SENATE DOCKET, NO. 1244        FILED ON: 2/12/2021

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1399

The Commonwealth of Massachusetts

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PRESENTED BY:

Julian Cyr

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act to strengthen the worker voice in hospital care planning.

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PETITION OF:

SENATE DOCKET, NO. 1244        FILED ON: 2/12/2021

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1399

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Second General Court
(2021-2022)

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An Act to strengthen the worker voice in hospital care planning.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. Chapter 111 of the Massachusetts General Laws, as appearing in the 2018 Official Edition, is hereby amended by striking out section 226, and inserting in place thereof the following section:-

Section 226. (a)  For the purposes of this section the following words shall, unless the context clearly requires otherwise, have the following meanings:

"Facility" shall mean a hospital licensed under section 51 of this chapter, the teaching hospital of the University of Massachusetts medical school, any licensed private or state-owned and state-operated general acute care hospital, an acute psychiatric hospital, an acute care specialty hospital, any acute care unit within a state operated healthcare facility, or a medium-security state correctional facility for male inmates located in Plymouth County that is operated and maintained by a private company under contract with the Department of Corrections.  For purposes of this section, facility shall not include rehabilitation facilities, skilled nursing facilities, other long-term care facilities, or any other Massachusetts correctional facilities. 

"Health Care Workforce" shall mean personnel employed by or contracted to work at a facility who have an effect upon the delivery of quality care to patients, including but not limited to registered nurses, licensed practical nurses, unlicensed assistive personnel, service, maintenance, clerical, professional and technical workers, and all other health care workers. For purposes of this section, doctors, interns, residents and facility management personnel, as well as any correctional facility security personnel not providing health care services, shall not be considered the health care workforce.

“Mandatory Overtime'' shall mean any hours worked by a member of the health care workforce in a facility to deliver patient care, beyond the predetermined and regularly scheduled number of hours that the hospital and a member of the health care workforce have agreed that the employee shall work, provided that in no case shall such predetermined and regularly scheduled number of hours exceed 12 hours in any 24-hour period. 

(b) Notwithstanding any general or special law to the contrary, a facility shall not require a member of the health care workforce to work mandatory overtime except in the case of an emergency situation where the safety of the patient requires its use and when there is no reasonable alternative. 

(c) Under subsection (b), whenever there is an emergency situation where the safety of a patient requires its use and when there is no reasonable alternative, the facility shall, before requiring overtime, make a good faith effort to have such hours covered on a voluntary basis. Mandatory overtime shall not be used as a regular practice for providing appropriate staffing for the level of patient care required. 

(d) Under subsection (c), the health policy commission established under section 2 of chapter 6D, shall further develop guidelines and procedures to determine what constitutes an emergency situation for the purposes of allowing mandatory overtime.  In developing those guidelines, the commission shall consult with those employees and employers who would be affected by such a policy. The commission shall solicit comment from those same parties through a public hearing. 

(e) Facilities shall report all instances of mandatory overtime and the circumstances requiring its use to the department of public health or, in the case of the aforementioned state correctional institution, by the contracting management company and to the department of corrections.  Such reports shall be public documents. 

(f) A member of the health care workforce shall not be allowed to exceed 16 consecutive hours worked in a 24-hour period.  In the event a member of the health care workforce works 16 consecutive hours, that member of the health care workforce must be given at least 8 consecutive hours of off-duty time immediately-after the worked overtime.

(g) This section is intended as a remedial measure to protect the public health and the quality and safety of patient care and shall not be construed to diminish or waive any rights of the member of the healthcare workforce under other laws, regulations or collective bargaining agreements. The refusal of a member of the healthcare workforce to accept work in excess of the limitations set forth in this section shall not be grounds for discrimination, dismissal, discharge or any other employment decision.

