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HB 50: "An Act relating to limitations on mandatory overtime for registered nurses and licensed practical nurses in health care facilities; and providing for an effective date."

00 HOUSE BILL NO. 50 01 "An Act relating to limitations on mandatory overtime for registered nurses and 02 licensed practical nurses in health care facilities; and providing for an effective date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 05 to read: 06 LEGISLATIVE FINDINGS AND INTENT. The legislature finds that 07 (1) it is essential that registered nurses and licensed practical nurses providing 08 direct patient care be available to meet the needs of patients; 09 (2) quality patient care is jeopardized by registered nurses and licensed 10 practical nurses who work unnecessarily long hours in health care facilities; 11 (3) registered nurses and licensed practical nurses are leaving their profession 12 because of workplace stresses, long work hours, and depreciation of their essential role in the 13 delivery of quality and direct patient care; 14 (4) it is necessary to safeguard the efficiency, health, and general well-being

01 of registered nurses and licensed practical nurses, and the health and general well-being of the 02 persons receiving care from registered nurses and licensed practical nurses in health care 03 facilities; 04 (5) it is necessary that registered nurses and licensed practical nurses be made 05 aware of their rights, duties, and remedies concerning hours worked and patient safety; and 06 (6) health care facilities should provide adequate and safe nurse staffing 07 without the need for or use of mandatory overtime. 08 * Sec. 2. AS 18.20 is amended by adding new sections to read: 09 Article 4. Overtime Limitations for Nurses. 10 Sec. 18.20.400. Limitations on nursing overtime. (a) Except as provided in 11 (c) of this section, a nurse in a health care facility may not be required or coerced, 12 directly or indirectly, 13 (1) to work beyond a predetermined and regularly scheduled shift that 14 is agreed to by the nurse and the health care facility; 15 (2) to work beyond 80 hours in a 14-day period; or 16 (3) to accept an assignment of overtime if, in the judgment of the 17 nurse, the overtime would jeopardize patient or employee safety. 18 (b) Except as provided by (c) of this section, after working a predetermined 19 and regularly scheduled shift that is agreed to by the nurse and the health care facility 20 as authorized by (a)(1) of this section, a nurse in a health care facility shall be allowed 21 not less than 10 consecutive hours of off-duty time immediately following the end of 22 that work. 23 (c) Subsection (a) of this section does not apply to 24 (1) a nurse who is employed by a health care facility providing 25 services for a school, school district, or other educational institution, when the nurse is 26 on duty for more than 14 consecutive hours during an occasional special event, such as 27 a field trip, that is sponsored by the employer; 28 (2) a nurse voluntarily working overtime on an aircraft in use for 29 medical transport, so long as the shift worked is allowable under regulations adopted 30 by the Board of Nursing based on accreditation standards adopted by the Commission 31 on Accreditation of Medical Transport Systems;

01 (3) a nurse on duty in overtime status because of an unforeseen 02 emergency situation that could jeopardize patient safety; in this paragraph, 03 "unforeseen emergency situation" means an unusual, unpredictable, or unforeseen 04 situation caused by an act of terrorism, disease outbreak, natural disaster, major 05 disaster as defined in 42 U.S.C. 5122, or disaster emergency under AS 26.23.020 or 06 26.23.140, but does not include a situation in which a health care facility has 07 reasonable knowledge of increased patient volume or inadequate staffing because of 08 some other cause, if that cause is foreseeable; 09 (4) a nurse fulfilling on-call time that is agreed on by the nurse and a 10 health care facility before it is scheduled; 11 (5) a nurse voluntarily working overtime so long as the work is 12 consistent with professional standards and safe patient care and does not exceed 14 13 consecutive hours; 14 (6) a nurse voluntarily working beyond 80 hours in a 14-day period so 15 long as the nurse does not work more than 14 consecutive hours without a 10-hour 16 break and the work is consistent with professional standards and safe patient care; 17 (7) the first hour on overtime status when the health care facility is 18 obtaining another nurse to work in place of the nurse in overtime status. 19 Sec. 18.20.410. Health care facility complaint process for overtime work 20 by nurses. A health care facility shall provide for an anonymous process by which a 21 patient or a nurse may make a complaint about staffing levels and patient safety that 22 relate to overtime work by nurses and to limitations on overtime work by nurses under 23 AS 18.20.400. 24 Sec. 18.20.420. Enforcement, offenses, and penalties. (a) The commissioner 25 shall administer AS 18.20.400 - 18.20.449 and adopt regulations for implementing and 26 enforcing AS 18.20.400 - 18.20.449. 27 (b) A complaint alleging a violation of AS 18.20.400 - 18.20.449 must be filed 28 with the commissioner within 30 days after the date of the alleged violation. The 29 commissioner shall provide a copy of the complaint to the health care facility named 30 in the filing within three business days after receiving the complaint. 31 (c) If the commissioner finds that a health care facility has knowingly violated

