103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB3709

 

Introduced 2/9/2024, by Sen. Lakesia Collins

 

SYNOPSIS AS INTRODUCED:
 
New Act

    Creates the Hospital Staffing Plans Act. Provides that for each hospital there shall be established a hospital professional and technical staffing committee. Sets forth requirements and makeup of committee members and cochairs. Directs the professional and technical staffing committee to develop a written hospital-wide professional and technical staffing plan. Sets forth committee rules of operation. Requires the plan to be consistent with the approved nurse staffing plan for the hospital and takes into account the hospital service staffing plan for the hospital. Provides that if the committee does not adopt a staffing plan, or adopts only part of a plan, then either cochair may invoke an additional 60 day period to continue to develop the plan. Sets forth opportunities to extend the discussion, amendment, or adoption timeframe of the staffing plan. Provides that the committee must meet 3 times per year and additionally at the call of either cochair. Sets forth open meeting and record-keeping requirements. Requires the hospital to submit the staffing plan to the Department of Public Health. Provides for a hospital service staffing plan in the same manner and methods as the professional and technical staffing committee. Provides that hospitals may combine 2 or more staffing committees into one committee in particular circumstances. Provides for a nurse staffing committee as the same manner and methods of the professional and technical staffing committee. Provides that hospitals may combine 2 or more staffing committees into one committee in particular circumstances. Sets forth the roles and responsibilities of a nurse in a hospital setting. Sets forth arbitration and complaint resolution. Sets forth required periodic reviews. Provides for penalties for violations of the Act. Provides that the Department of Labor may grant a variance to a written hospital-wide staffing plan. Provides for emergency staffing variances. Establishes the Nurse Staffing Advisory Board within the Department of Public Health. Effective immediately.


LRB103 39484 CES 69680 b

 

 

A BILL FOR

 

SB3709LRB103 39484 CES 69680 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the
5Hospital Staffing Plans Act.
 
6    Section 5. Definitions. As used in this Act:
7    "Charge nurse" means a direct-care registered nurse who
8coordinates patient care responsibilities among nurses in a
9hospital unit.
10    "Clinical care staff" means individuals who are licensed
11or certified by the state and who provide direct care.
12    "Direct care" means any care provided by a licensed or
13certified member of the hospital staff that is within the
14scope of the license or certification of the member.
15    "Direct-care staff" means any of the following who are
16routinely assigned to patient care and are replaced when they
17are absent:
18        (1) registered nurses, including registered nurses
19    that do not assume primary responsibility for a patient's
20    care but have responsibility for consulting on patient
21    care;
22        (2) licensed practical nurses; or
23        (3) certified nursing assistants.

 

 

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1    "Exclusive bargaining representative" means a labor
2organization that is:
3        (1) certified as an exclusive representative by the
4    National Labor Relations Board; or
5        (2) certified as an exclusive representative by the
6    Employment Relations Board.
7    "Hospital" means a hospital as defined in the Hospital
8Licensing Act and an acute inpatient care facility.
9    "Intensive care unit" means a unit of a hospital that
10provides care to critically ill patients who require advanced
11treatments, such as mechanical ventilation, vasoactive
12infusions, or continuous renal replacement treatment or who
13require frequent assessment and monitoring.
14    "Intermediate care unit" means a unit of a hospital that
15provides progressive care, intensive specialty care, or
16step-down care.
17    "Medical-surgical unit" means an inpatient unit in which
18general medical or post- surgical level of care is provided,
19excluding critical care units and any units referred to in
20Sections of this Act.
21    "Professional staff" means professional workers as defined
22in a collective bargaining agreement or, if no collective
23bargaining agreement exists, by the chief executive officer of
24the hospital or the chief executive officer's designee,
25consistent with National Labor Relations Board regulations.
26    "Progressive care" means care provided to hospital

 

 

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1patients who need more monitoring and assessment than patients
2on the medical-surgical units but whose conditions are not so
3unstable that they require care in an intensive care unit.
4    "Service staff" means service workers as defined by a
5collective bargaining agreement or, if no collective
6bargaining agreement exists, by the chief executive officer of
7the hospital or the chief executive officer's designee,
8consistent with National Labor Relations Board regulations.
9    "Step-down care" means care for patients transitioning out
10of the intensive care unit who require more care and attention
11than patients in a hospital's medical-surgical units.
12    "Technical staff" means technical workers as defined in a
13collective bargaining agreement or, if no collective
14bargaining agreement exists, by the chief executive officer of
15the hospital or the chief executive officer's designee,
16consistent with National Labor Relations Board regulations.
 
17    Section 10. Professional and technical committee staffing.
18    (a) For each hospital, there shall be established a
19hospital professional and technical staffing committee as
20follows:
21        (1) A hospital professional and technical staffing
22    committee shall consist of an equal number of hospital
23    professional and technical managers and professional and
24    technical staff who work at the hospital.
25        (2) If the professional and technical staff who work

 

 

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1    at the hospital have an exclusive bargaining
2    representative, the exclusive bargaining representative
3    shall select the staff members of the hospital
4    professional and technical staffing committee.
5        (3) If none of the professional and technical staff
6    who work at the hospital have an exclusive bargaining
7    representative, the professional and technical managers
8    shall select the professional and technical staff members
9    of the hospital professional and technical staffing
10    committee.
11    (b) A hospital professional and technical staffing
12committee shall develop a written hospital-wide professional
13and technical staffing plan in accordance with subsection (e).
14In developing the staffing plan, the primary goal of the
15committee shall be to ensure that the hospital is staffed
16sufficiently to meet the health care needs of the patients in
17the hospital. The committee shall review and modify the
18staffing plan, as needed, in accordance with this Section.
19    (c) A majority of the members of the hospital professional
20and technical staffing committee constitutes a quorum for the
21transaction of business.
22    (d) A hospital professional and technical staffing
23committee must have 2 cochairs. One cochair shall be a
24professional or technical manager elected by the members of
25the committee who are professional or technical managers. The
26other cochair shall be a professional or technical staff

 

 

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1person elected by the members of the committee who are
2professional and technical staff.
3    (e) A hospital professional and technical staffing
4committee shall develop a professional and technical staffing
5plan that is consistent with the approved nurse staffing plan
6for the hospital and that takes into account the hospital
7service staffing plan for the hospital developed under Section
815. The hospital professional and technical staffing committee
9shall consider the following criteria when developing the
10professional and technical staffing plan:
11        (1) the hospital's census;
12        (2) location of the patients;
13        (3) patient types and patient acuity;
14        (4) national standards, if any;
15        (5) the size of the hospital and square footage of the
16    hospital; and
17        (6) feedback received during committee meetings from
18    staff.
19    (f) The hospital professional and technical staffing
20committee must adopt a professional and technical staffing
21plan by a majority vote of the members of the committee. If a
22quorum of members present at a meeting comprises an unequal
23number of professional and technical staff and professional
24and technical managers, only an equal number of staff and
25managers may vote. A staffing plan adopted by the committee
26must include a summary of the committee's consideration of the

 

 

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1criteria in subsection (e) and how the plan is consistent with
2the approved nurse staffing plan and approved hospital service
3staffing plan for the hospital.
4    If the hospital professional and technical staffing
5committee does not adopt a professional and technical staffing
6plan or adopts only a part of the staffing plan, either cochair
7may invoke the commencement of a 60-day period during which
8the committee shall continue to develop the staffing plan. If,
9by the end of the 60-day period, the committee does not adopt a
10staffing plan or adopts only part of a staffing plan, the
11committee shall submit the disputed plan or parts of the plan,
12as applicable, including a summary of the committee's
13consideration of the criteria in subsection (e), to the chief
14executive officer of the hospital. No later than 60 days after
15receiving the submission from the committee, the chief
16executive officer or the chief executive officer's designee
17shall decide the disputed plan or parts of the plan, as
18applicable, considering the summary of the committee's
19consideration of the criteria in subsection (e), and adopt the
20staffing plan or parts of the staffing plan that were not
21adopted by the committee. The chief executive officer or the
22chief executive officer's designee shall provide to the
23committee:
24        (1) a written explanation of the staffing plan or the
25    parts of the staffing plan that were in dispute;
26        (2) the final written proposals of the members of the

