Bill Text: IL HB5320 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Amends the Hospital Licensing Act. Provides that "hospital worker" means any person who receives an hourly wage directly or indirectly via a subcontractor by a hospital licensed under the Act. Replaces references to "nurse" with "hospital worker". Provides for additional staffing transparency and reporting requirements. Provides that hospitals licensed under the Act must employ and schedule enough hospital workers to provide quality patient care and ensure patient safety. Provides that hospitals must make available, at the beginning of each calendar year and upon request, all staffing matrices and other staffing metrics, if any, used to assess and maintain safe staffing levels for hospital workers in each unit. Provides that the Department of Public Health shall produce an annual report based on staffing disclosures. Provides that the Department shall make recommendations for minimum staffing standards for hospital workers in each hospital unit. Provides that hospitals licensed under the Act shall conduct, within the first month of employment and at no cost, a competency validation for each hospital worker hired. Provides that a hospital must submit documentation of each hospital worker's competency validation to the Department within 4 weeks after the worker's start date. Provides that hospitals shall conduct ongoing verification for each hospital worker employed during a given calendar year to determine each worker's continued competency to perform the worker's job and shall submit documentation of each worker's ongoing verification to the Department within 2 weeks of completion. Provides that hospitals shall submit a list of all competent employees currently employed at the end of each calendar year. Provides for a public registry of all competent employees to be maintained by the Department. Provides for the imposition of civil penalties for specified violations of the Act. Describes an assignment despite objection resolution process to be implemented by each hospital that is licensed under the Act. Provides for a Hospital Safety Advocate role to be created within the Department.

Spectrum: Partisan Bill (Democrat 6-0)

Status: (Introduced) 2024-04-12 - Added Co-Sponsor Rep. Kevin John Olickal [HB5320 Detail]

Download: Illinois-2023-HB5320-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5320 Introduced , by Rep. Kam Buckner SYNOPSIS AS INTRODUCED:
See Index
Amends the Hospital Licensing Act. Provides that "hospital worker" means any person who receives an hourly wage directly or indirectly via a subcontractor by a hospital licensed under the Act. Replaces references to "nurse" with "hospital worker". Provides for additional staffing transparency and reporting requirements. Provides that hospitals licensed under the Act must employ and schedule enough hospital workers to provide quality patient care and ensure patient safety. Provides that hospitals must make available, at the beginning of each calendar year and upon request, all staffing matrices and other staffing metrics, if any, used to assess and maintain safe staffing levels for hospital workers in each unit. Provides that the Department of Public Health shall produce an annual report based on staffing disclosures. Provides that the Department shall make recommendations for minimum staffing standards for hospital workers in each hospital unit. Provides that hospitals licensed under the Act shall conduct, within the first month of employment and at no cost, a competency validation for each hospital worker hired. Provides that a hospital must submit documentation of each hospital worker's competency validation to the Department within 4 weeks after the worker's start date. Provides that hospitals shall conduct ongoing verification for each hospital worker employed during a given calendar year to determine each worker's continued competency to perform the worker's job and shall submit documentation of each worker's ongoing verification to the Department within 2 weeks of completion. Provides that hospitals shall submit a list of all competent employees currently employed at the end of each calendar year. Provides for a public registry of all competent employees to be maintained by the Department. Provides for the imposition of civil penalties for specified violations of the Act. Describes an assignment despite objection resolution process to be implemented by each hospital that is licensed under the Act. Provides for a Hospital Safety Advocate role to be created within the Department.
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A BILL FOR
HB5320 LRB103 37477 CES 67600 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Hospital Licensing Act is amended by
changing Section 10.9 and by adding Sections 10.15 and 10.20
as follows:
(210 ILCS 85/10.9)
Sec. 10.9. Hospital worker Nurse mandated overtime
prohibited.
(a) Definitions. As used in this Section:
"Mandated overtime" means work that is required by the
hospital in excess of an agreed-to, predetermined work shift.
Time spent by nurses required to be available as a condition of
employment in specialized units, such as surgical nursing
services, shall not be counted or considered in calculating
the amount of time worked for the purpose of applying the
prohibition against mandated overtime under subsection (b).
"Hospital worker" means any person who receives an hourly
wage, directly or indirectly, via a subcontractor by a
hospital licensed under this Act.
"Nurse" means any advanced practice registered nurse,
registered professional nurse, or licensed practical nurse, as
defined in the Nurse Practice Act, who receives an hourly wage

