Illinois 2025-2026 Regular Session

Illinois Senate Bill SB0021 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB0021 Introduced 1/13/2025, by Sen. Christopher Belt SYNOPSIS AS INTRODUCED: 210 ILCS 85/10.9210 ILCS 85/10.15 new210 ILCS 85/10.20 new Amends the Hospital Licensing Act. Defines "hospital worker" as any person who receives an hourly wage, directly or indirectly via a subcontractor, from a hospital licensed under the Act. In provisions concerning limitations on mandated overtime and requiring rest periods for nurses, replaces "nurse" with "hospital worker". Requires additional hospital staffing information to be reported to the Department of Public Health, including any and all staffing matrices, staffing metrics, and underlying materials used to determine the metrics. Provides that the Department shall produce an annual report based on staffing disclosures and make recommendations for minimum staffing standards for hospital workers in each hospital unit. Requires hospitals to conduct a competency validation for each hospital worker hired, as a condition of employment, within the first month of employment and at no cost to the new hire. Provides that each hospital worker's competency validation must be submitted to the Department within 2 weeks after the hospital worker's start date. Establishes ongoing verification requirements for each hospital worker, and requires hospitals to submit a list of all competent employees currently employed at the end of each calendar year. Requires the Department to maintain, and make available to the public, a registry of all competent employees, including the hospital worker's name, address, contact information, and current employer. Provides that hospital employers that fail to comply with the competency validations requirements shall receive a fine equal to 0.1% of annual revenue reported during the most recently completed fiscal year each day until the hospital complies. Sets forth provisions concerning a hospital's requirements regarding assignment despite objection forms, a resolution process under the Department for assignment despite objection for certain hospital workers, and a fine for hospitals that fail to honor the assignment despite objection process. Makes other changes. LRB104 06121 BAB 16154 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB0021 Introduced 1/13/2025, by Sen. Christopher Belt SYNOPSIS AS INTRODUCED: 210 ILCS 85/10.9210 ILCS 85/10.15 new210 ILCS 85/10.20 new 210 ILCS 85/10.9 210 ILCS 85/10.15 new 210 ILCS 85/10.20 new Amends the Hospital Licensing Act. Defines "hospital worker" as any person who receives an hourly wage, directly or indirectly via a subcontractor, from a hospital licensed under the Act. In provisions concerning limitations on mandated overtime and requiring rest periods for nurses, replaces "nurse" with "hospital worker". Requires additional hospital staffing information to be reported to the Department of Public Health, including any and all staffing matrices, staffing metrics, and underlying materials used to determine the metrics. Provides that the Department shall produce an annual report based on staffing disclosures and make recommendations for minimum staffing standards for hospital workers in each hospital unit. Requires hospitals to conduct a competency validation for each hospital worker hired, as a condition of employment, within the first month of employment and at no cost to the new hire. Provides that each hospital worker's competency validation must be submitted to the Department within 2 weeks after the hospital worker's start date. Establishes ongoing verification requirements for each hospital worker, and requires hospitals to submit a list of all competent employees currently employed at the end of each calendar year. Requires the Department to maintain, and make available to the public, a registry of all competent employees, including the hospital worker's name, address, contact information, and current employer. Provides that hospital employers that fail to comply with the competency validations requirements shall receive a fine equal to 0.1% of annual revenue reported during the most recently completed fiscal year each day until the hospital complies. Sets forth provisions concerning a hospital's requirements regarding assignment despite objection forms, a resolution process under the Department for assignment despite objection for certain hospital workers, and a fine for hospitals that fail to honor the assignment despite objection process. Makes other changes. LRB104 06121 BAB 16154 b LRB104 06121 BAB 16154 b A BILL FOR
