Partnership #856 - Agreement - October 31, 2014

United States Department of Labor
Occupational Safety & Health

Occupational Safety and Health Administration


Partnership Agreement

ACW Alliance. Integrated Healthcare Construction


BJC Healthcare & Washington
University School of Medicine –
Kingshighway Campus Renewal Project



      BJC HealthCare is undergoing a significant Kingshighway Campus Renewal Project. BJC HealthCare is one of the largest nonprofit health care organizations in the United States, and is focused on delivering services to residents primarily in the greater St. Louis, southern Illinois and mid-Missouri regions. BJC HealthCare serves the health care needs of urban, suburban and rural communities and includes 12 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

      The St. Louis Area Office of the Occupational Safety and Health Administration (OSHA); Alberci, Clayco and S. M. Wilson (ACW); project subcontractors; and labor organizations recognize the need for a safe and healthy jobsite. The goal of this Partnership agreement is to help ensure that an injury free safety culture is established creating a safe environment for all workers, patients, staff, and visitors of the hospital.

      In addition, the Partners are deeply committed to BJC HealthCare's mission of patient care and will implement Interim Life Safety Measures and Infection Control Procedures to protect patients, staff and visitors to the hospital.

      This Partnership is designed to not only address the hazards within the construction industry, but also to promote and recognize jobsites that demonstrate an effective safety and health program.

      This document will serve to establish a cooperative effort in ensuring safety and maintaining an open line of communication between OSHA, ACW, project subcontractors and labor organizations on this project.

      Specifications and assignments within this Partnership document do not relieve the contractors from or lessen their safety & health responsibilities nor change any contractual obligations between ACW, BJC HealthCare, or any of the project subcontractors. Nor does it lessen any/all affirmative defenses, legal rights or due process afforded contractors with respect to Agency enforcement action.

    2. Project Description

      This project will encompass the construction of two (2) twelve story towers expanding the Barnes Jewish Hospital – north campus and the St. Louis Children's Hospital. Construction for phase 1 will be approximately 757,000 square feet.

    3. Identification of Partnership Organizations

      • Alberici, Clayco, S.M. Wilson (ACW)
      • Project Subcontractors
      • OSHA – St Louis Area Office

      All subcontractors that work on this project are considered Partners

      Pledge Support for the partnership

      • BJC HealthCare
      • Washington University School of Medicine (WUSM)
      • Associated General Contractors – St Louis Chapter
      • Carpenters District Council of Greater St. Louis

    The goal of this Partnership agreement is to help ensure the BJC - Kingshighway Campus Renewal Project will be a safe and healthy work environment for all workers, patients, staff and visitors of the hospital campus.

    OSHA has identified the top four causes of fatalities in construction as: falls, being struck by equipment or machinery, electrocution, and caught-in-between equipment or materials. ACW has added an additional focus hazard of overexertion and ergonomic hazards that will be identified, corrected and tracked throughout the project in result of preventing injuries – "Focus 5".


    The overall goal for this Partnership Agreement is to create an injury free safety culture, promote effective safety management systems, train and educate, job hazard recognition, hazard controls, self-inspection practices, abatement efforts, accountability measures and cooperative attitudes among all partners resulting in the reduction/elimination of injuries, illnesses, and incidents on the project.

    This table is best viewed on tablets, notebooks, or desktop computer screens.

