Illinois 2023-2024 Regular Session

Illinois House Bill HB3890 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	Public Act 103-0211
2	1		HB3890 EnrolledLRB103 30120 CPF 56544 b HB3890 Enrolled LRB103 30120 CPF 56544 b
3	2		HB3890 Enrolled LRB103 30120 CPF 56544 b
4		-	AN ACT concerning regulation.
5		-	Be it enacted by the People of the State of Illinois,
6		-	represented in the General Assembly:
7		-	Section 5. The Hospital Licensing Act is amended by
8		-	changing Section 10.10 as follows:
9		-	(210 ILCS 85/10.10)
10		-	Sec. 10.10. Nurse Staffing by Patient Acuity.
11		-	(a) Findings. The Legislature finds and declares all of
12		-	the following:
13		-	(1) The State of Illinois has a substantial interest
14		-	in promoting quality care and improving the delivery of
15		-	health care services.
16		-	(2) Evidence-based studies have shown that the basic
17		-	principles of staffing in the acute care setting should be
18		-	based on the complexity of patients' care needs aligned
19		-	with available nursing skills to promote quality patient
20		-	care consistent with professional nursing standards.
21		-	(3) Compliance with this Section promotes an
22		-	organizational climate that values registered nurses'
23		-	input in meeting the health care needs of hospital
24		-	patients.
25		-	(b) Definitions. As used in this Section:
26		-	"Acuity model" means an assessment tool selected and
	3	+	1 AN ACT concerning regulation.
	4	+	2 Be it enacted by the People of the State of Illinois,
	5	+	3 represented in the General Assembly:
	6	+	4 Section 5. The Hospital Licensing Act is amended by
	7	+	5 changing Section 10.10 as follows:
	8	+	6 (210 ILCS 85/10.10)
	9	+	7 Sec. 10.10. Nurse Staffing by Patient Acuity.
	10	+	8 (a) Findings. The Legislature finds and declares all of
	11	+	9 the following:
	12	+	10 (1) The State of Illinois has a substantial interest
	13	+	11 in promoting quality care and improving the delivery of
	14	+	12 health care services.
	15	+	13 (2) Evidence-based studies have shown that the basic
	16	+	14 principles of staffing in the acute care setting should be
	17	+	15 based on the complexity of patients' care needs aligned
	18	+	16 with available nursing skills to promote quality patient
	19	+	17 care consistent with professional nursing standards.
	20	+	18 (3) Compliance with this Section promotes an
	21	+	19 organizational climate that values registered nurses'
	22	+	20 input in meeting the health care needs of hospital
	23	+	21 patients.
	24	+	22 (b) Definitions. As used in this Section:
	25	+	23 "Acuity model" means an assessment tool selected and
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28	27
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33		-	implemented by a hospital, as recommended by a nursing care
34		-	committee, that assesses the complexity of patient care needs
35		-	requiring professional nursing care and skills and aligns
36		-	patient care needs and nursing skills consistent with
37		-	professional nursing standards.
38		-	"Department" means the Department of Public Health.
39		-	"Direct patient care" means care provided by a registered
40		-	professional nurse with direct responsibility to oversee or
41		-	carry out medical regimens or nursing care for one or more
42		-	patients.
43		-	"Nursing care committee" means a hospital-wide committee
44		-	or committees of nurses whose functions, in part or in whole,
45		-	contribute to the development, recommendation, and review of
46		-	the hospital's nurse staffing plan established pursuant to
47		-	subsection (d).
48		-	"Registered professional nurse" means a person licensed as
49		-	a Registered Nurse under the Nurse Practice Act.
50		-	"Written staffing plan for nursing care services" means a
51		-	written plan for the assignment of patient care nursing staff
52		-	based on multiple nurse and patient considerations that yield
53		-	minimum staffing levels for inpatient care units and the
54		-	adopted acuity model aligning patient care needs with nursing
55		-	skills required for quality patient care consistent with
56		-	professional nursing standards.
57		-	(c) Written staffing plan.
