093_SB1787sam002
LRB093 11032 AMC 14312 a
1 AMENDMENT TO SENATE BILL 1787
2 AMENDMENT NO. . Amend Senate Bill 1787 by replacing
3 the title with the following:
4 "AN ACT concerning health care."; and
5 by replacing everything after the enacting clause with the
6 following:
7 "Section 1. Short title. This Act may be cited as the
8 Nursing and Hospital Worker Protection Act.
9 Section 5. Findings. The Legislature finds and declares
10 all of the following:
11 (1) Health care services are becoming complex and
12 it is increasingly difficult for patients to access
13 integrated services.
14 (2) Quality of patient care could be impacted by
15 staffing changes implemented in response to managed care.
16 (3) To ensure the adequate protection of patients
17 in acute care settings, it is essential that qualified
18 registered nurses be accessible and available to meet the
19 needs of patients.
20 (4) The basic principles of staffing in the acute
21 care setting should be based on the patient's care needs,
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1 the severity of condition, services needed, and the
2 complexity surrounding those services.
3 Section 10. Definitions. As used in this Act:
4 "Critical care unit" means a unit that is established to
5 safeguard and protect patients whose medical conditions are
6 severe enough to require continuous monitoring and complex
7 intervention by registered nurses.
8 "Employee" means any individual permitted to work by an
9 employer in an occupation, including both individuals hired
10 directly by the company and those hired pursuant to a
11 contract with an outside entity, such as a staffing agency.
12 "Employer" means any person or entity licensed under the
13 Hospital Licensing Act, or the parent or holding company of
14 such person or entity, who directly or indirectly, or through
15 an agent or any other person, employs or exercises control
16 over the wages, hours, or working conditions of any person.
17 "Health system" means a company (i) that is non-profit or
18 for-profit, religious or non-religious and (ii) that owns,
19 operates, or controls more than 2 hospitals.
20 "Hospital" means an entity licensed under the Hospital
21 Licensing Act.
22 "Hospital unit" means a critical care unit, burn unit,
23 labor and delivery room, postanesthesia service area,
24 emergency department, operating room, pediatric unit,
25 step-down or intermediate care unit, specialty care unit,
26 telemetry unit, general medical care unit, subacute care
27 unit, and transitional inpatient care unit.
28 "Nurse" or "registered nurse" means a person licensed as
29 a registered nurse or registered professional nurse under the
30 Nursing and Advanced Practice Nursing Act.
31 "Violation" means a finding by a court, governmental
32 commission, or neutral arbiter that wage and hour laws or
33 regulations were violated.
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1 "Wage and hour laws or regulations" means any State or
2 federal law that regulates the hours and wages paid or worked
3 by registered nurses.
4 Section 15. Registered nurse staff planning. Each
5 hospital shall develop and implement a written organizational
6 plan of nursing services. It shall be an integral part of the
7 overall hospital organizational plan and shall be available
8 to all nursing personnel. Each hospital shall have a process
9 that ensures the consideration of input from direct care
10 clinical staff in the development, implementation,
11 monitoring, evaluation and modification of the plan of
12 nursing services. At least half the members of the committee
13 charged with developing, monitoring, evaluating and modifying
14 the plan shall be nurses and at least half of the nurse
15 members shall be registered nurses who provide direct patient
16 care. The organizational plan shall include:
17 (1) Competency validation for registered nurses
18 based on the statutorily recognized duties and
19 responsibilities of the registered nurse and the
20 standards that are specific to each patient care unit.
21 (2) A patient classification system that
22 establishes staffing requirements by unit, patient, and
23 shift; determines staff resource allocation based on
24 nursing care requirements for each shift and each unit;
25 establishes a method by which the hospital validates the
26 reliability of the patient classification system; and
27 incorporates a method by which the hospital improves
28 patient outcomes based on clinical data.
29 (3) Written nursing service policies and procedures
30 based on current standards of nursing practice and
31 consistent with the nursing process, which includes:
32 assessment, nursing diagnosis, planning, intervention,
33 evaluation, and patient advocacy. The hospital
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1 administration and the governing body shall review and
2 approve all policies and procedures that relate to
3 nursing service at least once every 3 years.
4 The organizational plan may include a schedule for meal
5 periods and rest periods different from those required by
6 Section 20 of this Act, provided that such schedule has been
7 approved by (and cannot be altered, suspended, or terminated
8 without the consent of) the committee charged with
9 developing, monitoring, evaluating, and modifying the
10 organizational plan. The Department of Public Health may
11 establish by rule additional criteria for organizational
12 plans.
13 Section 20. Rest periods. Every hospital shall permit
14 each employee to take a 30-minute meal period and 2 10-minute
15 rest periods during the first 7 1/2 hours of work, and an
16 additional 15 minutes of meal or break period time for each
17 additional 2 hours worked beyond the first 7 1/2 hours of
18 work. If circumstances require an employee to work during or
19 through a meal period or break period for which the employee
20 would have received no compensation, then the employer shall
21 pay the employee for the time worked without compensation at
22 one and one-half times the employee's regular rate of
23 compensation. This Section 20 does not apply to employees for
24 whom meal and break periods are established through a
25 collective bargaining plan or pursuant to an organizational
26 plan schedule prepared in accordance with Section 15 of this
27 Act. This Section does not apply to employees who monitor
28 patients with developmental disabilities or mental illness,
29 or both, and who, in the course of those duties, are required
30 to be on-call during the entire work period; provided,
31 however, that such employees shall be permitted to eat a meal
32 or meals during the work period while continuing to monitor
33 those patients.
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1 Section 25. Violation of Act. The Director, after notice
2 and opportunity for hearing, may deny, suspend, revoke, or
3 place conditional provisions upon a license of a hospital in
4 any case in which the Director finds that there has been a
5 substantial failure to comply with the provisions of this
6 Act.
7 Section 30. Wage and hour provisions for registered
8 nurses.
9 (a) Any employer that is a health system as defined in
10 this Act and commits more than 500 violations of wage and
11 hour laws or regulations for registered nurses within a
12 3-year period shall be fined up to 5% of gross hospital
13 patient revenues.
14 (b) The fine moneys shall be allocated to the Department
15 of Public Health for nursing scholarships awarded pursuant to
16 the Nursing Education Scholarship Law in addition to any
17 other funds set aside and appropriated for that purpose.
18 (c) The Attorney General shall determine if 500
19 violations were committed and set the penalty based on the
20 severity of the violations.
21 Section 99. Effective date. This Act takes effect upon
22 becoming law.".