OLR Bill Analysis
SB 855 (File 93, as amended by Senate "A" and "B")*
AN ACT CONCERNING REPORTS OF NURSE STAFFING LEVELS.
This bill requires hospitals to report annually to the Department of Public Health (DPH) on their prospective nurse staffing plans, rather than make the plans available to DPH upon request. It expands, in two stages, the information that must be included in the plans, such as the (1) ratio of patients to certain nursing staff and (2) differences between the prospective staffing levels and actual levels.
The bill requires the DPH commissioner to annually report, beginning January 1, 2016, to the Public Health Committee on hospital compliance with staffing plan reporting requirements and recommendations for any additional reporting requirements.
The bill also requires certain health care employers to annually report to DPH, rather than report upon the department's request, on the number of workplace violence incidents occurring on the employer's premises and the specific area or department where they occurred. The first report is due January 1, 2016, and the reports must cover incidents occurring the prior year.
For this purpose, a “health care employer” is any DPH-licensed institution with 50 or more full- or part-time employees (e.g., hospitals, nursing homes, residential care homes, home health care agencies). It includes a (1) facility for care or treatment of people with mental illness or issues involving substance abuse; (2) residential care facility for persons with intellectual disability, licensed by the Department of Developmental Services; and (3) community health center.
*Senate Amendment “A” (1) adds the requirement that information on registered nurse staffing be reported by patient care unit and (2) removes the requirement that the commissioner's annual report address the effectiveness of hospital staffing plans.
*Senate Amendment “B” adds the provisions on workplace violence reporting.
EFFECTIVE DATE: July 1, 2015, except the workplace violence provisions are effective October 1, 2015.
PROSPECTIVE NURSE STAFFING PLANS
In addition to the information currently required by law (see BACKGROUND), the bill requires plans developed and implemented after January 1, 2016 to include:
1. the number of direct patient care staff in three categories (registered nurses, licensed practical nurses, and assistive personnel) and the ratio of patients to each category, reported by patient care units;
2. the hospital's method to determine and adjust direct patient care staffing levels; and
3. a description of supporting personnel assisting on each patient care unit.
In addition, plans developed and implemented after January 1, 2017 must include:
1. a description of any differences between the plan's staffing levels and actual staffing levels for each patient care unit (presumably for the prior year) and
2. any actions the hospital intends to take to address these differences or adjust staffing levels in future plans.
Prospective Nurse Staffing Plans
By law, when submitting its prospective nurse staffing plan to DPH, a hospital must certify that the plan is sufficient to provide adequate and appropriate health care services in the ensuing hospital licensure period. The plan must promote collaborative practice in the hospital that improves patient care and the level of services that nurses and other hospital patient care team members provide. The law specifies certain information that must be included in the plan.
Under existing law, the plan must:
1. include the minimum professional skill mix for each patient care unit,
2. identify the hospital's employment practices for temporary and traveling nurses,
3. establish the level of administrative staffing in each patient care unit that ensures that direct care staff are not used for administrative functions,
4. describe the hospital's process for internal review of the plan, and
5. include the hospital's method for involving its direct care staff in developing the plan (CGS § 19a-89e).
Public Health Committee