58		-	(1) Every hospital shall implement a written
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	34	+	1 implemented by a hospital, as recommended by a nursing care
	35	+	2 committee, that assesses the complexity of patient care needs
	36	+	3 requiring professional nursing care and skills and aligns
	37	+	4 patient care needs and nursing skills consistent with
	38	+	5 professional nursing standards.
	39	+	6 "Department" means the Department of Public Health.
	40	+	7 "Direct patient care" means care provided by a registered
	41	+	8 professional nurse with direct responsibility to oversee or
	42	+	9 carry out medical regimens or nursing care for one or more
	43	+	10 patients.
	44	+	11 "Nursing care committee" means a hospital-wide committee
	45	+	12 or committees of nurses whose functions, in part or in whole,
	46	+	13 contribute to the development, recommendation, and review of
	47	+	14 the hospital's nurse staffing plan established pursuant to
	48	+	15 subsection (d).
	49	+	16 "Registered professional nurse" means a person licensed as
	50	+	17 a Registered Nurse under the Nurse Practice Act.
	51	+	18 "Written staffing plan for nursing care services" means a
	52	+	19 written plan for the assignment of patient care nursing staff
	53	+	20 based on multiple nurse and patient considerations that yield
	54	+	21 minimum staffing levels for inpatient care units and the
	55	+	22 adopted acuity model aligning patient care needs with nursing
	56	+	23 skills required for quality patient care consistent with
	57	+	24 professional nursing standards.
	58	+	25 (c) Written staffing plan.
	59	+	26 (1) Every hospital shall implement a written
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60	61
61		-	hospital-wide staffing plan, prepared by a nursing care
62		-	committee or committees, that provides for minimum direct
63		-	care professional registered nurse-to-patient staffing
64		-	needs for each inpatient care unit, including inpatient
65		-	emergency departments. If the staffing plan prepared by
66		-	the nursing care committee is not adopted by the hospital,
67		-	or if substantial changes are proposed to it, the chief
68		-	nursing officer shall either: (i) provide a written
69		-	explanation to the committee of the reasons the plan was
70		-	not adopted; or (ii) provide a written explanation of any
71		-	substantial changes made to the proposed plan prior to it
72		-	being adopted by the hospital. The written hospital-wide
73		-	staffing plan shall include, but need not be limited to,
74		-	the following considerations:
75		-	(A) The complexity of complete care, assessment on
76		-	patient admission, volume of patient admissions,
77		-	discharges and transfers, evaluation of the progress
78		-	of a patient's problems, ongoing physical assessments,
79		-	planning for a patient's discharge, assessment after a
80		-	change in patient condition, and assessment of the
81		-	need for patient referrals.
82		-	(B) The complexity of clinical professional
83		-	nursing judgment needed to design and implement a
84		-	patient's nursing care plan, the need for specialized
85		-	equipment and technology, the skill mix of other
86		-	personnel providing or supporting direct patient care,
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88	63
89		-	and involvement in quality improvement activities,
90		-	professional preparation, and experience.
91		-	(C) Patient acuity and the number of patients for
92		-	whom care is being provided.
93		-	(D) The ongoing assessments of a unit's patient
94		-	acuity levels and nursing staff needed shall be
95		-	routinely made by the unit nurse manager or his or her
96		-	designee.
97		-	(E) The identification of additional registered
98		-	nurses available for direct patient care when
99		-	patients' unexpected needs exceed the planned workload
100		-	for direct care staff.
101		-	(2) In order to provide staffing flexibility to meet
102		-	patient needs, every hospital shall identify an acuity
103		-	model for adjusting the staffing plan for each inpatient
104		-	care unit.
105		-	(2.5) Each hospital shall implement the staffing plan
106		-	and assign nursing personnel to each inpatient care unit,
107		-	including inpatient emergency departments, in accordance
108		-	with the staffing plan.
109		-	(A) A registered nurse may report to the nursing
110		-	care committee any variations where the nurse
111		-	personnel assignment in an inpatient care unit is not
112		-	in accordance with the adopted staffing plan and may
113		-	make a written report to the nursing care committee
114		-	based on the variations.
