Sen. Don Harmon
Filed: 4/28/2004
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1 | AMENDMENT TO HOUSE BILL 1083
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2 | AMENDMENT NO. ______. Amend House Bill 1083 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 1. Short title. This Act may be cited as the | ||||||
5 | Responsible Hospital Staffing Act. | ||||||
6 | Section 5. Findings. The Legislature finds and declares all | ||||||
7 | of the following: | ||||||
8 | (1) Adequate staffing in hospitals contributes to high | ||||||
9 | quality patient care and the prevention of medical errors.
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10 | (2) To ensure the adequate protection of patients in | ||||||
11 | acute care settings, it is essential that qualified | ||||||
12 | registered nurses be accessible and available to meet the | ||||||
13 | needs of patients.
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14 | (3) The basic principles of staffing in the acute care | ||||||
15 | setting should be based on the patient's care needs, the | ||||||
16 | severity of the condition, services needed, and the | ||||||
17 | complexities surrounding those services, as well as the | ||||||
18 | experience level, clinical competencies, and education of | ||||||
19 | the licensed nurses providing patient care services.
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20 | Section 10. Definitions. As used in this Act: | ||||||
21 | "Critical care unit" means a unit that is established to | ||||||
22 | safeguard and protect patients whose medical conditions are | ||||||
23 | severe enough to require continuous monitoring and complex |
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1 | interventions by registered nurses. | ||||||
2 | "Department" means the Department of Public Health. | ||||||
3 | "Director" means the Director of Public Health. | ||||||
4 | "Employee" means any individual permitted to work by an | ||||||
5 | employer in an occupation, including both individuals hired | ||||||
6 | directly by the company and those hired pursuant to a contract | ||||||
7 | with an outside entity, such as a staffing agency. | ||||||
8 | "Employer" means any person or entity licensed under the | ||||||
9 | Hospital Licensing Act, or the parent or holding company of any | ||||||
10 | such person or entity, who directly or indirectly, or through | ||||||
11 | an agent or any other person, employs or exercises control over | ||||||
12 | the wages, hours, or working conditions of any person. | ||||||
13 | "Health system" means a company (i) that is non-profit or | ||||||
14 | for-profit, religious or non-religious, and (ii) that owns, | ||||||
15 | operates, or controls more than 2 hospitals. | ||||||
16 | "Hospital" means an entity licensed under the Hospital | ||||||
17 | Licensing Act. | ||||||
18 | "Hospital unit" means a critical care unit, burn unit, | ||||||
19 | labor and delivery room, postanesthesia service area, | ||||||
20 | emergency department, operating room, pediatric unit, | ||||||
21 | step-down or intermediate care unit, specialty care unit, | ||||||
22 | telemetry unit, general medical care unit, sub-acute care unit, | ||||||
23 | or transitional inpatient care unit. | ||||||
24 | "Nurse" or "registered nurse" means a person licensed as a | ||||||
25 | registered professional nurse or licensed practical nurse | ||||||
26 | under the Nursing and Advanced Practice Nursing Act. | ||||||
27 | "Violation" means a finding by a court, governmental | ||||||
28 | commission, or neutral arbiter that wage-and-hour laws or | ||||||
29 | regulations were violated. | ||||||
30 | "Wage-and-hour laws or regulations" means any State or | ||||||
31 | federal law that regulates the hours worked by and wages paid | ||||||
32 | to registered nurses. | ||||||
33 | "Organizational plan of nursing services" means a written | ||||||
34 | plan of direct care nursing personnel staffing requirements |
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1 | that are appropriate to ensure that all patients receive health | ||||||
2 | care under normal and emergent circumstances. | ||||||
3 | Section 15. Registered nurse staff planning. Each hospital | ||||||
4 | shall develop and implement an organizational plan of nursing | ||||||
5 | services. It shall be an integral part of the overall hospital | ||||||
6 | organizational plan and shall be available to all nursing | ||||||
7 | personnel. Each hospital shall have a process that ensures the | ||||||
8 | consideration of input from direct care clinical staff in the | ||||||
9 | development, implementation, monitoring, evaluation, and | ||||||
10 | modification of the organizational plan of nursing services. At | ||||||
11 | least one-third the members of the committee charged with | ||||||
12 | developing, monitoring, evaluating, and modifying the plan | ||||||
13 | shall be nurses who provide direct patient care. The | ||||||
14 | organizational plan of nursing services shall include: | ||||||
15 | (1) Competency validation for registered nurses based | ||||||
16 | on the statutorily recognized duties and responsibilities | ||||||
17 | of the registered nurse and the standards that are specific | ||||||
18 | to each patient care unit. | ||||||
19 | (2) A patient classification system that establishes | ||||||
20 | staffing requirements by unit, patient, and shift; | ||||||
21 | determines staff resource allocation based on nursing care | ||||||
22 | requirements for each shift and each unit; establishes a | ||||||
23 | method by which the hospital validates the reliability of | ||||||
24 | the patient classification system; and incorporates a | ||||||
25 | method by which the hospital improves patient outcomes | ||||||
26 | based on clinical data. | ||||||
27 | (3) Written nursing service policies and procedures | ||||||
28 | based on current standards of nursing practice and | ||||||
29 | consistent with the nursing process, which includes | ||||||
30 | assessment, nursing diagnosis, planning, intervention, | ||||||
31 | evaluation, and patient advocacy. | ||||||
32 | The hospital administration and the governing body shall | ||||||
33 | review and approve all policies and procedures that relate to |
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1 | nursing service at least once every 3 years.