2	2	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB0021 Introduced 1/13/2025, by Sen. Christopher Belt SYNOPSIS AS INTRODUCED:
3	3	210 ILCS 85/10.9210 ILCS 85/10.15 new210 ILCS 85/10.20 new 210 ILCS 85/10.9 210 ILCS 85/10.15 new 210 ILCS 85/10.20 new
4	4	210 ILCS 85/10.9
5	5	210 ILCS 85/10.15 new
6	6	210 ILCS 85/10.20 new
7	7	Amends the Hospital Licensing Act. Defines "hospital worker" as any person who receives an hourly wage, directly or indirectly via a subcontractor, from a hospital licensed under the Act. In provisions concerning limitations on mandated overtime and requiring rest periods for nurses, replaces "nurse" with "hospital worker". Requires additional hospital staffing information to be reported to the Department of Public Health, including any and all staffing matrices, staffing metrics, and underlying materials used to determine the metrics. Provides that the Department shall produce an annual report based on staffing disclosures and make recommendations for minimum staffing standards for hospital workers in each hospital unit. Requires hospitals to conduct a competency validation for each hospital worker hired, as a condition of employment, within the first month of employment and at no cost to the new hire. Provides that each hospital worker's competency validation must be submitted to the Department within 2 weeks after the hospital worker's start date. Establishes ongoing verification requirements for each hospital worker, and requires hospitals to submit a list of all competent employees currently employed at the end of each calendar year. Requires the Department to maintain, and make available to the public, a registry of all competent employees, including the hospital worker's name, address, contact information, and current employer. Provides that hospital employers that fail to comply with the competency validations requirements shall receive a fine equal to 0.1% of annual revenue reported during the most recently completed fiscal year each day until the hospital complies. Sets forth provisions concerning a hospital's requirements regarding assignment despite objection forms, a resolution process under the Department for assignment despite objection for certain hospital workers, and a fine for hospitals that fail to honor the assignment despite objection process. Makes other changes.
8	8	LRB104 06121 BAB 16154 b LRB104 06121 BAB 16154 b
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10	10	A BILL FOR
11	11	SB0021LRB104 06121 BAB 16154 b SB0021 LRB104 06121 BAB 16154 b
12	12	SB0021 LRB104 06121 BAB 16154 b
13	13	1 AN ACT concerning regulation.
14	14	2 Be it enacted by the People of the State of Illinois,
15	15	3 represented in the General Assembly:
16	16	4 Section 5. The Hospital Licensing Act is amended by
17	17	5 changing Section 10.9 and by adding Sections 10.15 and 10.20
18	18	6 as follows:
19	19	7 (210 ILCS 85/10.9)
20	20	8 Sec. 10.9. Hospital worker Nurse mandated overtime
21	21	9 prohibited.
22	22	10 (a) Definitions. As used in this Section:
23	23	11 "Hospital worker" means any person who receives an hourly
24	24	12 wage, directly or indirectly via a subcontractor, from a
25	25	13 hospital licensed under this Act.
26	26	14 "Mandated overtime" means work that is required by the
27	27	15 hospital in excess of an agreed-to, predetermined work shift.
28	28	16 Time spent by nurses required to be available as a condition of
29	29	17 employment in specialized units, such as surgical nursing
30	30	18 services, shall not be counted or considered in calculating
31	31	19 the amount of time worked for the purpose of applying the
32	32	20 prohibition against mandated overtime under subsection (b).
