Full Text of HB1083 93rd General Assembly
HB1083sam001 93RD GENERAL ASSEMBLY
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Sen. Don Harmon
Filed: 4/28/2004
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LRB093 05459 DRJ 50226 a |
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| AMENDMENT TO HOUSE BILL 1083
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| AMENDMENT NO. ______. Amend House Bill 1083 by replacing | 3 |
| everything after the enacting clause with the following:
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| "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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| (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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| (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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| 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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| 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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| 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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| 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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| 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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| 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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| 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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