00 HOUSE CS FOR CS FOR SENATE BILL NO. 28(HES) 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 12 (1) to work beyond a predetermined and regularly scheduled shift that 13 is agreed to by the nurse and the health care facility; 14 (2) to work beyond 80 hours in a 14-day period; or 15 (3) to accept an assignment of overtime if, in the judgment of the 16 nurse, the overtime would jeopardize patient or employee safety. 17 (b) Except as provided by (c) of this section, after working a predetermined 18 and regularly scheduled shift that is agreed to by the nurse and the health care facility 19 as authorized by (a)(1) of this section, a nurse in a health care facility shall be allowed 20 not less than 10 consecutive hours of off-duty time immediately following the end of 21 that work. 22 (c) Subsection (a) of this section does not apply to 23 (1) a nurse who is employed by a health care facility providing 24 services for a school, school district, or other educational institution, when the nurse is 25 on duty for more than 14 consecutive hours during an occasional special event, such as 26 a field trip, that is sponsored by the employer; 27 (2) a nurse voluntarily working overtime on an aircraft in use for 28 medical transport, so long as the shift worked is allowable under regulations adopted 29 by the Board of Nursing based on accreditation standards adopted by the Commission 30 on Accreditation of Medical Transport Systems; 31 (3) a nurse on duty in overtime status because of an unforeseen 01 emergency situation that could otherwise jeopardize patient safety; in this paragraph, 02 "unforeseen emergency situation" means an unusual, unpredictable, or unforeseen 03 situation caused by an act of terrorism, disease outbreak, natural disaster, weather, or a 04 declared national, state, or local emergency, but does not include a situation in which a 05 health care facility has reasonable knowledge of increased patient volume or 06 inadequate staffing because of some other cause, if that cause is foreseeable; 07 (4) a nurse fulfilling on-call time that is agreed on by the nurse and a 08 health care facility before it is scheduled; 09 (5) a nurse voluntarily working overtime so long as the work is 10 consistent with professional standards and safe patient care and does not exceed 14 11 consecutive hours; 12 (6) a nurse voluntarily working beyond 80 hours in a 14-day period so 13 long as the nurse does not work more than 14 consecutive hours without a 10-hour 14 break and the work is consistent with professional standards and safe patient care; 15 (7) a nurse at a residential psychiatric treatment center who agrees to 16 work under a contract that requires the employer to provide full-time pay and benefits 17 equivalent to the pay and benefits for a 40-hour workweek if the nurse works a 18 weekend schedule of four eight-hour shifts with not more than 16 consecutive hours 19 on duty without a break of at least eight hours; in this paragraph, a "weekend" means 20 the period that begins Friday at 5:00 p.m. and ends Monday at 8:00 a.m.; 21 (8) the first hour on overtime status when the health care facility is 22 obtaining another nurse to work in place of the nurse in overtime status. 23 Sec. 18.20.410. Health care facility complaint process for overtime work 24 by nurses. A health care facility shall provide for an anonymous process by which a 25 patient or a nurse may make a complaint about staffing levels and patient safety that 26 relate to overtime work by nurses and to limitations on overtime work by nurses under 27 AS 18.20.400. 28 Sec. 18.20.420. Enforcement, offenses, and penalties. (a) The commissioner 29 shall administer AS 18.20.400 - 18.20.449 and adopt regulations for implementing and 30 enforcing AS 18.20.400 - 18.20.449. 31 (b) A complaint alleging a violation of AS 18.20.400 - 18.20.449 must be filed 01 with the commissioner within 30 days after the date of the alleged violation. The 02 commissioner shall provide a copy of the complaint to the health care facility named 03 in the filing within three business days after receiving the complaint. 04 (c) If the commissioner finds that a health care facility has knowingly violated 05 an overtime provision of AS 18.20.400 - 18.20.449, the following civil penalties shall 06 apply: 07 (1) for a first violation of AS 18.20.400 - 18.20.449, the health care 08 facility shall receive a reprimand; 09 (2) for a second violation of AS 18.20.400 - 18.20.449 within 12 10 months, the health care facility shall receive a reprimand and shall be assessed a 11 penalty of $500; 12 (3) for a third violation of AS 18.20.400 - 18.20.449 within 12 months, 13 the health care facility shall receive a reprimand and shall be assessed a penalty of not 14 less than $2,500 but not more than $5,000; 15 (4) for each violation of AS 18.20.400 - 18.20.449 after a third 16 overtime violation of AS 18.20.400 - 18.20.449 within 12 months, the health care 17 facility shall receive a public reprimand and shall be assessed a penalty of not less than 18 $5,000 but not more than $25,000. 