Bill Text: IL HB2604 | 2019-2020 | 101st General Assembly | Introduced


Bill Title: Creates the Safe Patient Limits Act. Provides the maximum number of patients that may be assigned to a registered nurse in specified situations. Provides that nothing shall preclude a facility from assigning fewer patients to a registered nurse than the limits provided in Act. Provides that nothing in the Act precludes the use of patient acuity systems consistent with the Nurse Staffing by Patient Acuity Act; however, the maximum patient assignments in the Act may not be exceeded, regardless of the use and application of any patient acuity system. Provides that the Department of Public Health shall adopt rules governing the implementation and operation of the Act. Provides that all facilities shall adopt written policies and procedures for training and orientation of nursing staff and that no registered nurse shall be assigned to a nursing unit or clinical area unless that nurse has, among other things, demonstrated competence in providing care in that area. Provides that the written policies and procedures for the training and orientation of nursing staff shall require that all temporary personnel receive the same amount and type of training and orientation that is required for permanent staff. Provides that the Act's provisions are severable.

Spectrum: Partisan Bill (Democrat 7-0)

Status: (Introduced) 2019-03-20 - House Committee Amendment No. 1 Rules Refers to Labor & Commerce Committee [HB2604 Detail]

Download: Illinois-2019-HB2604-Introduced.html


101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB2604

Introduced , by Rep. Fred Crespo

SYNOPSIS AS INTRODUCED:
New Act

Creates the Safe Patient Limits Act. Provides the maximum number of patients that may be assigned to a registered nurse in specified situations. Provides that nothing shall preclude a facility from assigning fewer patients to a registered nurse than the limits provided in Act. Provides that nothing in the Act precludes the use of patient acuity systems consistent with the Nurse Staffing by Patient Acuity Act; however, the maximum patient assignments in the Act may not be exceeded, regardless of the use and application of any patient acuity system. Provides that the Department of Public Health shall adopt rules governing the implementation and operation of the Act. Provides that all facilities shall adopt written policies and procedures for training and orientation of nursing staff and that no registered nurse shall be assigned to a nursing unit or clinical area unless that nurse has, among other things, demonstrated competence in providing care in that area. Provides that the written policies and procedures for the training and orientation of nursing staff shall require that all temporary personnel receive the same amount and type of training and orientation that is required for permanent staff. Provides that the Act's provisions are severable.
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FISCAL NOTE ACT MAY APPLY

A BILL FOR

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1 AN ACT concerning health.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 1. Short title. This Act may be cited as the Safe
5Patient Limits Act.
6 Section 5. Definitions. In this Act:
7 "Couplet" means one mother and one baby.
8 "Critical trauma patient" means a patient who has an injury
9to an anatomic area that (i) requires life-saving
10interventions, or (ii) in conjunction with unstable vital
11signs, poses an immediate threat to life or limb.
12 "Department" means the Department of Public Health.
13 "Facility" means a hospital licensed under the Hospital
14Licensing Act or organized under the University of Illinois
15Hospital Act, a private or State-owned and State-operated
16general acute care hospital, an acute psychiatric hospital, an
17acute care specialty hospital, or an acute care unit within a
18health care facility.
19 "Health care workforce" means personnel employed by or
20contracted to work at a facility that have an effect upon the
21delivery of quality care to patients, including, but not
22limited to, registered nurses, licensed practical nurses,
23unlicensed assistive personnel, service, maintenance,

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1clerical, professional, and technical workers, and other
2health care workers.
3 "Immediate postpartum patients" means those patients who
4have given birth within the previous 2 hours.
5 "Nursing care" means care that falls within the scope of
6practice as defined in the Illinois Nurse Practice Act or is
7otherwise encompassed within recognized standards of nursing
8practice, including assessment, nursing diagnosis, planning,
9intervention, evaluation, and patient advocacy.
10 "Specialty care unit" means a unit which is organized,
11operated, and maintained to provide care for a specific medical
12condition or a specific patient population.
13 For the purposes of this Act, a patient is considered
14assigned to a registered nurse if the registered nurse accepts
15responsibility for the patient's nursing care.
16 Section 10. Maximum patient assignments for registered
17nurses.
18 (a) The maximum number of patients assigned to a registered
19nurse in a facility shall not exceed the limits provided in
20this Section. However, nothing shall preclude a facility from
21assigning fewer patients to a registered nurse than the limits
22provided in this Section.
23 (b) In all units with critical care patients, the maximum
24patient assignment of critical care patients to a registered
25nurse is 2.

