Connecticut 2023 Regular Session

Connecticut Senate Bill SB01067 Compare Versions

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Version 2 (New)

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7	5		General Assembly Raised Bill No. 1067
8	6		January Session, 2023
9	7		LCO No. 4107
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12	10		Referred to Committee on PUBLIC HEALTH
13	11
14	12
15	13		Introduced by:
16	14		(PH)
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18	17
19	18
20	19		AN ACT CONCERNING ADEQUATE AND SAFE HEALTH CARE
21	20		STAFFING.
22	21		Be it enacted by the Senate and House of Representatives in General
23	22		Assembly convened:
24	23
25	24		Section 1. Section 19a-89e of the general statutes is repealed and the 1
26	25		following is substituted in lieu thereof (Effective October 1, 2023): 2
27	26		(a) For purposes of this section: 3
28	27		(1) "Department" means the Department of Public Health; [and] 4
29	28		(2) "Hospital" means an establishment for the lodging, care and 5
30	29		treatment of persons suffering from disease or other abnormal physical 6
31	30		or mental conditions and includes inpatient psychiatric services in 7
32	31		general hospitals; 8
33	32		(3) "Assistive personnel" means personnel who are not licensed by 9
34	33		the Department of Public Health, but who work under the direct 10
35	34		supervision of a registered nurse to implement specifically delegated 11
36	35		patient care activities; and 12
37		-	(4) "Professional judgment" means the application of knowledge, 13 Bill No. 1067
	36	+	(4) "Professional judgment" means the application of knowledge, 13 Raised Bill No. 1067
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44	42		expertise and experience, in accordance with the provisions of the 14
45	43		general statutes and regulations of Connecticut state agencies 15
46	44		concerning the practice of nursing, in conducting a comprehensive 16
47	45		nursing assessment of each patient and making independent decisions 17
48		-	about patient care, including, but not limited to, the need for 18
49		-	~~additional~~ staff providing patient care. 19
	46	+	about patient care, including, but not limited to, the need for additional 18
	47	+	staff providing patient care. 19
50	48		(b) Each hospital licensed by the department pursuant to chapter 20
51	49		368v shall report, annually, to the department on a prospective nurse 21
52	50		staffing plan with a written certification that the nurse staffing plan is 22
53	51		sufficient to provide adequate and appropriate delivery of health care 23
54	52		services to patients in the ensuing period of licensure. Such plan shall 24
55	53		promote a collaborative practice in the hospital that enhances patient 25
56	54		care and the level of services provided by nurses and other members of 26
57	55		the hospital's patient care team. Nurse staffing plans developed and 27
58	56		implemented on or after January 1, 2028, shall require the following 28
59	57		ratios of (1) patients to registered nurses providing direct patient care 29
60	58		per corresponding patient care unit: (A) Four to one for the emergency 30
61	59		department; (B) two to one for patients requiring intensive care in the 31
62	60		emergency department; (C) one to one for trauma patients in the 32
63	61		emergency department; (D) two to one for the intensive care unit; (E) 33
64	62		three to one for the progressive care unit; (F) four to one for the 34
65	63		telemetry unit; (G) five to one for the medical-surgical unit; (H) four to 35
66	64		one for the pediatric unit; (I) one to one for the operating room; (J) two 36
67		-	to one ~~for~~ the post-anesthesia recovery unit; (K) five to one for the 37
68		-	oncology unit; (L) five to one for the orthopedics unit; (M) six to one 38
69		-	~~for~~ the psychiatry unit; (N) two to one ~~for~~ the labor and delivery unit; 39
70		-	~~(O)~~ four to one ~~for~~ the postpartum unit; (P) four to one ~~for~~ the nursery 40
71		-	~~unit;~~ and (Q) two to one ~~for~~ the neonatal intensive care unit; and (2) 41
72		-	~~patients~~ to assistive personnel providing patient care per 42
73		-	~~corresponding patient~~ care unit: (A) Eight to one ~~for~~ the emergency 43
74		-	~~department; (B) eight to one for~~ the intensive care unit; (C) six to one 44
75		-	~~for the progressive care unit; (D)~~ eight to one ~~for~~ the telemetry unit; (E) 45
76		-	~~eight to one for the medical-surgical~~ unit; (F) eight to one ~~for~~ the 46
77		-	~~pediatric unit; (G) eight to one for the~~ oncology unit; (H) six to one ~~for~~ 47 Bill No. 1067
	65	+	to one in the post-anesthesia recovery unit; (K) five to one for the 37
