093_SB1787sam001

 










                                     LRB093 11032 AMC 13102 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 it
12        is  increasingly  difficult  for   patients   to   access
13        integrated services.
14             (2)  Quality  of patient care is jeopardized because
15        of staffing changes implemented in  response  to  managed
16        care.
17             (3) To ensure the adequate protection of patients in
18        acute  care  settings,  it  is  essential  that qualified
19        registered nurses be accessible and available to meet the
20        needs of patients.
21             (4) The basic principles of staffing  in  the  acute
 
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 1        care setting should be based on the patient's care needs,
 2        the  severity  of  condition,  services  needed,  and the
 3        complexity surrounding those services.

 4        Section 10. Definitions. As used in this Act:
 5        "Critical care unit" means a unit that is established  to
 6    safeguard  and  protect patients whose medical conditions are
 7    severe enough to require continuous  monitoring  and  complex
 8    intervention by registered nurses.
 9        "Employee"  means  any individual permitted to work by an
10    employer in an occupation, including both  individuals  hired
11    directly  by  the  company  and  those  hired  pursuant  to a
12    contract with an outside entity, such as a staffing agency.
13        "Employer" means any person or entity licensed under  the
14    Hospital  Licensing  Act, or the parent or holding company of
15    such person or entity, who directly or indirectly, or through
16    an agent or any other person, employs  or  exercises  control
17    over the wages, hours, or working conditions of any person.
18        "Health system" means a company (i) that is non-profit or
19    for-profit,  religious  or  non-religious and (ii) that owns,
20    operates, or controls more than 2 hospitals.
21        "Hospital" means an entity licensed  under  the  Hospital
22    Licensing Act.
23        "Hospital  unit"  means  a critical care unit, burn unit,
24    labor  and  delivery  room,  postanesthesia   service   area,
25    emergency   department,   operating   room,  pediatric  unit,
26    step-down or intermediate care  unit,  specialty  care  unit,
27    telemetry  unit,  general  medical  care  unit, subacute care
28    unit, and transitional inpatient care unit.
29        "Nurse" or "registered nurse" means a person licensed  as
30    a registered nurse or registered professional nurse under the
31    Nursing and Advanced Practice Nursing Act.
32        "Violation"  means  a  finding  by  a court, governmental
33    commission, or neutral arbiter that wage  and  hour  laws  or
 
                            -3-      LRB093 11032 AMC 13102 a
 1    regulations were violated.
 2        "Wage  and  hour  laws or regulations" means any State or
 3    federal law that regulates the hours and wages paid or worked
 4    by registered nurses.

 5        Section  15.  Registered  nurse  staff   planning.   Each
 6    hospital   shall  be  responsible  for  the  development  and
 7    implementation of a written hospital-wide staffing  plan  for
 8    nursing  services.  A  hospital  shall  have  a  process that
 9    ensures the consideration of input from direct care  clinical
10    staff   in   the   development,  implementation,  monitoring,
11    evaluation, and modification of the staffing plan. At least 6
12    of the members of  the  committee  charged  with  developing,
13    implementing,   monitoring,  evaluating,  and  modifying  the
14    staffing plan shall be nurses and at least half of the  nurse
15    members shall be registered nurses who provide direct patient
16    care. The staffing 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 establishes
22        staffing   requirements  by  unit,  patient,  and  shift;
23        determines staff resource  allocation  based  on  nursing
24        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
 
                            -4-      LRB093 11032 AMC 13102 a
 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             (4) Provisions for a  complete  orientation  to  the
 5        hospital  and assigned patient care unit before receiving
 6        patient  care  assignments,  and  a  written,   organized
 7        in-service   education   program  for  all  patient  care
 8        personnel, including temporary staff.
 9        The Department of Public Health  may  establish  by  rule
10    additional criteria for staffing plans.

11        Section  20.  Rest  periods.  A  hospital  employee  must
12    receive  a 30-minute meal period and 2 15-minute rest periods
13    for every 5 hours of work. Pursuant to mutual consent by  the
14    employer  and  the  employee,  an  employee  may  (i) waive a
15    30-minute meal period if the day's work will be completed  in
16    no  more  than  6  hours  or  (ii)  may waive the second of 2
17    30-minute meal periods when the day's work will be  completed
18    in  no more than 12 hours and the first 30-minute meal period
19    was not waived.
20        When an employer fails to provide a meal or  rest  period
21    in accordance with the applicable provisions of this Act, the
22    employer shall pay the employee one additional hour of pay at
23    the  employee's regular rate of compensation for each workday
24    that the meal or rest period is not provided.

25        Section 25. Penalties. The Department  of  Public  Health
26    may  impose  civil  penalties  or  suspend,  revoke, or place
27    conditional provisions upon a license of  a  hospital  for  a
28    violation  of any provision of this Act. The Department shall
29    adopt by rule a schedule establishing  the  amount  of  civil
30    penalty  that may be imposed for any violation of Sections 15
31    through 25 of this Act when there is a reasonable belief that
32    safe patient care has been or  may  be  negatively  impacted.
 
                            -5-      LRB093 11032 AMC 13102 a
 1    Each  violation  of  a  staffing  plan  shall be considered a
 2    separate violation.

 3        Section 30.  Wage  and  hour  provisions  for  registered
 4    nurses.
 5        (a)  Any  employer  that is a health system as defined in
 6    this Act and commits more than 500  violations  of  wage  and
 7    hour  laws  or  regulations  for  registered  nurses within a
 8    3-year period shall be fined  up  to  5%  of  gross  hospital
 9    patient revenues.
10        (b)  The fine moneys shall be allocated to the Department
11    of Public Health for nursing scholarships awarded pursuant to
12    the Nursing Education Scholarship  Law  in  addition  to  any
13    other funds set aside and appropriated for that purpose.
14        (c)   The   Attorney   General  shall  determine  if  500
15    violations were committed and set the penalty  based  on  the
16    severity of the violations.

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