REGULATORY INTELLIGENCE YEAR-END REPORT - 2023 Health Policy Tracking Service - Issue Briefs Healthcare Providers & Facilities Medical Errors and Patient Safety This Issue Brief was written by Jeffrey Karberg, J.D., a member of the Maryland bar and a contributing writer. 12/18/2023 Medical Errors and Patient Safety Authored by the Publisher's Staff. [FN1] Reducing Medical Errors and Improving Patient Safety 2023 State and Federal Action Federal 2023 CONG US S 3130 was introduced October 25, 2023. The proposed bill is an act seeking to amend the Indian Health Care Improvement Act to improve the recruitment and retention of employees in the Indian Health Service, restore accountability in the Indian Health Service, improve health services. The proposed bill states that an employee of the Service who witnesses retaliation against a whistleblower, a violation of a patient safety requirement, or other similar conduct must submit to the specified official a report of the conduct. In California 2023 CA A.B. 1570 (NS) was introduced February 17, 2023. Existing law, the Optometry Practice Act, establishes the State Board of Optometry in the Department of Consumer Affairs for the licensure and regulation of the practice of optometry. This bill would authorize an optometrist certified to treat glaucoma to obtain certification to perform specified advanced procedures if the optometrist meets certain education, training, examination, and other requirements, as specified. By requiring optometrists, qualified educators, and course administrators to certify or attest specified information relating to advanced procedure competency, thus expanding the crime of perjury, the bill would impose a state-mandated local program. Additionally, the California State Board of Optometry must review adverse treatment outcome reports in a timely manner, requesting additional information as necessary to make decisions regarding the need to impose additional training, or to restrict or revoke certifications based on its patient safety authority. The California State Board of Optometry must compile a report summarizing the data collected, including, but not limited to, percentage of adverse outcome distributions by unidentified licensee and California State Board of Optometry interventions, and must make the report available on its internet website. 2023 CA A.B. 1286 (NS), a previously introduced bill, was amended April 19, 2023. This bill would authorize a pharmacist-in-charge to make staffing decisions to ensure sufficient personnel are present in the pharmacy to prevent fatigue, distraction, or other conditions that may interfere with a pharmacist's ability to practice competently and safely. The bill would authorize a pharmacist on duty, if the pharmacist-in-charge is not available, to adjust staffing according to workload if needed. The bill would authorize a pharmacist-in- charge, or, if not available, the pharmacist on duty, to close a pharmacy under conditions that, based on the pharmacist-in-charge's professional judgment, present an immediate risk to the health and safety of patients, personnel, or pharmacy staff. The bill would require the pharmacist-in-charge or pharmacist on duty to reopen the pharmacy as soon as reasonably possible upon the abatement of the condition or conditions that presented an immediate risk to the health and safety of patients, personnel, or pharmacy staff. 2023 CA A.B. 1286 (NS), a previously introduced bill, was amended July 31, 2023. If passed, this bill would authorize a pharmacist- in-charge to make staffing decisions to ensure sufficient personnel are present in the pharmacy to prevent fatigue, distraction, or other conditions that may interfere with a pharmacist's ability to practice competently and safely. The bill would authorize a pharmacist on duty, if the pharmacist-in-charge is not available, to adjust staffing according to workload if needed. The bill would require a pharmacist- in-charge or pharmacist on duty to immediately notify store management of any conditions that present an immediate risk of death, THOMSON REUTERS © 2024 Thomson Reuters. No claim to original U.S. Government Works. illness, or irreparable harm to patients, personnel, or pharmacy staff. The bill would require store management to take immediate and reasonable steps to address and resolve those conditions, and, if those conditions are not resolved within 24 hours, would require the pharmacist-in-charge or pharmacist on duty to ensure the board is notified. The bill would require the executive officer, upon a reasonable belief that conditions within a pharmacy exist that present an immediate risk of death, illness, or irreparable harm to patients, personnel, or pharmacy staff, to issue a cease and desist order, as specified. The bill would make a failure to comply with the cease and desist order unprofessional conduct for a pharmacy corporation. 