	66	+	oncology unit; (L) five to one for the orthopedics unit; (M) six to one for 38
	67	+	the psychiatry unit; (N) two to one in the labor and delivery unit; (O) 39
	68	+	four to one in the postpartum unit; (P) four to one in the nursery unit; 40
	69	+	and (Q) two to one in the neonatal intensive care unit; and (2) patients 41
	70	+	to assistive personnel providing patient care per corresponding patient 42
	71	+	care unit: (A) Eight to one in the emergency department; (B) eight to one 43
	72	+	in the intensive care unit; (C) six to one in the progressive care unit; (D) 44
	73	+	eight to one in the telemetry unit; (E) eight to one in the medical-surgical 45
	74	+	unit; (F) eight to one in the pediatric unit; (G) eight to one in the 46
	75	+	oncology unit; (H) six to one in the orthopedics unit; (I) eight to one in 47 Raised Bill No. 1067
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84		-	the orthopedics unit; (I) eight to one for the psychiatric unit; and (J) 48
85		-	twelve to one for the obstetrics unit. 49
86		-	(c) Each hospital shall establish a hospital staffing committee to 50
87		-	assist in the preparation of the nurse staffing plan required pursuant to 51
88		-	subsection (b) of this section. Registered nurses employed by the 52
89		-	hospital whose primary responsibility is to provide direct patient care 53
90		-	shall account for not less than fifty per cent of the membership of each 54
91		-	hospital's staffing committee. In order to comply with the requirement 55
92		-	that a hospital establish a hospital staffing committee, a hospital may 56
93		-	utilize an existing committee or committees to assist in the preparation 57
94		-	of the nurse staffing plan, provided not less than fifty per cent of the 58
95		-	members of such existing committee or committees are registered 59
96		-	nurses employed by the hospital whose primary responsibility is to 60
97		-	provide direct patient care. When registered nurses employed by the 61
98		-	hospital are members of a collective bargaining unit, a representative 62
99		-	of the collective bargaining unit shall select the registered nurses who 63
100		-	shall be members of the hospital staffing committee, provided such 64
101		-	selection shall not be construed to permit conduct prohibited under the 65
102		-	National Labor Relations Act, 29 USC 151 et seq., as amended from 66
103		-	time to time, or 5 USC Chapter 71, as amended from time to time. Each 67
104		-	hospital, in collaboration with its staffing committee, shall develop and 68
105		-	implement to the best of its ability the prospective nurse staffing plan. 69
106		-	Such plan shall: (1) Include the minimum professional skill mix for 70
107		-	each patient care unit in the hospital, including, but not limited to, 71
108		-	inpatient services, critical care and the emergency department; (2) 72
109		-	identify the hospital's employment practices concerning the use of 73
110		-	temporary and traveling nurses; (3) set forth the level of administrative 74
111		-	staffing in each patient care unit of the hospital that ensures direct care 75
112		-	staff are not utilized for administrative functions; (4) set forth the 76
113		-	hospital's process for internal review of the nurse staffing plan; and (5) 77
114		-	include the hospital's mechanism of obtaining input from direct care 78
115		-	staff, including nurses and other members of the hospital's patient care 79
116		-	team, in the development of the nurse staffing plan. In addition to the 80
117		-	information described in subdivisions (1) to (5), inclusive, of this 81 Bill No. 1067
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	81	+	the psychiatric unit; and (J) twelve to one in the obstetrics unit. 48
	82	+	(c) Each hospital shall establish a hospital staffing committee to assist 49
	83	+	in the preparation of the nurse staffing plan required pursuant to 50
	84	+	subsection (b) of this section. Registered nurses employed by the 51
	85	+	hospital whose primary responsibility is to provide direct patient care 52
	86	+	shall account for not less than fifty per cent of the membership of each 53
	87	+	hospital's staffing committee. In order to comply with the requirement 54
	88	+	that a hospital establish a hospital staffing committee, a hospital may 55
	89	+	utilize an existing committee or committees to assist in the preparation 56
	90	+	of the nurse staffing plan, provided not less than fifty per cent of the 57
	91	+	members of such existing committee or committees are registered 58
	92	+	nurses employed by the hospital whose primary responsibility is to 59
	93	+	provide direct patient care. When registered nurses employed by the 60