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117		-	(B) Shift-to-shift adjustments in staffing levels
118		-	required by the staffing plan may be made by the
119		-	appropriate hospital personnel overseeing inpatient
120		-	care operations. If a registered nurse in an inpatient
121		-	care unit objects to a shift-to-shift adjustment, the
122		-	registered nurse may submit a written report to the
123		-	nursing care committee.
124		-	(C) The nursing care committee shall develop a
125		-	process to examine and respond to written reports
126		-	submitted under subparagraphs (A) and (B) of this
127		-	paragraph (2.5), including the ability to determine if
128		-	a specific written report is resolved or should be
129		-	dismissed.
130		-	(3) The written staffing plan shall be posted, either
131		-	by physical or electronic means, in a conspicuous and
132		-	accessible location for both patients and direct care
133		-	staff, as required under the Hospital Report Card Act. A
134		-	copy of the written staffing plan shall be provided to any
135		-	member of the general public upon request.
136		-	(d) Nursing care committee.
137		-	(1) Every hospital shall have a nursing care committee
138		-	that meets at least 6 times per year. A hospital shall
139		-	appoint members of a committee whereby at least 55% of the
140		-	members are registered professional nurses providing
141		-	direct inpatient care, one of whom shall be selected
142		-	annually by the direct inpatient care nurses to serve as
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	70	+	1 hospital-wide staffing plan, prepared by a nursing care
	71	+	2 committee or committees, that provides for minimum direct
	72	+	3 care professional registered nurse-to-patient staffing
	73	+	4 needs for each inpatient care unit, including inpatient
	74	+	5 emergency departments. If the staffing plan prepared by
	75	+	6 the nursing care committee is not adopted by the hospital,
	76	+	7 or if substantial changes are proposed to it, the chief
	77	+	8 nursing officer shall either: (i) provide a written
	78	+	9 explanation to the committee of the reasons the plan was
	79	+	10 not adopted; or (ii) provide a written explanation of any
	80	+	11 substantial changes made to the proposed plan prior to it
	81	+	12 being adopted by the hospital. The written hospital-wide
	82	+	13 staffing plan shall include, but need not be limited to,
	83	+	14 the following considerations:
	84	+	15 (A) The complexity of complete care, assessment on
	85	+	16 patient admission, volume of patient admissions,
	86	+	17 discharges and transfers, evaluation of the progress
	87	+	18 of a patient's problems, ongoing physical assessments,
	88	+	19 planning for a patient's discharge, assessment after a
	89	+	20 change in patient condition, and assessment of the
	90	+	21 need for patient referrals.
	91	+	22 (B) The complexity of clinical professional
	92	+	23 nursing judgment needed to design and implement a
	93	+	24 patient's nursing care plan, the need for specialized
	94	+	25 equipment and technology, the skill mix of other
	95	+	26 personnel providing or supporting direct patient care,
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144	97
145		-	co-chair of the committee.
146		-	(2) (Blank).
147		-	(2.5) A nursing care committee shall prepare and
148		-	recommend to hospital administration the hospital's
149		-	written hospital-wide staffing plan. If the staffing plan
150		-	is not adopted by the hospital, the chief nursing officer
151		-	shall provide a written statement to the committee prior
152		-	to a staffing plan being adopted by the hospital that: (A)
153		-	explains the reasons the committee's proposed staffing
154		-	plan was not adopted; and (B) describes the changes to the
155		-	committee's proposed staffing or any alternative to the
156		-	committee's proposed staffing plan.
157		-	(3) A nursing care committee's or committees' written
158		-	staffing plan for the hospital shall be based on the
159		-	principles from the staffing components set forth in
160		-	subsection (c). In particular, a committee or committees
161		-	shall provide input and feedback on the following:
162		-	(A) Selection, implementation, and evaluation of
163		-	minimum staffing levels for inpatient care units.
164		-	(B) Selection, implementation, and evaluation of
165		-	an acuity model to provide staffing flexibility that
166		-	aligns changing patient acuity with nursing skills
167		-	required.
