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S01168 Summary:

BILL NOS01168A
 
SAME ASSAME AS A00108-B
 
SPONSORRIVERA
 
COSPNSRADDABBO, BAILEY, BENJAMIN, BIAGGI, BOYLE, BRESLIN, BRISPORT, BROOKS, BROUK, COMRIE, GAUGHRAN, GOUNARDES, HARCKHAM, HINCHEY, HOYLMAN, JACKSON, KAMINSKY, KAPLAN, KAVANAGH, KENNEDY, KRUEGER, LIU, MANNION, MATTERA, MAY, MAYER, MYRIE, PARKER, PERSAUD, RAMOS, REICHLIN-MELNICK, RYAN, SALAZAR, SANDERS, SEPULVEDA, SERINO, SERRANO, SKOUFIS, STAVISKY, THOMAS
 
MLTSPNSR
 
Amd 2805-t, Pub Health L
 
Requires certain facilities establish clinical staffing committees.
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S01168 Actions:

BILL NOS01168A
 
01/07/2021REFERRED TO HEALTH
04/22/2021AMEND (T) AND RECOMMIT TO HEALTH
04/22/2021PRINT NUMBER 1168A
04/26/20211ST REPORT CAL.729
04/27/20212ND REPORT CAL.
04/28/2021ADVANCED TO THIRD READING
05/04/2021SUBSTITUTED BY A108B
 A00108 AMEND=B Gunther
 01/06/2021referred to health
 02/02/2021reported referred to codes
 02/17/2021amend and recommit to codes
 02/17/2021print number 108a
 03/01/2021reported referred to ways and means
 04/22/2021amend (t) and recommit to ways and means
 04/22/2021print number 108b
 04/28/2021reported
 04/29/2021advanced to third reading cal.232
 05/04/2021passed assembly
 05/04/2021delivered to senate
 05/04/2021REFERRED TO HEALTH
 05/04/2021SUBSTITUTED FOR S1168A
 05/04/20213RD READING CAL.729
 05/04/2021PASSED SENATE
 05/04/2021RETURNED TO ASSEMBLY
 06/07/2021delivered to governor
 06/18/2021signed chap.155
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S01168 Memo:

Memo not available
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S01168 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         1168--A
 
                               2021-2022 Regular Sessions
 
                    IN SENATE
 
                                     January 7, 2021
                                       ___________
 
        Introduced  by  Sens.  RIVERA, ADDABBO, BAILEY, BENJAMIN, BIAGGI, BOYLE,
          BRESLIN, BRISPORT, BROOKS, BROUK, COMRIE, GAUGHRAN, GOUNARDES,  HARCK-
          HAM,  HINCHEY,  HOYLMAN, JACKSON, KAMINSKY, KAPLAN, KAVANAGH, KENNEDY,
          KRUEGER, LIU, MANNION, MATTERA,  MAY,  MAYER,  MYRIE,  PARKER,  RAMOS,
          REICHLIN-MELNICK,  RYAN, SALAZAR, SANDERS, SEPULVEDA, SERINO, SERRANO,
          SKOUFIS, STAVISKY, THOMAS -- read twice and ordered printed, and  when
          printed  to  be  committed  to  the  Committee  on Health -- committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee
 
        AN ACT to amend the public health law, in relation to establishing clin-
          ical staffing committees
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1. Section 2805-t of the public health law, as added by chap-
     2  ter 422 of the laws of 2009, is amended to read as follows:
     3    § 2805-t. [Disclosure] Clinical staffing committees and disclosure  of
     4  nursing  quality  indicators.  1.  Legislative intent.   The legislature
     5  hereby finds and declares:
     6    (a) Research demonstrates that nurses play a critical role in  improv-
     7  ing patient safety and quality of care;
     8    (b)  Appropriate  staffing  of  general  hospital personnel, including
     9  registered nurses  available  for  patient  care,  assists  in  reducing
    10  errors,  complications  and  adverse patient care events, improves staff
    11  safety and satisfaction, and reduces incidences of workplace injuries;
    12    (c) Health care professional, technical, and  support  staff  comprise
    13  vital  components  of  the  patient care team, bringing their particular
    14  skills and services to ensuring quality patient care;
    15    (d)  Ensuring  sufficient  staffing  of  general  hospital  personnel,
    16  including  registered  nurses,  is  an  urgent public policy priority in
    17  order to protect patients and support greater  retention  of  registered
    18  nurses and safer working conditions; and
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02466-13-1