33	33	21 "Nurse" means any advanced practice registered nurse,
34	34	22 registered professional nurse, or licensed practical nurse, as
35	35	23 defined in the Nurse Practice Act, who receives an hourly wage
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39	39	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB0021 Introduced 1/13/2025, by Sen. Christopher Belt SYNOPSIS AS INTRODUCED:
40	40	210 ILCS 85/10.9210 ILCS 85/10.15 new210 ILCS 85/10.20 new 210 ILCS 85/10.9 210 ILCS 85/10.15 new 210 ILCS 85/10.20 new
41	41	210 ILCS 85/10.9
42	42	210 ILCS 85/10.15 new
43	43	210 ILCS 85/10.20 new
44	44	Amends the Hospital Licensing Act. Defines "hospital worker" as any person who receives an hourly wage, directly or indirectly via a subcontractor, from a hospital licensed under the Act. In provisions concerning limitations on mandated overtime and requiring rest periods for nurses, replaces "nurse" with "hospital worker". Requires additional hospital staffing information to be reported to the Department of Public Health, including any and all staffing matrices, staffing metrics, and underlying materials used to determine the metrics. Provides that the Department shall produce an annual report based on staffing disclosures and make recommendations for minimum staffing standards for hospital workers in each hospital unit. Requires hospitals to conduct a competency validation for each hospital worker hired, as a condition of employment, within the first month of employment and at no cost to the new hire. Provides that each hospital worker's competency validation must be submitted to the Department within 2 weeks after the hospital worker's start date. Establishes ongoing verification requirements for each hospital worker, and requires hospitals to submit a list of all competent employees currently employed at the end of each calendar year. Requires the Department to maintain, and make available to the public, a registry of all competent employees, including the hospital worker's name, address, contact information, and current employer. Provides that hospital employers that fail to comply with the competency validations requirements shall receive a fine equal to 0.1% of annual revenue reported during the most recently completed fiscal year each day until the hospital complies. Sets forth provisions concerning a hospital's requirements regarding assignment despite objection forms, a resolution process under the Department for assignment despite objection for certain hospital workers, and a fine for hospitals that fail to honor the assignment despite objection process. Makes other changes.
45	45	LRB104 06121 BAB 16154 b LRB104 06121 BAB 16154 b
46	46	LRB104 06121 BAB 16154 b
47	47	A BILL FOR
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53	53	210 ILCS 85/10.9
54	54	210 ILCS 85/10.15 new
55	55	210 ILCS 85/10.20 new
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74	74	1 and has direct responsibility to oversee or carry out nursing
75	75	2 care. For the purposes of this Section, "advanced practice
76	76	3 registered nurse" does not include a certified registered
77	77	4 nurse anesthetist who is primarily engaged in performing the
78	78	5 duties of a nurse anesthetist.
79	79	6 "Related to the subcontractor" means that the
80	80	7 subcontractor is, to a significant extent, associated or
81	81	8 affiliated with, owns or is owned by, or has control of or is
82	82	9 controlled by, the organization furnishing services to a
83	83	10 hospital licensed under this Act.
84	84	11 "Subcontractor" means any entity, including an individual
85	85	12 or individuals, that contracts with a hospital licensed under
86	86	13 this Act to supply a service. "Subcontractor" includes an
87	87	14 organization that is related to the subcontractor that has a
88	88	15 contract with the subcontractor.
89	89	16 "Unforeseen emergent circumstance" means (i) any declared
90	90	17 national, State, or municipal disaster or other catastrophic
91	91	18 event, or any implementation of a hospital's disaster plan,
92	92	19 that will substantially affect or increase the need for health
93	93	20 care services or (ii) any circumstance in which patient care
94	94	21 needs require specialized nursing skills through the
95	95	22 completion of a procedure. An "unforeseen emergent
96	96	23 circumstance" does not include situations in which the
97	97	24 hospital fails to have enough nursing staff to meet the usual
98	98	25 and reasonably predictable patient care nursing needs of its
99	99	26 patients.
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110	110	1 (b) Mandated overtime prohibited. No hospital worker nurse
111	111	2 may be required to work mandated overtime except in the case of
112	112	3 an unforeseen emergent circumstance when such overtime is
113	113	4 required only as a last resort. Such mandated overtime shall
114	114	5 not exceed 4 hours beyond an agreed-to, predetermined work
115	115	6 shift.
116	116	7 (c) Rest period required Off-duty period. When a hospital
117	117	8 worker nurse is mandated to work up to 12 consecutive hours,
118	118	9 the hospital worker nurse must be allowed at least 8
119	119	10 consecutive hours of time off off-duty time immediately
120	120	11 following the completion of a shift.
121	121	12 (d) Retaliation prohibited. No hospital may discipline,
122	122	13 discharge, or take any other adverse employment action against
123	123	14 a hospital worker nurse solely because the hospital worker
124	124	15 nurse refused to work mandated overtime as prohibited under
125	125	16 subsection (b).
