STATE OF NEW YORK
________________________________________________________________________
1168--A
2021-2022 Regular Sessions
IN SENATE
January 7, 2021
___________
Introduced by Sens. RIVERA, ADDABBO, BAILEY, BENJAMIN, BIAGGI, BOYLE,
BRESLIN, BRISPORT, BROOKS, BROUK, COMRIE, GAUGHRAN, GOUNARDES, HARCK-
HAM, HINCHEY, HOYLMAN, JACKSON, KAMINSKY, KAPLAN, KAVANAGH, KENNEDY,
KRUEGER, LIU, MANNION, MATTERA, MAY, MAYER, MYRIE, PARKER, RAMOS,
REICHLIN-MELNICK, RYAN, SALAZAR, SANDERS, SEPULVEDA, SERINO, SERRANO,
SKOUFIS, STAVISKY, THOMAS -- read twice and ordered printed, and when
printed to be committed to the Committee on Health -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee
AN ACT to amend the public health law, in relation to establishing clin-
ical staffing committees
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 2805-t of the public health law, as added by chap-
2 ter 422 of the laws of 2009, is amended to read as follows:
3 § 2805-t. [Disclosure] Clinical staffing committees and disclosure of
4 nursing quality indicators. 1. Legislative intent. The legislature
5 hereby finds and declares:
6 (a) Research demonstrates that nurses play a critical role in improv-
7 ing patient safety and quality of care;
8 (b) Appropriate staffing of general hospital personnel, including
9 registered nurses available for patient care, assists in reducing
10 errors, complications and adverse patient care events, improves staff
11 safety and satisfaction, and reduces incidences of workplace injuries;
12 (c) Health care professional, technical, and support staff comprise
13 vital components of the patient care team, bringing their particular
14 skills and services to ensuring quality patient care;
15 (d) Ensuring sufficient staffing of general hospital personnel,
16 including registered nurses, is an urgent public policy priority in
17 order to protect patients and support greater retention of registered
18 nurses and safer working conditions; and
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02466-13-1
S. 1168--A 2
1 (e) It is the public policy of the state to promote evidence-based
2 nurse staffing standards and increase transparency of health care data
3 and decision making based on the data.
4 2. Clinical staffing committee. (a) Each general hospital licensed
5 pursuant to this article shall establish and maintain a clinical staff-
6 ing committee, either by creating a new committee or assigning the func-
7 tions of the clinical staffing committee to an existing committee, no
8 later than January first, two thousand twenty-two.
9 (b) Where a collective bargaining agreement provides for a staffing
10 committee, the required functions of the clinical staffing committee
11 established pursuant to this section shall be incorporated into that
12 committee. Any staffing or non-staffing committees established by a
13 collective bargaining agreement, shall continue to function in accord-
14 ance with the terms of the agreement, and the clinical staffing commit-
15 tee established by this section shall not limit or otherwise supplant
16 the collective bargaining agreement.
17 (c) At least one-half of the members of the clinical staffing commit-
18 tee shall be registered nurses, licensed practical nurses, and ancillary
19 members of the frontline team currently providing or supporting direct
20 patient care and up to one-half of the members shall be selected by the
21 general hospital administration and shall include but not be limited to
22 the chief financial officer, the chief nursing officer, and patient care
23 unit directors or managers or their designees. The selection of the
24 registered nurses, licensed practical nurses, and ancillary frontline
25 team members of the committee shall be according to their respective
26 collective bargaining agreements if there is one in effect at the gener-
27 al hospital for their bargaining unit. If there is no applicable collec-
28 tive bargaining agreement, the members of the clinical staffing commit-
29 tee who are registered nurses, licensed practical nurses, and ancillary
30 members providing direct patient care shall be selected by their peers.
31 Ancillary members of the frontline team on the committee shall include
32 but are not limited to patient care technicians, certified nursing
33 assistants, other non-licensed staff assisting with nursing or clerical
34 tasks, and unit clerks.