        S. 1168--A                          2
 
     1    (e)  It  is  the  public policy of the state to promote evidence-based
     2  nurse staffing standards and increase transparency of health  care  data
     3  and decision making based on the data.
     4    2.  Clinical  staffing  committee.  (a) Each general hospital licensed
     5  pursuant to this article shall establish and maintain a clinical  staff-
     6  ing committee, either by creating a new committee or assigning the func-
     7  tions  of  the  clinical staffing committee to an existing committee, no
     8  later than January first, two thousand twenty-two.
     9    (b) Where a collective bargaining agreement provides  for  a  staffing
    10  committee,  the  required  functions  of the clinical staffing committee
    11  established pursuant to this section shall  be  incorporated  into  that
    12  committee.  Any  staffing  or  non-staffing  committees established by a
    13  collective bargaining agreement, shall continue to function  in  accord-
    14  ance  with the terms of the agreement, and the clinical staffing commit-
    15  tee established by this section shall not limit  or  otherwise  supplant
    16  the collective bargaining agreement.
    17    (c)  At least one-half of the members of the clinical staffing commit-
    18  tee shall be registered nurses, licensed practical nurses, and ancillary
    19  members of the frontline team currently providing or  supporting  direct
    20  patient  care and up to one-half of the members shall be selected by the
    21  general hospital administration and shall include but not be limited  to
    22  the chief financial officer, the chief nursing officer, and patient care
    23  unit  directors  or  managers  or  their designees. The selection of the
    24  registered nurses, licensed practical nurses,  and  ancillary  frontline
    25  team  members  of  the  committee shall be according to their respective
    26  collective bargaining agreements if there is one in effect at the gener-
    27  al hospital for their bargaining unit. If there is no applicable collec-
    28  tive bargaining agreement, the members of the clinical staffing  commit-
    29  tee  who are registered nurses, licensed practical nurses, and ancillary
    30  members providing direct patient care shall be selected by their  peers.
    31  Ancillary  members  of the frontline team on the committee shall include
    32  but are not limited  to  patient  care  technicians,  certified  nursing
    33  assistants,  other non-licensed staff assisting with nursing or clerical
    34  tasks, and unit clerks.
    35    3. Employee participation.  Participation  in  the  clinical  staffing
    36  committee by a general hospital employee shall be on scheduled work time
    37  and  compensated  at  the  appropriate  rate  of  pay. Clinical staffing
    38  committee members shall be fully  relieved  of  all  other  work  duties
    39  during meetings of the committee and shall not have work duties added or
    40  displaced  to  other  times  as a result of their committee responsibil-
    41  ities.
    42    4. Primary responsibilities. Primary responsibilities of the  clinical
    43  staffing committee shall include the following functions:
    44    (a)  Development and oversight of implementation of an annual clinical
    45  staffing plan. The clinical staffing plan shall include specific  staff-
    46  ing  for each patient care unit and work shift and shall be based on the
    47  needs of patients. Staffing plans shall include specific  guidelines  or
    48  ratios,  matrices, or grids indicating how many patients are assigned to
    49  each registered nurse and the number of nurses and ancillary staff to be
    50  present on each unit and shift and shall be used as the  primary  compo-
    51  nent of the general hospital staffing budget.
    52    (b)  Factors  to  be considered and incorporated in the development of
    53  the plan shall include, but are not limited to:
    54    (i) Census, including total numbers of patients on the  unit  on  each
    55  shift  and  activity  such as patient discharges, admissions, and trans-
    56  fers;