126	126	17 (e) Violations. Any employee of a hospital that is subject
127	127	18 to this Act may file a complaint with the Department of Public
128	128	19 Health regarding an alleged violation of this Section. The
129	129	20 complaint must be filed within 45 days following the
130	130	21 occurrence of the incident giving rise to the alleged
131	131	22 violation. The Department must forward notification of the
132	132	23 alleged violation to the hospital in question within 3
133	133	24 business days after the complaint is filed. Upon receiving a
134	134	25 complaint of a violation of this Section, the Department may
135	135	26 take any action authorized under Section 7 or 9 of this Act.
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146	146	1 (f) Proof of violation. Any violation of this Section must
147	147	2 be proved by clear and convincing evidence that a hospital
148	148	3 worker nurse was required to work overtime against the
149	149	4 hospital worker's his or her will. The hospital may defeat the
150	150	5 claim of a violation by presenting clear and convincing
151	151	6 evidence that an unforeseen emergent circumstance, which
152	152	7 required overtime work, existed at the time the employee was
153	153	8 required or compelled to work.
154	154	9 (Source: P.A. 100-513, eff. 1-1-18.)
155	155	10 (210 ILCS 85/10.15 new)
156	156	11 Sec. 10.15. Additional staffing transparency and reporting
157	157	12 requirements.
158	158	13 (a) Definitions. As used in this Section:
159	159	14 "Hospital worker" means any person who receives an hourly
160	160	15 wage, directly or indirectly via a subcontractor, from a
161	161	16 hospital licensed under this Act.
162	162	17 "Related to the subcontractor" means that the
163	163	18 subcontractor is, to a significant extent, associated or
164	164	19 affiliated with, owns or is owned by, or has control of or is
165	165	20 controlled by, the organization furnishing services to a
166	166	21 hospital licensed under this Act.
167	167	22 "Staffing metric" means any tool used by hospital
168	168	23 management to determine safe staffing levels in a patient care
169	169	24 or support services unit.
170	170	25 "Subcontractor" means any entity, including an individual
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181	181	1 or individuals, that contracts with a hospital licensed under
182	182	2 this Act to supply a service. "Subcontractor" includes an
183	183	3 organization that is related to the subcontractor that has a
184	184	4 contract with the subcontractor.
185	185	5 "Unit" means a functional division of a hospital that
186	186	6 provides patient care or support services.
187	187	7 (b) Hospitals licensed under this Act must employ and
188	188	8 schedule enough hospital workers to provide quality patient
189	189	9 care and ensure patient safety.
190	190	10 (c) In order to ensure compliance with safe staffing
191	191	11 practices, hospitals licensed under this Act must make
192	192	12 available upon request all the staffing matrices or other
193	193	13 staffing metrics used to assess and maintain safe staffing
194	194	14 levels for hospital workers in each unit.
195	195	15 (d) A hospital must also share with the Department at the
196	196	16 beginning of each calendar year any and all staffing matrices,
197	197	17 staffing metrics, and underlying materials used to determine
198	198	18 the metrics.
199	199	19 (e) The Department shall produce an annual report based on
200	200	20 staffing disclosures required under this Section, beginning
201	201	21 the first year after implementation.
202	202	22 (f) The Department shall make recommendations for minimum
203	203	23 staffing standards for hospital workers in each hospital unit
204	204	24 based on the information collected under this Section.
205	205	25 (210 ILCS 85/10.20 new)
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216	216	1 Sec. 10.20. Hospital worker competency validation and
217	217	2 assignment despite objection.
218	218	3 (a) Findings. The General Assembly finds that:
219	219	4 (1) The State of Illinois has an obligation to ensure
220	220	5 hospitals provide quality patient care.
221	221	6 (2) Numerous studies have linked patient outcomes,
222	222	7 including in-hospital mortality rates, to hospital worker
223	223	8 staffing.