	94	+	hospital are members of a collective bargaining unit, a representative of 61
	95	+	the collective bargaining unit shall select the registered nurses who shall 62
	96	+	be members of the hospital staffing committee, provided such selection 63
	97	+	shall not be construed to permit conduct prohibited under the National 64
	98	+	Labor Relations Act, 29 USC 151 et seq., as amended from time to time, 65
	99	+	or 5 USC Chapter 71, as amended from time to time. Each hospital, in 66
	100	+	collaboration with its staffing committee, shall develop and implement 67
	101	+	to the best of its ability the prospective nurse staffing plan. Such plan 68
	102	+	shall: (1) Include the minimum professional skill mix for each patient 69
	103	+	care unit in the hospital, including, but not limited to, inpatient services, 70
	104	+	critical care and the emergency department; (2) identify the hospital's 71
	105	+	employment practices concerning the use of temporary and traveling 72
	106	+	nurses; (3) set forth the level of administrative staffing in each patient 73
	107	+	care unit of the hospital that ensures direct care staff are not utilized for 74
	108	+	administrative functions; (4) set forth the hospital's process for internal 75
	109	+	review of the nurse staffing plan; and (5) include the hospital's 76
	110	+	mechanism of obtaining input from direct care staff, including nurses 77
	111	+	and other members of the hospital's patient care team, in the 78
	112	+	development of the nurse staffing plan. In addition to the information 79
	113	+	described in subdivisions (1) to (5), inclusive, of this subsection, nurse 80
	114	+	staffing plans developed and implemented after January 1, 2016, shall 81 Raised Bill No. 1067
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124		-	subsection, nurse staffing plans developed and implemented after 82
125		-	January 1, 2016, shall include: (A) The number of registered nurses 83
126		-	providing direct patient care and the ratio of patients to such 84
127		-	registered nurses by patient care unit; (B) the number of licensed 85
128		-	practical nurses providing direct patient care and the ratio of patients 86
129		-	to such licensed practical nurses, by patient care unit; (C) the number 87
130		-	of assistive personnel providing direct patient care and the ratio of 88
131		-	patients to such assistive personnel, by patient care unit; (D) the 89
132		-	method used by the hospital to determine and adjust direct patient 90
133		-	care staffing levels; and (E) a description of supporting personnel 91
134		-	assisting on each patient care unit. In addition to the information 92
135		-	described in subdivisions (1) to (5), inclusive, of this subsection and 93
136		-	subparagraphs (A) to (E), inclusive, of this subdivision, nurse staffing 94
137		-	plans developed and implemented after January 1, 2017, shall include: 95
138		-	(i) A description of any differences between the staffing levels 96
139		-	described in the staffing plan and actual staffing levels for each patient 97
140		-	care unit; and (ii) any actions the hospital intends to take to address 98
141		-	such differences or adjust staffing levels in future staffing plans. 99
142		-	(d) Each hospital shall post the nurse staffing plan developed 100
143		-	pursuant to subsections (b) and (c) of this section on each patient care 101
144		-	unit in a conspicuous location visible and accessible to staff, patients 102
145		-	and members of the public. Each hospital shall maintain accurate 103
146		-	records, for at least the preceding three years, of the ratios of patients 104
147		-	to registered nurses providing direct patient care and patients to 105
148		-	assistive personnel providing patient care in each direct care unit for 106
149		-	each shift. Such records shall include the number of (1) patients in each 107
150		-	unit on each shift; (2) registered nurses providing direct patient care 108
151		-	assigned to each patient in each unit on each shift; and (3) assistive 109
152		-	personnel providing patient care assigned to each patient in each unit 110
153		-	on each shift. Each hospital shall make such records available, upon 111
154		-	request, to the Department of Public Health, the staff of the hospital, 112
155		-	any collective bargaining unit representing such staff, the patients of 113
156		-	the hospital and members of the general public. 114 Bill No. 1067
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	120	+	include: (A) The number of registered nurses providing direct patient 82
	121	+	care and the ratio of patients to such registered nurses by patient care 83
	122	+	unit; (B) the number of licensed practical nurses providing direct patient 84
