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,
 
                            -2-      LRB093 11032 AMC 14312 a
 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.
 
                            -3-      LRB093 11032 AMC 14312 a
 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
 
                            -4-      LRB093 11032 AMC 14312 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        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.
 
                            -5-      LRB093 11032 AMC 14312 a
 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.".