224	224	9 (3) Despite the preponderance of evidence that
225	225	10 adequate staffing improves patient outcomes, hospitals in
226	226	11 Illinois and elsewhere too often systemically and
227	227	12 intentionally understaff to maximize profit, even at the
228	228	13 expense of quality patient care.
229	229	14 (4) The COVID-19 pandemic both exposed and exacerbated
230	230	15 these unsafe staffing practices.
231	231	16 (5) The State asserts that, based on their
232	232	17 demonstrated competencies and training, hospital workers
233	233	18 are best positioned to identify unsafe conditions that
234	234	19 jeopardize quality patient care, especially short
235	235	20 staffing.
236	236	21 (6) Hospitals perform competency validations and
237	237	22 ongoing verifications to ensure hospital workers know how
238	238	23 to perform their jobs safely and to identify unsafe
239	239	24 practices, including short staffing.
240	240	25 (7) The State should require hospitals to affirm that
241	241	26 hospital workers have received the necessary training to
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252	252	1 safely perform their work via competency validations and
253	253	2 ongoing verification and empower these hospital workers to
254	254	3 identify and formally object to unsafe working conditions,
255	255	4 including short staffing.
256	256	5 (8) To facilitate this, the State should create a
257	257	6 dispute resolution process for hospital workers to
258	258	7 formally object to unsafe working conditions.
259	259	8 (b) Definitions. As used in this Section:
260	260	9 "Assignment despite objection" means a formal process by
261	261	10 which hospital workers notify management when they receive an
262	262	11 assignment that, based on their training, is potentially
263	263	12 unsafe.
264	264	13 "Competency validation" means a determination based on a
265	265	14 hospital worker's satisfactory performance of each specific
266	266	15 element of the hospital worker's job description and of
267	267	16 specific requirements of the unit in which the hospital worker
268	268	17 is employed in a safe and ethical manner.
269	269	18 "Competent employee" means a hospital worker whose
270	270	19 employer has received a competency validation or ongoing
271	271	20 verification during a given calendar year.
272	272	21 "Hospital worker" means any person who receives an hourly
273	273	22 wage, directly or indirectly via a subcontractor, from a
274	274	23 hospital licensed under this Act.
275	275	24 "Ongoing verification" means an annual redetermination
276	276	25 based on a hospital worker's satisfactory performance of each
277	277	26 specific element of the hospital worker's job description and
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288	288	1 the specific requirements of the unit in which the hospital
289	289	2 worker is employed in a safe and ethical manner.
290	290	3 "Subcontractor" means any entity, including an individual
291	291	4 or individuals, that contracts with a hospital licensed under
292	292	5 this Act to supply a service. "Subcontractor" includes an
293	293	6 organization that, to a significant extent, is associated or
294	294	7 affiliated with, owns or is owned by, or has control of or is
295	295	8 controlled by, the entity furnishing services to a hospital
296	296	9 licensed under this Act.
297	297	10 (c) Competency validation credential.
298	298	11 (1) Hospitals licensed under this Act shall conduct a
299	299	12 competency validation for each hospital worker hired, as a
300	300	13 condition of employment, within the first month of
301	301	14 employment and at no cost to the new hire.
302	302	15 (2) The competency validation formally affirms the
303	303	16 hospital has adequately trained a hospital worker to
304	304	17 perform all aspects of the hospital worker's job safely
305	305	18 and to identify unsafe conditions, including inadequate
306	306	19 staffing.
307	307	20 (3) Hospitals must submit documentation of each
308	308	21 hospital worker's competency validation to the Department
309	309	22 within 2 weeks after the hospital worker's start date.
310	310	23 (4) Hospitals licensed under this Act shall also
311	311	24 conduct an ongoing verification for each hospital worker
312	312	25 employed during the calendar year to determine each
313	313	26 hospital worker's continued competency to perform the
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324	324	1 hospital worker's job. The hospitals shall submit
325	325	2 documentation of each hospital worker's ongoing
326	326	3 verification to the Department within 2 weeks after
327	327	4 completion.