	123	+	care and the ratio of patients to such licensed practical nurses, by patient 85
	124	+	care unit; (C) the number of assistive personnel providing direct patient 86
	125	+	care and the ratio of patients to such assistive personnel, by patient care 87
	126	+	unit; (D) the method used by the hospital to determine and adjust direct 88
	127	+	patient care staffing levels; and (E) a description of supporting 89
	128	+	personnel assisting on each patient care unit. In addition to the 90
	129	+	information described in subdivisions (1) to (5), inclusive, of this 91
	130	+	subsection and subparagraphs (A) to (E), inclusive, of this subdivision, 92
	131	+	nurse staffing plans developed and implemented after January 1, 2017, 93
	132	+	shall include: (i) A description of any differences between the staffing 94
	133	+	levels described in the staffing plan and actual staffing levels for each 95
	134	+	patient care unit; and (ii) any actions the hospital intends to take to 96
	135	+	address such differences or adjust staffing levels in future staffing plans. 97
	136	+	(d) Each hospital shall post the nurse staffing plan developed 98
	137	+	pursuant to subsections (b) and (c) of this section on each patient care 99
	138	+	unit in a conspicuous location visible and accessible to staff, patients and 100
	139	+	members of the public. Each hospital shall maintain accurate records, 101
	140	+	for at least the preceding three years, of the ratios of patients to 102
	141	+	registered nurses providing direct patient care and patients to assistive 103
	142	+	personnel providing patient care in each direct care unit for each shift. 104
	143	+	Such records shall include the number of (1) patients in each unit on 105
	144	+	each shift; (2) registered nurses providing direct patient care assigned to 106
	145	+	each patient in each unit on each shift; and (3) assistive personnel 107
	146	+	providing patient care assigned to each patient in each unit on each shift. 108
	147	+	Each hospital shall make such records available, upon request, to the 109
	148	+	Department of Public Health, the staff of the hospital, any collective 110
	149	+	bargaining unit representing such staff, the patients of the hospital and 111
	150	+	members of the general public. 112
	151	+	(e) A registered nurse may object to or refuse to participate in any 113
	152	+	activity, policy, practice or task assigned by a hospital, provided the 114
	153	+	registered nurse acts in good faith and, in the registered nurse's 115 Raised Bill No. 1067
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163		-	(e) A registered nurse may object to or refuse to participate in any 115
164		-	activity, policy, practice or task assigned by a hospital, provided the 116
165		-	registered nurse acts in good faith and, in the registered nurse's 117
166		-	professional judgment, the registered nurse (1) reasonably believes 118
167		-	participation in the activity, policy, practice or task would violate a 119
168		-	provision of this section, or (2) is not prepared by education, training 120
169		-	or experience to participate in the activity, policy, practice or task 121
170		-	without compromising the safety of a patient or jeopardizing the 122
171		-	registered nurse's license. No hospital shall discharge, retaliate against, 123
172		-	discriminate against or take any other adverse action against a 124
173		-	registered nurse or any aspect of the registered nurse's employment, 125
174		-	including, but not limited to, discharge, promotion, reduction in 126
175		-	compensation or revisions to terms, conditions or privileges of 127
176		-	employment, as a result of such objection or refusal by the registered 128
177		-	nurse. No hospital shall file a complaint or report against a registered 129
178		-	nurse with the Department of Public Health as a result of such 130
179		-	objection or refusal. Any registered nurse or collective bargaining 131
180		-	representative or legal representative of a registered nurse who has 132
181		-	been discharged, discriminated against or retaliated against in 133
182		-	violation of the provisions of this subsection, or against whom a 134
183		-	complaint or report has been filed in violation of such provisions, may 135
184		-	bring a cause of action against the hospital. A registered nurse who 136
185		-	prevails in such cause of action shall be entitled to one or more of the 137
186		-	following: (A) Reinstatement of employment, (B) reimbursement of 138
187		-	lost wages, compensation and benefits, (C) attorneys' fees, (D) court 139
188		-	costs, and (E) any other relevant damages. 140
