OFFICE OF FISCAL ANALYSIS
Legislative Office Building, Room 5200
Hartford, CT 06106 (860) 240-0200
http://www.cga.ct.gov/ofa
SB-1067
AN ACT CONCERNING ADEQUATE AND SAFE HEALTH CARE
STAFFING.
Primary Analyst: ES 4/5/23
Contributing Analyst(s): SB, RDP
OFA Fiscal Note
State Impact:
Agency Affected Fund-Effect FY 24 $ FY 25 $
UConn Health Ctr.; Mental
Health & Addiction Serv., Dept.;
Children & Families, Dept.
GF - Cost See Below Potential
Significant
Note: GF=General Fund
Municipal Impact: None
Explanation
The bill, which establishes requirements regarding nurse staffing and
mandatory overtime in hospitals, results in a potentially significant
fiscal impact to UConn Health Center (UCHC) and the Departments of
Mental Health and Addiction Services (DMHAS) and Children and
Families (DCF), as described below.
Mandatory overtime as regular practice/prohibition. The bill
prohibits hospitals from using mandatory overtime as a regular
practice. These provisions will have a significant impact to the state as
mandatory overtime is used with some frequency to staff John Dempsey
Hospital, Whiting Forensic Hospital and Albert J. Solnit Children’s
Center, when voluntary overtime is insufficient to meet staffing needs.
The hospitals currently have numerous nurse vacancies they are
attempting to fill.
As the bill does allow for the continuation of mandatory overtime 2023SB-01067-R000465-FN.DOCX Page 2 of 2
until existing collective bargaining agreements expire, the cost is
anticipated to be incurred closer to that time in preparation for meeting
the bill’s requirements. The expiration date for the relevant state
contracts is June 30, 2025. The current cost to hire 75 new nurses to meet
the bill’s provisions regarding overtime at John Dempsey Hospital is
estimated at approximately $10.4 million annually.
Hospital Staffing Ratios. The bill requires specific hospital patient to
staff ratios as of January 1, 2028. Based on current data, UCHC would
incur annual costs totaling approximately $11.5 million to meet the
staffing ratios for registered nurses (RNs) and aides. The actual costs to
the state, including those associated with DMHAS and DCF, will
depend on the staffing levels at the time the bill’s provisions go into
effect.
RN Refusal to Participate. The bill allows an RN to object or refuse
to participate in any activity, policy, practice, or task the hospital
assigns, in certain circumstances. These provisions are effective October
1, 2023. This could result in increased costs to the extent this leads to
additional overtime requirements or hospital liability costs.
To the extent that the bill’s provisions cannot be met due to staffing
shortages, the state could experience offsetting savings as well as
decreased patient revenues associated with serving fewer patients in,
order to accommodate the overtime and staffing ratio requirements.
The Out Years
The annualized ongoing fiscal impact identified above would
continue into the future subject to hospital staffing level requirements
and associated salaries.