Establishes the "Safe Staffing for Hospital Care Act"

Summary of provisions

Section 1. Short title: "Safe Staffing for Hospital Care Act" Section

2. Legislative findings and intent

Section 3. Creates Article 28-F of the public health law: "Safe Staffing for Hospital Care Act", which includes the following provisions:

Licensed Article 28 facilitates must provide the appropriate numbers of qualified nursing staff in each department and submit an annual staffing plan to the Department of Health with a written certification plan. The staffing plan must meet the minimum requirements established in the bill as well as meet additional requirements as provided by other law or regulation.

An approved acuity system must be established to address fluctuations in patient care and nursing care requirements, and must identify administrative work that is performed by direct care nurses. Requires the Department of Health to develop regulations by which it will approve a facility's acuity system.

The facility must: identify the assessment tool used to document actual daily staffing; include a written assessment of the accuracy of the prior year's staffing plan; and identify each nurse staff classification with a statement setting forth minimum qualifications for each classification. Such system must be developed in consultation with the direct-care nursing staff or an approved collective bargaining representative.

Describes minimum direct-care nurse to patient ratios for specific department and units. Requires the Department of Health to adopt regulations to establish minimum nurse to patient ratios. When the approved acuity system indicates that additional staff are needed, the facility must staff at the higher level. The skill mix reflected in a staffing plan must ensure that specific elements in the nursing process are performed.

Registered nurses must constitute 50% of the direct care nurses in the staffing plan. Prohibits unlicensed personnel from performing duties established in law or regulation that are limited to licensed personnel.

Requires a facility to be staffed at all times in accordance with its staffing plan. The facility may staff at higher nurse to patient staffing ratios.

Requires the nurse to be appropriately licensed, to receive appropriate orientation, and verification that the nurse can provide competent nursing care in order to be included in the staffing plan.

In order to be licensed as an Article 28 facility, the facility must maintain accurate daily records containing specific information described in the bill.

Requires the facility to maintain daily statistics on mortality, morbidity, infection, accident, injury and medical errors. Records required by this bill must be maintained for a period of seven years.

Requires records to be made available to the Department of Health and the public. Provides patient Privacy protections.

Prohibits mandatory overtime except during a state of emergency declared by the Governor. Establishes limits on work hours and requires specific hours for employees to be off duty.

Allows for an overtime program in excess of limits established in the bill, provided that such over time is pursuant to a collective bargaining agreement and that adequate measures to prevent employee fatigue are included in the agreement.

Requires each licensed health care facility to adopt and disseminate written policies under which direct care nurses may refuse a work assignment. Describes conditions under which a nurse may refuse a work assignment. Describes minimum standards to be included in the written work assignment policy.

Prohibits a facility from penalizing the employee if the employee reasonably acted in good faith in refusing a work assignment. Describes situations constituting good faith.

Allows for actions to be brought by any person who has been injured by reason of a violation of this article.

Requires the Commissioner of Health to enforce this article and to adopt rules and regulations to promulgate its provisions.

Prohibits health care facilities from taking adverse actions against an individual because such individual seeks to enforce this article.

Allows for monetary relief to be awarded to an employee when the employee prevails in any action under this article. Enjoins the health care facility from continuing to violate the provisions of this article. The facility may be required to take affirmative steps as needed. Requires the health care facility to pay reasonable attorney's and expert witness fees and other costs associated with the action.

Section 4. Effective Date

Justification

This bill will: protect the safety of New York State residents by ensuring that licensed health care facilities hire adequate numbers of qualified nursing staff in each department; require minimum

direct-care nurse to patient ratios; prohibit unlicensed personnel from performing tasks that are limited by state law or regulation to licensed personnel; prohibit mandatory overtime; require the facility to adopt written regulations under which a nurse may refuse a work assignment, and prohibit the employee from being penalized if he or she has acted in good faith in refusing a work assignment. It is the responsibility of the State to ensure that the delivery of health care services to patients in health care facilities in New York is adequate and safe. Furthermore, these facilities must retain sufficient nursing staff in order to promote optimal health outcomes. Higher acuity levels among patients in our health care facilities require safe staffing levels. Low staffing levels and lack of adequately trained staff can result in dangerous and unnecessary medical errors and infections, that unfortunately can lead to preventable deaths. A substantial number of nurses indicate that hospital-patient acuity measurements are inadequate and that many hospitals, rarely, if ever, staff according to an established acuity measurement tool. Establishing staffing standards will ensure that health care facilities throughout the state operate in a manner that guarantees the public safety and the delivery of quality health care services.

Legislative history

2013-14: S.1634 Referred to Health 2011-12: S.1134 Referred to Health 2010: S.1780 Referred to Health A.5370 Referred to Health 2008: S.2482 Referred to Health A.8107 Referred to Health 2006: S.2965 Referred to Health

Fiscal implications

Undetermined.

Local fiscal implications

Undetermined.

Effective date

July first after it becomes law.