    Goals Strategies Performance Measures
    Minimize accidents, injuries and illnesses on the project; zero fatalities; Project injury/illness data below the current Bureau of Labor Statistics (BLS) National Average for NAICS 23 (all of construction) Implementation of comprehensive safety and health management system for the site Proactive safety metrics – Behavior based safety observations, audits, near miss reporting, and education/training; The Project’s injury and illness data-Total Case Incident Rate (TCIR); Days Away, Restricted or Transferred (DART) Rate; Days Away From Work (DAFW) Rate will be compared with the most current BLS published data for NAICS 23 for each year. The 2012 BLS TCI, DART, and DAFW Rates for NAICS 23 are 3.7, 2.0 and 1.4, respectively, will be utilized as the baseline for the Partnership. The Project’s injury and illness data will be also compared to the baseline
    Developing a contractor/government partnership that will encourage involvement of the owner, construction manager and subcontractors in the improvement of safety and health performance Require the contractor and all subcontractors to develop and implement written safety and health management systems (including a fall protection plan) Review of site specific safety plans Preconstruction meetings with heavy emphasis on safety Verify by reviewing the number of subcontractors that implemented and/or improved written safety and health management systems
    Implementing innovative strategies to eliminate serious accidents, including the four primary construction hazards (falls, struck-by, caught in, and electrical), and ergonomic hazards
    1. Provide all employees site specific safety orientation;
    2. Conduct 10-hour OSHA training courses
    3. Implement and enforce an ongoing site safety audit program (to include weekly site walk through).
    4. Perform daily pre-task safety planning by all crews on the job site
    5. Create applicable safety awareness initiatives to help maintain focus on key areas
    6. Perform incident investigation and root cause analysis for any OSHA recordable and near miss incidents
    Document the number of employees trained and the training hours received (including orientation and 10 & 30-hour courses); document the number of hazards identified and abated during the safety audits, including ergonomic hazards; track all injuries and illnesses
    Provide for worker/union representation involvement Provide worker/union representation involvement in weekly site safety meetings; site safety walkarounds Document the number of workers/union representatives involved in weekly site safety meetings; and site safety walkarounds
    1. The overall success of the Partnership will be measured as follows:

      1. The annual and total project aggregate TCIR, DART and DAFW Rates will be compared to the most currently published Bureau of Labor (BLS) National Average rates for construction (NAICS 23), with zero fatalities. The BLS 2012 rates for NAICS 23 are 3.7, 2.0 and 1.4, respectively for TCIR, DART and DAFW will serve as the baseline for the Partnership.
      2. Project Injury/Illness data will be evaluated for trends in injuries and near misses, from year to year. Partners will seek to establish a Zero incident rate on the Project whereby it is understood that nearly all accidents are linked to human decision making and therefore preventable when the proper considerations, assessments, controls and decisions are made. Such attitudes and efforts will achieve accident and injury rates well below the latest published BLS national average (2012) for the construction industry, NAICS 23.
      3. Comparison of anticipated injury costs based on Missouri Division Workers' Compensation estimates for this type of construction versus actual injury costs following completion of the project.
      4. Documented jobsite inspections and observations, with an emphasis on hazard identification and remediation, and tracking the total number of hazards identified and corrected.
      5. Records of training certifications/training rosters will be maintained. Report the total number of people trained. These may include, but not be limited to, OSHA 10 and 30 hour courses as well as the site orientation and on-site training.
      6. Evaluate the effectiveness of the 100% Fall Protection Plan, through the number of plans implemented and/or improved. Additional measurements of effectiveness may include injury/illness records and near misses for falls.
      7. Safety and Health Programs will be maintained on file by ACW. Reports to be made available quarterly, concerning the general effectiveness of the safety and health programs. Copies will be made available to all members of the Partnership for review.

    The Partnership will be evaluated quarterly, and will include data used to monitor the success of the Partnership efforts. On a quarterly basis the Executive Committee comprised of ACW Project Director and Safety Manager, appointed Safety Representatives from our Partnership members, BJC, WUSM staff, a Representative from Labor, and a Representative from OSHA shall meet and discuss the program and make any modifications as required to continually improve the partnership. When an OSHA representative attends these meetings, the meeting will serve as an on-site non-enforcement verification visit by OSHA. A written evaluation will be completed annually and submitted to the Regional OSHA Office.


    Participant benefits from OSHA may include:

    1. In the event that a company performing work at the site is cited by OSHA, a maximum penalty reduction for good faith will be provided, in accordance with CPL 02-00-150, Field Operations Manual (FOM), dated April 22, 2011. In the event that the FOM is revised, OSHA shall provide such revised FOM provision to ACW and the most current FOM will be utilized.
    2. Priority will be given to "phone and fax" investigations of all informal complaints in lieu of on-site inspections.
    3. Any non-serious violation observed during an OSHA inspection visit shall not be cited if it is immediately abated during the inspection.
    4. This Partnership requires frequent inspections of the worksite by ACW, subcontractors and other members of the Partnership to identify and correct hazards. It also serves as a model to subcontractors and others by demonstrating how to implement a strong safety and health program on a large multi-employer jobsite. It also encourages a higher level of participation in the safety process by involving everyone on the jobsite. The knowledge gained from this Partnership will be applied to reduce injuries and illnesses at future work sites.