35 3. Employee participation. Participation in the clinical staffing
36 committee by a general hospital employee shall be on scheduled work time
37 and compensated at the appropriate rate of pay. Clinical staffing
38 committee members shall be fully relieved of all other work duties
39 during meetings of the committee and shall not have work duties added or
40 displaced to other times as a result of their committee responsibil-
41 ities.
42 4. Primary responsibilities. Primary responsibilities of the clinical
43 staffing committee shall include the following functions:
44 (a) Development and oversight of implementation of an annual clinical
45 staffing plan. The clinical staffing plan shall include specific staff-
46 ing for each patient care unit and work shift and shall be based on the
47 needs of patients. Staffing plans shall include specific guidelines or
48 ratios, matrices, or grids indicating how many patients are assigned to
49 each registered nurse and the number of nurses and ancillary staff to be
50 present on each unit and shift and shall be used as the primary compo-
51 nent of the general hospital staffing budget.
52 (b) Factors to be considered and incorporated in the development of
53 the plan shall include, but are not limited to:
54 (i) Census, including total numbers of patients on the unit on each
55 shift and activity such as patient discharges, admissions, and trans-
56 fers;
S. 1168--A 3
1 (ii) Measures of acuity and intensity of all patients and nature of
2 the care to be delivered on each unit and shift;
3 (iii) Skill mix;
4 (iv) The availability, level of experience, and specialty certif-
5 ication or training of nursing personnel providing patient care, includ-
6 ing charge nurses, on each unit and shift;
7 (v) The need for specialized or intensive equipment;
8 (vi) The architecture and geography of the patient care unit, includ-
9 ing but not limited to placement of patient rooms, treatment areas,
10 nursing stations, medication preparation areas, and equipment;
11 (vii) Mechanisms and procedures to provide for one-to-one patient
12 observation, when needed, for patients on psychiatric or other units as
13 appropriate;
14 (viii) Other special characteristics of the unit or community patient
15 population, including age, cultural and linguistic diversity and needs,
16 functional ability, communication skills, and other relevant social or
17 socio-economic factors;
18 (ix) Measures to increase worker and patient safety, which could
19 include measures to improve patient throughput;
20 (x) Staffing guidelines adopted or published by other states or local
21 jurisdictions, national nursing professional associations, specialty
22 nursing organizations, and other health professional organizations;
23 (xi) Availability of other personnel supporting nursing services on
24 the unit;
25 (xii) Waiver of plan requirements in the case of unforeseeable emer-
26 gency circumstances as defined in subdivision fourteen of this section;
27 (xiii) Coverage to enable registered nurses, licensed practical nurs-
28 es, and ancillary staff to take meal and rest breaks, planned time off,
29 and unplanned absences that are reasonably foreseeable as required by
30 law or the terms of an applicable collective bargaining agreement, if
31 any, between the general hospital and a representative of the nursing or
32 ancillary staff;
33 (xiv) The nursing quality indicators required under subdivision seven-
34 teen of this section;
35 (xv) General hospital finances and resources; and
36 (xvi) Provisions for limited short-term adjustments made by appropri-
37 ate general hospital personnel overseeing patient care operations to the
38 staffing levels required by the plan, necessary to account for unex-
39 pected changes in circumstances that are to be of limited duration.
40 (c) Semiannual review of the staffing plan against patient needs and
41 known evidence-based staffing information, including the nursing sensi-
42 tive quality indicators collected by the general hospital.
43 (d) Review, assessment, and response to complaints regarding potential
44 violations of the adopted staffing plan, staffing variations, or other
45 concerns regarding the implementation of the staffing plan and within
46 the purview of the committee.
47 5. Compliance provisions. (a) The clinical staffing plan shall comply
48 with all federal and state laws and regulations and shall not diminish
49 other standards contained in state or federal law and regulations, or
50 the terms of an applicable collective bargaining agreement, if any.