        S. 1168--A                          3
 
     1    (ii) Measures of acuity and intensity of all patients  and  nature  of
     2  the care to be delivered on each unit and shift;
     3    (iii) Skill mix;
     4    (iv)  The  availability,  level  of  experience, and specialty certif-
     5  ication or training of nursing personnel providing patient care, includ-
     6  ing charge nurses, on each unit and shift;
     7    (v) The need for specialized or intensive equipment;
     8    (vi) The architecture and geography of the patient care unit,  includ-
     9  ing  but  not  limited  to  placement of patient rooms, treatment areas,
    10  nursing stations, medication preparation areas, and equipment;
    11    (vii) Mechanisms and procedures  to  provide  for  one-to-one  patient
    12  observation,  when needed, for patients on psychiatric or other units as
    13  appropriate;
    14    (viii) Other special characteristics of the unit or community  patient
    15  population,  including age, cultural and linguistic diversity and needs,
    16  functional ability, communication skills, and other relevant  social  or
    17  socio-economic factors;
    18    (ix)  Measures  to  increase  worker  and  patient safety, which could
    19  include measures to improve patient throughput;
    20    (x) Staffing guidelines adopted or published by other states or  local
    21  jurisdictions,  national  nursing  professional  associations, specialty
    22  nursing organizations, and other health professional organizations;
    23    (xi) Availability of other personnel supporting  nursing  services  on
    24  the unit;
    25    (xii)  Waiver  of plan requirements in the case of unforeseeable emer-
    26  gency circumstances as defined in subdivision fourteen of this section;
    27    (xiii) Coverage to enable registered nurses, licensed practical  nurs-
    28  es,  and ancillary staff to take meal and rest breaks, planned time off,
    29  and unplanned absences that are reasonably foreseeable  as  required  by
    30  law  or  the  terms of an applicable collective bargaining agreement, if
    31  any, between the general hospital and a representative of the nursing or
    32  ancillary staff;
    33    (xiv) The nursing quality indicators required under subdivision seven-
    34  teen of this section;
    35    (xv) General hospital finances and resources; and
    36    (xvi) Provisions for limited short-term adjustments made by  appropri-
    37  ate general hospital personnel overseeing patient care operations to the
    38  staffing  levels  required  by  the plan, necessary to account for unex-
    39  pected changes in circumstances that are to be of limited duration.
    40    (c) Semiannual review of the staffing plan against patient  needs  and
    41  known  evidence-based staffing information, including the nursing sensi-
    42  tive quality indicators collected by the general hospital.
    43    (d) Review, assessment, and response to complaints regarding potential
    44  violations of the adopted staffing plan, staffing variations,  or  other
    45  concerns  regarding  the  implementation of the staffing plan and within
    46  the purview of the committee.
    47    5. Compliance provisions. (a) The clinical staffing plan shall  comply
    48  with  all  federal and state laws and regulations and shall not diminish
    49  other standards contained in state or federal law  and  regulations,  or
    50  the terms of an applicable collective bargaining agreement, if any.
    51    (b)  The  clinical staffing plan shall comply with applicable laws and
    52  regulations, including, but not limited to:
    53    (i) Regulations made by the department on burn  unit  staffing,  liver
    54  transplant staffing, and operating room circulating nurse staffing;
    55    (ii) Staffing regulations to be promulgated by the commissioner relat-
    56  ing  to staffing in intensive care and critical care units no later than