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and has direct responsibility to oversee or carry out nursing
care. For the purposes of this Section, "advanced practice
registered nurse" does not include a certified registered
nurse anesthetist who is primarily engaged in performing the
duties of a nurse anesthetist.
"Related to the subcontractor" means that the
subcontractor is, to a significant extent, associated or
affiliated with, owns, or is owned by, or has control of or is
controlled by, the organization furnishing services to a
hospital licensed under this Act.
"Subcontractor" means any entity, including an individual
or individuals, that contracts with a hospital licensed under
this Act to supply a service. "Subcontractor" includes
organizations related to the subcontractor that have a
contract with the subcontractor.
"Unforeseen emergent circumstance" means (i) any declared
national, State, or municipal disaster or other catastrophic
event, or any implementation of a hospital's disaster plan,
that will substantially affect or increase the need for health
care services or (ii) any circumstance in which patient care
needs require specialized nursing skills through the
completion of a procedure. An "unforeseen emergent
circumstance" does not include situations in which the
hospital fails to have enough nursing staff to meet the usual
and reasonably predictable patient care nursing needs of its
patients.

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(b) Mandated overtime prohibited. No hospital worker nurse
may be required to work mandated overtime except in the case of
an unforeseen emergent circumstance when such overtime is
required only as a last resort. Such mandated overtime shall
not exceed 4 hours beyond an agreed-to, predetermined work
shift.
(c) Rest period required Off-duty period. When a hospital
worker nurse is mandated to work up to 12 consecutive hours,
the worker nurse must be allowed at least 8 consecutive hours
of off-duty time off immediately following the completion of a
shift.
(d) Retaliation prohibited. No hospital may discipline,
discharge, or take any other adverse employment action against
a hospital worker nurse solely because the worker nurse
refused to work mandated overtime as prohibited under
subsection (b).
(e) Violations. Any employee of a hospital that is subject
to this Act may file a complaint with the Department of Public
Health regarding an alleged violation of this Section. The
complaint must be filed within 45 days following the
occurrence of the incident giving rise to the alleged
violation. The Department must forward notification of the
alleged violation to the hospital in question within 3
business days after the complaint is filed. Upon receiving a
complaint of a violation of this Section, the Department may
take any action authorized under Section 7 or 9 of this Act.

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(f) Proof of violation. Any violation of this Section must
be proved by clear and convincing evidence that a hospital
worker nurse was required to work overtime against the
worker's his or her will. The hospital may defeat the claim of
a violation by presenting clear and convincing evidence that
an unforeseen emergent circumstance, which required overtime
work, existed at the time the employee was required or
compelled to work.
(Source: P.A. 100-513, eff. 1-1-18.)
(210 ILCS 85/10.15 new)
Sec. 10.15. Additional staffing transparency and reporting
requirements.
(a) As used in this Section:
"Hospital worker" means any person who receives an hourly
wage, directly or indirectly, via a subcontractor by a
hospital licensed under this Act.
"Related to the subcontractor" means that the
subcontractor is, to a significant extent, associated or
affiliated with, owns, or is owned by, or has control of or is
controlled by, the organization furnishing services to a
hospital licensed under this Act.
"Staffing metric" means any tool used by hospital
management to determine safe staffing levels in a patient care
or support services unit.
"Subcontractor" means any entity, including an individual