    1. OSHA will continue to investigate fatalities and catastrophes should they occur at the jobsite as well as alleged "imminent" danger situations per the FOM. Note: In the event that the FOM is revised, the most current FOM will be utilized.
    2. OSHA will continue to investigate all complaints and referrals received in accordance with procedures contained in the FOM. Note: In the event that the FOM is revised, the most current FOM will be utilized.
    3. OSHA will complete at least one focused "monitoring" (on-site enforcement verification visit) inspection each year during the term of the Partnership. These inspections will follow the most current FOM and the "Focused Inspection" protocol {Memorandum from James W. Stanley, "Guidance to Compliance Officers for Focused Inspections in the Construction Industry", dated August 22, 1994 (Revision 2 issued September 20, 1995 and incorporated herein)} addressing hazards related to falls, struck by, caught-in, and electrical hazards. Inspections conducted in response to complaints, Local and/or National Emphasis Programs (LEP/NEP), or referrals will qualify as the monitoring inspection if, in addition to addressing the complaint/LEP/NEP/referral item(s), the compliance officer completes the focused inspection protocol for the worksite.
    4. On-site non-enforcement verification visits will be performed by OSHA representatives, by their participation in the quarterly Executive Safety Committee meetings (as outlined in Section IV of the Partnership).
    5. ACW will permit OSHA immediate access for any inspection to be made pursuant to Section VI paragraphs A, B, and C and will not require an inspection warrant for any such inspection.

    Each Prime Contractor and their respective subcontractors with 30 or more employees will have a full-time safety person and will designate an employee to attend on-site safety review committee meetings. The Safety Manager for ACW will oversee the committee and convene a general meeting quarterly to evaluate the progress of the Partnership. The committee will review the completed and summarized inspections, observations reported, near misses, injury and illness data of the site as part of the quarterly meeting. Identified hazards, abatement and best management practices will also be discussed. OSHA may provide a representative to share current issues in construction risk control and provide input for improvement.

    1. ACW:

      ACW is being assigned the lead role in the administering of the project specific safety program for the BJC-Kingshighway Campus Renewal Project. ACW will ensure implementation of the following:

      1. Implement a comprehensive safety and health program, which includes:
        1. Management commitment and employee involvement
        2. Worksite analysis
        3. Hazard control
        4. Arrange for training assistance for subcontractors and their sub-tier contractors on-site.
        5. Require subcontractor(s) to implement an appropriate Disciplinary Program for safety rule violations.
      2. All Prime Contractors and subcontractors shall have an effective safety program in place and a copy of their company's written safety and health program and site specific safety plan submitted and approved by ACW before the start of any on-site work. Subcontractors that do not have their own written safety and health programs have the option of adopting the safety and health program of ACW, develop one by utilizing services provided by other Partnership Members, or secure the services of an outside consulting firm. ACW may refer subcontractors who have not developed their own safety and health program to a qualified resource for assistance. These programs in addition to the Site Specific Safety Plan established for the BJC – Kingshighway Campus Renewal Project will establish policy guidelines and behavioral expectations for the project.
      3. Have the authority to enforce safety rules and regulations. This authority will include provisions to hold contractors and employees accountable and, if necessary, take appropriate action to enforce compliance with the established Project safety rules and regulations.
      4. Work scope planning will take into consideration any exposures that the construction activity may create for the hospital patients, visitors and staff. Infection control and life safety planning will be considered with all scopes of work. This will include efforts to control and reduce airborne silica, dust and mold. Infection Control Risk Assessments will be conducted and logged when applicable.
      5. Where airborne silica exposure exists, ACW will require the use of wet cutting techniques and/or dust collection systems in addition to the appropriate use of approved respiratory protection where warranted.
      6. Require the use of conventional fall protection (i.e. personal fall arrest / restraint systems, safety net systems or guardrail systems) when performing work that is in excess of 6' above a lower level. This includes steel erection, roofing (other than roofing work within a properly erected six foot perimeter warning line system), and other leading edge construction operations even when it may exceed OSHA requirements.
      7. Guardrails or fall protection must be employed on all scaffolding over six feet.
      8. Evaluate the effectiveness of the Fall Protection Plan, and take corrective action as needed.
      9. Ground Fault Circuit Interrupters (GFCI) will be used throughout the project.
      10. Back up alarms shall be present on all heavy duty motorized construction vehicles.
      11. OSHA-required trench and excavation protection shall be enforced.
      12. All workers, management and visitors shall wear hardhats, safety glasses, gloves, steel-toed boots and high visibility vests or clothing at all times while on site. (Exception shall be inside the isolated on-site management offices or designated break areas.)
      13. Cranes: All crane operators working on the site, whether by subcontract, or provided as part of a lease or rental agreement, shall be trained in crane safety. Appropriate training shall be verified by ACW before crane operation is permitted on the worksite.
      14. 100% tagline policy will be enforced with the lifting of all crane loads.
      15. A proactive integrated project safety inspection protocol will be implemented to increase reporting of hazards and near-miss incidents. Multiple weekly site safety inspections will be documented by project management, site supervision, and project safety management.
      16. Compile and maintain injury and illness data and make the data compilations available to all Partners, including OSHA. In addition, subcontractor's Experience Modification Rates (EMR) will be made available to OSHA upon request.
      17. Review quarterly accident reports with the Safety Committee including first aid and near miss reports.
      18. As a goal, the elimination of work related injuries from inadequate planning and execution by ensuring key job hazards are identified and controlled. Conduct and retain summary documentation of weekly toolbox talks and Jobsite Safety Analysis (JHA.)
      19. Housekeeping initiatives will be introduced to maintain orderly storage of materials and removal of workplace trash and debris:
        1. Eating, drinking and consumption of food products will only be allowed within designated controlled areas of the project site.
        2. All trash and waste shall be removed and placed in appropriate provided receptacles.
        3. Adequate number of trash containers will be provided and maintained throughout the floors and areas of construction.
        4. Project has adopted a continuous clean-up strategy whereby contractors are to remove construction debris closely following work activity. Nails and screws are to be bent over or retracted following form stripping operations.
        5. Access to work areas, ladders, stairs, buck hoist, and storage areas are to remain free and clear of obstructions.
        6. Methods to control dust will be employed whenever possible (e.g. Wet/dry vacuums, misting, damp wiping, covering / tarping of materials, dust reducing sweeping compounds, etc…)
        7. Spills and loose materials that pose potential slip hazards are to be cleaned up immediately.
        8. Tools and materials are to be brought and stored only when they are needed and removed from site when no longer required.
        9. Loose materials are to be contained, stacked, racked and otherwise kept in an orderly condition.
        10. Flammable storage cabinets are to be provided by contractors for all aerosols, and flammable liquids maintained within the building structure (Most job/tool boxes are not approved for this use).
      20. Employee training and safety meetings:
        1. All contractor employees will receive a site-specific safety orientation from ACW covering jobsite safety and health issues and procedures relative to the work being performed. A copy of the Project Safety and Health Work Rules will be provided and signature pages maintained on file.
        2. Daily pre-task hazard prevention planning will be conducted by all crews. This planning, hazard recognition, and determination of controls will be documented daily on Pre-Task Safety Analysis (PTSA) forms. PTSA's will be available in the field for review and periodically audited by the ACW management and project safety staff. PTSA records will be filed and maintained in the project trailer.
        3. Daily "Stretch and Flex" sessions will be conducted at the start of each day.
        4. Weekly safety meetings will be held by ACW and each contractor and a copy maintained in the ACW project office.
        5. Periodic job-wide safety meetings will be held and various guest speakers including OSHA, AGC, BJC/WU Staff, Manufacturer Reps, Vendors, and Contractor Supervision and Safety Personnel will be invited to participate. When an OSHA representative attends these meetings, the meeting will serve as an on-site non-enforcement verification visit by OSHA.
        6. Superintendents, foreman and site personnel designated as safety representatives shall, at a minimum, have completed the OSHA 30 hour construction outreach training course (or its equivalent). Field supervisory personnel and those acting in the capacity as a competent person shall have completed the OSHA 10 hour construction outreach training course for the construction industry (or its equivalent). Training is to be completed prior to commencement of work on-site. Records of training will be maintained by the ACW site safety manager and available for review by OSHA upon request.
        7. To help keep safety awareness at peak levels, safety commitment banners, warning signs, safety reminder signs such as "Wear Your Gloves" will be strategically placed around the job site.
        8. Site Specific Infection Control Training for employees engaged in work within the active hospital premises.
        9. Additional craft specific hazard recognition education sessions will be conducted on an as-needed basis by the respective contractors through weekly tool box talks.
      21. Provide signage identifying the site as an OSHA Partnership Project as well as signage indicating Lost Time Incidents.
      22. In addition to OSHA's notification requirements, ACW will notify the local OSHA office of safety or health related events, which are likely to generate public attention and/or news media coverage. This notification will be provided in a timely manner and will include sufficient background and incident information for responding to agency and public inquiries.
      23. Another goal of the Partnership is to create a working relationship between the OSHA St. Louis Area Office and the other Partnership members. OSHA's technical resources capability may facilitate greater understanding of issues and enhance effective prevention and control efforts.
      24. Establish a Project Safety Committee with participation from project management, safety personnel and labor to review safety goals and objectives, audit safety performance of contractors, address the effectiveness of the project safety program, and make recommendations to improve on identified weakness in the safety management system.
      25. The project will provide the forum for a Safety Mentoring Program initiative by ACW, to assist Minority and disadvantaged businesses in the development and implementation of quality safety programs and the promotion of a positive Safety Culture within their organization.
    2. Subcontractors:

      1. Appoint an on-site person to act as a labor representative to resolve jobsite safety matters and be the liaison to the ACW Safety Manager.
      2. Conduct and document job site safety inspections weekly for those employees under their control. This is in addition to the general, non-documented inspections that should occur daily.
      3. Conduct and document jobsite safety meetings and make them available to ACW and OSHA upon request.
      4. Participate with ACW during the weekly on-site safety inspections and if non-compliant activity or hazards are discovered, the affected contractor shall promptly abate the conditions. The subcontractor shall provide written documentation to ACW within 24 hours that the unsafe condition has been corrected.
      5. Will receive a copy of all reports of job site inspections for their respective areas.
    3. OSHA:

      1. OSHA may participate in the quarterly Safety Committee meetings, but will not participate in the weekly walk-around inspections. OSHA's participation in these quarterly meetings will serve as an on-site non-enforcement verification visit.
      2. Compliance Assistant Personnel from the OSHA St. Louis Area Office may aid with on-site and off-site safety and health training.
      3. Give priority to the Site when technical assistance is needed.
      4. Audit the quarterly reports and make recommendations for improvement in meeting the Partnership Goals.
      5. Review Partnership company safety and health programs, along with subcontractors as necessary, and provide technical assistance and recommendations for improvement.
      6. Provide national statistics covering all areas of standards enforcement for distribution to the Partners.
  8. Employee and Employer Rights and Responsibilities

    This partnership does not preclude employees and/or employers from exercising any right provided under the OSH Act (or, for federal employees, 29 CFR 1960), nor does it abrogate any responsibility to comply with the Act.

  9. Term of OSP

    This agreement shall be in effect until completion of the Site and Building construction activities, but not to extend past completion of Phase One or January 1, 2018.

    Should any of the principal participants (OSHA, ACW or prime subcontractors) elect to withdraw from the Partnership, notification in writing shall be given to the other Parties. A thirty (30) day notice is required prior to termination and gives the parties an opportunity to resolve any issues to avoid termination. Withdrawal by any of the prime contractors shall constitute a cancellation of the Partnership. In the event of a termination, all parties agree not to contact the media and discuss the issues surrounding the termination.

United States Department of Labor
Occupational Safety & Health

Based upon a mutual interest to protect construction workers in the Bi-State area, the Parties below agree to the above terms of the ACW, OSHA Partnering Agreement for the BJC – Kingshighway Campus Renewal Project.

Signed this 7th day of October, 2014


Principal Participants

  • William McDonald
  • Area Director
  • Occupational Safety & Health Administration
  • St. Louis Area Office

  • William Wagner
  • ACW Program Director

  • Dean Foth
  • ACW Project Director

  • Todd Friis
  • ACW Risk Management Director


The following Pledge both support and cooperation to the partnership:


  • (Authorized Representative)
  • BJC Corporate

  • (Authorized Representative)
  • WUSM Corporate

  • (Authorized Representative)
  • BJH

  • (Authorized Representative)
  • St. Louis Children's

  • (Authorized Representative)
  • PMO / Jacobs Engineering

  • (Authorized Representative)
  • PMO / Jacobs Engineering

  • Vic Sunshine
  • Associated General Contractors, STL Chapter

  • (Authorized Representative)
  • STL Carpenters' District Council
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