 

 

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1    committee and the members' rationales for their proposals
2    and the committee's summary of the committee's
3    consideration of the criteria in subsection (e); and
4        (3) a summary of the consideration by the chief
5    executive officer or the chief executive officer's
6    designee of the criteria in subsection (e).
7    If the hospital professional and technical staffing
8committee is unable to reach an agreement on the professional
9and technical staffing plan during the 60-day period invoked
10under subsection (g), the members of the committee may extend
11deliberations for one additional 60-day period before the
12disputed plan or parts of the plan must be submitted to the
13chief executive officer or the chief executive officer's
14designee in accordance with subsection (f). The deliberations
15may be extended under this subsection only by a majority vote
16of the members of the committee. If a quorum of members present
17at a meeting comprises an unequal number of professional and
18technical staff and professional and technical managers, only
19an equal number of staff and managers may vote.
20    A professional and technical staffing plan adopted by a
21hospital professional and technical staffing committee, a
22chief executive officer or the chief executive officer's
23designee must include any staffing-related terms and
24conditions that were previously adopted through any applicable
25collective bargaining agreement, including any meal break and
26rest break requirements, unless a term or condition is in

 

 

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1direct conflict with an applicable statute or administrative
2rule.
3    A hospital professional and technical staffing committee
4must meet 3 times each year and at the call of either cochair,
5at a time and place specified by the cochairs.
6    (g) Except as provided in this subsection, a hospital
7professional and technical staffing committee meeting must be
8open to:
9        (1) the hospital's professional and technical staff,
10    who shall be offered the opportunity to provide feedback
11    to the committee during the committee's meetings; and
12        (2) other observers or presenters invited by either
13    cochair.
14        While the committee is deliberating or voting during a
15meeting, either cochair may exclude individuals described in
16this subsection.
17    (h) Minutes must be taken at every hospital professional
18and technical staffing committee meeting and the minutes must:
19        (1) include all motions made and the outcome of all
20    votes taken;
21        (2) include a summary of all discussions; and
22        (3) be made available in a timely manner to any of the
23    hospital staff upon request.
24    (i) A manager shall release from their duties staff and
25managers who serve on the hospital professional and technical
26staffing committee and compensate the staff and managers who

 

 

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1serve on the committee for time spent attending committee
2meetings.
3    (j) The hospital shall submit the professional and
4technical staffing plan adopted under subsection (f) to the
5Department of Public Health no later than 30 days after
6adoption of the staffing plan and shall submit any subsequent
7changes to the Department no later than 30 days after the
8changes are adopted.
9    (k) Each hospital unit, as defined by the chief executive
10officer or the chief executive officer's designee, may deviate
11from the professional and technical staffing plan within a
12period of 12 consecutive hours, no more than 6 times during a
13rolling 30-day period, without being in violation of the
14staffing plan. The unit manager must notify the hospital
15professional and technical staffing committee cochairs no
16later than 10 days after each deviation. Each subsequent
17deviation during the 30-day period constitutes a separate
18violation under Section 90.
 
19    Section 15. Hospital service staffing.
20    (a) For each hospital there shall be established a
21hospital service staffing committee.
22        (1) A hospital service staffing committee shall
23    consist of an equal number of service staff managers and
24    service staff who work at the hospital.
25        (2) If the service staff who work at the hospital have

 

 

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1    an exclusive bargaining representative, the exclusive
2    bargaining representative shall select the service staff
3    members of the hospital service staffing committee.
4        (3) If none of the service staff who work at the
5    hospital have an exclusive bargaining representative, the
6    service staff managers shall select the service staff
7    members of the hospital service staffing committee.
8    (b) A hospital service staffing committee shall develop a
9written hospital-wide hospital service staffing plan in
10accordance with subsection (e). The committee shall review and
11modify the staffing plan as needed in accordance with this
12Section.
13    (c) A majority of the members of the hospital service
14staffing committee constitutes a quorum for the transaction of
15business.
16    (d) A hospital service staffing committee must have 2
17cochairs. One cochair shall be a service staff manager elected
18by the members of the committee who are service staff
19managers. The other cochair shall be a service staff person
20elected by the members of the committee who are service staff.
21    (e) A hospital service staffing committee shall develop a
22hospital service staffing plan that is consistent with the
23approved nurse staffing plan for the hospital and that takes
24into account the professional and technical staffing plan for
25the hospital developed under Section 10. The committee shall
26consider the following criteria in developing the staffing

 

 

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1plan:
2        (1) the hospital's census;
3        (2) location of the patients;
4        (3) patient types and patient acuity;
5        (4) national standards, if any;
6        (5) the size of the hospital and square footage of the
7    hospital;
8        (6) ensuring patient access to care; and
9        (7) feedback received during committee meetings from
10    staff.
11    (f) A hospital service staffing committee must adopt a
12hospital service staffing plan by a majority vote of the
13members of the committee. If a quorum of members present at a
14meeting comprises an unequal number of service staff and
15service staff managers, only an equal number of staff and
16managers may vote. A staffing plan adopted by the committee
17must include a summary of the committee's consideration of the
18criteria in subsection (e) and how the plan is consistent with
19the approved nurse staffing plan and approved professional and
20technical staffing plan for the hospital.
21    If the hospital service staffing committee does not adopt
22a hospital service staffing plan or adopts only a part of the
23staffing plan, either cochair may invoke the commencement of a
2460-day period during which the committee shall continue to
25develop the staffing plan. If, by the end of the 60-day period,
26the committee does not adopt a staffing plan or adopts only

 

 

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1part of a staffing plan, the committee shall submit the
2disputed plan or parts of the plan, as applicable, including a
3summary of the committee's consideration of the criteria in
4subsection (e), to the chief executive officer of the
5hospital. No later than 60 days after receiving the submission
6from the committee, the chief executive officer or the chief
7executive officer's designee shall decide the disputed plan or
8parts of the plan, as applicable, considering the summary of
9the committee's consideration of the criteria in subsection
10(e), and adopt the staffing plan or parts of the staffing plan
11that were not adopted by the committee. The chief executive
12officer or the chief executive officer's designee shall
13provide to the committee:
14        (1) a written explanation of the staffing plan or the
15    parts of the staffing plan that were in dispute;
16        (2) the final written proposals of the members of the
17    committee and the members' rationales for their proposals
18    and the committee's summary of the committee's
19    consideration of the criteria in this Section; and
20        (3) a summary of the consideration by the chief
21    executive officer or the chief executive officer's
22    designee of the criteria in subsection (e).
23    If the hospital service staffing committee is unable to
24reach an agreement on the hospital service staffing plan
25during the 60-day period invoked under this subsection, the
26members of the committee may extend deliberations for one

 

 

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1additional 60-day period before the disputed plan or parts of
2the plan must be submitted to the chief executive officer or
3the chief executive officer's designee in accordance with
4Section. The deliberations may be extended under this
5paragraph only by a majority vote of the members of the
6committee. If a quorum of members present at a meeting
7comprises an unequal number of hospital service staff and
8hospital service managers, only an equal number of staff and
9managers may vote.
10    A hospital service staffing plan adopted by a hospital
11service staffing committee, a chief executive officer or the
12chief executive officer's designee must include any
13staffing-related terms and conditions that were previously
14adopted through any applicable collective bargaining
15agreement, including any meal break and rest break
16requirements, unless a term or condition is in direct conflict
17with an applicable statute or administrative rule.
18    A hospital service staffing committee must meet 3 times
19each year and at the call of either cochair, at a time and
20place specified by the cochairs.
21    (g) Except as provided in this subsection, a hospital
22service staffing committee meeting must be open to:
23        (1) the hospital's service staff, who shall be offered
24    the opportunity to provide feedback to the committee
25    during the committee's meetings; and
26        (2) other observers or presenters invited by either

 

 

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1    cochair.
2        While the committee is deliberating or voting during a
3meeting, either cochair may exclude individuals described in
4paragraph (1) or (2) of this subsection.
5    (h) Minutes shall be taken at every hospital service
6staffing committee meeting and the minutes must:
7        (1) include all motions made and the outcome of all
8    votes taken;
9        (2) include a summary of all discussions; and
10        (3) be made available in a timely manner to any of the
11    hospital staff upon request.
12    (i) A manager shall release from their duties staff and
13managers who serve on the hospital service staffing committee
14and compensate the staff and managers who serve on the
15committee for time spent attending committee meetings.
16    (j) The hospital shall submit the hospital service
17staffing plan adopted under this Section to the Department of
18Healthcare and Family Services no later than 30 days after
19adoption of the staffing plan and shall submit any subsequent
20changes to the Department no later than 30 days after the
21changes are adopted.
22    (k) Each hospital unit, as defined by the chief executive
23officer or the chief executive officer's designee, may deviate
24from the hospital service staffing plan within a period of 12
25consecutive hours, no more than 6 times during a rolling
2630-day period, without being in violation of the staffing

 

 

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1plan. The unit manager must notify the hospital service
2staffing committee cochairs no later than 10 days after each
3deviation. Each subsequent deviation during the 30-day period
4constitutes a separate violation under Section 90.
 