        S. 1168--A                          4
 
     1  January first, two thousand twenty-two. Such regulations shall  consider
     2  the  factors  set  forth  in  paragraph  (b) of subdivision four of this
     3  section, standards in place in neighboring states, and a minimum  stand-
     4  ard of twelve hours of registered nurse care per patient per day;
     5    (iii) Such other staffing standards or regulations as are currently in
     6  effect  or  may hereafter be established by the department or enacted by
     7  the legislature; and
     8    (iv) The provisions of section one hundred sixty-seven  of  the  labor
     9  law and any related regulations.
    10    (c)  The  clinical staffing plan shall comply with and incorporate any
    11  minimum staffing  levels  provided  for  in  any  applicable  collective
    12  bargaining  agreement,  including  but  not  limited to nurse-to-patient
    13  ratios, caregiver-to-patient ratios, staffing grids, staffing  matrices,
    14  or other staffing provisions.
    15    6.  Process  for adoption of clinical staffing plans. (a) The clinical
    16  staffing committee shall produce the general hospital's annual  clinical
    17  staffing plan by July first of each year.
    18    (b)  Clinical staffing plans shall be developed and adopted by consen-
    19  sus of the clinical staffing committee.  For the purposes of determining
    20  whether there is a consensus, the management members  of  the  committee
    21  shall have one vote and the employee members of the committee shall have
    22  one  vote,  regardless of the actual number of members of the committee.
    23  Each side may determine its own method of casting its vote to adopt  all
    24  or part of the clinical staffing plan.
    25    (c)  The  general hospital shall adopt any clinical staffing plan that
    26  is wholly or partially recommended by a consensus of the clinical staff-
    27  ing committee. If there is no consensus on the recommended staffing plan
    28  or any of its parts, the chief executive officer of the general hospital
    29  shall use the officer's discretion to adopt a plan or partial  plan  for
    30  which  there  is no consensus. In this case, the chief executive officer
    31  shall provide a written explanation of  the  elements  of  the  clinical
    32  staffing  plan  that the committee was unable to agree on, including the
    33  final written proposals from the two parties and their rationales. In no
    34  event may a chief executive officer fail to include in the adopted  plan
    35  any staffing related terms and conditions of the plan that has previous-
    36  ly been adopted through any applicable collective bargaining agreement.
    37    (d)  Each  general  hospital shall adopt and submit its first hospital
    38  clinical staffing plan under this section to  the  department  no  later
    39  than  July  first,  two thousand twenty-two and annually thereafter. The
    40  plan submitted to the department shall, where  applicable,  include  the
    41  written  explanation  from  the  chief  executive  officer  and  written
    42  proposals from the two parties regarding elements that the committee did
    43  not agree on as required in  paragraph  (c)  of  this  subdivision.  The
    44  submitted  clinical  staffing plan shall include data, from at least the
    45  previous year, on the frequency and  duration  of  variations  from  the
    46  adopted clinical staffing plan, the number of complaints relating to the
    47  clinical staffing plan and their disposition, as well as descriptions of
    48  unresolved complaints submitted pursuant to paragraph (b) of subdivision
    49  seven  of  this  section.  The department shall post the plan as part of
    50  each individual general hospital's health profile on the website of  the
    51  department no later than July thirty-first of each year.  If the adopted
    52  clinical  staffing  plan is subsequently amended, the amended plan shall
    53  be submitted to the department within thirty days of  adoption.  Adopted
    54  staffing  plans  shall  be  amended  to  include newly created units and
    55  existing units that undergo clinical or programmatic changes that funda-