The organizational | ||||||
2 | plan of nursing services may include a schedule for meal | ||||||
3 | periods and rest periods different from those required by | ||||||
4 | Section 20 of this Act, provided that the schedule has been | ||||||
5 | approved by (and cannot be altered, suspended, or terminated | ||||||
6 | without the consent of) the committee charged with developing, | ||||||
7 | monitoring, evaluating, and modifying the organizational plan. | ||||||
8 | The Department of Public Health may establish by rule | ||||||
9 | additional criteria for organizational plans of nursing | ||||||
10 | services.
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11 | Section 20. Rest periods. Every hospital shall permit each | ||||||
12 | employee to take a 30-minute meal period and 2 10-minute rest | ||||||
13 | periods during the first 7.5 hours of work, and an additional | ||||||
14 | 15 minutes of meal or break period time for each additional 2 | ||||||
15 | hours worked beyond the first 7.5 hours of work. If | ||||||
16 | circumstances require an employee to work during or through a | ||||||
17 | meal period or break period for which the employee would have | ||||||
18 | received no compensation, then the employer shall pay the | ||||||
19 | employee for the time worked without compensation at 1.5 times | ||||||
20 | the employee's regular rate of compensation. | ||||||
21 | This Section 20 does not apply to employees for whom meal | ||||||
22 | and break periods are established through a collective | ||||||
23 | bargaining plan or pursuant to an organizational plan of | ||||||
24 | nursing services schedule prepared in accordance with Section | ||||||
25 | 15 of this Act. This Section does not apply to employees who | ||||||
26 | monitor patients with developmental disabilities or mental | ||||||
27 | illness, or both, and who, in the course of those duties, are | ||||||
28 | required to be on-call during the entire work period; provided, | ||||||
29 | however, that such employees shall be permitted to eat a meal | ||||||
30 | or meals during the work period while continuing to monitor | ||||||
31 | those patients. | ||||||
32 | Section 25. Violation of Act; license. The Director, after |
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1 | notice and opportunity for hearing, may deny, suspend, revoke, | ||||||
2 | or place conditional provisions upon a license of a hospital in | ||||||
3 | any case in which the Director finds that there has been a | ||||||
4 | substantial failure to comply with the provisions of this Act. | ||||||
5 | Section 30. Wage-and-hour provisions for registered | ||||||
6 | nurses. | ||||||
7 | (a) An employer that is a health system as defined in this | ||||||
8 | Act and commits more than 500 violations of wage-and-hour laws | ||||||
9 | or regulations for registered nurses within a 3-year period | ||||||
10 | shall be subject to a civil monetary penalty of up to 5% of the | ||||||
11 | employer's gross hospital patient revenues. | ||||||
12 | (b) The Attorney General shall determine whether 500 | ||||||
13 | violations were committed and shall set the penalty based on | ||||||
14 | the severity of the violations. | ||||||
15 | (c) The Department may impose a civil penalty under this | ||||||
16 | Section only after it provides the following to the employer: | ||||||
17 | (1) Written notice of the alleged violation. | ||||||
18 | (2) Written notice of the employer's right to request | ||||||
19 | an administrative hearing on the question of the alleged | ||||||
20 | violation. | ||||||
21 | (3) An opportunity to present evidence, orally or in | ||||||
22 | writing or both, on the question of the alleged violation | ||||||
23 | before an impartial hearing examiner appointed by the | ||||||
24 | Director. | ||||||
25 | (4) A written decision from the Director, based on the | ||||||
26 | evidence introduced at the hearing and the hearing | ||||||
27 | examiner's recommendations, finding that the employer | ||||||
28 | violated this Act and imposing the civil penalty. | ||||||
29 | (d) The Attorney General may bring an action in the circuit | ||||||
30 | court to enforce the collection of a monetary penalty imposed | ||||||
31 | under this Section. | ||||||
32 | (e) The moneys collected under this Section shall be | ||||||
33 | allocated to the Department for nursing scholarships awarded |
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1 | pursuant to the Nursing Education Scholarship Law in addition | ||||||
2 | to any other funds set aside and appropriated for that purpose. | ||||||
3 | Section 99. Effective date. This Act takes effect upon | ||||||
4 | becoming law.".
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