Full Text of HB0923 99th General Assembly
HB0923ham001 99TH GENERAL ASSEMBLY | Rep. Mary E. Flowers Filed: 3/4/2015
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| 1 | | AMENDMENT TO HOUSE BILL 923
| 2 | | AMENDMENT NO. ______. Amend House Bill 923 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 5. The Hospital Licensing Act is amended by | 5 | | changing Section 10.10 as follows: | 6 | | (210 ILCS 85/10.10) | 7 | | Sec. 10.10. Nurse Staffing by Patient Acuity.
| 8 | | (a) Findings. The The Legislature finds and declares all of | 9 | | the 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 Nurse
Practice Act. | 25 | | "Written staffing plan for nursing care services" means a | 26 | | written plan for guiding the assignment of patient care nursing |
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| 1 | | staff based on multiple nurse and patient considerations that | 2 | | yield minimum staffing levels for inpatient care units and the | 3 | | adopted acuity model aligning patient care needs with nursing | 4 | | skills required for quality patient care consistent with | 5 | | professional nursing standards. | 6 | | (c) Written staffing plan. | 7 | | (1) Every hospital shall implement a written | 8 | | hospital-wide staffing plan, recommended by a nursing care | 9 | | committee or committees, that provides for minimum direct | 10 | | care professional registered nurse-to-patient staffing | 11 | | needs for each inpatient care unit. The written | 12 | | hospital-wide staffing plan shall include, but need not be | 13 | | limited to, the following considerations: | 14 | | (A) The complexity of complete care, assessment on | 15 | | patient admission, volume of patient admissions, | 16 | | discharges and transfers, evaluation of the progress | 17 | | of a patient's problems, ongoing physical assessments, | 18 | | planning for a patient's discharge, assessment after a | 19 | | change in patient condition, and assessment of the need | 20 | | for patient referrals. | 21 | | (B) The complexity of clinical professional | 22 | | nursing judgment needed to design and implement a | 23 | | patient's nursing care plan, the need for specialized | 24 | | equipment and technology, the skill mix of other | 25 | | personnel providing or supporting direct patient care, | 26 | | and involvement in quality improvement activities, |
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| 1 | | professional preparation, and experience. | 2 | | (C) Patient acuity and the number of patients for | 3 | | whom care is being provided. | 4 | | (D) The ongoing assessments of a unit's patient | 5 | | acuity levels and nursing staff needed shall be | 6 | | routinely made by the unit nurse manager or his or her | 7 | | designee. | 8 | | (E) The identification of additional registered | 9 | | nurses available for direct patient care when | 10 | | patients' unexpected needs exceed the planned workload | 11 | | for direct care staff. | 12 | | (2) In order to provide staffing flexibility to meet | 13 | | patient needs, every hospital shall identify an acuity | 14 | | model for adjusting the staffing plan for each inpatient | 15 | | care unit. | 16 | | (3) The written staffing plan shall be posted in a | 17 | | conspicuous and accessible location for both patients and | 18 | | direct care staff, as required under the Hospital Report | 19 | | Card Act. A copy of the written staffing plan shall be | 20 | | provided to any member of the general public upon request. | 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 in 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 | | (Source: P.A. 96-328, eff. 8-11-09; 97-423, eff. 1-1-12; | 3 | | 97-813, eff. 7-13-12.)".
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