On DOL’s Ill-Advised Proposal to Repeal Child Labor Protections in Nursing Homes and Hospitals

Following is a statement by Deborah Berkowitz, program director for worker safety and health with the National Employment Law Project (NELP), in response to a new U.S. Labor Department proposal to repeal child labor protections for workers in nursing homes and hospitals:

“By issuing a proposed rule that would allow 16- and 17-year-old nursing-home workers to operate power-driven patient lifting devices without any adult supervision or assistance, the Department of Labor is deliberately ignoring the clear expert and scientific evidence about the danger of young workers using these devices unattended.  Although NELP supports the goal of providing more job-training and apprenticeship opportunities for young workers who wish to enter the health care field, we cannot do so at the expense of those very workers’ health and safety and the health and safety of nursing home residents.  This proposed rule presents far more danger than benefits to young workers and, as such, NELP must oppose its implementation.

“In 2011, the National Institute for Occupational Safety and Health (NIOSH) studied precisely whether it was safe for 16- and 17-year-olds to use patient lifts by themselves, and it came to the following conclusion:

Based on a review of the relevant scientific literature regarding evaluations of patient handling devices and biomechanical analyses, NIOSH has determined that many 16- and 17-year-old employees cannot safely operate power-driven hoists to lift and transfer patients by themselves . . . Independent use of power-driven hoists by 16- and 17-year-olds would put them at increased risk for serious musculoskeletal injuries.  Moreover, the scientific literature indicates that most 16- and 17-year-old workers do not have the ability to properly assess the risks associated with using power-driven lifts.

“As a result, NIOSH recommended, and the Labor Department adopted, a common-sense enforcement policy mandating that if a 16- or 17-year-old caregiver is going to use a mechanical lift, he or she must be assisted by an experienced caregiver who is at least 18 years of age.

“But today, without providing any countervailing evidence to refute the expert recommendations of NIOSH, the Labor Department is proposing to rescind this enforcement policy, under the guise of its commitment to expanding apprenticeships for young workers.  Unfortunately, the logic fails on its face.  The risk of harm to these workers is too great to abandon the simple requirement that they have adult assistance when operating machinery that could put them at risk for injuries that could affect them for the rest of their lives.

“This proposed rule is also dangerous for patients.  On Friday, September 24, 2018, a group of resident advocates met with officials from the Office of Management and Budget to oppose this rule.  In particular, they delivered a statement from nursing home advocates that said, “Revoking the 2011 DOL Field Memo that prohibits 16- and 17-year-old nursing home assistants from operating patient lifts by themselves would recklessly ignore research and experience and turn over one of the most complicated and hazardous jobs in nursing homes to the least experienced workers. The most vulnerable and dependent patients in the health care system would be at increased risk of injuries that can cause pain, broken bones, medical complications, increased disablement, hospitalization, and frequently, death.” (Janet Wells, California Advocates for Nursing Home Reform; Toby Edelman, Center for Medicare Advocacy; Richard Mollot, Long Term Care Community Coalition; Lori Smetanka, National Consumer Voice for Quality Long-Term Care; and Penelope Ann Shaw, Nursing Home Resident.)

NELP urges the Department of Labor to reconsider this ill-advised proposed regulation and to pull it from circulation.


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