168		-	(C) Selection, implementation, and evaluation of a
169		-	written staffing plan incorporating the items
170		-	described in subdivisions (c)(1) and (c)(2) of this
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172	99
173		-	Section.
174		-	(D) Review the nurse staffing plans for all
175		-	inpatient areas and current acuity tools and measures
176		-	in use. The nursing care committee's review shall
177		-	consider:
178		-	(i) patient outcomes;
179		-	(ii) complaints regarding staffing, including
180		-	complaints about a delay in direct care nursing or
181		-	an absence of direct care nursing;
182		-	(iii) the number of hours of nursing care
183		-	provided through an inpatient hospital unit
184		-	compared with the number of inpatients served by
185		-	the hospital unit during a 24-hour period;
186		-	(iv) the aggregate hours of overtime worked by
187		-	the nursing staff;
188		-	(v) the extent to which actual nurse staffing
189		-	for each hospital inpatient unit differs from the
190		-	staffing specified by the staffing plan; and
191		-	(vi) any other matter or change to the
192		-	staffing plan determined by the committee to
193		-	ensure that the hospital is staffed to meet the
194		-	health care needs of patients.
195		-	(4) A nursing care committee must issue a written
196		-	report addressing the items described in subparagraphs (A)
197		-	through (D) of paragraph (3) semi-annually. A written copy
198		-	of this report shall be made available to direct inpatient
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200	103
201		-	care nurses by making available a paper copy of the
202		-	report, distributing it electronically, or posting it on
203		-	the hospital's website.
204		-	(5) A nursing care committee must issue a written
205		-	report at least annually to the hospital governing board
206		-	that addresses items including, but not limited to: the
207		-	items described in paragraph (3); changes made based on
208		-	committee recommendations and the impact of such changes;
209		-	and recommendations for future changes related to nurse
210		-	staffing.
211		-	(6) A nursing care committee must annually notify the
212		-	hospital nursing staff of the staff's rights under this
213		-	Section. The annual notice must provide a phone number and
214		-	an email address for staff to report noncompliance with
215		-	the nursing staff's rights as described in this Section.
216		-	The notice must be provided by email or by regular mail in
217		-	a manner that effectively facilitates receipt of the
218		-	notice. The Department shall monitor and enforce the
219		-	requirements of this paragraph (6).
220		-	(e) Nothing in this Section 10.10 shall be construed to
221		-	limit, alter, or modify any of the terms, conditions, or
222		-	provisions of a collective bargaining agreement entered into
223		-	by the hospital.
224		-	(f) No hospital may discipline, discharge, or take any
225		-	other adverse employment action against an employee solely
226		-	because the employee expresses a concern or complaint
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	106	+	1 and involvement in quality improvement activities,
	107	+	2 professional preparation, and experience.
	108	+	3 (C) Patient acuity and the number of patients for
	109	+	4 whom care is being provided.
	110	+	5 (D) The ongoing assessments of a unit's patient
	111	+	6 acuity levels and nursing staff needed shall be
	112	+	7 routinely made by the unit nurse manager or his or her
	113	+	8 designee.
	114	+	9 (E) The identification of additional registered
	115	+	10 nurses available for direct patient care when
	116	+	11 patients' unexpected needs exceed the planned workload
	117	+	12 for direct care staff.
	118	+	13 (2) In order to provide staffing flexibility to meet
	119	+	14 patient needs, every hospital shall identify an acuity
	120	+	15 model for adjusting the staffing plan for each inpatient
	121	+	16 care unit.
	122	+	17 (2.5) Each hospital shall implement the staffing plan
	123	+	18 and assign nursing personnel to each inpatient care unit,
	124	+	19 including inpatient emergency departments, in accordance
	125	+	20 with the staffing plan.
	126	+	21 (A) A registered nurse may report to the nursing
	127	+	22 care committee any variations where the nurse
	128	+	23 personnel assignment in an inpatient care unit is not
	129	+	24 in accordance with the adopted staffing plan and may
	130	+	25 make a written report to the nursing care committee
	131	+	26 based on the variations.