5    Section 20. Combined committees.
6    (a) A hospital nurse staffing committee, a professional
7and technical staffing committee, and a hospital service
8staffing committee may, by mutual agreement, combine 2 or more
9of the staffing committees into one committee if:
10        (1) the structures of the committees to be combined
11    meet the requirements of the individual committee
12    requirements under this Act, as applicable; and
13        (2) the members of the combined committee are selected
14    from each committee by an exclusive bargaining
15    representative, or otherwise as provided in this Act.
16    (b) A majority of members of each staffing committee
17constitutes a quorum for the transaction of the business of
18the combined committee. If there is an unequal number of staff
19and management from each committee present at a meeting of the
20combined committee, only an equal number of staff and managers
21from each committee may vote.
22    (c) Disputes arising in combined committees shall be
23resolved using the applicable dispute resolution processes
24under this Act.
 

 

 

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1    Section 25. Nurse staffing plan.
2    (a) As used in this Section, "unit" means a hospital unit
3as defined by the chief executive officer of the hospital or
4the chief executive officer's designee.
5    (b) With respect to direct-care registered nurses, a nurse
6staffing plan must ensure that at all times:
7        (1) In an emergency department:
8            (A) a direct-care registered nurse is assigned to
9        not more than one trauma patient; and
10            (B) the ratio of direct-care registered nurses to
11        patients averages no more than one to 4 over a 12-hour
12        shift and a single direct-care registered nurse may
13        not be assigned more than 5 patients at one time.
14        direct-care registered nurses assigned to trauma
15        patients may not be taken into account in determining
16        the average ratio.
17        (2) In an intensive care unit, a direct-care
18    registered nurse is assigned to no more than 2 patients.
19        (3) In a labor and delivery unit, a direct-care
20    registered nurse is assigned to no more than:
21            (A) 2 patients if the patients are not in active
22        labor or experiencing complications; or
23            (B) One patient if the patient is in active labor
24        or if the patient is at any stage of labor and is
25        experiencing complications.
26        (4) In a postpartum, antepartum, and well-baby

 

 

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1    nursery, a direct-care registered nurse is assigned to no
2    more than 6 patients, counting mother and baby each as
3    separate patients.
4        (5) In a mother-baby unit, a direct-care registered
5    nurse is assigned to no more than 8 patients, counting
6    mother and baby each as separate patients.
7        (6) In an operating room, a direct-care registered
8    nurse is assigned to no more than one patient.
9        (7) In an oncology unit, a direct-care registered
10    nurse is assigned to no more than 4 patients.
11        (8) In a post-anesthesia care unit, a direct-care
12    registered nurse is assigned to no more than 2 patients.
13        (9) In an intermediate care unit, a direct-care
14    registered nurse is assigned to no more than 3 patients.
15        (10) In a medical-surgical unit, a direct-care
16    registered nurse is assigned to no more than 5 patients.
17        (11) In a cardiac telemetry unit, a direct-care
18    registered nurse is assigned to no more than 4 patients.
19        (12) In a pediatric unit, a direct-care registered
20    nurse is assigned to no more than 4 patients.
21    (c) Notwithstanding subsection (b), the direct-care
22registered nurse-to-patient ratio for an individual patient
23shall be based on a licensed independent practitioner's
24classification of the patient, as indicated in the patient's
25medical record, regardless of the unit where the patient is
26being cared for.

 

 

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1    (d) With the approval of a majority of the members of the
2hospital nurse staffing committee, a unit can deviate from the
3direct-care registered nurse-to-patient ratios in subsection
4(b), in pursuit of innovative care models that were considered
5by the committee, by allowing other clinical care staff to
6constitute up to 50% of the registered nurses needed to comply
7with the applicable nurse-to-patient ratio. The staffing in an
8innovative care model must be reapproved by the committee
9every 2 years.
10    (e) A hospital shall provide for meal breaks and rest
11breaks in accordance with all rules and applicable laws.
12    (f) Each hospital unit may deviate from a nurse staffing
13plan, except with respect to meal breaks and rest breaks,
14including the applicable direct-care registered
15nurse-to-patient ratios under this Section, within a period of
1612 consecutive hours, no more than 6 times during a rolling
1730-day period, without being in violation of the nurse
18staffing plan. The unit manager must notify the hospital nurse
19staffing committee no later than 10 days after each deviation.
20Each subsequent deviation during the 30-day period constitutes
21a separate violation under Section 90.
22    (g) A hospital may not require a direct-care registered
23nurse to be assigned to more patients than as specified in this
24Section or in the nurse staffing plan approved by the hospital
25nurse staffing committee, as applicable.
26    (h) A charge nurse may:

 

 

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1        (1) take patient assignments, including patient
2    assignments taken for the purpose of covering staff who
3    are on meal breaks or rest breaks, in units with 10 or
4    fewer beds;
5        (2) take patient assignments, including patient
6    assignments taken for the purpose of covering staff who
7    are on meal breaks or rest breaks, in units with 11 or more
8    beds with the approval of the hospital nurse staffing
9    committee; and
10        (3) be taken into account in determining the
11    direct-care registered nurse-to-patient ratio during
12    periods when the charge nurse is taking patient
13    assignments under this Section.
 
14    Section 30. Psychiatric multidisciplinary subcommittee.
15    (a) As used in this Section, "psychiatric unit" includes:
16        (1) inpatient psychiatric units;
17        (2) psychiatric geriatric units;
18        (3) psychiatric pediatric units; or
19        (4) emergency departments that provide psychiatric
20    emergency service, as defined by rule.
21    (b) A psychiatric unit shall create a multidisciplinary
22subcommittee of the hospital nurse staffing committee
23consisting of staff from the unit. The subcommittee shall
24adopt the staffing plan for the psychiatric unit and shall be
25considered a hospital nurse staffing committee for purposes

 

 

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1of:
2        (1) The adoption of a nurse staffing plan under
3    Section 25; and
4        (2) Provisions of this Act related to:
5            (A) Dispute resolution through mandatory
6        arbitration; and
7            (B) Determining the circumstances when the
8        nurse-to-patient ratios in Section 25 will not apply.
 
9    Section 35. Certified nursing assistants and patient care
10technicians. A hospital may not assign a certified nursing
11assistant or patient care technician to more than 7 patients
12at a time during a day or evening shift or to more than 11
13patients at a time during a night shift.
 