2023 CA S.B. 271 (NS), a previously introduced bill, was amended July 10, 2023. Existing law authorizes the department to waive any licensing requirements for a medical device retail facility when, in the opinion of the department, a high standard of patient safety, consistent with good patient care, can be provided by the licensure of a home medical device retail facility that does not meet all of the requirements for licensure. If passed, this bill would, except as specified, require an original manufacturer of a powered wheelchair, as those terms are defined, to provide documentation, parts, embedded software, firmware, and tools used to inspect, diagnose, maintain, and repair the wheelchair to an owner or an independent repair provider for the purposes of providing service on the equipment in the state, on fair and reasonable terms and costs, as defined. The bill would also require an original manufacturer, for a powered wheelchair that contains an electronic security lock or other security-related function, to provide any documentation, parts, embedded software, firmware, or tools needed to reset the lock or function when disabled in the course of providing services, as specified. 2023 CA S.B. 271 (NS), a previously introduced bill, was amended September 1, 2023. Existing law authorizes the department to waive any licensing requirements for a medical device retail facility when, in the opinion of the department, a high standard of patient safety, consistent with good patient care, can be provided by the licensure of a home medical device retail facility that does not meet all of the requirements for licensure. This bill would, except as specified, require an original manufacturer of a powered wheelchair, as those terms are defined, to provide documentation, parts, embedded software, firmware, and tools used to inspect, diagnose, maintain, and repair the wheelchair to an owner or an independent repair provider for the purposes of providing service on the equipment in the state, on fair and reasonable terms and costs, as defined. The bill would also require an original manufacturer, for a powered wheelchair that contains an electronic security lock or other security-related function, to provide any documentation, parts, embedded sofiware, firmware, or tools needed to reset the lock or function when disabled in the course of providing services, as specified. The bill would require an independent repair provider to provide a written notice to a customer before providing repair services. 2023 CA A.B. 1286 (NS) was enrolled September 18, 2023. Existing law requires every pharmacy to designate a pharmacist-in-charge who is responsible for a pharmacy's compliance with all state and federal laws and regulations pertaining to the practice of pharmacy. If passed, this bill would authorize a pharmacist-in-charge to make staffing decisions to ensure sufficient personnel are present in the pharmacy to prevent fatigue, distraction, or other conditions that may interfere with a pharmacist's ability to practice competently and safely. The bill would authorize a pharmacist on duty, if the pharmacist-in-charge is not available, to adjust staffing according to workload if needed. The bill would require a pharmacist-in-charge or pharmacist on duty to immediately notify store management of any conditions that present an immediate risk of death, illness, or irreparable harm to patients, personnel, or pharmacy staff. CA LEGIS 470 (2023) was filed with the secretary of State on October 8, 2023. Existing law requires every pharmacy to designate a pharmacist-in-charge who is responsible for a pharmacy's compliance with all state and federal laws and regulations pertaining to the practice of pharmacy. This bill will authorize a pharmacist-in-charge to make staffing decisions to ensure sufficient personnel are present in the pharmacy to prevent fatigue, distraction, or other conditions that may interfere with a pharmacist's ability to practice competently and safely. The bill would authorize a pharmacist on duty, if the pharmacist-in-charge is not available, to adjust staffing according to workload if needed. The bill would require a pharmacist-in-charge or pharmacist on duty to immediately notify store management of any conditions that present an immediate risk of death, iliness, or irreparable harm to patients, personnel, or pharmacy staff. The bill will also require a licensed community pharmacy, as defined, to report all medication errors to an entity approved by the board and to maintain records, as prescribed. The bill would deem these reports confidential and not subject to discovery, subpoena, or disclosure pursuant to the California Public Records Act, except that the board would be authorized to publish certain deidentified information compiled from the data in the reports in accordance with specified requirements. In Connecticut 2023 CT H.B. 6741 (NS), a previously introduced bill, was amended March 29, 2023. The proposed bill seeks to improve the safety of health care providers, hospital staff and patients in Connecticut. If passed, the proposed bill states that each hospital may establish policies and procedures related to health care provider, staff and patient safety that govern when the hospital may require a patient receiving nonemergency health care to leave the hospital if, due to the patient's behavior or conduct while in the hospital, allowing the patient to remain in the hospital to receive such nonemergency health care would threaten the safety of a health care provider, staff member or another patient at the hospital. 