19 (d) As an employer, a health care facility violates an overtime provision of 20 AS 18.20.400 - 18.20.449 "knowingly" when the facility is either aware that its 21 conduct is of a nature prohibited by the overtime provision or aware that the 22 circumstances described in the overtime prohibition exist; however, when knowledge 23 of the existence of a particular fact is required to establish that the violation was 24 knowing, that knowledge exists when the facility is aware of a substantial probability 25 of its existence, unless the facility reasonably believes it does not exist. 26 Sec. 18.20.430. Prohibition of retaliation. A health care facility may not 27 discharge, discipline, threaten, discriminate against, penalize, or file a report with the 28 Board of Nursing against a nurse for exercising rights under AS 18.20.400 - 18.20.449 29 or for the good faith reporting of an alleged violation of AS 18.20.400 - 18.20.449. 30 Sec. 18.20.440. Enforcement against prohibition of retaliation. The 31 commissioner shall investigate every complaint alleging a violation of AS 18.20.430, 01 and, within 90 days after the complaint's date of filing, provide to the complainant, the 02 office of the attorney general, and the health care facility named in the complaint a 03 written determination as to whether the health care facility violated AS 18.20.430. If 04 the commissioner finds a violation of AS 18.20.430, the commissioner shall request 05 that the office of the attorney general represent the department and the complainant 06 and obtain from the health care facility all appropriate relief, including rehiring or 07 reinstatement of the complainant to the complainant's former position with back pay. 08 Sec. 18.20.445. Report requirements. A health care facility shall file with the 09 division of labor standards and safety, Department of Labor and Workforce 10 Development, a semiannual report. The report for the six-month period ending June 30 11 must be filed before the following August 1, and the report for the six-month period 12 ending December 31 must be filed before the following February 1. The report must 13 include, for each nurse employed by the health care facility or under contract with the 14 health care facility, the number of overtime hours worked, the number of overtime 15 hours that were mandatory, the number of overtime hours that were voluntary, the 16 number of on-call hours, the number of on-call hours that were mandatory, and the 17 number of on-call hours that were voluntary. 18 Sec. 18.20.449. Definitions. In AS 18.20.400 - 18.20.449, 19 (1) "commissioner" means the commissioner of labor and workforce 20 development; 21 (2) "health care facility" means a private, municipal, state, or federal 22 hospital; psychiatric hospital; independent diagnostic testing facility; residential 23 psychiatric treatment center; skilled nursing facility; kidney disease treatment center, 24 including freestanding hemodialysis units; intermediate care facility; ambulatory 25 surgical facility; Alaska Pioneers' Home or Alaska Veterans' Home administered by 26 the Department of Health and Social Services under AS 47.55; correctional facility 27 administered by the Department of Corrections or the Department of Health and 28 Social Services; private, municipal, state, or federal facility employing one or more 29 public health nurses; long-term care facility; or primary care outpatient facility; 30 (3) "nurse" means an individual licensed to practice registered nursing 31 or practical nursing under AS 08.68 who provides nursing services through direct 01 patient care or clinical services and includes a nurse manager when delivering in- 02 hospital patient care; 03 (4) "on-call" means a status in which a nurse must be ready to report to 04 the health care facility and may be called to work by the health care facility; 05 (5) "overtime" means the hours worked in excess of a predetermined 06 and regularly scheduled shift that is agreed to by a nurse and a health care facility; 07 (6) "residential psychiatric treatment center" has the meaning given in 08 AS 18.07.111. 09 * Sec. 3. The uncodified law of the State of Alaska is amended by adding a new section to 10 read: 11 APPLICABILITY. The first report required to be filed under AS 18.20.445, enacted in 12 sec. 2 of this Act, shall be filed before February 1, 2009, for the period July 1, 2008, through 13 December 31, 2008. 14 * Sec. 4. AS 18.20.445, enacted in sec. 2 of this Act, and sec. 3 of this Act take effect 15 July 1, 2008. 16 * Sec. 5. Except as provided in sec. 4 of this Act, this Act takes effect January 1, 2009.