14    Section 40. Direct-care registered nurse-to-patient
15staffing ratios.
16    (a) Direct-care registered nurse-to-patient staffing
17ratios under Section 25 do not apply to the care of:
18        (1) patients in intensive care or critical units in
19    circumstances prescribed by the hospital nurse staffing
20    committee;
21        (2) emergency department patients who are in critical
22    condition, until they are stable;
23        (3) patients in swing beds, as defined by the Centers
24    for Medicare and Medicaid Services;

 

 

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1        (4) patients in inpatient units who are ready for
2    discharge but are facing a barrier to discharge, as
3    indicated by a licensed independent practitioner in each
4    patient's medical record;
5        (5) patients, including patients in an emergency
6    department, who are located in adjacent rooms or the same
7    room in the hospital and who are ready for discharge but
8    are facing a barrier to discharge, as indicated by a
9    licensed independent practitioner in each patient's
10    medical record;
11        (6) patients in outpatient units that operate under a
12    hospital's license; or
13        (7) patients in psychiatric units.
14    (b) For patients described in subsection (a), the hospital
15nurse staffing committee shall adopt a nurse staffing plan
16that is:
17        (1) consistent with nationally recognized nurse
18    staffing standards or benchmarks;
19        (2) consistent with a tool that measures patient
20    acuity and intensity and that has been calibrated to the
21    applicable unit; or
22        (3) approved after the committee has considered:
23            (A) the specialized qualifications and
24            competencies of the staff in the unit;
25            (B) historic acuity and intensity of the patients
26        in the unit;

 

 

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1            (C) nationally recognized nurse staffing
2        standards, if any; and
3            (D) ensuring patient access to care.
4    (c) If the hospital nurse staffing committee does not
5adopt a nurse staffing plan under subsection (b), either
6cochair of the committee may invoke the commencement of a
760-day period during which the committee shall continue to
8develop the staffing plan as follows:
9        (1) If by the end of the 60-day period, the hospital
10    nurse staffing committee does not adopt a nurse staffing
11    plan, the members of the committee may extend
12    deliberations for one additional 60-day period only by a
13    majority vote of the members of the committee.
14        (2) If a quorum of members present at a meeting
15    comprises an unequal number of nursing staff and managers,
16    only an equal number of staff and managers may vote.
17        (3) If by the end of the initial 60-day period of
18    deliberations, or by the end of the second 60-day period
19    of deliberations, or if deliberations are extended under
20    this subsection, the hospital nurse staffing committee
21    does not adopt a nurse staffing plan, the cochairs of the
22    committee shall submit the disputed plan or parts of the
23    plan, as applicable, to the and the Department shall
24    initiate expedited binding arbitration as follows:
25            (A) The arbitrator shall be selected using
26        alternating strikes by the cochairs or their designees

 

 

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1        from a list of 7 drawn from the interest arbitrator
2        panel maintained by the State.
3            (B) Arbitration must be scheduled by mutual
4        agreement no later than 30 calendar days after the
5        cochairs submit the disputed nurse staffing plan or
6        the disputed parts of the plan to the Department
7        except as, by mutual agreement, the time may be
8        extended.
9            (C) The arbitrator shall issue a decision on the
10        nurse staffing plan, or the disputed parts of the
11        plan, as applicable, based on the written submissions
12        of evidence and arguments and may not conduct an
13        evidentiary hearing or allow discovery. The
14        arbitrator's decision must be based on and within the
15        parameters of the versions of the plan or the disputed
16        parts of the plan submitted by the cochairs and must be
17        within the staffing parameters.
18            (D) The arbitrator shall issue a decision no later
19        than 60 days after the submission of evidence and
20        written arguments.
21            (E) The hospital shall pay for the cost of the
22        arbitrator.
 
23    Section 45. Complaint procedure.
24    (a) As used in this Section:
25    "Employee" includes the following:

 

 

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1        (1) registered nurses who provide direct care;
2        (2) professional staff;
3        (3) technical staff; and
4        (4) service staff.
5    "Employee" does not include an individual described in
6this Section if the individual is covered by a collective
7bargaining agreement that includes a monetary remedy for
8missed meal periods and missed rest periods.
9    (b) An employee or an exclusive bargaining representative
10of an employee may enforce requirements for meal periods and
11rest periods adopted by rule by the Illinois Department of
12Labor by electing to file a complaint in one of the following
13ways:
14        (1) with the Illinois Department of Labor under this
15    Act; or
16        (2) with the State Department of Labor under rules
17    adopted under this Act.
18    (c) Upon the receipt of a complaint forwarded by the
19Department to the commissioner under this Act, the Illinois
20Department of Labor shall proceed on the complaint in
21accordance with this Section.
22    (d) The State Department of Labor shall deem a complaint
23filed under this subsection to be withdrawn if notified by an
24employer that:
25        (1) the employer received a grievance filed by the
26    employee or an exclusive bargaining representative of the

 

 

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1    employee alleging the same violation as the violation
2    alleged in a complaint filed under this subsection; or
3        (2) the employee or the exclusive bargaining
4    representative of the employee has filed a civil complaint
5    against the employer alleging the same violation as the
6    violation alleged in a complaint filed under this
7    subsection.
8    (e) If the commissioner receives a complaint under
9subsection (b) that was filed with the Department more than 60
10days after the date of the missed meal period or missed rest
11period alleged in the complaint, the Department of Labor:
12        (1) shall dismiss the complaint; and
13        (2) may not investigate the complaint or take any
14    enforcement action with respect to the complaint.
15    (f) Following an investigation of a complaint filed under
16subsection (b), if the Department of Labor determines that a
17civil penalty is appropriate, the commissioner shall provide
18to the hospital, to the cochairs of the relevant staffing
19committee, and to the exclusive bargaining representative, if
20any, a notice of the Department of Labor's intent to assess a
21civil penalty of $200.
22        (3) A civil penalty imposed under this Section:
23            (A) constitutes the liquidated damages of the
24        complainant for the missed meal period or rest period;
25            (B) may not be combined with a penalty assessed in
26        accordance with all applicable rules or laws;

 

 

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1            (C) precludes any other penalty or remedy provided
2        by law for the violation found by the commissioner;
3        and
4            (D) becomes final if an application for hearing is
5        not requested in a timely manner.
6    (g) The liquidated damages imposed under this Section
7shall be paid to the complainant no later than 15 business days
8after the date on which the order becomes final by operation of
9law or 15 days after the issuance of a decision on appeal. A
10hospital shall provide to the commissioner proof of the
11payment of liquidated damages no later than 30 days after
12making the payment.
13    (h) An employee's failure to file a complaint under
14subsection (b) does not preclude the employee from pursuing
15any other remedy otherwise available to the employee under any
16provision of law.
17    (i) Nothing in this Section creates a private cause of
18action.
 
19    Section 50. Department of Labor.
20    (a) The Department of Labor shall implement a process for
21an employee or an employee's exclusive bargaining
22representative to file a complaint against a hospital under
23subsection (b) for missed meal periods and rest periods.
24    (b) The Department shall forward to the Director of Labor
25any complaint filed under this Act no later than 14 days after

 

 

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1the complaint is filed;
2    (c) No later than 30 days after receiving a complaint
3under this Act, the Department shall provide notice of the
4filing of the complaint to the following:
5        (1) the hospital;
6        (2) the cochairs of the relevant staffing committee
7    established under this Act; and
8        (3) the exclusive bargaining representative, if any,
9    of the employee filing the complaint.
 
10    Section 55. Hospital nurse staffing committee rules and
11responsibilities.
12    (a) For each hospital there shall be established a
13hospital nurse staffing committee. Each hospital nurse
14staffing committee shall:
15        (1) consist of an equal number of hospital nurse
16    managers and direct-care staff;
17        (2) for the portion of the committee composed of
18    direct-care staff, consist entirely of direct-care
19    registered nurses, except for one position to be filled by
20    a direct-care staff member who is not a registered nurse
21    and whose services are covered by a written hospital-wide
22    nurse staffing plan; and
23        (3) include at least one direct-care registered nurse
24    from each hospital nurse specialty or unit;
25        (4) for any of the direct-care registered nurses who

 

 

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1    work at a hospital who are represented under a collective
2    bargaining agreement, the bargaining unit shall conduct a
3    selection process by which the direct-care registered
4    nurses who work at the hospital select the members of the
5    committee. Nurses who are direct-care registered nurses
6    which have an exclusive bargaining representative, the
7    exclusive bargaining representative shall select the
8    direct-care registered nurses, or members of the committee
9    as follows:
10            (A) If the direct-care staff member who is not a
11        registered nurse who works at a hospital is
12        represented under a collective bargaining agreement,
13        the bargaining unit shall use the selection process
14        conducted under subparagraph (B) to select that member
15        of the committee, or has an exclusive bargaining
16        representative, the exclusive bargaining
17        representative shall select the direct-care staff
18        member of the committee who is not a registered nurse.
19            (B) If none of the direct-care registered nurses
20        who work at a hospital are represented by an exclusive
21        bargaining representative, the direct-care registered
22        nurses belonging to a hospital nurse specialty or unit
23        shall select the members of the committee who are
24        direct-care registered nurses from the specialty or
25        unit to serve on the committee.
26            (C) If none of the direct-care staff working at