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or individuals, that contracts with a hospital licensed under
this Act to supply a service. This includes organizations
related to the subcontractor that have a contract with the
subcontractor.
"Unit" means a functional division of a hospital that
provides patient care or support services.
(b) Hospitals licensed under this Act must employ and
schedule enough hospital workers to provide quality patient
care and ensure patient safety.
(c) In order to ensure compliance with safe staffing
practices, hospitals licensed under this Act shall make
available, upon request, all the staffing matrices and other
staffing metrics, if any, used to assess and maintain safe
staffing levels for hospital workers in each unit.
(d) Hospitals shall share any and all staffing matrices,
staffing metrics, and underlying materials used to determine
staffing levels with the Department at the beginning of each
calendar year.
(e) The Department shall produce an annual report based on
staffing disclosures required under this Section beginning the
first year after implementation.
(f) The Department shall make recommendations for minimum
staffing standards for hospital workers in each hospital unit
based on the information collected under this Section.
(210 ILCS 85/10.20 new)

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Sec. 10.20. Hospital worker competency validation and
assignment despite objection process.
(a) Findings. The Legislature finds and declares all of
the following:
(1) The State of Illinois has an obligation to ensure
hospitals provide quality patient care.
(2) Numerous studies have linked patient outcomes,
including in-hospital mortality rates, to hospital worker
staffing.
(3) In spite of the preponderance of evidence that
adequate staffing improves patient outcomes, hospitals in
Illinois and elsewhere too often systemically and
intentionally understaff to maximize profit even at the
expense of quality patient care.
(4) The COVID-19 pandemic both exposed and exacerbated
these unsafe staffing practices.
(5) The State asserts that based on their demonstrated
competencies and training, hospital workers themselves are
best positioned to identify unsafe conditions that
jeopardize quality patient care, including, especially,
short staffing.
(6) Hospitals perform competency validations and
ongoing verifications to ensure workers know how to
perform their jobs safely and to identify unsafe practices
including short staffing.
(7) The State should require hospitals to affirm that

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hospital workers have received the necessary training to
safely perform their work via competency validations and
ongoing verification and empower these workers to identify
and formally object to unsafe working conditions,
including short staffing.
(8) To facilitate this, the State should create a
dispute resolution process for hospital workers to
formally object to unsafe working conditions.
(b) Definitions. As used in this Section:
"Assignment despite objection" means a formal process by
which hospital workers notify management when they receive an
assignment that, based on their training, is potentially
unsafe.
"Competent employee" means a hospital worker whose
employer has received a competency validation or ongoing
verification during a given calendar year.
"Competency validation" means a determination based on a
hospital worker's satisfactory performance of each specific
element of the employee's job description and of specific
requirements of the unit in which they are employed in a safe
and ethical manner.
"Hospital worker" means any person who receives an hourly
wage, directly or indirectly, via a subcontractor by a
hospital licensed under this Act.
"Ongoing verification" means annual redetermination based
on a hospital worker's satisfactory performance of each

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specific element of the hospital worker's job description and
the specific requirements of the unit in which the worker is
employed in a safe and ethical manner.
"Related to the subcontractor" means that the
subcontractor is, to a significant extent, associated or
affiliated with, owns, or is owned by, or has control of or is
controlled by, the organization furnishing services to a
hospital licensed under this Act.
"Subcontractor" means any entity, including an individual
or individuals, that contracts with a hospital licensed under
this Act to supply a service. "Subcontractor" includes
organizations related to the subcontractor that have a
contract with the subcontractor.
(c) Competency Validation Credential.
(1) Hospitals licensed under this Act shall conduct a
competency validation for each hospital worker hired as a
condition of employment within the first month after
employment and at no cost to the new hire.
(2) The competency validation formally affirms the
hospital has adequately trained a hospital worker to
perform all aspects of the hospital worker's job safely
and to identify unsafe conditions, including inadequate
staffing.
(3) Hospitals must submit documentation of each
hospital worker's competency validation to the Department
of Public Health within 4 weeks after the worker's start