328	328	5 (5) Hospitals licensed under this Act shall submit a
329	329	6 list of all competent employees currently employed at the
330	330	7 end of each calendar year.
331	331	8 (6) The Department shall maintain, and make available
332	332	9 to the public, a registry of all competent employees,
333	333	10 including the hospital worker's name, address, contact
334	334	11 information, and current employer.
335	335	12 (7) Hospital employers that fail to comply with the
336	336	13 requirements of this Section shall receive a fine equal to
337	337	14 0.1% of annual revenue reported during the most recently
338	338	15 completed fiscal year each day until the hospital complies
339	339	16 with the law.
340	340	17 (d) Assignment despite objection.
341	341	18 (1) A hospital licensed under this Act must create an
342	342	19 assignment despite objection form that is applicable and
343	343	20 accessible to all hospital workers that enables the
344	344	21 hospital workers to formally object to unsafe working
345	345	22 conditions (including unsafe staffing levels) and shifts
346	346	23 liability for the unsafe working conditions to the
347	347	24 hospital.
348	348	25 (2) The assignment despite objection form must include
349	349	26 the following language: "This is to confirm that I
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360	360	1 notified you that, in my professional judgment derived
361	361	2 from my competency validation, today's assignment is
362	362	3 unsafe and places patients at risk. As a result, the
363	363	4 facility is responsible for any adverse effects on patient
364	364	5 care."
365	365	6 (3) A hospital must retain a copy of each assignment
366	366	7 despite objection form and provide copies to the hospital
367	367	8 worker's union (where relevant) and the Department.
368	368	9 Hospitals must provide a report of all assignment despite
369	369	10 objection forms filed annually at the end of each calendar
370	370	11 year and maintain these records for a minimum of 5 years.
371	371	12 (4) A hospital must not retaliate against hospital
372	372	13 workers for filing an assignment despite objection form or
373	373	14 for reporting or objecting to unsafe conditions.
374	374	15 (e) Resolution process.
375	375	16 (1) A hospital must develop a transparent, fair, and
376	376	17 expedient assignment despite objection resolution process
377	377	18 for all hospital workers either via collective bargaining
378	378	19 or in accordance with the Department process described in
379	379	20 paragraph (3).
380	380	21 (2) Hospital workers currently covered by a collective
381	381	22 bargaining agreement that includes an assignment despite
382	382	23 objection resolution process shall abide by the process
383	383	24 included in the collective bargaining agreement.
384	384	25 (3) Hospital workers not covered by a collective
385	385	26 bargaining agreement that includes an assignment despite
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396	396	1 objection resolution process may use the Department's
397	397	2 resolution process. The Department's resolution process
398	398	3 for an assignment despite objection shall be as follows:
399	399	4 (A) Step 1: The objecting hospital worker shall
400	400	5 make a good faith effort to inform the manager or
401	401	6 supervisor at the time of the objection to assignment.
402	402	7 (B) Step 2: If the manager or supervisor fails to
403	403	8 resolve the unsafe situation to the reporting hospital
404	404	9 worker's satisfaction, the hospital worker shall then
405	405	10 complete an assignment despite objection form and
406	406	11 submit a copy to the manager or supervisor, submit a
407	407	12 copy to the representative organization if covered by
408	408	13 a collective bargaining agreement, and keep a copy for
409	409	14 the hospital worker's records.
410	410	15 (C) Hospital management must respond in writing to
411	411	16 the assignment despite objection within one week of
412	412	17 its receipt and shall provide a copy of the response to
413	413	18 the hospital worker's representative organization if
414	414	19 the hospital worker is covered by a collective
415	415	20 bargaining agreement.
416	416	21 (D) If the affected hospital worker is unsatisfied
417	417	22 with the management's response, the hospital must
418	418	23 convene a Safety Review Panel composed of 3
419	419	24 representatives selected by the hospital and 3
420	420	25 representatives selected by hospital workers via a
421	421	26 transparent democratic process (the hospital workers'
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