 

 

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1        the hospital who are not registered nurses are
2        represented by an exclusive bargaining representative,
3        the direct-care registered nurses who are members of
4        the staffing committee shall select the direct-care
5        staff who are not registered nurses to serve on the
6        committee.
7        (5) If the direct-care registered nurses who work at a
8    hospital are not represented under a collective bargaining
9    agreement, the direct-care registered nurses belonging to
10    a hospital nurse specialty or unit shall select each
11    member of the committee who is a direct-care registered
12    nurse from that specialty or unit.
13    (b) A hospital nurse staffing committee shall develop a
14written hospital-wide nurse staffing plan in accordance with
15this Act. The committee's primary goals in developing the
16staffing plan shall be to ensure that the hospital is staffed
17to meet the health care needs of patients. The committee shall
18review and modify the staffing plan in accordance with all
19applicable laws and rules.
20    (c) A majority of the members of a hospital nurse staffing
21committee constitutes a quorum for the transaction of
22business.
23    (d) A hospital nurse staffing committee shall have two
24cochairs. One cochair shall be a hospital nurse manager
25elected by the members of the committee who are hospital nurse
26managers and one cochair shall be a direct-care registered

 

 

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1nurse elected by the members of the committee who are
2direct-care staff.
3    (e) A decision made by a hospital nurse staffing committee
4must be made by a vote of a majority of the members of the
5committee as follows:
6        (1) If a quorum of members present at a meeting
7    comprises an unequal number of hospital nurse managers and
8    direct-care staff, only an equal number of hospital nurse
9    managers and direct-care staff may vote.
10        (2) If the committee is unable to reach an agreement
11    on the staffing plan, either cochair of the committee may
12    invoke a 30-day period during which the committee shall
13    continue to develop the staffing plan. During the 30-day
14    period, the hospital shall respond in a timely manner to
15    reasonable requests from members of the committee for data
16    that will enable the committee to reach a resolution. If
17    at the end of the 30-day period, the committee remains
18    unable to reach an agreement on the staffing plan, one of
19    the cochairs shall notify the Department of Public Health
20    of the impasse.
21        (3) Upon receiving notification under this subsection,
22    the Department of Public Health shall provide the
23    committee with a mediator to assist the committee in
24    reaching an agreement on the staffing plan. Mediation
25    conducted under this paragraph must be consistent with the
26    requirements for implementing and reviewing staffing

 

 

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1    plans.
2        (4) If the committee is unable to reach an agreement
3    on the staffing plan after 90 days of mediation, the
4    Department may impose a civil penalty against the hospital
5    as described under this Act.
6    (g) A hospital nurse staffing committee shall meet:
7        (1) at least once every 4 months; and
8        (2) at any time and place specified by either cochair.
9    (g) A hospital nurse staffing committee meeting must be
10open to the hospital nursing staff as observers and, upon
11invitation by either cochair, other observers or presenters.
12At any time, either cochair may exclude persons described in
13this subsection from a committee meeting for purposes related
14to deliberation and voting.
15    (h) Hospital nurse staffing committee meetings must:
16        (A) include motions made and outcomes of votes taken;
17        (B) summarize discussions; and
18        (c) be made available in a timely manner to hospital
19    nursing staff and other hospital staff upon request.
20    (i) A hospital shall release a member of a hospital nurse
21staffing committee described in the member's assignment, and
22provide the member with paid time, to attend committee
23meetings.
 
24    Section 60. Hospital-wide nurse staffing plans.
25    (a) Each hospital shall implement a written hospital-wide

 

 

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1staffing plan for nursing services that:
2        (1) meets the requirements of this Section and any
3    applicable statute;
4        (2) includes any staffing-related terms and conditions
5    that were previously adopted through any applicable
6    collective bargaining agreement, including meal breaks and
7    rest breaks, unless a term or condition is in direct
8    conflict with an applicable statute or administrative
9    rule; and
10        (3) has been developed and approved by the hospital
11    nurse staffing committee.
12    (b) If the nurse-to-patient ratios in this Act apply, the
13hospital nurse staffing committee:
14        (1) may consider:
15            (A) the specialized qualifications and
16        competencies of the nursing staff, and the skill mix
17        and level of competency necessary to ensure that the
18        hospital is staffed to meet the health care needs of
19        patients;
20            (B) the size of the hospital and a measurement of
21        hospital unit activity that quantifies the rate of
22        admissions, discharges, and transfers for each
23        hospital unit and the time required for a direct-care
24        registered nurse belonging to a hospital unit to
25        complete admissions, discharges, and transfers for
26        that hospital unit; and

 

 

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1            (C) the unit's general and predominant patient
2        population as defined by the Medicare Severity
3        Diagnosis Related Groups adopted by the Centers for
4        Medicare and Medicaid Services, or by other measures
5        for patients who are not classified in the Medicare
6        Severity Diagnosis Related Groups;
7        (2) must:
8            (A) base the staffing plan on total diagnoses for
9        each hospital unit and the nursing staff required to
10        manage that set of diagnoses;
11            (B) be consistent with nationally recognized
12        evidence-based standards and guidelines established by
13        professional nursing specialty organizations, if any;
14            (C) recognize differences in patient acuity;
15            (D) establish minimum numbers of nursing staff,
16        including licensed practical nurses and certified
17        nursing assistants, required on specified shifts,
18        provided that at least one registered nurse and one
19        other nursing staff member is on duty in a unity when a
20        patient is present;
21            (E) include a formal process for evaluating and
22        initiating limitations on admission or diversion of
23        patients to another hospital when, in the judgment of
24        a direct-care registered nurse or nurse manager, there
25        is an inability to meet patient care needs or a risk of
26        harm to patients; and

 

 

SB3709- 34 -LRB103 39484 CES 69680 b

1            (F) consider tasks not related to providing direct
2        care, including meal breaks and rest breaks;
3        (3) may not base nursing staff requirements solely on
4    external benchmarking data; and
5        (4) must comply with this Act.
6    (c) A hospital must maintain and post, in a physical
7location or online, a list of on-call nursing staff or
8staffing agencies to provide replacement nursing staff in the
9event of a vacancy. The list of on-call nursing staff or
10staffing agencies must be sufficient to provide for
11replacement nursing staff.
12    (d) An employer may not impose upon unionized nursing
13staff any changes in wages, hours, or other terms and
14conditions of employment under a staffing plan unless the
15employer first provides notice to and, upon request, bargains
16with the union as the exclusive collective bargaining
17representative of the nursing staff in the bargaining unit.
18    A staffing plan does not create, preempt, or modify a
19collective bargaining agreement or re- quire a union or
20employer to bargain over the staffing plan while a collective
21bargaining agreement is in effect.
22    A hospital shall submit to the Illinois Department of
23Labor nurse staffing plan adopted in accordance with this
24Section and submit any changes to the plan no later than 30
25days after approval of the changes by the hospital nurse
26staffing committee.
 

 

 

SB3709- 35 -LRB103 39484 CES 69680 b

1    Section 65. Prior staffing plan approval.
2    (a) Prior to July 1, 2025, a hospital nurse staffing
3committee established under existing laws, rules, or
4regulations may approve a staffing plan that is:
5        (1) consistent with nationally recognized nurse
6    staffing standards or benchmarks;
7        (2) consistent with a tool that measures patient
8    acuity and intensity and that has been calibrated to the
9    hospital unit, as defined by the hospital nurse staffing
10    committee; or
11        (3) approved after the hospital nurse staffing
12    committee has considered:
13            (A) the specialized qualifications and
14        competencies of the staff in the unit;
15            (B) the historic acuity and intensity of the
16        patients in the unit;
17            (C) nationally recognized nurse staffing
18        standards, if any; and
19            (D) patients' access to care.
 
