BY CHAPTER SEVEN
HUNDRED THIRTY-EIGHT OF THE LAWS OF TWO THOUSAND FIVE;
  (C) CONSULT WITH  ANY  ORGANIZATION,  EDUCATIONAL  INSTITUTION,  OTHER
GOVERNMENT ENTITY OR AGENCY OR PERSON;
  (D) CONDUCT PUBLIC HEARINGS, AS IT DEEMS NECESSARY;
  (E)  IDENTIFY OR DEVELOP TRAINING MATERIALS AND PROCEDURES WITH REGARD
TO THE EQUIPMENT OR TECHNOLOGY REQUIRED BY THE STATEWIDE POLICY;
  (F) REVIEW RULES AND REGULATIONS PRIOR TO ADOPTION BY THE DEPARTMENT;
  (G) REVIEW AND UPDATE THE POLICY STATEMENT ON A BI-ANNUAL BASIS; AND
  (H) SUBMIT A REPORT TO THE COMMISSIONER BY JULY  FIRST,  TWO  THOUSAND
FIFTEEN IDENTIFYING SAFE PATIENT HANDLING PROGRAM ELEMENTS AND RECOMMEN-
DATIONS OF SAFE PATIENT LIFTING EQUIPMENT, TECHNIQUES OR DEVICES.
  8. ALL STATE DEPARTMENTS, COMMISSIONS, AGENCIES AND PUBLIC AUTHORITIES
SHALL PROVIDE THE TASK FORCE WITH ANY REASONABLY REQUESTED ASSISTANCE OF
ADVICE IN A TIMELY MANNER.
  S 2997-J. STATEWIDE SAFE PATIENT HANDLING POLICY. 1. THE COMMISSIONER,
IN  CONSULTATION  WITH  THE TASK FORCE, SHALL PROMULGATE RULES AND REGU-

S. 2470--C                          4

LATIONS FOR A STATEWIDE SAFE PATIENT HANDLING  POLICY  FOR  HEALTH  CARE
FACILITIES COVERED BY THIS TITLE. SUCH POLICY SHALL BE MADE AVAILABLE TO
ALL  FACILITIES  COVERED  BY  THIS TITLE ON OR BEFORE JANUARY FIRST, TWO
THOUSAND SIXTEEN.
  2.  THE STATEWIDE SAFE PATIENT HANDLING POLICY SHALL INCLUDE STANDARDS
WITH REGARD TO:
  (A) THE EQUIPMENT, DEVICES OR TECHNOLOGY TO BE  USED  BY  A  NURSE  OR
DIRECT CARE WORKER WHO IS ENGAGED IN PATIENT HANDLING;
  (B)  THE  RATIO OF SUCH EQUIPMENT OR TECHNOLOGY BASED UPON THE TYPE OF
FACILITY, THE NUMBER OF BEDS IN A FACILITY, THE NUMBER  OF  PATIENT-HAN-
DLING  TASKS, TYPES OF CARE UNITS, PATIENT POPULATIONS, AND PATIENT CARE
AREAS;
  (C) THE MINIMUM NUMBER OF DEVICES  TO  ENSURE  THAT  CURRENT  ASSESSED
HAZARDS ARE ELIMINATED OR MITIGATED;
  (D)  ESTABLISHING  PROCEDURES  FOR  THE  SUBMISSION  AND  REPORTING OF
COMPLIANCE BY EACH HEALTH CARE FACILITY COVERED BY THIS TITLE; AND
  (E) ESTABLISHING PROCEDURES FOR COMPLAINTS  OR  VIOLATIONS,  INCLUDING
THE FILING PROCESS, REVIEW, AND EVALUATION AND CORRECTIVE ACTION OF SUCH
COMPLAINTS.
  3.  EACH  HEALTH  CARE FACILITY SHALL FILE WITH THE DEPARTMENT BY JULY
FIRST, TWO THOUSAND SIXTEEN A DETAILED PLAN TO COMPLY WITH THE RULES AND
REGULATIONS OF THE STATEWIDE SAFE PATIENT HANDLING POLICY.  THE  DEPART-
MENT SHALL ACCEPT SUCH PLAN BY JULY FIRST, TWO THOUSAND SEVENTEEN.
  S  2997-K.  HEALTH  CARE FACILITY SAFE PATIENT HANDLING COMMITTEES. 1.