        S. 1168--A                          5
 
     1  mentally alter their character or  nature.  The  department  shall  post
     2  amended staffing plans upon receipt.
     3    7.  Implementation  of  clinical staffing plans. (a) Beginning January
     4  first, two thousand twenty-three, and annually thereafter, each  general
     5  hospital  shall  implement  the  clinical  staffing plan adopted by July
     6  first of the prior calendar year, and  any  subsequent  amendments,  and
     7  assign personnel to each patient care unit in accordance with the plan.
     8    (b)  A registered nurse, licensed practical nurse, ancillary member of
     9  the frontline team, or collective bargaining representative  may  report
    10  to  the  clinical  staffing committee any variations where the personnel
    11  assignment in a patient care unit is not in accordance with the  adopted
    12  staffing  plan  and  may  make a complaint to the committee based on the
    13  variations.
    14    (c) The clinical staffing committee shall develop a process  to  exam-
    15  ine,  respond  to,  and track data submitted under paragraph (b) of this
    16  subdivision. The  clinical  staffing  committee  may  by  consensus,  as
    17  described in paragraph (b) of subdivision six of this section, determine
    18  a complaint resolved or dismissed. The clinical staffing committee shall
    19  also  establish  agreed upon rules and criteria to provide for confiden-
    20  tiality of complaints that are in the process of being examined  or  are
    21  found to be unsubstantiated.  This subdivision does not infringe upon or
    22  limit  the rights of any collective bargaining representative of employ-
    23  ees, or of any employee or group of  employees  pursuant  to  applicable
    24  law,  including without limitation any applicable state or federal labor
    25  laws.
    26    8. Posting of staffing information. Each general hospital shall  post,
    27  in  a  publicly conspicuous area on each patient care unit, the clinical
    28  staffing plan for that unit and the actual daily staffing for that shift
    29  on that unit as well as the relevant clinical staffing.
    30    9. Retaliation and intimidation prohibited. A general  hospital  shall
    31  not retaliate against or engage in any form of intimidation of:
    32    (a)  An  employee  for  performing  any  duties or responsibilities in
    33  connection with the clinical staffing committee; or
    34    (b) An employee, patient, or other individual who notifies  the  clin-
    35  ical  staffing  committee or the hospital administration of the individ-
    36  ual's staffing concerns.
    37    10. Special considerations. Nothing in this  section  is  intended  to
    38  create unreasonable burdens on critical access hospitals under 42 U.S.C.
    39  Sec.   1395i-4  and  sole  community  hospitals  under  42  U.S.C.  Sec.
    40  1395ww(d)(5) related to the operation of their clinical staffing commit-
    41  tees. Critical access and sole community hospitals may develop  flexible
    42  approaches  to  accomplish  the  requirements of this section.  Clinical
    43  staffing plans from such entities  submitted  to  the  department  shall
    44  contain  a  description  of  any  ways  in  which the general hospital's
    45  approach to creating the plan differed from the process outlined in this
    46  section.  This subdivision does not relieve such entities  from  compli-
    47  ance  with  other  provisions  of  this section related to the adoption,
    48  implementation and adherence  to  an  adopted  clinical  staffing  plan,
    49  reporting and disclosure, or other requirements of this section.
    50    11.  Investigations.  (a)  The  department shall investigate potential
    51  violations of  this  section  following  receipt  of  a  complaint  with
    52  supporting evidence, of failure to:
    53    (i) Form or establish a clinical staffing committee;
    54    (ii)  Comply with the requirements of this section in creating a clin-
    55  ical staffing plan;

        S. 1168--A                          6
 
     1    (iii)  Adopt all or part of a clinical staffing plan that is  approved
     2  by  consensus  of  the  clinical staffing committee and submitted to the
     3  department;
     4    (iv) Conduct a semiannual review of a clinical staffing plan; or
     5    (v)  Submit  to  the  department a clinical staffing plan on an annual
     6  basis and any updates.
     7    (b) The department  shall  initiate  an  investigation  of  unresolved
     8  complaints,  that  have  first  been  submitted to the clinical staffing
     9  committee, regarding compliance with the clinical staffing plan, person-
    10  nel assignments in a patient care unit or staffing levels, or any  other
    11  requirement  of the adopted clinical staffing plan, excluding complaints
    12  determined  by  the  clinical  staffing  committee  to  be  resolved  or
    13  dismissed  as determined by consensus of the clinical staffing committee
    14  as described in paragraph (b) of subdivision six of this section.
    15    (c) The department shall initiate an  investigation  after  making  an
    16  assessment  that  there  is  a  pattern of failure to resolve complaints
    17  submitted to the clinical staffing committee or a pattern of failure  to
    18  reach  consensus  on  the adoption of all or part of a clinical staffing
    19  plan. In the case of a pattern of failure to resolve  complaints  or  to
    20  reach  consensus  on  the adoption of all or part of a clinical staffing
    21  plan, the department shall determine if the pattern was due  to  one  of
    22  the parties routinely refusing to resolve complaints or reach consensus.
    23    (d) Any department investigation of a complaint under this subdivision
    24  shall  consider whether unforeseeable emergency circumstances as defined
    25  in subdivision fourteen of this section contributed to  the  failure  of
    26  the general hospital to comply with this section.
    27    (e)  After  an  investigation  conducted under paragraph (a) or (b) of
    28  this subdivision, if the department determines that  there  has  been  a
    29  violation, the department shall require the general hospital to submit a
    30  corrective  plan of action within forty-five days of the presentation of
    31  findings from the department to the hospital. If the  department  deter-
    32  mines  after  investigation under paragraph (c) of this subdivision that
    33  the general hospital representatives on the clinical staffing  committee
    34  were  responsible  for  a  pattern  of not resolving complaints or for a
    35  pattern of not reaching consensus,  the  department  shall  require  the
    36  general  hospital  to  submit a corrective action plan within forty-five
    37  days of the presentation of findings to the general hospital.    If  the
    38  department  finds  that the frontline staff representatives on the clin-
    39  ical staffing committee were responsible for a pattern of not  resolving
    40  complaints  or  for  a pattern of not reaching consensus, the department
    41  shall not require the general hospital to  submit  a  corrective  action
    42  plan  or  impose  a  civil  penalty  on the general hospital pursuant to
    43  subdivision twelve of this section.
    44    12. Civil penalties. In the event that a  general  hospital  fails  to
    45  submit  or  submits  but  fails to implement a corrective action plan in
    46  response to a violation or violations found by the department based on a
    47  complaint filed pursuant to paragraph (a), (b)  or  (c)  of  subdivision
    48  eleven  of  this  section,  the department may impose a civil penalty as
    49  authorized by section twelve of this chapter for all violations asserted
    50  against the general hospital, until  the  general  hospital  submits  or
    51  implements  a  corrective  action plan or takes other action directed by
    52  the department.
    53    13. Posting of penalties and related information. The department shall
    54  maintain for public inspection, including posting on the general  hospi-
    55  tal  profile  on the department website, records of any civil penalties,