20    Section 70. Staffing plan review requirements.
21    (a) A hospital nurse staffing committee established under
22this Act shall review the written hospital-wide staffing plan
23developed by the committee and shall review the nurse staffing
24plan:

 

 

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1        (1) at least once every year; and
2        (2) at any other date and time specified by either
3    cochair of the committee.
4    (b) In reviewing a staffing plan, a hospital nurse
5staffing committee shall consider:
6        (1) patient outcomes;
7        (2) complaints regarding staffing, including
8    complaints about a delay in direct care nursing or an
9    absence of direct care nursing;
10        (3) the number of hours of nursing care provided
11    through a hospital unit compared with the number of
12    patients served by the hospital unit during a 24-hour
13    period;
14        (4) the aggregate hours of mandatory overtime worked
15    by the nursing staff;
16        (5) the aggregate hours of voluntary overtime worked
17    by the nursing staff;
18        (6) the percentage of shifts for each hospital unit
19    for which staffing differed from what is required by the
20    staffing plan;
21        (7) the number of meal breaks and rest breaks missed
22    by direct-care staff; and
23        (8) any other matter determined by the committee to be
24    necessary to ensure that the hospital is staffed to meet
25    the health care needs of patients.
26    (c) Upon reviewing a staffing plan, a hospital nurse

 

 

SB3709- 37 -LRB103 39484 CES 69680 b

1staffing committee shall:
2        (1) report whether the staffing plan ensures that the
3    hospital is staffed to meet the health care needs of
4    patients; and
5        (2) modify the staffing plan, if necessary, to ensure
6    that the hospital is staffed to meet the health care needs
7    of patients.
 
8    Section 75. Staffing investigations.
9    (a) For purposes of ensuring compliance with all
10applicable laws and rules, the Illinois Department of Labor
11shall:
12        (1) within 60 days after receiving a complaint against
13    a hospital for violating a provision of this Act, conduct
14    an on-site investigation of the hospital; and
15        (2) within 60 days after issuing an order requiring a
16    hospital to implement a plan to correct a violation of
17    this Act, conduct an investigation of the hospital to
18    ensure compliance with the plan.
19    (b) When conducting an investigation of a hospital to
20ensure compliance with this Act, the Department shall, if the
21Department provides notice of the investigation to the
22hospital, provide notice of the investigation to the cochairs
23of the hospital nurse staffing committee established under
24this Act and other applicable laws and rules.
25    (c) Following an investigation conducted under this

 

 

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1Section, the Department shall provide in writing a report of
2the Department's findings to the hospital and the cochairs of
3the hospital nurse staffing committee.
4    (d) When conducting an investigation of a hospital to
5ensure compliance with all applicable laws and rules, the
6Department may:
7        (1) take evidence;
8        (2) take the depositions of witnesses in the manner
9    provided by law in civil cases;
10        (3) compel the appearance of witnesses in the manner
11    provided by law in civil cases;
12        (4) require answers to interrogatories; and
13        (5) compel the production of books, papers, accounts,
14    documents, and testimony pertaining to the matter under
15    investigation.
 
16    Section 80. Complaint procedures.
17    (a) As used in this Section, "valid complaint" means a
18complaint containing an allegation that, if assumed to be
19true, is a violation of this Act.
20    (b) To ensure compliance with all applicable laws and
21rules, the Illinois Department of Labor shall:
22        (1) establish a method by which a hospital staff
23    person or an exclusive bargaining representative of a
24    hospital staff person may submit a complaint through the
25    Department's website regarding any violation of this Act;

 

 

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1        (2) no later than 14 days after receiving a complaint,
2    send a copy of the complaint to the exclusive bargaining
3    representative, if any, of the staff person or staff
4    persons who filed the complaint;
5        (3) no later than 30 days after receiving a valid
6    complaint of a violation of this Act, open an
7    investigation of the hospital and provide a notice of the
8    investigation to the hospital and the cochairs of the
9    relevant staffing committee established under this Act, or
10    other lawfully established committees, and to the
11    exclusive bargaining representative, if any, of the staff
12    person or staff persons filing the complaint. The notice
13    must include a summary of the complaint that does not
14    include the complainant's name or the specific date,
15    shift, or unit but does include the calendar week in which
16    the complaint arose;
17        (4) not later than 80 days after opening the
18    investigation, conclude the investigation and provide a
19    written report on the complaint to the hospital, the
20    cochairs of the hospital staffing committee, and the
21    exclusive bargaining representative, if any, of the staff
22    person or staff persons filing the complaint. The report:
23            (A) shall include a summary of the complaint;
24            (B) shall include the nature of the alleged
25        violation or violations;
26            (C) shall include the Department's findings and

 

 

SB3709- 40 -LRB103 39484 CES 69680 b

1        factual bases for the findings;
2            (D) shall include other information the Department
3        determines is appropriate to include in the report;
4        and
5            (E) may not include the name of any complainant,
6        the name of any patient, or the names of any
7        individuals that the Department interviewed in
8        investigating the complaint;
9        (5) if the Department issues a warning or imposes one
10    or more civil penalties based on the report described in
11    this Section, the Department shall provide a notice of the
12    civil penalty that complies with all applicable laws and
13    rules, and to the hospital, the cochairs of the applicable
14    hospital staffing committee, and the exclusive bargaining
15    representative, if any, of the staff person or staff
16    persons who filed the complaint; and
17        (6) in determining whether to impose a civil penalty,
18    consider all relevant evidence, including, but not limited
19    to, witness testimony, written documents, and the
20    observations of the investigator.
21    (c) A hospital subject to a valid complaint shall provide
22to the Department, no later than 20 days after receiving the
23notice under of this Section:
24        (1) the staffing plan that is the subject of the
25    complaint;
26        (2) if relevant to the complaint, documents that show

 

 

SB3709- 41 -LRB103 39484 CES 69680 b

1    the scheduled staffing and the actual staffing on the unit
2    that is the subject of the complaint during the period of
3    time specified in the complaint; and
4        (3) documents that show the actions described in this
5    Act, if any, that the hospital took to comply with the
6    staffing plan or to address the issue raised by the
7    complaint.
8    (d) In conducting an investigation, the Department shall
9review any document:
10        (1) related to the complaint that is provided by the
11    exclusive bargaining representative that filed the
12    complaint or by the hospital staff person who filed the
13    complaint and the person's exclusive bargaining
14    representative, if any; and
15        (2) provided by the hospital in response to the
16    complaint.
17    (e) In conducting an investigation, the Department may:
18        (1) make an on-site inspection of the unit that is the
19    subject of the complaint;
20        (2) interview a manager for the unit and any other
21    staff persons with information relevant to the complaint;
22        (3) interview the cochairs of the relevant staffing
23    committee;
24        (4) interview the staff person or staff persons who
25    filed the complaint unless the individual declines to be
26    interviewed; and

 

 

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1        (5) compel the production of books, papers, accounts,
2    documents, and testimony pertaining to the complaint,
3    other than documents that are privileged or not otherwise
4    subject to disclosure.
5    (f) A complaint by a hospital staff person or the staff
6person's exclusive bargaining representative must be filed no
7later than 60 days after the date of the violation alleged in
8the complaint. The Department may not investigate a complaint
9or take any enforcement action with respect to a complaint
10that has not been filed timely.
 
11    Section 85. Penalties.
12    (a) The Department of Labor shall impose civil penalties
13in the manner provided for, or suspend or revoke a license of a
14hospital, for a violation of any provision of this Act. The
15Department shall adopt by rule a schedule establishing the
16amount of civil penalty that may be imposed for a violation of
17this Act when there is a reasonable belief that safe patient
18care has been or may be negatively impacted, except that a
19civil penalty may not exceed $5,000.
20    (b) The Department may suspend or revoke the license of a
21hospital, in the manner provided by law or rule, for a
22violation described in this Act.
23    (c) Each violation of a written hospital-wide staffing
24plan shall be considered a separate violation and there is no
25limit on the number times that a penalty may be imposed for

 

 

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1repeated violations of the same provision.
2    (d) The Department may not impose a civil penalty for a
3violation of a nurse staffing plan, a hospital professional
4and technical staffing plan, or a hospital service staffing
5plan if the hospital took the following actions:
6        (1) scheduled staff in accordance with the staffing
7    plan;
8        (2) sought volunteers from all available qualified
9    employees to work extra time;
10        (3) contacted qualified employees who made themselves
11    available to work extra time;
12        (4) solicited per diem staff to work; and
13        (5) contacted contracted temporary agencies, that the
14    hospital regularly uses, if temporary staff from such
15    agencies are permitted to work in the hospital by law or
16    any applicable collective bargaining agreement.
17    (e) The Department shall maintain for public inspection
18records of any civil penalties or license suspensions or
19revocations imposed on hospitals penalized under this Section.
 