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228	133
229		-	regarding an alleged violation of this Section or concerns
230		-	related to nurse staffing.
231		-	(g) Any employee of a hospital may file a complaint with
232		-	the Department regarding an alleged violation of this Section.
233		-	The Department must forward notification of the alleged
234		-	violation to the hospital in question within 10 business days
235		-	after the complaint is filed. Upon receiving a complaint of a
236		-	violation of this Section, the Department may take any action
237		-	authorized under Sections 7 or 9 of this Act.
238		-	(Source: P.A. 102-4, eff. 4-27-21; 102-641, eff. 8-27-21;
239		-	102-813, eff. 5-13-22.)
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	142	+	1 (B) Shift-to-shift adjustments in staffing levels
	143	+	2 required by the staffing plan may be made by the
	144	+	3 appropriate hospital personnel overseeing inpatient
	145	+	4 care operations. If a registered nurse in an inpatient
	146	+	5 care unit objects to a shift-to-shift adjustment, the
	147	+	6 registered nurse may submit a written report to the
	148	+	7 nursing care committee.
	149	+	8 (C) The nursing care committee shall develop a
	150	+	9 process to examine and respond to written reports
	151	+	10 submitted under subparagraphs (A) and (B) of this
	152	+	11 paragraph (2.5), including the ability to determine if
	153	+	12 a specific written report is resolved or should be
	154	+	13 dismissed.
	155	+	14 (3) The written staffing plan shall be posted, either
	156	+	15 by physical or electronic means, in a conspicuous and
	157	+	16 accessible location for both patients and direct care
	158	+	17 staff, as required under the Hospital Report Card Act. A
	159	+	18 copy of the written staffing plan shall be provided to any
	160	+	19 member of the general public upon request.
	161	+	20 (d) Nursing care committee.
	162	+	21 (1) Every hospital shall have a nursing care committee
	163	+	22 that meets at least 6 times per year. A hospital shall
	164	+	23 appoint members of a committee whereby at least 55% of the
	165	+	24 members are registered professional nurses providing
	166	+	25 direct inpatient care, one of whom shall be selected
	167	+	26 annually by the direct inpatient care nurses to serve as
	168	+
	169	+
	170	+
	171	+
	172	+
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	178	+	1 co-chair of the committee.
	179	+	2 (2) (Blank).
	180	+	3 (2.5) A nursing care committee shall prepare and
	181	+	4 recommend to hospital administration the hospital's
	182	+	5 written hospital-wide staffing plan. If the staffing plan
	183	+	6 is not adopted by the hospital, the chief nursing officer
	184	+	7 shall provide a written statement to the committee prior
	185	+	8 to a staffing plan being adopted by the hospital that: (A)
	186	+	9 explains the reasons the committee's proposed staffing
	187	+	10 plan was not adopted; and (B) describes the changes to the
	188	+	11 committee's proposed staffing or any alternative to the
	189	+	12 committee's proposed staffing plan.
	190	+	13 (3) A nursing care committee's or committees' written
	191	+	14 staffing plan for the hospital shall be based on the
	192	+	15 principles from the staffing components set forth in
	193	+	16 subsection (c). In particular, a committee or committees
	194	+	17 shall provide input and feedback on the following:
	195	+	18 (A) Selection, implementation, and evaluation of
	196	+	19 minimum staffing levels for inpatient care units.
	197	+	20 (B) Selection, implementation, and evaluation of
	198	+	21 an acuity model to provide staffing flexibility that
	199	+	22 aligns changing patient acuity with nursing skills
	200	+	23 required.
	201	+	24 (C) Selection, implementation, and evaluation of a
	202	+	25 written staffing plan incorporating the items
	203	+	26 described in subdivisions (c)(1) and (c)(2) of this
	204	+
	205	+
	206	+
	207	+
	208	+
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	214	+	1 Section.
