Full Text of SB0361 095th General Assembly
SB0361 95TH GENERAL ASSEMBLY
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95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008 SB0361
Introduced 2/7/2007, by Sen. Carol Ronen SYNOPSIS AS INTRODUCED: |
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New Act |
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210 ILCS 85/7 |
from Ch. 111 1/2, par. 148 |
210 ILCS 85/9 |
from Ch. 111 1/2, par. 150 |
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Creates the Patient Acuity Nursing Staffing Act and amends the Hospital Licensing Act. Provides that every hospital shall implement a written hospital-wide staffing plan that includes a matrix for staffing decision-making that provides for minimum direct care professional registered nurse-to-patient staffing needs for each unit of care. Sets forth items that must be included in the staffing plan. Provides that every hospital shall establish a nursing care committee, which shall determine a written staffing plan for the hospital; sets forth particular responsibilities of the committee. Provides that any nurse who is an employee of a hospital that is subject to the Patient Acuity Nursing Staffing Act Act may file a complaint with the Department of Public Health regarding an alleged violation of the Act without fear of retaliation, discipline, or discharge. Provides that upon receiving a complaint of a violation, the Department may take any action authorized under certain provisions of the Hospital Licensing Act, including denial, suspension, or revocation of a permit or license or making an inspection or investigation. Effective January 1, 2008.
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A BILL FOR
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SB0361 |
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LRB095 09342 DRJ 29537 b |
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| AN ACT concerning regulation.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 1. Short title. This Act may be cited as the | 5 |
| Patient Acuity Nursing Staffing Act. | 6 |
| Section 5. Findings. The legislature finds and declares all | 7 |
| of the following: | 8 |
| (1) The State of Illinois has a substantial interest in | 9 |
| promoting quality care and improving the delivery of health | 10 |
| care services in health care facilities in the State. | 11 |
| (2) Numerous studies have shown that improved patient | 12 |
| outcomes are directly correlated to direct care registered | 13 |
| nurse staffing levels. | 14 |
| (3) Evidence-based studies have shown that the basic | 15 |
| principles of staffing in the acute care setting should be | 16 |
| based on the complexity of patients' care needs matched to | 17 |
| nursing skills required for optimal outcomes and improved | 18 |
| quality of care within the system's environment. | 19 |
| Section 10. Definitions. In this Act: | 20 |
| "Acuity model" means an acuity tool developed and | 21 |
| implemented by a hospital, as determined by that hospital's | 22 |
| nursing care committee, that matches patient care needs and |
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LRB095 09342 DRJ 29537 b |
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| nurse competency required for optimal outcomes into the | 2 |
| staffing plan.
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| "Department" means the Department of Public Health. | 4 |
| "Direct patient care" means a registered professional | 5 |
| nurse with direct responsibility to carry out medical regimens | 6 |
| or nursing care for one or more patients.
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| "Hospital" means an entity licensed under the Hospital | 8 |
| Licensing Act or organized under the University of Illinois | 9 |
| Hospital Act.
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| "Nursing care committee" means a committee to develop and | 11 |
| review a hospital's staffing plan, established pursuant to | 12 |
| Section 20. | 13 |
| "Registered professional nurse" means a person licensed as | 14 |
| a Registered Nurse under the Nursing and Advanced Practice | 15 |
| Nursing Act. | 16 |
| "Written staffing plan for nursing care services" means a | 17 |
| written plan for assignment of nursing staff based on minimum | 18 |
| staffing levels for each patient care unit and the adopted | 19 |
| acuity model linking patient care needs with nursing skills | 20 |
| required for optimal outcomes. | 21 |
| Section 15. Written staffing plan. | 22 |
| (a) Every hospital shall implement a written hospital-wide | 23 |
| staffing plan, adopted by the hospital's nursing care | 24 |
| committee, that includes a matrix for staffing decision-making | 25 |
| that provides for minimum direct care professional registered |
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| nurse-to-patient staffing needs for each unit of care.
The | 2 |
| written hospital-wide staffing plan shall include, but need not | 3 |
| be
limited to, the following considerations:
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| (1) The complexity of complete care, assessment on | 5 |
| patient admission, patient admissions, discharges and | 6 |
| transfers, and volume; individual patient intensity; and | 7 |
| evaluation of the progress of the patient problems, ongoing | 8 |
| physical assessments, planning for patient discharge, | 9 |
| assessment after a change in patient condition, or | 10 |
| assessment of the need for patient referrals.
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| (2) The complexity of clinical professional nursing | 12 |
| judgment needed to design and implement the patient's | 13 |
| nursing care plan, the need for specialized equipment and | 14 |
| technology, and the skill mix of other personnel providing | 15 |
| or supporting direct patient care not required by direct | 16 |
| care registered professional nurse; the learning curve for | 17 |
| individuals and groups of nurses; staffing consistency, | 18 |
| continuity, and cohesion; cross-training; control of | 19 |
| practice; and involvement in quality improvement | 20 |
| activities, professional expectations, preparation, and | 21 |
| experience.