20    Section 90. Violations.
21    (a) Following the receipt of a complaint and completion of
22an investigation described in this Act, for a violation
23described in this Section, the Department of Public Health
24shall:
25        (1) issue a warning for the first violation in a 4 year

 

 

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1    period;
2        (2) impose a civil penalty of $1,750 for the second
3    violation of the same provision in a 4 year period;
4        (3) impose a civil penalty of $2,500 for the third
5    violation of the same provision in a 4 year period; and
6        (d) impose a civil penalty of $5,000 for the fourth
7    and subsequent violations of the same provision in a 4
8    year period.
9    (b) The Department shall take the actions described in
10subsection (a) for the following violations by a hospital of
11this Act:
12        (1) failure to establish a hospital professional and
13    technical staffing committee or a hospital service
14    staffing committee;
15        (2) failure to create a professional and technical
16    staffing plan or a hospital service staffing plan;
17        (3) failure to adopt a nurse staffing plan by
18    agreement or after binding arbitration;
19        (4) failure to comply with the staffing level in the
20    nurse staffing plan, including the nurse-to-patient
21    staffing ratios prescribed in this Act, if applicable, and
22    the failure to comply is not an allowed deviation
23    described in this Act;
24        (5) failure to comply with the staffing level in the
25    professional and technical staffing plan or the hospital
26    service staffing plan and the failure to comply is not an

 

 

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1    allowed deviation as described in this Act;
2        (6) failure to comply with the staffing requirements
3    for certified nursing assistants in this Act and the
4    failure is not an allowed deviation this Act; or
5        (7) requiring a nursing staff, except as allowed by
6    applicable law or rule to work:
7            (A) beyond an agreed-upon prearranged shift
8        regardless of the length of the shift;
9            (B) more than 48 hours in any hospital-defined
10        work week;
11            (C) more than 12 hours in a 24-hour period; or
12            (D) during the 10-hour period immediately
13        following the 12th hour worked during a 24-hour
14        period.
15    (c) If a staff person at a hospital is unable to attend a
16staffing committee meeting because the staff person was not
17released from other hospital duties to attend the meeting, in
18violation of this Act, the Department shall:
19        (1) issue a warning for the first violation; and
20        (2) impose a civil penalty of $500 for a second and
21    each subsequent violation.
22    (d) A direct-care staff person, a hospital professional or
23technical staff person, or a hospital service staff person, or
24an exclusive bargaining representative of a direct-care staff
25person, a hospital professional or technical staff person, or
26a hospital service staff person, may elect to enforce meal

 

 

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1break and rest break violations under this Act and other
2applicable laws and rules by filing a complaint with the
3Department in accordance with this Act.
 
4    Section 95. Public records. The Illinois Department of
5Labor shall post on a website maintained by the Department:
6        (1) reports of audits described in this Act of the
7    hospital staffing plans received by the Department;
8        (2) any report of this Act made pursuant to an
9    investigation under this Act;
10        (3) any order requiring a hospital to implement a plan
11    to correct a violation;
12        (4) any order imposing a civil penalty against a
13    hospital or suspending or revoking the license of a
14    hospital pursuant; and
15        (5) any other matter recommended by the Illinois
16    Nursing Workforce Center and Advisory Board.
 
17    Section 100. Long term care facilities.
18    (a) Licenses for long term care facilities must be
19obtained from the Department of Public Health.
20    (b) Applications shall be upon such forms and shall
21contain such information as the Department or may reasonably
22require, which may include affirmative evidence of ability to
23comply with such reasonable standards and rules as may
24lawfully be prescribed.

 

 

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1    (c) Each application submitted to the Department must be
2accompanied by the application fee or the annual renewal fee,
3as applicable. If the license is denied, the fee shall be
4refunded to the applicant. If the license is issued, the fee
5shall be paid into the State Treasury to the credit of the
6Department of Public Health for the purpose of carrying out
7the functions of the Department.
8    (d) Except as otherwise provided in this Act, for
9hospitals with:
10        (1) fewer than 26 beds, the annual license fee shall
11    be $1,250;
12        (2) 26 beds or more but fewer than 50 beds, the annual
13    license fee shall be $1,850;
14        (3) 50 or more beds but fewer than 100 beds, the annual
15    license fee shall be $3,800;
16        (4) 100 beds or more but fewer than 200 beds, the
17    annual license fee shall be $6,525;
18        (5) 200 or more beds, but fewer than 500 beds, the
19    annual license fee shall be $8,500; and
20        (6) 500 or more beds, the annual license fee shall be
21    $12,070.
22    (e) A hospital shall pay an annual fee of $750 for each
23hospital satellite endorsed under the hospital's license.
24    (f) The Department of Public Health may charge a reduced
25hospital fee or hospital satellite fee if the Department
26determines that charging the standard fee constitutes a

 

 

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1significant financial burden to the facility.
2    (g) For long term care facilities with:
3        (1) one to 15 beds, the application fee shall be
4    $2,000 and the annual renewal fee shall be $1,000;
5        (2) 16 to 49 beds, the application fee shall be $3,000
6    and the annual renewal fee shall be $1,500;
7        (3) 50 to 99 beds, the application fee shall be $4,000
8    and the annual renewal fee shall be $2,000;
9        (4) 100 to 150 beds, the application fee shall be
10    $5,000 and the annual renewal fee shall be $2,500; and
11        (5) More than 150 beds, the application fee shall be
12    $6,000 and the annual renewal fee shall be $3,000.
13    (h) For ambulatory surgical centers, the annual license
14fee shall be:
15        (1) $1,750 for certified and high complexity
16    noncertified ambulatory surgical centers with more than 2
17    procedure rooms.
18        (2) $1,250 for certified and high complexity
19    noncertified ambulatory surgical centers with no more than
20    2 procedure rooms.
21        (3) $1,000 for moderate complexity noncertified
22    ambulatory surgical centers.
23    (i) For birthing centers, the annual license fee shall be
24$750.
25    (j) For outpatient renal dialysis facilities, the annual
26license fee shall be $2,000.

 

 

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1    (k) The Department shall prescribe by rule the fee for
2licensing an extended stay center, not to exceed:
3        (1) an application fee of $25,000; and
4        (2) an annual renewal fee of $5,000.
5    (l) During the time the license remains in force, a holder
6is not required to pay inspection fees to any county, city, or
7other municipality.
8    (m) Any health care facility license may be endorsed to
9permit operation at more than one location. If so, the
10applicable license fee shall be the sum of the license fees
11that would be applicable if each location were separately
12licensed. The Department may include hospital satellites on a
13hospital's license in accordance with rules adopted by the
14Department.
15    (n) Licenses for health maintenance organizations shall be
16obtained from the Department of Public Health.
17    (o) Notwithstanding any other provisions, all moneys
18received for approved applications under this Act shall be
19deposited in the Long Term Care Ombudsman Fund.
20    (p) As used in this Section:
21        "Hospital satellite" has the meaning prescribed by the
22    Department by rule.
23        "Procedure room" means a room where surgery or
24    invasive procedures are performed.
 
25    Section 105. Hospital-wide staffing plan variances. Upon

 

 

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1request of a hospital, the Illinois Department of Labor may
2grant a variance to the written hospital-wide staffing plan
3requirements described in this Act if the variance is
4necessary to ensure that the hospital is staffed to meet the
5health care needs of patients.
 