EACH HEALTH CARE  FACILITY  SHALL  ESTABLISH  A  SAFE  PATIENT  HANDLING
COMMITTEE EITHER BY CREATING A NEW COMMITTEE OR ASSIGNING THE POWERS AND
DUTIES  TO  AN EXISTING COMMITTEE.   AT LEAST ONE-HALF OF THE MEMBERS OF
THE SAFE PATIENT HANDLING COMMITTEE SHALL  BE  FRONTLINE  NON-MANAGERIAL
NURSES OR DIRECT CARE WORKERS. AT LEAST ONE NON-MANAGERIAL NURSE AND ONE
NON-MANAGERIAL  DIRECT CARE WORKER SHALL BE ON THE SAFE PATIENT HANDLING
COMMITTEE. THE COMMITTEE SHALL HAVE TWO CO-CHAIRS WITH ONE FROM  MANAGE-
MENT AND ONE FRONTLINE NON-MANAGERIAL NURSE OR DIRECT CARE WORKER.
  2.  THE  SAFE  PATIENT  HANDLING COMMITTEE SHALL: (A) SET CRITERIA FOR
EVALUATION OF PATIENTS AND/OR RESIDENTS TO DETERMINE WHICH  LIFT  AND/OR
REPOSITIONING  EQUIPMENT,  DEVICES OR TECHNOLOGY ARE TO BE USED; AND FOR
PERFORMANCE OF RISK  ASSESSMENTS  OF  THE  ENVIRONMENT,  JOB  TASKS  AND
PATIENT NEEDS;
  (B)  ENSURE  LIFT  AND/OR  REPOSITIONING EQUIPMENT IS SET UP, USED AND
MAINTAINED ACCORDING TO MANUFACTURER'S INSTRUCTIONS;
  (C) PROVIDE INITIAL AND ON-GOING YEARLY TRAINING AND EDUCATION ON SAFE
PATIENT HANDLING FOR CURRENT EMPLOYEES AND NEW HIRES,  AND  ENSURE  THAT
RETRAINING FOR THOSE FOUND TO BE DEFICIENT IS PROVIDED AS NEEDED WITHOUT
IMPACT TO THE EMPLOYMENT STATUS OF THE RETRAINED EMPLOYEES;
  (D)  SET UP AND UTILIZE A PROCESS FOR INCIDENT INVESTIGATION AND POST-
INVESTIGATION REVIEW WHICH INCLUDES A PLAN OF CORRECTION AND IMPLEMENTA-
TION OF CONTROLS;
  (E) MAKE RECOMMENDATIONS FOR THE ACQUISITION OF  EQUIPMENT  OR  PROCE-
DURES BEYOND THE MINIMUM STATE RECOMMENDATIONS; AND
  (F) PERFORM, AT MINIMUM, AN ANNUAL PROGRAM ASSESSMENT AND EVALUATION.
  S  2997-L. ENFORCEMENT. 1. ANY NURSE OR DIRECT CARE WORKER OR EMPLOYEE
REPRESENTATIVE WHO BELIEVES THE HEALTH CARE FACILITY  HAS  NOT  MET  THE
STANDARDS  SET  FORTH IN THIS TITLE SHALL BRING THE MATTER TO THE ATTEN-
TION OF THE HEALTH CARE FACILITY IN THE FORM OF  A  WRITTEN  NOTICE  AND
SHALL  AFFORD  THE  HEALTH  CARE  FACILITY  A  REASONABLE OPPORTUNITY TO
CORRECT SUCH  DEFICIENCIES,  PROVIDED  THAT  SUCH  NOTICE  NEED  NOT  BE
PROVIDED  WHERE  THE  NURSE  OR DIRECT WORKER OR EMPLOYEE REPRESENTATIVE

S. 2470--C                          5

REASONABLY BELIEVES THAT THE FAILURE TO MEET STANDARDS PRESENTS AN IMMI-
NENT THREAT TO THE SAFETY OF A SPECIFIC NURSE OR DIRECT CARE WORKER,  OR
TO  THE  GENERAL  HEALTH  OF  A SPECIFIC PATIENT, AND REPORTING WILL NOT
RESULT IN CORRECTIVE ACTION.