        S. 1168--A                          7
 
     1  administrative actions, or license suspensions or revocations imposed on
     2  general hospitals under this section.
     3    14.  Unforeseeable  emergency  circumstances. (a) For purposes of this
     4  section, "unforeseeable emergency circumstance" means:
     5    (i) Any officially declared national, state, or municipal emergency;
     6    (ii) When a general hospital disaster plan is activated; or
     7    (iii) Any unforeseen disaster or other catastrophic event  that  imme-
     8  diately affects or increases the need for health care services.
     9    (b)  In  determining whether a general hospital has violated its obli-
    10  gations under this section to comply with the general  hospital's  clin-
    11  ical  staffing  plan,  it  shall  not be a defense that it was unable to
    12  secure sufficient staff if the lack  of  staffing  was  foreseeable  and
    13  could  be prudently planned for or involved routine nurse staffing needs
    14  that arose due to typical staffing patterns, typical levels of absentee-
    15  ism, and time off typically approved by the employer for vacation, holi-
    16  days, sick leave, and personal leave.
    17    15. Complaints. Nothing in this section shall be construed to preclude
    18  the ability to submit a complaint to  the  department  as  provided  for
    19  under  this  chapter.  Nothing  in  this  section  shall be construed as
    20  supplanting other complaint mechanisms established by a  general  hospi-
    21  tal,  including  mechanisms  designed  to  aid  in compliance with other
    22  federal, state or  local  laws.    Nothing  in  this  section  shall  be
    23  construed  as  limiting or supplanting the rights of employees and their
    24  collective bargaining representatives  to  fully  enforce  any  and  all
    25  rights under the terms of a collective bargaining agreement.  An employ-
    26  er shall not assert or attempt to assert a claim that enforcement of the
    27  collective  bargaining  agreement is barred or limited by any provisions
    28  of this section.
    29    16. Annual report. (a) The department shall submit an annual report to
    30  the speaker of the assembly, the temporary president of the senate,  and
    31  the  chairs  of the health committees of the assembly and senate and the
    32  governor on or before December thirty-first of each  year.  This  report
    33  shall  include the number of complaints submitted to the department, the
    34  disposition of these complaints, the number of investigations conducted,
    35  and the associated costs for complaint investigations, if any.
    36    (b) Prior to the submission of  the  report,  the  commissioner  shall
    37  convene  a stakeholder workgroup consisting of hospital associations and
    38  unions representing nurses and other ancillary members of the  frontline
    39  team.  The  stakeholder  workgroup  shall review the report prior to its
    40  submission to the speaker of the assembly, the  temporary  president  of
    41  the  senate, and the chairs of the health committees of the assembly and
    42  senate.
    43    17. Disclosure of nursing quality indicators. (a) Every facility  with
    44  an  operating  certificate  pursuant to the requirements of this article
    45  shall make available to the public information regarding nurse  staffing
    46  and  patient outcomes as specified by the commissioner by rule and regu-
    47  lation. The commissioner shall promulgate rules and regulations  on  the
    48  disclosure of nursing quality indicators providing for the disclosure of
    49  information  including  at  least  the  following, as appropriate to the
    50  reporting facility:
    51    [(a)] (i) The number of registered nurses providing  direct  care  and
    52  the  ratio  of  patients  per  registered  nurse,  full-time equivalent,
    53  providing direct care. This information shall  be  expressed  in  actual
    54  numbers,  in terms of total hours of nursing care per patient, including
    55  adjustment for case mix and acuity, and as a percentage of patient  care