51 (b) The clinical staffing plan shall comply with applicable laws and
52 regulations, including, but not limited to:
53 (i) Regulations made by the department on burn unit staffing, liver
54 transplant staffing, and operating room circulating nurse staffing;
55 (ii) Staffing regulations to be promulgated by the commissioner relat-
56 ing to staffing in intensive care and critical care units no later than
S. 1168--A 4
1 January first, two thousand twenty-two. Such regulations shall consider
2 the factors set forth in paragraph (b) of subdivision four of this
3 section, standards in place in neighboring states, and a minimum stand-
4 ard of twelve hours of registered nurse care per patient per day;
5 (iii) Such other staffing standards or regulations as are currently in
6 effect or may hereafter be established by the department or enacted by
7 the legislature; and
8 (iv) The provisions of section one hundred sixty-seven of the labor
9 law and any related regulations.
10 (c) The clinical staffing plan shall comply with and incorporate any
11 minimum staffing levels provided for in any applicable collective
12 bargaining agreement, including but not limited to nurse-to-patient
13 ratios, caregiver-to-patient ratios, staffing grids, staffing matrices,
14 or other staffing provisions.
15 6. Process for adoption of clinical staffing plans. (a) The clinical
16 staffing committee shall produce the general hospital's annual clinical
17 staffing plan by July first of each year.
18 (b) Clinical staffing plans shall be developed and adopted by consen-
19 sus of the clinical staffing committee. For the purposes of determining
20 whether there is a consensus, the management members of the committee
21 shall have one vote and the employee members of the committee shall have
22 one vote, regardless of the actual number of members of the committee.
23 Each side may determine its own method of casting its vote to adopt all
24 or part of the clinical staffing plan.
25 (c) The general hospital shall adopt any clinical staffing plan that
26 is wholly or partially recommended by a consensus of the clinical staff-
27 ing committee. If there is no consensus on the recommended staffing plan
28 or any of its parts, the chief executive officer of the general hospital
29 shall use the officer's discretion to adopt a plan or partial plan for
30 which there is no consensus. In this case, the chief executive officer
31 shall provide a written explanation of the elements of the clinical
32 staffing plan that the committee was unable to agree on, including the
33 final written proposals from the two parties and their rationales. In no
34 event may a chief executive officer fail to include in the adopted plan
35 any staffing related terms and conditions of the plan that has previous-
36 ly been adopted through any applicable collective bargaining agreement.
37 (d) Each general hospital shall adopt and submit its first hospital
38 clinical staffing plan under this section to the department no later
39 than July first, two thousand twenty-two and annually thereafter. The
40 plan submitted to the department shall, where applicable, include the
41 written explanation from the chief executive officer and written
42 proposals from the two parties regarding elements that the committee did
43 not agree on as required in paragraph (c) of this subdivision. The
44 submitted clinical staffing plan shall include data, from at least the
45 previous year, on the frequency and duration of variations from the
46 adopted clinical staffing plan, the number of complaints relating to the
47 clinical staffing plan and their disposition, as well as descriptions of
48 unresolved complaints submitted pursuant to paragraph (b) of subdivision
49 seven of this section. The department shall post the plan as part of
50 each individual general hospital's health profile on the website of the
51 department no later than July thirty-first of each year. If the adopted
52 clinical staffing plan is subsequently amended, the amended plan shall
53 be submitted to the department within thirty days of adoption. Adopted
54 staffing plans shall be amended to include newly created units and
55 existing units that undergo clinical or programmatic changes that funda-
S. 1168--A 5
1 mentally alter their character or nature. The department shall post
2 amended staffing plans upon receipt.
3 7. Implementation of clinical staffing plans. (a) Beginning January
4 first, two thousand twenty-three, and annually thereafter, each general
5 hospital shall implement the clinical staffing plan adopted by July
6 first of the prior calendar year, and any subsequent amendments, and
7 assign personnel to each patient care unit in accordance with the plan.