6    Section 110. Emergency staffing variances.
7    (a) As used in this Section, "epidemic" means the
8occurrence of a group of similar conditions of public health
9importance in a community or region that are in excess of
10normal expectancy and that are from a common or propagated
11source.
12    (b) Notwithstanding any other provision of law, a hospital
13is not required to follow a written hospital-wide staffing
14plan developed and approved by the hospital nurse staffing
15committee upon the occurrence of:
16        (1) a national emergency or State emergency
17    declaration requiring the implementation of a facility
18    disaster plan and crisis standards of care;
19        (2) sudden unforeseen adverse weather conditions; or
20        (3) an infectious disease epidemic suffered by
21    hospital staff.
22    (c) No later than 30 days after a hospital deviates from a
23written hospital-wide staffing plan under this Section, the
24hospital incident command shall report to the cochairs of the
25hospital nurse staffing committee an assessment of the nurse

 

 

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1staffing needs arising from the national or State emergency
2declaration as follows:
3        (1) Upon receipt of the report described in this
4    subsection, the hospital nurse staffing committee shall
5    convene to develop a contingency nurse staffing plan to
6    address the needs arising from the national or State
7    emergency declaration. The contingency nurse staffing plan
8    must include crisis standards of care.
9        (2) The hospital's deviation from the written
10    hospital-wide staffing plan may not be in effect for more
11    than 90 days without the approval of the hospital nurse
12    staffing committee.
13        (3) Upon the occurrence of a national or State
14    emergency declaration, or circumstances not described in
15    this Act, either cochair of the hospital nurse staffing
16    committee may require the hospital nurse staffing
17    committee to meet to review, and potentially modify, the
18    staffing plan in response to the emergency declaration or
19    circumstances.
 
20    Section 115. Nurse staff advisory board.
21    (a) The Nurse Staffing Advisory Board is established
22within the Department of Public Health, consisting the
23following members appointed by the Governor:
24        (1) 6 must be hospital nurse managers;
25        (2) 3 must be direct-care registered nurses who work

 

 

SB3709- 52 -LRB103 39484 CES 69680 b

1    in hospitals;
2        (3) 3 must be patient-care nurses who work in
3    hospitals; and
4        (4) One must be either a direct-care registered nurse
5    who works in a hospital or a direct-care staff member who
6    is not a registered nurse and whose services are covered
7    by a written hospital wide staffing plan that meets the
8    requirements of this Act.
9    To the extent practicable, Board members shall be
10appointed to ensure that the Board is represented by members
11from hospitals where direct-care staff are represented under a
12collective bargaining agreement and hospitals where
13direct-care staff are not represented by a collective
14bargaining agreement and by hospitals of different sizes,
15types, and geographic locations.
16    The term of office of each Board member is 3 years, except
17each member serves at the pleasure of the Governor. Before the
18expiration of the term of a member, the Governor shall appoint
19a successor whose term begins January 1 of the next calendar
20year. A member is eligible for reappointment but may not serve
21more than 2 consecutive terms. If there is a vacancy for any
22cause, the Governor shall make an appointment to become
23immediately effective for the unexpired term.
24    (b) The Board shall:
25        (1) provide advice to the Department on the
26    administration of this Act;

 

 

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1        (2) identify trends, opportunities, and concerns
2    related to nurse staffing;
3        (3) make recommendations to the Department on the
4    basis of those trends, opportunities, and concerns; and
5        (4) review the Department's enforcement powers and
6    processes under this Act.
7    (c) Upon request, the Department shall provide the Board
8with written hospital-wide staffing plans, reviews conducted,
9information obtained during an audit, and complaints filed and
10investigations conducted as described in this Act as follows:
11        (1) The Department may not provide the Board with any
12    information under this subsection that is id
    entifiable
13    with a specific hospital unless the information is
14    publicly available.
15        (2) Hospital-wide staffing plans provided to the Board
16    under this Section are confidential and not subject to
17    public disclosure.
18    (d) A majority of the members of the Board constitutes a
19quorum for the transaction of business.
20    (e) The Board shall have 2 cochairs selected by the
21Governor. One cochair shall be a hospital nurse manager and
22one cochair shall be a patient care technician or certified
23nursing assistant.
24    (f) Official action by the Board requires the approval of
25a majority of the members of the Board.
26    (g) The Board shall meet:

 

 

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1        (1) at least once every 3 months; and
2        (2) at any time and place specified by the call of both
3    cochairs.
4    (h) The Board may adopt rules necessary for the operation
5of the Board.
6    (i) The Board shall submit a report on the administration
7of this Act to the General Assembly no later than September 15
8of each year. The Board may include in its report
9recommendations for legislation.
10    (j) Members of the Board are not entitled to compensation,
11but may be reimbursed for actual and necessary travel and
12other expenses incurred by them in the performance of their
13official duties in the manner and amounts provided for. Claims
14for expenses shall be paid out of funds appropriated to the
15Department for purposes of the Board.
 
16    Section 120. Record keeping. A hospital shall keep and
17maintain records necessary to demonstrate compliance with this
18Act. For purposes of this Section, the Department of Public
19Health shall adopt rules specifying the content of the records
20and the form and manner of keeping, maintaining, and disposing
21of the records. A hospital must provide records kept and
22maintained under this Section to the Department of Public
23Health upon request.
 
24    Section 125. Department of Labor rulemaking.

 

 

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1    (a) The Director of Labor may adopt rules prescribing such
2minimum conditions of employment, excluding minimum wages, in
3any occupation as may be necessary for the preservation of the
4health of employees. The rules may include, but are not
5limited to, minimum meal periods and rest periods, and maximum
6hours of work, but not less than 8 hours per day or 40 hours
7per workweek; however, after 40 hours of work in one workweek
8overtime may be paid, but in no case at a rate higher than one
9and one-half times the regular rate of pay of the employees
10when computed without benefits of commissions, overrides,
11bonuses, and similar benefits.
12        As used in this subsection, "workweek" means a fixed
13period of time established by an employer that reflects a
14regularly recurring period of 168 hours or 7 consecutive
1524-hour periods. A workweek may begin on any day of the week
16and any hour of the day and need not coincide with a calendar
17week. The beginning of the workweek may be changed if the
18change is intended to be permanent and is not designed to evade
19overtime requirements.
20    (b) Rules adopted by the Director of Labor under this
21Section do not apply to individuals employed by this State or a
22unit of local government if other provisions of law or
23collective bargaining agreements prescribe rules pertaining to
24conditions of employment referred to in this Section,
25including meal periods, rest periods, maximum hours of work,
26and overtime.

 

 

SB3709- 56 -LRB103 39484 CES 69680 b

1    (c) Except as provided, rules adopted by the Department of
2Labor under this Section regarding meal periods and rest
3periods do not apply to nurses who provide acute care in
4hospital settings if provisions of collective bargaining
5agreements entered into by the nurses prescribe rules
6concerning meal periods and rest periods.
7    (d) The Director of Labor shall adopt rules regarding meal
8periods for employees who serve food or beverages, receive
9tips, and report the tips to the employer as follows:
10        (1) In rules adopted by the Director of Labor under
11    this subsection, the Director shall permit an employee to
12    waive a meal period, except that, an employer may not
13    coerce an employee into waiving a meal period.
14        (2) Notwithstanding any other provision, in addition
15    to any other penalty provided by law, the Director may
16    assess a civil penalty not to exceed $2,000 against an
17    employer that the commissioner finds has coerced an
18    employee into waiving a meal period in violation of this
19    Section. Each violation is a separate and distinct
20    offense. In the case of a continuing violation, each day's
21    continuance is a separate and distinct violation.
22        (3) Civil penalties authorized by this Section shall
23    be imposed in the manner provided for under Illinois law.
24    All sums collected as penalties under this Section shall
25    be applied and paid over as provided.
 

 

 

SB3709- 57 -LRB103 39484 CES 69680 b

1    Section 130. Rulemaking. The Department of Public Health
2may adopt any rules necessary for implementation of this Act,
3except when this Act authorizes another State department to
4adopt rules relating to this Act.
 
5    Section 999. Effective date. This Act takes effect upon
6becoming law.