2023 CT S.B. 1067 (NS), a previously introduced bill, was amended April 6, 2023. The proposed bill relates to adequate and safe health care staffing. The bill also allows RNs to object to or refuse to participate in any hospital activity, policy, practice, or task if they reasonably believe that: - participating would violate the bill's requirements; or THOMSON REUTERS © 2024 Thomson Reuters. No claim to original U.S. Government Works. - they do not have the training, education, or experience to do so without compromising patient safety. It prohibits hospitals from taking adverse action against an RN for refusing to do so and allows RNs to bring a lawsuit against hospitals for any adverse action taken against them for doing so. 2023 CT S.B. 986 (NS) was adopted June 26, 2023. The bill relates to protecting matemal health. The bill defines 'Birth center' as a freestanding facility that is licensed by the department (1) to provide perinatal, labor, delivery and postpartum care during and immediately after delivery to persons presenting with a low-risk pregnancy and healthy newborns for a period typically less than twenty- four hours, and (2) that is not a hospital licensed pursuant to the provisions of this chapter, or attached to or located in such a hospital. For the purposes of this subsection, 'low-risk pregnancy' means an uncomplicated, singleton pregnancy that has vertex presentation and is at low risk for developing complications during labor and birth, as determined by an evaluation and examination conducted by a licensed health care provider acting within the scope of such provider's practice. The bill also states that Each birth center shall be accredited by the Commission for the Accreditation of Birth Centers on or before the effective date of its licensure and maintain such accreditation during the time it is licensed. If a birth center loses its accreditation, the birth center shall immediately notify the Commissioner of Public Health and cease providing birth center services to patients until authorized by the commissioner to reinstate such services. In Colorado 2023 CO H.B. 1031 (NS) was introduced January 9, 2023. Under current law, every health-care provider is required to report specified information about an individual known to the provider to have a diagnosis of or a positive test for a sexually transmitted infection to the department of public health and environment or a local public health agency. The bill exempts mental health professionals from this reporting requirement. In Florida 2023 FL REG TEXT 646611 (NS) was published September 6, 2023. The regulation relates to Chiropractic Physicians. The regulation relates to continuing education. The regulation states that in addition to the continuing chiropractic education credits authorized above, former Board members will receive thirteen hours of continuing education credit for the required hours in laws and rules, risk management, prevention of medical errors, boundaries and ethics, and record-keeping and documentation per biennium for service on a Probable Cause Panel. In Georgia 2023 GA H.B. 448 (NS) introduced February 21, 2023. If passed, this bill will enact the Medication and Patient Safety Act. If passed, the bill will: « prohibit a health insurer, pharmacy benefits manager, or their agent from imposing financial incentives on a participating provider or a covered person for a physician-administered medication and related service; « prohibit such entities from requiring a covered person to accept direct delivery of such medication with the intent that such person transport such medication to a healthcare provider for administration; and « allow such entities to arrange for an infused or injected medication to be administered to a covered person in such person's home or other healthcare facility under certain conditions. In lllinois 2023 IL S.B. 1779 (NS) was introduced February 9, 2023. The proposed bill seeks to amend the Nurse Practice Act. The bill changes the name of the Medication Aide Pilot Program to the Medication Aide Program. The bill also: « provides that to be approved as a qualified facility under the program (instead of for the duration of the pilot program), a facility must meet specified requirements; * removes provisions that provide that the Department of Financial and Professional Regulation must submit a report regarding patient safety, efficiency, and errors, as determined by rule, to the General Assembly no later than 6 months after termination of the pilot program; and « removes language providing that licenses under the Medication Aide Program Article may not be renewed or restored. 2023 IL H.B. 3437 (NS) was filed February 17, 2023. If passed, the bill will create the Task Force on Prescribing Psychologist Licensing and Oversight Act. The bill provides that the Task Force is created within the Department of Financial and Professional Regulation. The subject matter of the Task Force must include, but not be limited to, the following inquiries: « will allowing prescribing psychologists to expand the prescribing psychologists' scope to include children and seniors help increase access to treatment for underserved areas and populations, including rural patients and patients on Medicaid; and « do prescribing psychologists receive sufficient regulatory oversight, medical supervision, and disciplinary enforcement to fully protect patient safety. 