8 (b) A registered nurse, licensed practical nurse, ancillary member of
9 the frontline team, or collective bargaining representative may report
10 to the clinical staffing committee any variations where the personnel
11 assignment in a patient care unit is not in accordance with the adopted
12 staffing plan and may make a complaint to the committee based on the
13 variations.
14 (c) The clinical staffing committee shall develop a process to exam-
15 ine, respond to, and track data submitted under paragraph (b) of this
16 subdivision. The clinical staffing committee may by consensus, as
17 described in paragraph (b) of subdivision six of this section, determine
18 a complaint resolved or dismissed. The clinical staffing committee shall
19 also establish agreed upon rules and criteria to provide for confiden-
20 tiality of complaints that are in the process of being examined or are
21 found to be unsubstantiated. This subdivision does not infringe upon or
22 limit the rights of any collective bargaining representative of employ-
23 ees, or of any employee or group of employees pursuant to applicable
24 law, including without limitation any applicable state or federal labor
25 laws.
26 8. Posting of staffing information. Each general hospital shall post,
27 in a publicly conspicuous area on each patient care unit, the clinical
28 staffing plan for that unit and the actual daily staffing for that shift
29 on that unit as well as the relevant clinical staffing.
30 9. Retaliation and intimidation prohibited. A general hospital shall
31 not retaliate against or engage in any form of intimidation of:
32 (a) An employee for performing any duties or responsibilities in
33 connection with the clinical staffing committee; or
34 (b) An employee, patient, or other individual who notifies the clin-
35 ical staffing committee or the hospital administration of the individ-
36 ual's staffing concerns.
37 10. Special considerations. Nothing in this section is intended to
38 create unreasonable burdens on critical access hospitals under 42 U.S.C.
39 Sec. 1395i-4 and sole community hospitals under 42 U.S.C. Sec.
40 1395ww(d)(5) related to the operation of their clinical staffing commit-
41 tees. Critical access and sole community hospitals may develop flexible
42 approaches to accomplish the requirements of this section. Clinical
43 staffing plans from such entities submitted to the department shall
44 contain a description of any ways in which the general hospital's
45 approach to creating the plan differed from the process outlined in this
46 section. This subdivision does not relieve such entities from compli-
47 ance with other provisions of this section related to the adoption,
48 implementation and adherence to an adopted clinical staffing plan,
49 reporting and disclosure, or other requirements of this section.
50 11. Investigations. (a) The department shall investigate potential
51 violations of this section following receipt of a complaint with
52 supporting evidence, of failure to:
53 (i) Form or establish a clinical staffing committee;
54 (ii) Comply with the requirements of this section in creating a clin-
55 ical staffing plan;
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1 (iii) Adopt all or part of a clinical staffing plan that is approved
2 by consensus of the clinical staffing committee and submitted to the
3 department;
4 (iv) Conduct a semiannual review of a clinical staffing plan; or
5 (v) Submit to the department a clinical staffing plan on an annual
6 basis and any updates.
7 (b) The department shall initiate an investigation of unresolved
8 complaints, that have first been submitted to the clinical staffing
9 committee, regarding compliance with the clinical staffing plan, person-
10 nel assignments in a patient care unit or staffing levels, or any other
11 requirement of the adopted clinical staffing plan, excluding complaints
12 determined by the clinical staffing committee to be resolved or
13 dismissed as determined by consensus of the clinical staffing committee
14 as described in paragraph (b) of subdivision six of this section.
15 (c) The department shall initiate an investigation after making an
16 assessment that there is a pattern of failure to resolve complaints
17 submitted to the clinical staffing committee or a pattern of failure to
18 reach consensus on the adoption of all or part of a clinical staffing
19 plan. In the case of a pattern of failure to resolve complaints or to
20 reach consensus on the adoption of all or part of a clinical staffing
21 plan, the department shall determine if the pattern was due to one of
22 the parties routinely refusing to resolve complaints or reach consensus.