189		-	[(d)] (f) On or before January 1, 2016, and annually thereafter, the 141
190		-	Commissioner of Public Health shall report, in accordance with the 142
191		-	provisions of section 11-4a, to the joint standing committee of the 143
192		-	General Assembly having cognizance of matters relating to public 144
193		-	health concerning hospital compliance with reporting requirements 145
194		-	under this section and recommendations concerning any additional 146
195		-	reporting requirements. 147 Bill No. 1067
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	158	+
	159	+	professional judgment, the registered nurse (1) reasonably believes 116
	160	+	participation in the activity, policy, practice or task would violate a 117
	161	+	provision of this section, or (2) is not prepared by education, training or 118
	162	+	experience to participate in the activity, policy, practice or task without 119
	163	+	compromising the safety of a patient or jeopardizing the registered 120
	164	+	nurse's license. No hospital shall discharge, retaliate against, 121
	165	+	discriminate against or take any other adverse action against a 122
	166	+	registered nurse or any aspect of the registered nurse's employment, 123
	167	+	including, but not limited to, discharge, promotion, reduction in 124
	168	+	compensation or revisions to terms, conditions or privileges of 125
	169	+	employment, as a result of such objection or refusal by the registered 126
	170	+	nurse. No hospital shall file a complaint or report against a registered 127
	171	+	nurse with the Department of Public Health as a result of such objection 128
	172	+	or refusal. Any registered nurse or collective bargaining representative 129
	173	+	or legal representative of a registered nurse who has been discharged, 130
	174	+	discriminated against or retaliated against in violation of the provisions 131
	175	+	of this subsection, or against whom a complaint or report has been filed 132
	176	+	in violation of such provisions, may bring a cause of action against the 133
	177	+	hospital. A registered nurse who prevails in such cause of action shall 134
	178	+	be entitled to one or more of the following: (A) Reinstatement of 135
	179	+	employment, (B) reimbursement of lost wages, compensation and 136
	180	+	benefits, (C) attorneys' fees, (D) court costs, and (E) any other relevant 137
	181	+	damages. 138
	182	+	[(d)] (f) On or before January 1, 2016, and annually thereafter, the 139
	183	+	Commissioner of Public Health shall report, in accordance with the 140
	184	+	provisions of section 11-4a, to the joint standing committee of the 141
	185	+	General Assembly having cognizance of matters relating to public 142
	186	+	health concerning hospital compliance with reporting requirements 143
	187	+	under this section and recommendations concerning any additional 144
	188	+	reporting requirements. 145
	189	+	Sec. 2. Section 19a-490l of the general statutes is repealed and the 146
	190	+	following is substituted in lieu thereof (Effective October 1, 2023): 147
	191	+	(a) As used in this section: 148 Raised Bill No. 1067
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202		-	Sec. 2. Section 19a-490l of the general statutes is repealed and the 148
203		-	following is substituted in lieu thereof (Effective October 1, 2023): 149
204		-	(a) As used in this section: 150
205		-	(1) "Nurse" means a registered nurse or a practical nurse licensed 151
206		-	pursuant to chapter 378, or a nurse's aide registered pursuant to 152
207		-	chapter 378a; [and] 153
208		-	(2) "Hospital" has the same meaning as set forth in section 19a-490; 154
209		-	and 155
210		-	(3) "Overtime" means working (A) in excess of a predetermined 156
211		-	scheduled work shift, regardless of the length of such scheduled work 157
212		-	shift, provided such scheduled work shift is determined and 158
213		-	communicated not less than forty-eight hours prior to the 159
214		-	commencement of such scheduled work shift, (B) more than twelve 160
215		-	hours in a twenty-four-hour period, (C) during the ten-hour period 161
216		-	immediately following the end of the previous work shift of eight 162
217		-	hours or more, or (D) more than forty-eight hours in any hospital-163
218		-	defined work week. 164
219		-	(b) [No] Except as provided in this section, no hospital [may] shall 165
220		-	require a nurse to work [in excess of a predetermined scheduled work 166
221		-	shift, provided such scheduled work shift is determined and 167
222		-	promulgated not less than forty-eight hours prior to the 168
223		-	commencement of such scheduled work shift] overtime. No hospital 169
224		-	shall discriminate against, discharge, discipline, threaten to discharge 170
