SB3108sam001 93RD GENERAL ASSEMBLY

Sen. Don Harmon

Filed: 3/4/2004

09300SB3108sam001 LRB093 21196 AMC 48453 a

AMENDMENT TO SENATE BILL 3108

AMENDMENT NO. ____. Amend Senate Bill 3108 by replacing the title with the following:

"AN ACT concerning health care."; and

by replacing everything after the enacting clause with the following:

"Section 1. Short title. This Act may be cited as the Nursing and Hospital Worker Protection Act.

Section 5. Findings. The Legislature finds and declares all of the following:

(1) Health care services are becoming complex and it is increasingly difficult for patients to access integrated services.

(2) Quality of patient care could be impacted by staffing changes implemented in response to managed care.

(3) To ensure the adequate protection of patients in acute care settings, it is essential that qualified registered nurses be accessible and available to meet the needs of patients.

(4) The basic principles of staffing in the acute care setting should be based on the patient's care needs, the severity of condition, services needed, and the complexity surrounding those services, as well as the experience level, clinical competencies, and education of the licensed nurses providing patient care services.

Section 10. Definitions. As used in this Act:

"Critical care unit" means a unit that is established to safeguard and protect patients whose medical conditions are severe enough to require continuous monitoring and complex intervention by registered nurses.

"Employee" means any individual permitted to work by an employer in an occupation, including both individuals hired directly by the company and those hired pursuant to a contract with an outside entity, such as a staffing agency.

"Employer" means any person or entity licensed under the Hospital Licensing Act, or the parent or holding company of such person or entity, who directly or indirectly, or through an agent or any other person, employs or exercises control over the wages, hours, or working conditions of any person.

"Health system" means a company (i) that is non-profit or for-profit, religious or non-religious and (ii) that owns, operates, or controls more than 2 hospitals.

"Hospital" means an entity licensed under the Hospital Licensing Act.

"Hospital unit" means a critical care unit, burn unit, labor and delivery room, postanesthesia service area, emergency department, operating room, pediatric unit, step-down or intermediate care unit, specialty care unit, telemetry unit, general medical care unit, subacute care unit, and transitional inpatient care unit.

"Nurse" or "registered nurse" means a person licensed as a registered professional nurse or licensed practical nurse under the Nursing and Advanced Practice Nursing Act.

"Organizational plan of nursing services" means a written plan of direct care nursing personnel staffing requirements that are appropriate to ensure all patients receive health care under normal and emergent circumstances.

"Violation" means a finding by a court, governmental commission, or neutral arbiter that wage and hour laws or regulations were violated.

"Wage and hour laws or regulations" means any State or federal law that regulates the hours and wages paid or worked by registered nurses.

Section 15. Registered nurse staff planning. Each hospital shall develop and implement an organizational plan of nursing services. It shall be an integral part of the overall hospital organizational plan and shall be available to all nursing personnel. Each hospital shall have a process that ensures the consideration of input from direct care clinical staff in the development, implementation, monitoring, evaluation and modification of the plan of nursing services. At least one-third of the members of the committee charged with developing, monitoring, evaluating, and modifying the plan shall be nurses who provide direct patient care. The organizational plan shall include:

(1) Competency validation for registered nurses based on the statutorily recognized duties and responsibilities of the registered nurse and the standards that are specific to each patient care unit.

(2) A patient classification system that establishes staffing requirements by unit, patient, and shift; determines staff resource allocation based on nursing care requirements for each shift and each unit; establishes a method by which the hospital validates the reliability of the patient classification system; and incorporates a method by which the hospital improves patient outcomes based on clinical data.

(3) Written nursing service policies and procedures based on current standards of nursing practice and consistent with the nursing process, which includes: assessment, nursing diagnosis, planning, intervention, evaluation, and patient advocacy. The hospital administration and the governing body shall review and approve all policies and procedures that relate to nursing service at least once every 3 years.

The organizational plan may include a schedule for meal periods and rest periods different from those required by Section 20 of this Act, provided that such schedule has been approved by (and cannot be altered, suspended, or terminated without the consent of) the committee charged with developing, monitoring, evaluating, and modifying the organizational plan. The Department of Public Health may establish by rule additional criteria for organizational plans.

Section 20. Rest periods. Every hospital shall permit each employee to take a 30-minute meal period and 2 10-minute rest periods during the first 7 1/2 hours of work, and an additional 15 minutes of meal or break period time for each additional 2 hours worked beyond the first 7 1/2 hours of work. If circumstances require an employee to work during or through a meal period or break period for which the employee would have received no compensation, then the employer shall pay the employee for the time worked without compensation at one and one-half times the employee's regular rate of compensation. This Section 20 does not apply to employees for whom meal and break periods are established through a collective bargaining plan or pursuant to an organizational plan schedule prepared in accordance with Section 15 of this Act. This Section does not apply to employees who monitor patients with developmental disabilities or mental illness, or both, and who, in the course of those duties, are required to be on-call during the entire work period; provided, however, that such employees shall be permitted to eat a meal or meals during the work period while continuing to monitor those patients.

Section 25. Violation of Act. The Director of Public Health, after notice and opportunity for hearing, may deny, suspend, revoke, or place conditional provisions upon a license of a hospital in any case in which the Director finds that there has been a substantial failure to comply with the provisions of this Act.

Section 30. Wage and hour provisions for registered nurses.

(a) Any employer that is a health system as defined in this Act and commits more than 500 violations of wage and hour laws or regulations for registered nurses within a 3-year period shall be fined up to 5% of gross hospital patient revenues.

(b) The fine moneys shall be allocated to the Department of Public Health for nursing scholarships awarded pursuant to the Nursing Education Scholarship Law in addition to any other funds set aside and appropriated for that purpose.

(c) The Attorney General shall determine if 500 violations were committed and set the penalty based on the severity of the violations.

Section 99. Effective date. This Act takes effect upon becoming law.".