NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A1921
SPONSOR: Bichotte Hermelyn TITLE OF BILL:
An act to amend the public health law, in relation to establishing the
"safe staffing for hospital care act"
PURPOSE OR GENERAL IDEA OF BILL:
Establishes the "Safe Staffing for Hospital Care Act"
SUMMARY OF SPECIFIC 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 require-
ments 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 classi-
fication. 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 infor-
mation 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 emer-
gency 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 writ-
ten 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 need-
ed. 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 ensur-
ing that licensed health care facilities hire adequate numbers of quali-
fied 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 unfortu-
nately can lead to preventable deaths. A substantial number of nurses
indicate that hospital-patient acuity measurements are in adequate and t
hat 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.
PRIOR LEGISLATIVE HISTORY:
2021-22: A06848; referred to Health
2019-2020: A3374; referred to Health
2017-2018: A919; referred to Health
FISCAL IMPLICATIONS:
Undetermined
EFFECTIVE DATE:
July first after it becomes law.