23 (d) Any department investigation of a complaint under this subdivision
24 shall consider whether unforeseeable emergency circumstances as defined
25 in subdivision fourteen of this section contributed to the failure of
26 the general hospital to comply with this section.
27 (e) After an investigation conducted under paragraph (a) or (b) of
28 this subdivision, if the department determines that there has been a
29 violation, the department shall require the general hospital to submit a
30 corrective plan of action within forty-five days of the presentation of
31 findings from the department to the hospital. If the department deter-
32 mines after investigation under paragraph (c) of this subdivision that
33 the general hospital representatives on the clinical staffing committee
34 were responsible for a pattern of not resolving complaints or for a
35 pattern of not reaching consensus, the department shall require the
36 general hospital to submit a corrective action plan within forty-five
37 days of the presentation of findings to the general hospital. If the
38 department finds that the frontline staff representatives on the clin-
39 ical staffing committee were responsible for a pattern of not resolving
40 complaints or for a pattern of not reaching consensus, the department
41 shall not require the general hospital to submit a corrective action
42 plan or impose a civil penalty on the general hospital pursuant to
43 subdivision twelve of this section.
44 12. Civil penalties. In the event that a general hospital fails to
45 submit or submits but fails to implement a corrective action plan in
46 response to a violation or violations found by the department based on a
47 complaint filed pursuant to paragraph (a), (b) or (c) of subdivision
48 eleven of this section, the department may impose a civil penalty as
49 authorized by section twelve of this chapter for all violations asserted
50 against the general hospital, until the general hospital submits or
51 implements a corrective action plan or takes other action directed by
52 the department.
53 13. Posting of penalties and related information. The department shall
54 maintain for public inspection, including posting on the general hospi-
55 tal profile on the department website, records of any civil penalties,
S. 1168--A 7
1 administrative actions, or license suspensions or revocations imposed on
2 general hospitals under this section.
3 14. Unforeseeable emergency circumstances. (a) For purposes of this
4 section, "unforeseeable emergency circumstance" means:
5 (i) Any officially declared national, state, or municipal emergency;
6 (ii) When a general hospital disaster plan is activated; or
7 (iii) Any unforeseen disaster or other catastrophic event that imme-
8 diately affects or increases the need for health care services.
9 (b) In determining whether a general hospital has violated its obli-
10 gations under this section to comply with the general hospital's clin-
11 ical staffing plan, it shall not be a defense that it was unable to
12 secure sufficient staff if the lack of staffing was foreseeable and
13 could be prudently planned for or involved routine nurse staffing needs
14 that arose due to typical staffing patterns, typical levels of absentee-
15 ism, and time off typically approved by the employer for vacation, holi-
16 days, sick leave, and personal leave.
17 15. Complaints. Nothing in this section shall be construed to preclude
18 the ability to submit a complaint to the department as provided for
19 under this chapter. Nothing in this section shall be construed as
20 supplanting other complaint mechanisms established by a general hospi-
21 tal, including mechanisms designed to aid in compliance with other
22 federal, state or local laws. Nothing in this section shall be
23 construed as limiting or supplanting the rights of employees and their
24 collective bargaining representatives to fully enforce any and all
25 rights under the terms of a collective bargaining agreement. An employ-
26 er shall not assert or attempt to assert a claim that enforcement of the
27 collective bargaining agreement is barred or limited by any provisions
28 of this section.
29 16. Annual report. (a) The department shall submit an annual report to
30 the speaker of the assembly, the temporary president of the senate, and
31 the chairs of the health committees of the assembly and senate and the
32 governor on or before December thirty-first of each year. This report
33 shall include the number of complaints submitted to the department, the
34 disposition of these complaints, the number of investigations conducted,
35 and the associated costs for complaint investigations, if any.