        S. 1168--A                          8
 
     1  staff,  and  shall  be  broken  down  in terms of the total patient care
     2  staff, each unit, and each shift.
     3    [(b)]  (ii)  The  number of licensed practical nurses providing direct
     4  care. This information shall be expressed in actual numbers, in terms of
     5  total hours of nursing care per patient including  adjustment  for  case
     6  mix  and acuity, and as a percentage of patient care staff, and shall be
     7  broken down in terms of the total patient care  staff,  each  unit,  and
     8  each shift.
     9    [(c)]  (iii)  The  number  of unlicensed personnel utilized to provide
    10  direct patient care, including adjustment for case mix and acuity.  This
    11  information  shall be expressed both in actual numbers and as a percent-
    12  age of patient care staff and shall be broken down in terms of the total
    13  patient care staff, each unit, and each shift.
    14    [(d)] (iv) Incidence of adverse patient care, including incidents such
    15  as medication  errors,  patient  injury,  decubitus  ulcers,  nosocomial
    16  infections, and nosocomial urinary tract infections.
    17    [(e)]  (v)  Methods used for determining and adjusting staffing levels
    18  and patient care needs and the facility's compliance with these methods.
    19    [(f)] (vi) Data regarding complaints filed with any state  or  federal
    20  regulatory agency, or an accrediting agency, and data regarding investi-
    21  gations  and findings as a result of those complaints, degree of compli-
    22  ance with acceptable standards, and the findings of scheduled inspection
    23  visits.
    24    [2.] (b) Such information shall be provided to the commissioner of any
    25  state agency responsible for licensing or accrediting the  facility,  or
    26  responsible  for  overseeing the delivery of services either directly or
    27  indirectly, to any employee of a  general  hospital  or  the  employee's
    28  collective bargaining agent, if any, and to any member of the public who
    29  requests such information directly from the facility. Written statements
    30  containing such information shall state the source and date thereof.
    31    (c)  The  commissioner  shall  make  regulations  to provide a uniform
    32  format or form for complying with the reporting requirements of subpara-
    33  graphs (i), (ii) and (iii) of paragraph (a) of this subdivision,  allow-
    34  ing  patients  and the public to clearly understand and compare staffing
    35  patterns and actual levels of staffing across facilities.  Such  uniform
    36  format  or form shall allow facilities to include a description of addi-
    37  tional resources available to support unit  level  patient  care  and  a
    38  description of the general hospital. The information required by subpar-
    39  agraphs  (i),  (ii)  and  (iii)  of  paragraph  (a) of this subdivision,
    40  reported in a manner determined by the commissioner, shall be filed with
    41  the department electronically on a quarterly basis and shall  be  avail-
    42  able  to  the  public on the department's website. The regulations shall
    43  take effect no later than December thirty-first,  two  thousand  twenty-
    44  two.  Information required to be provided pursuant to subparagraphs (i),
    45  (ii) and (iii) of paragraph (a) of this subdivision shall be made avail-
    46  able to the public no later than July first, two thousand twenty-three.
    47    18. Advisory commission. (a) There is hereby established an  independ-
    48  ent  advisory commission, composed of nine experts in staffing standards
    49  and quality of patient care, including: three experts in  nursing  prac-
    50  tice,  quality  of  nursing  care or patient care standards, one of whom
    51  shall be appointed by the governor, one of whom shall  be  appointed  by
    52  the  speaker  of  the assembly and one of whom shall be appointed by the
    53  temporary president of  the  senate;  three  representatives  of  unions
    54  representing nurses, one of whom shall be appointed by the governor, one
    55  of  whom  shall  be  appointed by the speaker of the assembly and one of
    56  whom shall be appointed by the temporary president of  the  senate;  and

