U.S. Department of Labor - Employment of Youth in the
Health Care Industry
PDF Version of DQA 10-029
(PDF, 55 KB)
U.S. Department of Labor - Employment of Youth in the
Health Care Industry
The purpose of this memo is to share a recent U.S. Department of Labor
interpretation of The Fair Labor Standards Act (FLSA) which impacts youth
under the age of 18 working in the health care industry. The Division of
Quality Assurance (DQA) does not have regulatory authority to enforce these
child labor standards but wants to ensure that healthcare settings regulated
by DQA are aware of them.
This memo contains important information and guidance on the following
topics:
- U.S. Department of Labor Interpretation,
- Impact on Nurse Aide Training Programs,
- Follow-up.
U.S. Department of Labor Interpretation
On July 19, 2010, the U.S. Department of Labor, Wage and Hour Division (DOL
WHD) issued a restriction on the use of hoists and hoisting apparatus.
Hazardous Order No. 7 prohibits minors under the age of 18 from operating or
assisting in the operation of most power-driven hoists, including those
designed to lift and move patients.
Per U.S. DOL directive, employees under the age of 18 are prohibited from
operating or assisting with the operation of patient lifts, even with the
supervision of an employee who is 18 or older. See the attached U.S. DOL
"Fact Sheet #52 - The Employment of Youth in the Health Care
Industry" for more information.
Impact on Nurse Aide Training Programs
DQA has confirmed with the U.S. DOL that this restriction applies only to
employees; in order for the FLSA to apply, there must be an employment
relationship. Therefore, the restriction on the use of patient lifts does
not apply to students enrolled in a nurse aide training program (unless the
students are employed during training as nurse aides by the facility
providing the training).
Nurse aide training programs are required to train students to transfer
clients safely and according to the principles of patient care ergonomics
and with proficiency in the use of available equipment that is used to
transfer clients. Equipment used to transfer clients includes, but is not
limited to, mechanical lifts, friction reducing devices, wheelchairs and
gait belts.
Per DQA directive, nurse aide training programs must continue to train
all students, regardless of age, on the use of mechanical lifts. It is
important to note that a clinical site may refuse to allow a student under
the age of 18 in a nurse aide training program to transfer a resident using
a lift since employees under 18 are prohibited from doing so. But, the
clinical site should allow a student to practice the skill on another
student or instructor using the facility equipment.
Follow-Up
Secretary Roberta Gassman of the Wisconsin Department of Workforce
Development (DWD) sent a letter to the U.S. DOL regarding the restriction to
explain how it impacts the youth apprenticeship program and conflicts with
the Safe Lift Initiative. The American Association of Homes and Services for
the Aging (AAHSA) and the American Health Care Association (AHCA) met with
DOL to discuss the prohibition. AAHSA and AHCA provided data to show that
there is no evidence of mechanical lifts causing injuries to young workers,
and emphasized the negative effect that the rule has had on facility hiring
practices, as well as career ladder and youth apprenticeship programs
nationwide.
DOL has asked AAHSA and AHCA for additional data on safety practices in
long term care settings, adequacy of CNA training, and regulatory oversight
of quality of care. If you have feedback that you would like to share with
DOL on this issue, please send it to Jennifer Hilliard at jhilliard@aahsa.org.
Attachment:
U.S. DOL
Fact Sheet #52 - The Employment of Youth in the Health Care Industry
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Last Updated: September 30, 2011
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