225		-	or discipline or otherwise retaliate against a nurse for refusing to work 171
226		-	overtime. 172
227		-	(c) Any nurse may volunteer or agree to work [hours in addition to 173
228		-	such scheduled work shift but the refusal by a nurse to accept such 174
229		-	additional hours shall not be grounds for discrimination, dismissal, 175
230		-	discharge or any other penalty or employment decision adverse to the 176
231		-	nurse] overtime. 177 Bill No. 1067
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	196	+
	197	+	(1) "Nurse" means a registered nurse or a practical nurse licensed 149
	198	+	pursuant to chapter 378, or a nurse's aide registered pursuant to chapter 150
	199	+	378a; [and] 151
	200	+	(2) "Hospital" has the same meaning as set forth in section 19a-490; 152
	201	+	and 153
	202	+	(3) "Overtime" means working (A) in excess of a predetermined 154
	203	+	scheduled work shift, regardless of the length of such scheduled work 155
	204	+	shift, provided such scheduled work shift is determined and 156
	205	+	communicated not less than forty-eight hours prior to the 157
	206	+	commencement of such scheduled work shift, (B) more than twelve 158
	207	+	hours in a twenty-four-hour period, (C) during the ten-hour period 159
	208	+	immediately following the end of the previous work shift of eight hours 160
	209	+	or more, or (D) more than forty-eight hours in any hospital-defined 161
	210	+	work week. 162
	211	+	(b) [No] Except as provided in this section, no hospital [may] shall 163
	212	+	require a nurse to work [in excess of a predetermined scheduled work 164
	213	+	shift, provided such scheduled work shift is determined and 165
	214	+	promulgated not less than forty-eight hours prior to the commencement 166
	215	+	of such scheduled work shift] overtime. No hospital shall discriminate 167
	216	+	against, discharge, discipline, threaten to discharge or discipline or 168
	217	+	otherwise retaliate against a nurse for refusing to work overtime. 169
	218	+	(c) Any nurse may volunteer or agree to work [hours in addition to 170
	219	+	such scheduled work shift but the refusal by a nurse to accept such 171
	220	+	additional hours shall not be grounds for discrimination, dismissal, 172
	221	+	discharge or any other penalty or employment decision adverse to the 173
	222	+	nurse] overtime. 174
	223	+	[(c) The] (d) When the safety of a patient requires and when there is 175
	224	+	no reasonable alternative, the provisions of subsection (b) of this section 176
	225	+	shall not apply: (1) To any nurse participating in [a] an ongoing surgical 177
	226	+	procedure until such procedure is completed; (2) to any nurse working 178
	227	+	in a critical care unit until such nurse is relieved by another nurse who 179
	228	+	is commencing a scheduled work shift; (3) in the case of a public health 180 Raised Bill No. 1067
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238		-	[(c) The] (d) When the safety of a patient requires and when there is 178
239		-	no reasonable alternative, the provisions of subsection (b) of this 179
240		-	section shall not apply: (1) To any nurse participating in [a] an ongoing 180
241		-	surgical procedure until such procedure is completed; (2) to any nurse 181
242		-	working in a critical care unit until such nurse is relieved by another 182
243		-	nurse who is commencing a scheduled work shift; (3) in the case of a 183
244		-	public health emergency; or (4) in the case of an institutional 184
245		-	emergency, including, but not limited to, adverse weather conditions, 185
246		-	catastrophe or widespread illness, that in the opinion of the hospital 186
247		-	administrator will significantly reduce the number of nurses available 187
248		-	for a scheduled work shift, provided the hospital administrator has 188
249		-	made a good faith effort to mitigate the impact of such institutional 189
250		-	emergency on the availability of nurses. [; or (5) to any nurse who is 190
251		-	covered by a collective bargaining agreement that contains provisions 191
252		-	addressing the issue of mandatory overtime.] 192
253		-	(e) Before requiring a nurse to work overtime in accordance with the 193
254		-	provisions of subsection (d) of this section, a hospital shall make a 194
255		-	good faith effort to have such overtime hours covered on a voluntary 195
256		-	basis. Mandatory overtime shall not be required as a regular practice 196
257		-	for providing appropriate staffing for the necessary level of patient 197
258		-	care or in any situation that is the result of routine staffing needs 198
259		-	caused by typical staffing patterns, expected levels of absenteeism or 199