        S. 1168--A                          9
 
     1  three  members  representing  general  hospitals,  one  of whom shall be
     2  appointed by the governor, one of whom shall be appointed by the speaker
     3  of the assembly and one of whom shall  be  appointed  by  the  temporary
     4  president  of  the  senate. The members of the commission shall serve at
     5  the pleasure of the appointing official.    Members  of  the  commission
     6  shall  keep confidential any information received in the course of their
     7  duties and may only use such information in the course of  carrying  out
     8  their  duties  on  the  commission,  except those reports required to be
     9  issued by the commission under this  section,  which  may  only  include
    10  de-identified information.
    11    (b)  The  advisory commission shall convene from time to time in order
    12  to evaluate  the  effectiveness  of  the  clinical  staffing  committees
    13  required  by  this  section.  Such  review  shall evaluate the following
    14  metrics, including but not limited to quantitative and qualitative  data
    15  on  whether staffing levels were improved and maintained, patient satis-
    16  faction, employee satisfaction, patient quality of care  metrics,  work-
    17  place  safety, and any other metrics the commission deems relevant.  The
    18  commission shall also review the annual report submitted by the  depart-
    19  ment and make recommendations to the speaker of the assembly, the tempo-
    20  rary president of the senate, and the chairs of the health committees of
    21  the  assembly  and senate as set forth in paragraph (d) of this subdivi-
    22  sion.
    23    (c) The advisory commission may collect  and  shall  be  provided  all
    24  relevant  information,  necessary  to  carry out its functions, from the
    25  department and other state agencies.   The commission  may  also  invite
    26  testimony  by  experts  in  the field and from the public. In making its
    27  recommendations to the speaker of the assembly, the temporary  president
    28  of  the  senate, and the chairs of the health committees of the assembly
    29  and senate, the commission shall analyze relevant data,  including  data
    30  and  factors  set  forth  in  paragraph  (b) of subdivision four of this
    31  section related to clinical staffing plans.   The  commission  may  also
    32  make  recommendations  for additional or enhanced enforcement mechanisms
    33  or powers to address  general  hospital  failure  to  comply  with  this
    34  section and recommend the appropriation of funding for the department to
    35  enforce this section or to assist general hospitals in hiring additional
    36  staff to comply with this section.
    37    (d)  The advisory commission shall submit to the speaker of the assem-
    38  bly, the temporary president of the senate and the chairs of the  health
    39  committees  of the assembly and senate, and make available to the public
    40  a report that makes recommendations to the speaker of the assembly,  the
    41  temporary  president of the senate, and the chairs of the health commit-
    42  tees of the assembly and senate for further legislative action, if  any,
    43  in  order  to  improve working conditions and quality of care in general
    44  hospitals pursuant to this section and its intent.
    45    (e) The commission shall submit its report and recommendations to  the
    46  speaker  of the assembly, the temporary president of the senate, and the
    47  chairs of the health committees of the assembly and senate no later than
    48  October thirty-first, two thousand  twenty-four,  once  three  years  of
    49  staffing  plans  have  been submitted to the department pursuant to this
    50  section.
    51    (f) Members of the commission shall receive no compensation for  their
    52  services,  but  shall  be  allowed  their  actual and necessary expenses
    53  incurred in the performance of their duties hereunder.
    54    (g) The legislature may appropriate funding for the commission to hire
    55  staff or consultants and provide for the operation of the commission  as
    56  reasonably necessary to fulfill its functions.

        S. 1168--A                         10
 
     1    § 2. If any provision of this act, or any application of any provision
     2  of  this  act,  is  held to be invalid, or to violate or be inconsistent
     3  with any federal law or regulation, that shall not affect  the  validity
     4  or  effectiveness  of  any  other provision of this act, or of any other
     5  application  of  any  provision  of  this act, which can be given effect
     6  without that provision or application; and to that end,  the  provisions
     7  and applications of this act are severable.
     8    § 3. This act shall take effect immediately.
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