2023 IL S.B. 1779 (NS) was engrossed March 30, 2023. The bill amends the Nurse Practice Act. The bill: « changes the name of the Medication Aide Pilot Program to the Medication Aide Program; THOMSON REUTERS © 2024 Thomson Reuters. No claim to original U.S. Government Works. « provides that to be approved as a qualified facility under the program (instead of for the duration of the pilot program), a facility must meet specified requirements; « removes provisions that provide that the Department of Financial and Professional Regulation must submit a report regarding patient safety, efficiency, and errors, as determined by rule, to the General Assembly no later than 6 months after termination of the pilot program; and « removes language providing that licenses under the Medication Aide Program Article may not be renewed or restored. 2023 IL S.B. 1889 (NS) was engrossed March 30, 2023. The bill amends the Pharmacy Practice Act. The bill states that when a pharmacist is not present in the pharmacy, a registered pharmacy technician, a registered certified pharmacy technician, a student pharmacist, and other supportive staff shall dispense prescriptions that have received final verification by a pharmacist. 2023 IL S.B. 1779 (NS) was engrossed March 30, 2023. The bill amends the Nurse Practice Act. The bill changes the name of the Medication Aide Pilot Program to the Medication Aide Program. The bill: - provides that to be approved as a qualified facility under the program (instead of for the duration of the pilot program), a facility must meet specified requirements; - removes provisions that provide that the Department of Financial and Professional Regulation shall submit a report regarding patient safety, efficiency, and errors, as determined by rule, to the General Assembly no later than 6 months after termination of the pilot program; and - removes language providing that licenses under the Medication Aide Program Article may not be renewed or restored. 2023 IL H.R. 82 (NS) was adopted May 2, 2023. The bill declares January 29 through February 4, 2023 as Physician Anesthesiologists Week in the State of lllinois. 2023 IL S.B. 1889 (NS) was approved June 30, 2023. The bill amends the Pharmacy Practice Act. The bill states that supportive staff who solely perform clerical work are not required to be licensed as a registered pharmacy technician. It shall be the responsibility of the pharmacy, the pharmacist-in-charge, and the pharmacy technician to ensure supportive staff are properly trained. The pharmacy or pharmacist-in-charge must alert the Department's chief pharmacy coordinator when supportive staff have been terminated for threatening patient safety or diversion. The bill also states that any person who is also enrolled in a first professional degree program in pharmacy in a school or college of pharmacy or a department of pharmacy of a university approved by the Department, or has graduated from such a program within the last 18 months, must be considered a "student pharmacist" and entitled to use the title "student pharmacist". A student pharmacist must meet all of the specified requirements for licensure as a registered pharmacy technician, except for the requirement of certification prior to the second license renewal, and pay the required license fees. A student pharmacist may, under the supervision of a pharmacist, assist in the practice of pharmacy and perform any and all functions delegated to him or her by the pharmacist. 2023 IL S.B. 2294 (NS) was adopted August 4, 2023. The bill amends the lllinois Health Information Exchange and Technology Act. Provides that the Act is repealed on July 1, 2023. In Indiana 2023 IN S.B. 463 (NS) was introduced January 19, 2023. If passed, the proposed bill will require the Indiana department of health (department) to establish and implement a health care associated infection prevention pilot program (program) to evaluate the effectiveness of hand hygiene monitoring technology in preventing and reducing health care associated infections in Indiana. In lowa 2023 IA H.F. 161 (NS) was engrossed February 8, 2023. The bill relates to damage awards against health care providers, creating a medical error task force. The bill states that the department of health and human services must convene a task force to review medical error rates of licensed physicians and must make recommendations to the general assembly and the director of health and human services including recommendations that address options for reducing medical error rates, improvements in education and training to minimize medical errors, and whether applicable penalties for medical errors and physician licensure review measures are sufficient. In Kentucky 2023 KY H.B. 326 (NS) was introduced February 15, 2023. The proposed bill states that the Office of Data Analytics will be headed by an executive director who must be appointed by the secretary with the approval of the Governor and must identify and innovate strategic initiatives to inform public policy initiatives and provide opportunities for improved health outcomes for all Kentuckians though data analytics. The office will provide leadership in the redesign of the health care delivery system using electronic information technology to improve patient care and reduce medical errors and duplicative services. In Maryland 2023 MD H.B. 675 (NS) was adopted May 3, 2023. The bill establishes the Commission to Study Trauma Center Funding in Maryland to study the adequacy of trauma center funding across the State for operating, capital, and workforce costs. In Massachusetts THOMSON REUTERS © 2024 Thomson Reuters. No claim to original U.S. Government Works. 