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| (3) Patient characteristics and the number of patients | 23 |
| for whom care is being provided.
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| (4) Architecture (geographical dispersion of patients, | 25 |
| size and layout of individual patient rooms, arrangement of | 26 |
| entire patient care units, and so forth); technology; same |
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| unit or cluster of patients.
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| Ongoing patient assessments of a unit's patient acuity | 3 |
| level and nursing staff required shall be routinely made by the | 4 |
| patient care coordinator or charge nurse.
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| The charge nurse shall not be routinely assigned for direct | 6 |
| patient care in order to provide and accommodate changing | 7 |
| patient care needs and nurse availability.
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| As nurse and non-nurse staffing needs are identified from | 9 |
| the staffing-decision matrix, organizational policy should | 10 |
| reflect an organizational climate that values registered | 11 |
| nurses and other employees as strategic assets and exhibits a | 12 |
| true commitment to filling budgeted positions in a timely | 13 |
| manner.
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| (b) In addition to the written staffing plan, every | 15 |
| hospital shall adopt an acuity plan to adjust the staffing plan | 16 |
| for each patient care
unit to provide staffing flexibility to | 17 |
| meet patient care needs.
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| Section 20. Nursing care committee. | 19 |
| (a) Every hospital shall establish a nursing care | 20 |
| committee. A hospital shall appoint members of the committee | 21 |
| such that at least 50% of the members of the committee must be | 22 |
| registered professional nurses providing direct patient care.
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| (b) The nursing care committee shall determine a written | 24 |
| staffing plan for the hospital based on the
principles from the | 25 |
| staffing decision matrix components set forth in subsection (a) |
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| of Section 15. In particular, the committee shall do the | 2 |
| following:
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| (1) Develop, adopt, and implement minimum staffing | 4 |
| levels for each patient
care unit. | 5 |
| (2) Develop, adopt, and implement an acuity model to | 6 |
| provide staffing flexibility that links changing patient | 7 |
| acuity with nursing with nursing skills required.
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| (3) Develop and implement a written staffing plan | 9 |
| incorporating the items described in subsections (a) and | 10 |
| (b) of Section 15.
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| (4) Post the written staffing plan in a conspicuous and | 12 |
| accessible location for both patients and direct care | 13 |
| staff, as required under the Hospital Report Card Act.
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| (5) Analyze and recommend changes to improve patient | 15 |
| care. | 16 |
| (6) Meet no less than monthly.
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| (7) Review annually the following: budgeting of | 18 |
| nursing care hours for each
inpatient unit; | 19 |
| nurse-to-patient staffing guidelines for all inpatient | 20 |
| areas;
and current acuity measures in use.
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| Section 25. Violation; complaint; penalty. Any nurse who is | 22 |
| an employee of a hospital that is subject to this Act may file | 23 |
| a complaint with the Department of Public Health regarding an | 24 |
| alleged violation of this Act without fear of retaliation, | 25 |
| discipline, or discharge. Upon receiving a complaint of a |
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| violation of this Act, the Department may take any action | 2 |
| authorized under Section 7 or 9 of the Hospital Licensing Act. | 3 |
| Section 90. The Hospital Licensing Act is amended by | 4 |
| changing Sections 7 and 9 as follows:
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| (210 ILCS 85/7) (from Ch. 111 1/2, par. 148)
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| Sec. 7. (a) The Director after notice and opportunity for | 7 |
| hearing to the
applicant or licensee may deny, suspend, or | 8 |
| revoke a permit to establish a
hospital or deny, suspend, or | 9 |
| revoke a license to open, conduct, operate,
and maintain a | 10 |
| hospital in any case in which he finds that there has been a
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| substantial failure to comply with the provisions of this Act, | 12 |
| the Hospital
Report Card Act, the Patient Acuity Nursing | 13 |
| Staffing Act, or the Illinois Adverse Health Care Events | 14 |
| Reporting Law of 2005 or the standards, rules, and regulations | 15 |
| established by
virtue of any of those Acts.
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| (b) Such notice shall be effected by registered mail or by | 17 |
| personal
service setting forth the particular reasons for the | 18 |
| proposed action and
fixing a date, not less than 15 days from | 19 |
| the date of such mailing or
service, at which time the | 20 |
| applicant or licensee shall be given an
opportunity for a | 21 |
| hearing. Such hearing shall be conducted by the Director
or by | 22 |
| an employee of the Department designated in writing by the | 23 |
| Director
as Hearing Officer to conduct the hearing. On the | 24 |
| basis of any such
hearing, or upon default of the applicant or |
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| licensee, the Director shall
make a determination specifying | 2 |
| his findings and conclusions. In case of a
denial to an | 3 |
| applicant of a permit to establish a hospital, such
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| determination shall specify the subsection of Section 6 under | 5 |
| which the
permit was denied and shall contain findings of fact | 6 |
| forming the basis of
such denial. A copy of such determination | 7 |
| shall be sent by registered mail
or served personally upon the | 8 |
| applicant or licensee. The decision denying,
suspending, or | 9 |
| revoking a permit or a license shall become final 35 days
after | 10 |
| it is so mailed or served, unless the applicant or licensee, | 11 |
| within
such 35 day period, petitions for review pursuant to | 12 |
| Section 13.