	215	+	2 (D) Review the nurse staffing plans for all
	216	+	3 inpatient areas and current acuity tools and measures
	217	+	4 in use. The nursing care committee's review shall
	218	+	5 consider:
	219	+	6 (i) patient outcomes;
	220	+	7 (ii) complaints regarding staffing, including
	221	+	8 complaints about a delay in direct care nursing or
	222	+	9 an absence of direct care nursing;
	223	+	10 (iii) the number of hours of nursing care
	224	+	11 provided through an inpatient hospital unit
	225	+	12 compared with the number of inpatients served by
	226	+	13 the hospital unit during a 24-hour period;
	227	+	14 (iv) the aggregate hours of overtime worked by
	228	+	15 the nursing staff;
	229	+	16 (v) the extent to which actual nurse staffing
	230	+	17 for each hospital inpatient unit differs from the
	231	+	18 staffing specified by the staffing plan; and
	232	+	19 (vi) any other matter or change to the
	233	+	20 staffing plan determined by the committee to
	234	+	21 ensure that the hospital is staffed to meet the
	235	+	22 health care needs of patients.
	236	+	23 (4) A nursing care committee must issue a written
	237	+	24 report addressing the items described in subparagraphs (A)
	238	+	25 through (D) of paragraph (3) semi-annually. A written copy
	239	+	26 of this report shall be made available to direct inpatient
	240	+
	241	+
	242	+
	243	+
	244	+
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	247	+
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	250	+	1 care nurses by making available a paper copy of the
	251	+	2 report, distributing it electronically, or posting it on
	252	+	3 the hospital's website.
	253	+	4 (5) A nursing care committee must issue a written
	254	+	5 report at least annually to the hospital governing board
	255	+	6 that addresses items including, but not limited to: the
	256	+	7 items described in paragraph (3); changes made based on
	257	+	8 committee recommendations and the impact of such changes;
	258	+	9 and recommendations for future changes related to nurse
	259	+	10 staffing.
	260	+	11 (6) A nursing care committee must annually notify the
	261	+	12 hospital nursing staff of the staff's rights under this
	262	+	13 Section. The annual notice must provide a phone number and
	263	+	14 an email address for staff to report noncompliance with
	264	+	15 the nursing staff's rights as described in this Section.
	265	+	16 The notice must be provided by email or by regular mail in
	266	+	17 a manner that effectively facilitates receipt of the
	267	+	18 notice. The Department shall monitor and enforce the
	268	+	19 requirements of this paragraph (6).
	269	+	20 (e) Nothing in this Section 10.10 shall be construed to
	270	+	21 limit, alter, or modify any of the terms, conditions, or
	271	+	22 provisions of a collective bargaining agreement entered into
	272	+	23 by the hospital.
	273	+	24 (f) No hospital may discipline, discharge, or take any
	274	+	25 other adverse employment action against an employee solely
	275	+	26 because the employee expresses a concern or complaint
	276	+
	277	+
	278	+
	279	+
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	282	+
	283	+
	284	+	HB3890 Enrolled- 9 -LRB103 30120 CPF 56544 b HB3890 Enrolled - 9 - LRB103 30120 CPF 56544 b
	285	+	HB3890 Enrolled - 9 - LRB103 30120 CPF 56544 b
	286	+	1 regarding an alleged violation of this Section or concerns
	287	+	2 related to nurse staffing.
	288	+	3 (g) Any employee of a hospital may file a complaint with
	289	+	4 the Department regarding an alleged violation of this Section.
	290	+	5 The Department must forward notification of the alleged
	291	+	6 violation to the hospital in question within 10 business days
	292	+	7 after the complaint is filed. Upon receiving a complaint of a
	293	+	8 violation of this Section, the Department may take any action
	294	+	9 authorized under Sections 7 or 9 of this Act.
	295	+	10 (Source: P.A. 102-4, eff. 4-27-21; 102-641, eff. 8-27-21;
	296	+	11 102-813, eff. 5-13-22.)
	297	+
	298	+
	299	+
	300	+
	301	+
	302	+	HB3890 Enrolled - 9 - LRB103 30120 CPF 56544 b