SECTION 2. Said chapter 111 of the Massachusetts General Laws, as so appearing, is hereby further amended by adding the following new section:-

Section 226A: (a) For the purposes of this section the following words shall, unless the context clearly requires otherwise, have the following meanings:

"Facility" shall mean a hospital licensed under section 51 of this chapter, the teaching hospital of the University of Massachusetts medical school, any licensed private or state-owned and state-operated general acute care hospital, an acute psychiatric hospital, an acute care specialty hospital, or any acute care unit within a state operated healthcare facility. For the purposes of this section, a facility shall not include rehabilitation facilities or long-term care facilities.

"Health Care Workforce" shall mean personnel employed by or contracted to work at a facility that have an effect upon the delivery of quality care to patients, including but not limited to registered nurses, licensed practical nurses, unlicensed assistive personnel, service, maintenance, clerical, professional and technical workers, and all other health care workers. 

(b) Notwithstanding any special or general law to the contrary, each facility shall establish and develop a health care workforce care planning committee within 90 days of the effective date of this section.  The membership of the planning committee shall include at least one registered nurse, one unlicensed assistive personnel, one service or maintenance worker, one professional or technical worker, one clerical worker, and one representative for each labor organization representing bargaining units at the facility.  The membership of the planning committee shall include no more than the same number of management representatives relative to the number of appointed members of the health care workforce.  

(c) The committee shall participate in at least one meeting of labor management committee training.  Such training shall be provided by an outside training vendor with demonstrated experience in labor-management training.  The training vendor shall be selected by majority vote of the planning committee and the facility shall pay for costs of this training

(d) Each facility’s health care workforce planning committee shall develop, implement, monitor and regularly adjust a comprehensive care team plan that accounts for each unit or other facility division in which direct patient care is provided.  The care team plan shall be developed to ensure that the assigned health care workforce members are sufficient to ensure a safe working environment and to provide quality care to the facility’s patients.  Further, the care team plan shall account for all anticipated variables that can influence a facility’s delivery of quality patient care including but not limited to the development of a comprehensive acuity-based classification system. The care team plan shall include policies and staffing systems that account for (i) the numbers and skill mix of needed health care workforce members to be assigned to patients, (ii) anticipated patient volume, (iii) the time needed to complete expected care tasks, (iv) the need for specialized equipment and technology, (v) the physical environment of the facility; (vi) the necessity of ensuring a safe working environment; and (vii) all quality and safety data submitted on a unit-by-unit basis for each facility through PatientCareLink or any similar system.

(e) As a condition of licensure, each facility shall submit the care team plan developed under subsection (b) and (c) to the department of public health and the health policy commission on at least an annual basis.  Such submission shall include a certification from each member of the health care workforce planning committee that the care team plan submitted accurately represents the consensus decisions of the planning committee.  

(f) The department of public health, in consultation with the health policy commission, shall promulgate rules and regulations as needed to implement this section.

SECTION 3. Section 8 of chapter 6D of the Massachusetts General Laws, as appearing in the 2018 Official Edition, is hereby amended in subsection (e) by inserting after the words “the impact of price transparency on prices”, in lines 47-48, the following:-  

, the impact of new and existing laws and regulations on the provider’s incumbent workforce, wages, labor costs and labor supply, new hiring including the use of part-time, temporary, per diem or subcontracted staff, redeployments, retraining, layoffs or reductions in force, reassignment of former acute hospital workers to clinics and other outpatient settings, and other significant workforce changes implemented during the reporting year

SECTION 4: Said section 8 of chapter 6D of the Massachusetts General Laws, as so appearing, is hereby further amended in subsection (g) by inserting after the second sentence the following sentence:- 

The report shall also include an analysis of any available information on ongoing provider efforts and initiatives reported on under subsection (e) of this section that demonstrate planning and investment in worker readiness, including maintaining the engagement of the workforce and information on the workforces’ labor representatives in joint implementation.

SECTION 5:  Section 2 of this act shall take effect within 90 days of passage of this act.

SECTION 6: The department of public health, in consultation with the health policy commission, shall promulgate rules and regulations as needed to implement section 2 of this act within 90 days of passage of this act.