  2.  IN THE EVENT THAT THE HEALTH CARE FACILITY RECEIVING NOTICE PURSU-
ANT TO SUBDIVISION ONE OF THIS SECTION DOES NOT TAKE  CORRECTIVE  ACTION
WITHIN  SIXTY  DAYS,  OR  IN  THE EVENT THAT NOTICE OF A FAILURE TO MEET
STANDARDS IS NOT REQUIRED PURSUANT TO SUBDIVISION ONE OF THIS SECTION, A
NURSE OR DIRECT CARE WORKER SHALL HAVE THE RIGHT TO REFUSE TO ENGAGE  IN
PATIENT HANDLING UNTIL THE HEALTH CARE FACILITY HAS ADEQUATELY ADDRESSED
THE  SPECIFIC  FAILURE  TO MEET STANDARDS.   UPON REFUSAL, SUCH NURSE OR
DIRECT CARE WORKER OR HIS OR HER REPRESENTATIVE SHALL FILE  A  COMPLAINT
TO  THE DEPARTMENT IN THE MANNER SET FORTH IN THE STATEWIDE SAFE PATIENT
HANDLING POLICY.
  3. NO EMPLOYER SHALL TAKE RETALIATORY  ACTION  AGAINST  ANY  NURSE  OR
DIRECT CARE WORKER FOR RAISING CONCERNS OR ISSUES REGARDING SAFE PATIENT
HANDLING, FILING A COMPLAINT OR REFUSING TO ENGAGE IN PATIENT HANDLING.
  4.  NURSES  AND DIRECT CARE WORKERS, AS DEFINED IN SECTION TWENTY-NINE
HUNDRED NINETY-SEVEN-H OF THIS TITLE SHALL BE CONSIDERED  EMPLOYEES  FOR
THE PURPOSES OF SECTION SEVEN HUNDRED FORTY-ONE OF THE LABOR LAW.
  5.  THE  DEPARTMENT AND THE DEPARTMENT OF LABOR SHALL PUBLISH AND MAKE
PUBLIC WHICH HEALTH CARE FACILITIES ARE IN COMPLIANCE WITH THE STATEWIDE
SAFE PATIENT HANDLING POLICY.
  S 3. The education law is amended by adding a new  section  6510-f  to
read as follows:
  S  6510-F.  STATE  SAFE PATIENT HANDLING POLICY.   1. THE REFUSAL OF A
LICENSED PRACTICAL NURSE OR A REGISTERED  NURSE  TO  ENGAGE  IN  PATIENT
HANDLING  SHALL  NOT  CONSTITUTE  PATIENT ABANDONMENT OR NEGLECT IF SUCH
NURSE HAS, IN A MANNER CONSISTENT  WITH  ARTICLE  TWENTY-NINE-D  OF  THE
PUBLIC  HEALTH LAW AND THE RULES AND REGULATIONS PROMULGATED PURSUANT TO
SUCH  ARTICLE,  REFUSED  A  PATIENT  HANDLING  ASSIGNMENT  AND  FILED  A
COMPLAINT WITH THE DEPARTMENT OF HEALTH.
  2.  THE  REFUSAL  OF  A  LICENSED  OR UNLICENSED HEALTH CARE WORKER TO
ENGAGE IN PATIENT HANDLING NOT CONSISTENT WITH THE  STATE  SAFE  PATIENT
HANDLING  POLICY  OR A FACILITY'S SAFE PATIENT HANDLING POLICY SHALL NOT
BE CONSIDERED PROFESSIONAL MISCONDUCT. THE  REFUSAL  OF  A  LICENSED  OR
UNLICENSED  HEALTH  CARE  WORKER TO ENGAGE IN PATIENT HANDLING SHALL NOT
CONSTITUTE PATIENT ABANDONMENT OR NEGLECT  IF  SUCH  WORKER  HAS,  IN  A
MANNER  CONSISTENT  WITH  ARTICLE TWENTY-NINE-D OF THE PUBLIC HEALTH LAW
AND THE RULES AND REGULATIONS  PROMULGATED  PURSUANT  TO  SUCH  ARTICLE,
REFUSED  A  PATIENT  HANDLING  ASSIGNMENT AND FILED A COMPLAINT WITH THE
DEPARTMENT OF HEALTH.
  S 4. This act shall take effect on the one hundred twentieth day after
it shall have become a law.