Illinois General Assembly - Full Text of SB0867
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Full Text of SB0867  95th General Assembly


Sen. Carol Ronen

Filed: 3/23/2007





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2     AMENDMENT NO. ______. Amend Senate Bill 867 by replacing
3 everything after the enacting clause with the following:
4     "Section 5. The Hospital Licensing Act is amended by adding
5 Section 10.10 as follows:
6     (210 ILCS 85/10.10 new)
7     Sec. 10.10. Nurse Staffing by Patient Acuity.
8     (a) Findings. The legislature finds and declares all of the
9 following:
10         (1) The State of Illinois has a substantial interest in
11     promoting quality care and improving the delivery of health
12     care services.
13         (2) Evidence-based studies have shown that the basic
14     principles of staffing in the acute care setting should be
15     based on the complexity of patients' care needs aligned
16     with available nursing skills to promote quality patient



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1     care consistent with professional nursing standards.
2         (3) Compliance with this Section promotes an
3     organizational climate that values registered nurses'
4     input in meeting the health care needs of hospital
5     patients.
6     (b) Definitions. As used in this Section:
7     "Acuity model" means an assessment tool selected and
8 implemented by a hospital, as recommended by a nursing care
9 committee, that assesses the complexity of patient care needs
10 requiring professional nursing care and skills and aligns
11 patient care needs and nursing skills consistent with
12 professional nursing standards.
13     "Department" means the Department of Public Health.
14     "Direct patient care" means care provided by a registered
15 professional nurse with direct responsibility to oversee or
16 carry out medical regimens or nursing care for one or more
17 patients.
18     "Nursing care committee" means an existing or newly created
19 hospital-wide committee or committees of nurses whose
20 functions, in part or in whole, contribute to the development,
21 recommendation, and review of the hospital's nurse staffing
22 plan established pursuant to subsection (d).
23     "Registered professional nurse" means a person licensed as
24 a Registered Nurse under the Nursing and Advanced Practice
25 Nursing Act.
26     "Written staffing plan for nursing care services" means a



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1 written plan for guiding the assignment of patient care nursing
2 staff based on multiple nurse and patient considerations that
3 yield minimum staffing levels for inpatient care units and the
4 adopted acuity model aligning patient care needs with nursing
5 skills required for quality patient care consistent with
6 professional nursing standards.
7     (c) Written staffing plan.
8         (1) Every hospital shall implement a written
9     hospital-wide staffing plan, recommended by a nursing care
10     committee or committees, that provides for minimum direct
11     care professional registered nurse-to-patient staffing
12     needs for each inpatient care unit. The written
13     hospital-wide staffing plan shall include, but need not be
14     limited to, the following considerations:
15             (A) The complexity of complete care, assessment on
16         patient admission, volume of patient admissions,
17         discharges and transfers, evaluation of the progress
18         of a patient's problems, ongoing physical assessments,
19         planning for a patient's discharge, assessment after a
20         change in patient condition, and assessment of the need
21         for patient referrals.
22             (B) The complexity of clinical professional
23         nursing judgment needed to design and implement a
24         patient's nursing care plan, the need for specialized
25         equipment and technology, the skill mix of other
26         personnel providing or supporting direct patient care,



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1         and involvement in quality improvement activities,
2         professional preparation, and experience.
3             (C) Patient acuity and the number of patients for
4         whom care is being provided.
5             (D) The ongoing assessments of a unit's patient
6         acuity levels and nursing staff needed shall be
7         routinely made by the unit nurse manager or his or her
8         designee.
9             (E) The identification of additional registered
10         nurses available for direct patient care when
11         patients' unexpected needs exceed the planned workload
12         for direct care staff.
13         (2) In order to provide staffing flexibility to meet
14     patient needs, every hospital shall identify an acuity
15     model for adjusting the staffing plan for each inpatient
16     care unit.
17         (3) The written staffing plan shall be posted in a
18     conspicuous and accessible location for both patients and
19     direct care staff, as required under the Hospital Report
20     Card Act.
21     (d) Nursing care committee.
22         (1) Every hospital shall have a nursing care committee.
23     A hospital shall appoint members of a committee whereby at
24     least 50% of the members are registered professional nurses
25     providing direct patient care.
26         (2) A nursing care committee's recommendations must be



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1     given significant regard and weight in the hospital's
2     adoption and implementation of a written staffing plan.
3         (3) A nursing care committee or committees shall
4     recommend a written staffing plan for the hospital based on
5     the principles from the staffing components set forth in
6     subsection (c). In particular, a committee or committees
7     shall provide input and feedback on the following:
8             (A) Selection, implementation, and evaluation of
9         minimum staffing levels for inpatient care units.
10             (B) Selection, implementation, and evaluation of
11         an acuity model to provide staffing flexibility that
12         aligns changing patient acuity with nursing skills
13         required.
14             (C) Selection, implementation, and evaluation of a
15         written staffing plan incorporating the items
16         described in subdivisions (c)(1) and (c)(2) of this
17         Section.
18             (D) Review the following: nurse-to-patient
19         staffing guidelines for all inpatient areas; and
20         current acuity tools and measures in use.
21         (4) A nursing care committee must address the items
22     described in subparagraphs (A) through (D) of paragraph (3)
23     semi-annually.
24     (e) Nothing is this Section 10.10 shall be construed to
25 limit, alter, or modify any of the terms, conditions, or
26 provisions of a collective bargaining agreement entered into by



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1 the hospital.
2     Section 99. Effective date. This Act takes effect January
3 1, 2008.".