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date.
(4) Hospitals licensed under this Act shall also
conduct an ongoing verification for each hospital worker
employed during a given calendar year to determine the
continued competency of each hospital worker to perform
the worker's job and shall submit documentation of ongoing
verification of each hospital worker to the Department of
Public Health within 2 weeks after completion.
(5) Hospitals licensed under this Act shall submit a
list of all competent employees currently employed at the
end of each calendar year.
(6) The Department shall maintain a registry of all
competent employees that includes the name, address,
contact information and current employer of the worker and
make this registry available to the public.
(7) Following notice and an opportunity to be heard,
the Department shall impose, for each day that a hospital
licensed under this Act is in violation of this subsection
(c), a civil penalty against the hospital in an amount
equal to 0.1% of the hospital's annual revenue during the
most recently completed fiscal year.
(d) Assignment despite objection.
(1) A hospital licensed under this Act must create an
assignment despite objection form that is applicable and
accessible to all of its hospital workers that enables the
hospital workers to formally object to unsafe working

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conditions, including unsafe staffing levels, and that
assigns to the hospital liability for requiring a hospital
worker to work in an unsafe manner.
(2) The assignment despite objection form must include
the following language: "This is to confirm that I
notified you that, in my professional judgment derived
from my competency validation, today's assignment is
unsafe and places patients at risk. As a result, the
facility is responsible for any adverse effects on patient
care."
(3) The hospital must retain a copy of each assignment
despite objection form and provide a copy to the hospital
worker's union, if any, and the Department. Hospitals must
provide, at the end of each calendar year, a report of all
assignment despite objection forms filed during the
calendar year and must maintain these records for a
minimum of 5 years.
(4) Hospitals must not retaliate against hospital
workers for filing an assignment despite objection form or
otherwise reporting or objecting to unsafe conditions.
(e) Resolution Process.
(1) Hospitals must develop a transparent, fair, and
expedient assignment despite objection resolution process
for all hospital workers either via collective bargaining
or in accordance with Department process articulated
below.

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(2) Hospital workers currently covered by a collective
bargaining agreement that includes an assignment despite
objection resolution process shall abide by the process
included in the collective bargaining agreement.
(3) Hospital workers not covered by a collective
bargaining agreement that includes an assignment despite
objection resolution process may access the following
Department mandated assignment despite objection
resolution process:
(A) The objecting hospital worker shall make a
good faith effort to inform the hospital worker's
manager or supervisor at the time of the objection to
assignment.
(B) If the manager or supervisor fails to resolve
the unsafe situation to the reporting hospital
worker's satisfaction, the hospital worker shall then
complete an assignment despite objection form, shall
submit a copy to that person's manager or supervisor
and that person's representative organization, if
covered by a collective bargaining agreement, and
shall keep a copy for their records.
(C) Hospital management must respond in writing to
the assignment despite objection form within one week
after its receipt and shall provide a copy of the
response to the hospital worker's representative
organization, if the hospital worker is covered by a

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collective bargaining agreement.
(D) In any instance in which the affected hospital
worker(s) is unsatisfied with management's response,
the hospital must convene a Safety Review Panel
composed of 3 representatives selected by the hospital
and 3 representatives selected by hospital workers via
a transparent democratic process. The representatives
selected by hospital workers are not required to be
hospital employees. The panel shall attempt to resolve
the dispute within 15 days of referral, unless
extended by mutual consent.
(E) If the Safety Review Panel cannot resolve the
dispute within 15 days after referral, the Department
shall appoint a mutually agreed upon neutral
third-party to assist in resolving the dispute. The
neutral third-party shall make a binding decision to
resolve the dispute.
(4) Following notice and an opportunity to be heard,
the Department shall impose, for each day that a hospital
licensed under this Act is in violation of subsection (d)
or this subsection, a civil penalty against the hospital
in an amount equal to 0.1% of the hospital's annual
revenue during the most recently completed fiscal year.
(5) The Department shall create a Hospital Safety
Advocate position responsible for enforcing the new
competency credentialing and assignment despite objection

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requirements and developing additional rules, as needed.
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INDEX
Statutes amended in order of appearance