260		-	time off typically approved by the hospital for vacation, holidays, sick 200
261		-	leave and personal leave. 201
262		-	(f) (1) The provisions of this section shall not be construed to alter or 202
263		-	impair the terms of any bona fide collective bargaining agreement that 203
264		-	places additional restrictions or limitations on the use of mandatory 204
265		-	overtime. 205
266		-	(2) The provisions of this section shall not prohibit mandatory 206
267		-	overtime with respect to any nurse who is covered by a bona fide 207
268		-	collective bargaining agreement in effect prior to July 1, 2022, 208
269		-	containing provisions addressing the issue of mandatory overtime, 209
270		-	until the expiration date of the collective bargaining agreement. 210 Bill No. 1067
	232	+	LCO No. 4107 7 of 8
	233	+
	234	+	emergency; or (4) in the case of an institutional emergency, including, 181
	235	+	but not limited to, adverse weather conditions, catastrophe or 182
	236	+	widespread illness, that in the opinion of the hospital administrator will 183
	237	+	significantly reduce the number of nurses available for a scheduled 184
	238	+	work shift, provided the hospital administrator has made a good faith 185
	239	+	effort to mitigate the impact of such institutional emergency on the 186
	240	+	availability of nurses. [; or (5) to any nurse who is covered by a collective 187
	241	+	bargaining agreement that contains provisions addressing the issue of 188
	242	+	mandatory overtime.] 189
	243	+	(e) Before requiring a nurse to work overtime in accordance with the 190
	244	+	provisions of subsection (d) of this section, a hospital shall make a good 191
	245	+	faith effort to have such overtime hours covered on a voluntary basis. 192
	246	+	Mandatory overtime shall not be required as a regular practice for 193
	247	+	providing appropriate staffing for the necessary level of patient care or 194
	248	+	in any situation that is the result of routine staffing needs caused by 195
	249	+	typical staffing patterns, expected levels of absenteeism or time off 196
	250	+	typically approved by the hospital for vacation, holidays, sick leave and 197
	251	+	personal leave. 198
	252	+	(f) (1) The provisions of this section shall not be construed to alter or 199
	253	+	impair the terms of any bona fide collective bargaining agreement that 200
	254	+	places additional restrictions or limitations on the use of mandatory 201
	255	+	overtime. 202
	256	+	(2) The provisions of this section shall not prohibit mandatory 203
	257	+	overtime with respect to any nurse who is covered by a bona fide 204
	258	+	collective bargaining agreement in effect prior to July 1, 2022, containing 205
	259	+	provisions addressing the issue of mandatory overtime, until the 206
	260	+	expiration date of the collective bargaining agreement. 207
	261	+	(3) The provisions of this section shall not prohibit mandatory 208
	262	+	overtime with respect to any nurse who is covered by a bona fide 209
	263	+	collective bargaining agreement under chapter 68 to the extent such 210
	264	+	collective bargaining agreement permits mandatory overtime, provided 211
	265	+	mandatory overtime for reasons set forth in subsection (d) of this section 212 Raised Bill No. 1067
271	266
272	267
273		-	LCO 4107 {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-01067-
274		-	R01-SB.docx }
275		-	8 of 8
276	268
277		-	(3) The provisions of this section shall not prohibit mandatory 211
278		-	overtime with respect to any nurse who is covered by a bona fide 212
279		-	collective bargaining agreement under chapter 68 to the extent such 213
280		-	collective bargaining agreement permits mandatory overtime, 214
281		-	provided mandatory overtime for reasons set forth in subsection (d) of 215
282		-	this section shall be a mandatory subject of bargaining, and mandatory 216
283		-	overtime for reasons other than those set forth in subsection (d) of this 217
284		-	section shall be a permissible subject of bargaining. 218
	269	+	LCO No. 4107 8 of 8
	270	+
	271	+	shall be a mandatory subject of bargaining, and mandatory overtime for 213
	272	+	reasons other than those set forth in subsection (d) of this section shall 214
	273	+	be a permissible subject of bargaining. 215
285	274		This act shall take effect as follows and shall amend the following
286	275		sections:
287	276
288	277		Section 1 October 1, 2023 19a-89e
289	278		Sec. 2 October 1, 2023 19a-490l
290	279
291		-	PH Joint Favorable
	280	+	Statement of Purpose:
	281	+	To ensure adequate and safe health care staffing.
	282	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	283	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	284	+	underlined.]
292	285