36 (b) Prior to the submission of the report, the commissioner shall
37 convene a stakeholder workgroup consisting of hospital associations and
38 unions representing nurses and other ancillary members of the frontline
39 team. The stakeholder workgroup shall review the report prior to its
40 submission to the speaker of the assembly, the temporary president of
41 the senate, and the chairs of the health committees of the assembly and
42 senate.
43 17. Disclosure of nursing quality indicators. (a) Every facility with
44 an operating certificate pursuant to the requirements of this article
45 shall make available to the public information regarding nurse staffing
46 and patient outcomes as specified by the commissioner by rule and regu-
47 lation. The commissioner shall promulgate rules and regulations on the
48 disclosure of nursing quality indicators providing for the disclosure of
49 information including at least the following, as appropriate to the
50 reporting facility:
51 [(a)] (i) The number of registered nurses providing direct care and
52 the ratio of patients per registered nurse, full-time equivalent,
53 providing direct care. This information shall be expressed in actual
54 numbers, in terms of total hours of nursing care per patient, including
55 adjustment for case mix and acuity, and as a percentage of patient care
S. 1168--A 8
1 staff, and shall be broken down in terms of the total patient care
2 staff, each unit, and each shift.
3 [(b)] (ii) The number of licensed practical nurses providing direct
4 care. This information shall be expressed in actual numbers, in terms of
5 total hours of nursing care per patient including adjustment for case
6 mix and acuity, and as a percentage of patient care staff, and shall be
7 broken down in terms of the total patient care staff, each unit, and
8 each shift.
9 [(c)] (iii) The number of unlicensed personnel utilized to provide
10 direct patient care, including adjustment for case mix and acuity. This
11 information shall be expressed both in actual numbers and as a percent-
12 age of patient care staff and shall be broken down in terms of the total
13 patient care staff, each unit, and each shift.
14 [(d)] (iv) Incidence of adverse patient care, including incidents such
15 as medication errors, patient injury, decubitus ulcers, nosocomial
16 infections, and nosocomial urinary tract infections.
17 [(e)] (v) Methods used for determining and adjusting staffing levels
18 and patient care needs and the facility's compliance with these methods.
19 [(f)] (vi) Data regarding complaints filed with any state or federal
20 regulatory agency, or an accrediting agency, and data regarding investi-
21 gations and findings as a result of those complaints, degree of compli-
22 ance with acceptable standards, and the findings of scheduled inspection
23 visits.
24 [2.] (b) Such information shall be provided to the commissioner of any
25 state agency responsible for licensing or accrediting the facility, or
26 responsible for overseeing the delivery of services either directly or
27 indirectly, to any employee of a general hospital or the employee's
28 collective bargaining agent, if any, and to any member of the public who
29 requests such information directly from the facility. Written statements
30 containing such information shall state the source and date thereof.
31 (c) The commissioner shall make regulations to provide a uniform
32 format or form for complying with the reporting requirements of subpara-
33 graphs (i), (ii) and (iii) of paragraph (a) of this subdivision, allow-
34 ing patients and the public to clearly understand and compare staffing
35 patterns and actual levels of staffing across facilities. Such uniform
36 format or form shall allow facilities to include a description of addi-
37 tional resources available to support unit level patient care and a
38 description of the general hospital. The information required by subpar-
39 agraphs (i), (ii) and (iii) of paragraph (a) of this subdivision,
40 reported in a manner determined by the commissioner, shall be filed with
41 the department electronically on a quarterly basis and shall be avail-
42 able to the public on the department's website. The regulations shall
43 take effect no later than December thirty-first, two thousand twenty-
44 two. Information required to be provided pursuant to subparagraphs (i),
45 (ii) and (iii) of paragraph (a) of this subdivision shall be made avail-
46 able to the public no later than July first, two thousand twenty-three.