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| (c) The procedure governing hearings authorized by this | 14 |
| Section shall be
in accordance with rules promulgated by the | 15 |
| Department and approved by the
Hospital Licensing Board. A full | 16 |
| and complete record shall be kept of all
proceedings, including | 17 |
| the notice of hearing, complaint, and all other
documents in | 18 |
| the nature of pleadings, written motions filed in the
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| proceedings, and the report and orders of the Director and | 20 |
| Hearing Officer.
All testimony shall be reported but need not | 21 |
| be transcribed unless the
decision is appealed pursuant to | 22 |
| Section 13. A copy or copies of the
transcript may be obtained | 23 |
| by any interested party on payment of the cost
of preparing | 24 |
| such copy or copies.
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| (d) The Director or Hearing Officer shall upon his own | 26 |
| motion, or on the
written request of any party to the |
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| proceeding, issue subpoenas requiring
the attendance and the | 2 |
| giving of testimony by witnesses, and subpoenas
duces tecum | 3 |
| requiring the production of books, papers, records, or
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| memoranda. All subpoenas and subpoenas duces tecum issued under | 5 |
| the terms
of this Act may be served by any person of full age. | 6 |
| The fees of witnesses
for attendance and travel shall be the | 7 |
| same as the fees of witnesses before
the Circuit Court of this | 8 |
| State, such fees to be paid when the witness is
excused from | 9 |
| further attendance. When the witness is subpoenaed at the
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| instance of the Director, or Hearing Officer, such fees shall | 11 |
| be paid in
the same manner as other expenses of the Department, | 12 |
| and when the witness
is subpoenaed at the instance of any other | 13 |
| party to any such proceeding the
Department may require that | 14 |
| the cost of service of the subpoena or subpoena
duces tecum and | 15 |
| the fee of the witness be borne by the party at whose
instance | 16 |
| the witness is summoned. In such case, the Department in its
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| discretion, may require a deposit to cover the cost of such | 18 |
| service and
witness fees. A subpoena or subpoena duces tecum | 19 |
| issued as aforesaid shall
be served in the same manner as a | 20 |
| subpoena issued out of a court.
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| (e) Any Circuit Court of this State upon the application of | 22 |
| the
Director, or upon the application of any other party to the | 23 |
| proceeding,
may, in its discretion, compel the attendance of | 24 |
| witnesses, the production
of books, papers, records, or | 25 |
| memoranda and the giving of testimony before
the Director or | 26 |
| Hearing Officer conducting an investigation or holding a
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| hearing authorized by this Act, by an attachment for contempt, | 2 |
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otherwise, in the same manner as production of evidence may | 3 |
| be compelled
before the court.
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| (f) The Director or Hearing Officer, or any party in an | 5 |
| investigation or
hearing before the Department, may cause the | 6 |
| depositions of witnesses
within the State to be taken in the | 7 |
| manner prescribed by law for like
depositions in civil actions | 8 |
| in courts of this State, and to that end
compel the attendance | 9 |
| of witnesses and the production of books, papers,
records, or | 10 |
| memoranda.
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| (Source: P.A. 93-563, eff. 1-1-04; 94-242, eff. 7-18-05.)
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| (210 ILCS 85/9) (from Ch. 111 1/2, par. 150)
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| Sec. 9. Inspections and investigations. The Department | 14 |
| shall make or
cause
to be made such inspections and
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| investigations as it deems necessary. Information received by | 16 |
| the
Department through filed reports, inspection, or as | 17 |
| otherwise authorized
under this Act or under the Patient Acuity | 18 |
| Nursing Staffing Act shall not be disclosed publicly in such | 19 |
| manner as to
identify individuals or hospitals, except (i) in a | 20 |
| proceeding involving the
denial, suspension, or revocation of a | 21 |
| permit to establish a hospital or a
proceeding involving the | 22 |
| denial, suspension, or revocation of a license to
open, | 23 |
| conduct, operate, and maintain a hospital, (ii) to the | 24 |
| Department of
Children and Family Services in the course of a | 25 |
| child abuse or neglect
investigation conducted by that |
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| Department or by the Department of Public
Health, (iii) in | 2 |
| accordance with Section 6.14a of this Act, or (iv)
in other | 3 |
| circumstances as may be approved by the Hospital Licensing | 4 |
| Board.
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| (Source: P.A. 90-608, eff. 6-30-98; 91-242, eff. 1-1-00.)
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| Section 99. Effective date. This Act takes effect January | 7 |
| 1, 2008.
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