01 an overtime provision of AS 18.20.400 - 18.20.449, the following civil penalties shall 02 apply: 03 (1) for a first violation of AS 18.20.400 - 18.20.449, the commissioner 04 shall reprimand the health care facility; 05 (2) for a second violation of AS 18.20.400 - 18.20.449 within 12 06 months, the commissioner shall reprimand the health care facility and assess a penalty 07 of $500; 08 (3) for a third violation of AS 18.20.400 - 18.20.449 within 12 months, 09 the commissioner shall reprimand the health care facility and assess a penalty of not 10 less than $2,500 but not more than $5,000; 11 (4) for each violation of AS 18.20.400 - 18.20.449 after a third 12 violation of AS 18.20.400 - 18.20.449 within 12 months, the commissioner shall 13 reprimand the health care facility and assess a penalty of not less than $5,000 but not 14 more than $25,000. 15 (d) As an employer, a health care facility violates an overtime provision of 16 AS 18.20.400 - 18.20.449 "knowingly" when the facility is either aware that its 17 conduct is of a nature prohibited by the overtime provision or aware that the 18 circumstances described in the overtime prohibition exist; however, when knowledge 19 of the existence of a particular fact is required to establish that the violation was 20 knowing, that knowledge exists when the facility is aware of a substantial probability 21 of its existence, unless the facility reasonably believes it does not exist. 22 Sec. 18.20.430. Prohibition of retaliation. A health care facility may not 23 discharge, discipline, threaten, discriminate against, penalize, or file a report with the 24 Board of Nursing against a nurse for exercising rights under AS 18.20.400 - 18.20.449 25 or for the good faith reporting of an alleged violation of AS 18.20.400 - 18.20.449. 26 Sec. 18.20.440. Enforcement of prohibition against retaliation. The 27 commissioner shall investigate every complaint alleging a violation of AS 18.20.430, 28 and, within 90 days after the date of filing of the complaint, provide to the 29 complainant, the Department of Law, and the health care facility named in the 30 complaint a written determination as to whether the health care facility violated 31 AS 18.20.430. If the commissioner finds a violation of AS 18.20.430, the

01 commissioner shall request that the Department of Law represent the department and 02 the complainant and obtain from the health care facility all appropriate relief, 03 including rehiring or reinstatement of the complainant to the complainant's former 04 position with back pay. 05 Sec. 18.20.445. Report requirements. A health care facility shall file with the 06 division of labor standards and safety, Department of Labor and Workforce 07 Development, a semiannual report. The report for the six-month period ending June 30 08 must be filed before the following August 1, and the report for the six-month period 09 ending December 31 must be filed before the following February 1. The report must 10 include, for each nurse employed by the health care facility or under contract with the 11 health care facility, the number of overtime hours worked, the number of overtime 12 hours that were mandatory, the number of overtime hours that were voluntary, the 13 number of on-call hours, the number of on-call hours that were mandatory, and the 14 number of on-call hours that were voluntary. 15 Sec. 18.20.449. Definitions. In AS 18.20.400 - 18.20.449, 16 (1) "commissioner" means the commissioner of labor and workforce 17 development; 18 (2) "health care facility" means a private, municipal, state, or federal 19 hospital; psychiatric hospital; independent diagnostic testing facility; residential 20 psychiatric treatment center, as defined in AS 18.07.111; skilled nursing facility; 21 kidney disease treatment center, including freestanding hemodialysis units; 22 intermediate care facility; ambulatory surgical facility; Alaska Pioneers' Home or 23 Alaska Veterans' Home administered by the Department of Health and Social Services 24 under AS 47.55; correctional facility owned or administered by the state; juvenile 25 detention facility, juvenile detention home, juvenile work camp, or treatment facility, 26 as defined in AS 47.12.990; private, municipal, state, or federal facility employing one 27 or more public health nurses; long-term care facility; or primary care outpatient 28 facility; 29 (3) "nurse" means an individual licensed to practice registered nursing 30 or practical nursing under AS 08.68 who provides nursing services through direct 31 patient care or clinical services and includes a nurse manager when delivering in-

01 hospital patient care; 02 (4) "on-call" means a status in which a nurse must be ready to report to 03 the health care facility and may be called to work by the health care facility; 04 (5) "overtime" means the hours worked in excess of a predetermined 05 and regularly scheduled shift that is agreed to by a nurse and a health care facility. 06 * Sec. 3. The uncodified law of the State of Alaska is amended by adding a new section to 07 read: 08 APPLICABILITY. The first report required to be filed under AS 18.20.445, enacted in 09 sec. 2 of this Act, shall be filed before February 1, 2010, for the period July 1, 2009, through 10 December 31, 2009. 11 * Sec. 4. AS 18.20.445, enacted in sec. 2 of this Act, and sec. 3 of this Act take effect 12 July 1, 2009. 13 * Sec. 5. Except as provided in sec. 4 of this Act, this Act takes effect January 1, 2010.