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1 (c) In all units with step-down or intermediate care
2patients, the maximum patient assignment of step-down or
3intermediate care patients to a registered nurse is 3.
4 (d) In all units with postanesthesia care patients, the
5maximum patient assignment of postanesthesia care patients
6under the age of 18 to a registered nurse is one. The maximum
7patient assignment of postanesthesia care patients 18 years of
8age or older to a registered nurse is 2.
9 (e) In all units with operating room patients, the maximum
10patient assignment of operating room patients to a registered
11nurse is one, provided that a minimum of one additional person
12serves as a scrub assistant for each patient.
13 (f) In the emergency department:
14 (1) In a unit providing basic emergency medical
15 services or comprehensive emergency medical services, the
16 maximum patient assignment at any time to a registered
17 nurse is 3.
18 (2) The maximum assignment of critical care emergency
19 patients to a registered nurse is 2. A patient in the
20 emergency department shall be considered a critical care
21 patient when the patient meets the criteria for admission
22 to a critical care service area within the hospital.
23 (3) The maximum assignment of critical trauma patients
24 in an emergency unit to a registered nurse is one.
25 (g) In all units with maternal child care patients:
26 (1) The maximum patient assignment to a registered

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1 nurse of antepartum patients requiring continuous fetal
2 monitoring is 2.
3 (2) The maximum patient assignment of other antepartum
4 patients to a registered nurse is 3.
5 (3) The maximum patient assignment of active labor
6 patients to a registered nurse is one.
7 (4) The maximum patient assignment during birth is one
8 registered nurse responsible for the mother and, for each
9 baby born, one registered nurse whose sole responsibility
10 is that baby.
11 (5) The maximum patient assignment of immediate
12 postpartum patients is one couplet, and in the case of
13 multiple births, one nurse for each additional baby.
14 (6) The maximum patient assignment of postpartum
15 patients to a registered nurse is 6 patients or 3 couplets.
16 (h) In all units with pediatric patients, the maximum
17patient assignment of pediatric patients to a registered nurse
18is 4.
19 (i) In all units with psychiatric patients, the maximum
20patient assignment of psychiatric patients to a registered
21nurse is 4.
22 (j) In all units with medical and surgical patients, the
23maximum patient assignment of medical or surgical patients to a
24registered nurse is 4.
25 (k) In all units with telemetry patients, the maximum
26patient assignment of telemetry patients to a registered nurse

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1is 3.
2 (l) In all units with observational patients, the maximum
3patient assignment of observational patients to a registered
4nurse is 4.
5 (m) In all units with acute rehabilitation patients, the
6maximum patient assignment of acute rehabilitation patients to
7a registered nurse is 3.
8 (n) In all specialty care units, the maximum patient
9assignment to a registered nurse is 4.
10 (o) In any unit not otherwise listed in this Section, the
11maximum patient assignment to a registered nurse is 4.
12 Section 15. Implementation by a facility. A facility shall
13implement the patient limits established by Section 10 without
14diminishing the staffing levels of the facility's health care
15workforce.
16 Section 20. Implementation by the Department. The
17Department shall adopt rules governing the implementation and
18operation of this Act.
19 Section 25. Patient acuity systems. Nothing in this Act
20precludes the use of patient acuity systems consistent with
21Section 10.10 of the Hospital Licensing Act. However, the
22maximum patient assignments in Section 10 shall not be exceeded
23regardless of the use and application of any patient acuity

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1system.
2 Section 30. Training. All facilities shall adopt written
3policies and procedures for the training and orientation of
4nursing staff. No registered nurse shall be assigned to a
5nursing unit or clinical area unless that nurse has first
6received training and orientation in that clinical area that is
7sufficient to provide competent care to patients in that area
8and has demonstrated competence in providing care in that area.
9The written policies and procedures for that training and
10orientation of nursing staff shall require that all temporary
11personnel receive the same amount and type of training and
12orientation that is required for permanent staff.
13 Section 35. Enforcement. A facility's failure to adhere to
14the limits set by Section 10 shall be reported by the
15Department to the Attorney General for enforcement, for which
16the Attorney General may bring action in a court of competent
17jurisdiction seeking injunctive relief and civil penalties. A
18separate and distinct violation, for which the facility shall
19be subject to a civil penalty of up to $25,000, shall be deemed
20to have been committed on each day during which any violation
21continues after receipt of written notice of the violation from
22the Department by the facility. The requirements of this Act,
23and its enforcement, shall be suspended during a public health
24emergency declared by the State or federal government.

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1 Section 40. Severability. The provisions of this Act are
2severable, and if any clause, sentence, paragraph, subsection,
3or Section of this law or any application thereof shall be
4adjudged by any court of competent jurisdiction to be invalid,
5such judgment shall not affect, impair, or invalidate the
6remainder thereof but shall be confined in its operation to the
7clause, sentence, paragraph, subsection, Section, or
8application adjudged invalid and such clause, sentence,
9paragraph, subsection, Section, or application shall be
10reformed and construed so that it would be valid to the maximum
11extent permitted.
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