47 18. Advisory commission. (a) There is hereby established an independ-
48 ent advisory commission, composed of nine experts in staffing standards
49 and quality of patient care, including: three experts in nursing prac-
50 tice, quality of nursing care or patient care standards, one of whom
51 shall be appointed by the governor, one of whom shall be appointed by
52 the speaker of the assembly and one of whom shall be appointed by the
53 temporary president of the senate; three representatives of unions
54 representing nurses, one of whom shall be appointed by the governor, one
55 of whom shall be appointed by the speaker of the assembly and one of
56 whom shall be appointed by the temporary president of the senate; and
S. 1168--A 9
1 three members representing general hospitals, one of whom shall be
2 appointed by the governor, one of whom shall be appointed by the speaker
3 of the assembly and one of whom shall be appointed by the temporary
4 president of the senate. The members of the commission shall serve at
5 the pleasure of the appointing official. Members of the commission
6 shall keep confidential any information received in the course of their
7 duties and may only use such information in the course of carrying out
8 their duties on the commission, except those reports required to be
9 issued by the commission under this section, which may only include
10 de-identified information.
11 (b) The advisory commission shall convene from time to time in order
12 to evaluate the effectiveness of the clinical staffing committees
13 required by this section. Such review shall evaluate the following
14 metrics, including but not limited to quantitative and qualitative data
15 on whether staffing levels were improved and maintained, patient satis-
16 faction, employee satisfaction, patient quality of care metrics, work-
17 place safety, and any other metrics the commission deems relevant. The
18 commission shall also review the annual report submitted by the depart-
19 ment and make recommendations to the speaker of the assembly, the tempo-
20 rary president of the senate, and the chairs of the health committees of
21 the assembly and senate as set forth in paragraph (d) of this subdivi-
22 sion.
23 (c) The advisory commission may collect and shall be provided all
24 relevant information, necessary to carry out its functions, from the
25 department and other state agencies. The commission may also invite
26 testimony by experts in the field and from the public. In making its
27 recommendations to the speaker of the assembly, the temporary president
28 of the senate, and the chairs of the health committees of the assembly
29 and senate, the commission shall analyze relevant data, including data
30 and factors set forth in paragraph (b) of subdivision four of this
31 section related to clinical staffing plans. The commission may also
32 make recommendations for additional or enhanced enforcement mechanisms
33 or powers to address general hospital failure to comply with this
34 section and recommend the appropriation of funding for the department to
35 enforce this section or to assist general hospitals in hiring additional
36 staff to comply with this section.
37 (d) The advisory commission shall submit to the speaker of the assem-
38 bly, the temporary president of the senate and the chairs of the health
39 committees of the assembly and senate, and make available to the public
40 a report that makes recommendations to the speaker of the assembly, the
41 temporary president of the senate, and the chairs of the health commit-
42 tees of the assembly and senate for further legislative action, if any,
43 in order to improve working conditions and quality of care in general
44 hospitals pursuant to this section and its intent.
45 (e) The commission shall submit its report and recommendations to the
46 speaker of the assembly, the temporary president of the senate, and the
47 chairs of the health committees of the assembly and senate no later than
48 October thirty-first, two thousand twenty-four, once three years of
49 staffing plans have been submitted to the department pursuant to this
50 section.
51 (f) Members of the commission shall receive no compensation for their
52 services, but shall be allowed their actual and necessary expenses
53 incurred in the performance of their duties hereunder.
54 (g) The legislature may appropriate funding for the commission to hire
55 staff or consultants and provide for the operation of the commission as
56 reasonably necessary to fulfill its functions.
S. 1168--A 10
1 § 2. If any provision of this act, or any application of any provision
2 of this act, is held to be invalid, or to violate or be inconsistent
3 with any federal law or regulation, that shall not affect the validity
4 or effectiveness of any other provision of this act, or of any other
5 application of any provision of this act, which can be given effect
6 without that provision or application; and to that end, the provisions
7 and applications of this act are severable.
8 § 3. This act shall take effect immediately.
