BILL NUMBER: S4003
SPONSOR: PARKER
 
TITLE OF BILL:
An act to amend the public health law, in relation to establishing the
"safe staffing for hospital care act"
 
PURPOSE:
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 adminis-
trative 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 regu-
lations 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 staff-
ing ratios.
Requires the nurse to be appropriately licensed, to receive appropriate
orientation, and verification that the nurse can provide competent nurs-
ing 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, morbid-
ity, 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 bargain-
ing 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 arti-
cle. 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 employ-
ee prevails in any action under this article. Enjoins the heal th 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 go,
 
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 regu-
lations 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 unnec-
essary medical errors and infections, that unfortunately can lead to
preventable deaths. A substantial number of nurses indicate that hospi-
tal-patient acuity measurements are inadequate and th at 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:
2023-24: S4681- Referred to Health
2021-2022: S3023 - Referred to Health
2019-20: Referred to Health
2017-18: referred to Health
2015-16: S.1936/A.6788 Referred to Health
2013-14: S.1634 Referred to Health
2011-12: S.1134 Referred to Health
2010: S.1780/A.5370 Referred to Health
2008: S.2482/A.8107 Referred to Health
2006: S.2965 Referred to Health
 
FISCAL IMPLICATIONS:
Undetermined.
 
LOCAL FISCAL IMPLICATIONS:
Undetermined.
 
EFFECTIVE DATE:
This act shall take effect on the first of July next succeeding the date
on which it shall have become a law. Effective immediately the addition,
amendment and/or repeal of any rule or regulation necessary for the
implementation of this act on its effective date are authorized to be
made on or before such date