2023 MA H.D. 2254 (NS) was introduced January 19, 2023. The proposed bill is an act making technical changes to the Betsy Lehman Center for patient safety and medical error reduction enabling statute. If passed, the proposed bill states that The Lehman center must report annually to the general court regarding the progress made in improving patient safety and medical error reduction. The Lehman center must seek federal and foundation support to supplement state resources to carry out the Lehman center's patient safety and medical error reduction goals. 2023 MA H.D. 88 (NS) was introduced January 9, 2023. The proposed bill is an act providing worker compensation protection to emergency response and medical personnel related to COVID-19 infection. 2023 MA H.B. 3949 (NS) was introduced June 26, 2023. The proposed bill, if passed, will require that the executive office of health and human services must include: - the department of elder affairs under the direction of a secretary of elder affairs, who shall be appointed by the governor; - the office of health services, which shall include the department of public health, the department of mental health, the division of medical assistance and the Betsy Lehman center for patient safety and medical error reduction; - the office of children, youth and family services, which shall include the department of children and families, the department of transitional assistance, the department of youth services, the child abuse prevention board and the office for refugees and immigrants; - the department of correction, including the parole board; - the office of disabilities and community services, which shall include the department of developmental services, the Massachusetts rehabilitation commission, the Massachusetts commission for the blind and the Massachusetts commission for the deaf and hard of hearing; - the managed care oversight board; - the health facilities appeals board; and - the office of health equity. In Michigan 2023 MI H.B. 5116 (NS) was introduced October 10, 2023. The proposed bill relates to patient safety and physician's assistant licensure. If passed, the proposed bill states that an individual must not engage in the practice of osteopathic medicine and surgery or practice as a physician's assistant unless licensed or otherwise authorized. The board may grant a license in accordance after determining that each of the following conditions is satisfied: « the applicant has disclosed that a sanction is in force against him or her and considering the reasons for the sanction and the applicant's record of practice, experience, credentials, and competence to engage in the practice of osteopathic medicine and surgery, that sanction should not prevent the applicant from being granted a license; « the sanction imposed by the other state is not permanent; « the sanction imposed by the other state was not the result of a patient safety violation; « if the applicant was required by the state that imposed the sanction to participate in and complete a probationary period or treatment plan as a condition of the continuation of his or her the applicant's licensure, the applicant did not complete the probationary period or treatment plan because the applicant ceased engaging in the practice of osteopathic medicine and surgery; and « the applicant voluntarily agrees to complete a probationary period or treatment plan, the terms of which are no less stringent than those imposed by the state that imposed the sanction. 2023 MI H.B. 5283 (NS) was introduced October 26, 2023. The proposed bill states that the health information technology commission must develop and maintain a strategic plan to guide the implementation and ongoing maintenance of the health data utility that will reduce medical errors, improve quality of care, and produce greater value for health care expenditures. The strategic plan must include measures to reduce health care costs by addressing inefficiencies, redundancy in data capture and storage, medical errors, inappropriate care, incomplete information, and administrative, billing, and data collection costs. 2023 MI H.B. 5295 (NS) was introduced November 2, 2023. The proposed bill relates to the licensure of anesthesiologist assistants. 2023 MI H.B. 5259 (NS) was introduced October 26, 2023. The proposed bill relates to access to the Michigan care improvement registry. The bill also seeks to restrict and expand the registry to include the reporting of adverse events resulting from immunizing agents. If passed, the bill will require, beginning December 31, 2024, that a health care provider must submit to the department a report of the occurrence of an adverse event resulting from an immunizing agent pursuant to specified rules. The report must include all of the following information: « the age, date of birth, and sex of the patient; « the name and dosage of the immunizing agent; « the date, time, and location that the immunizing agent was administered; THOMSON REUTERS © 2024 Thomson Reuters. No claim to original U.S. Government Works. « the date and time when the adverse event resulting from an immunizing agent started; « the patient's symptoms; « if applicable, any medical test result and laboratory test result for the patient; and « the outcome of the adverse event resulting from an immunizing agent. In Minnesota 2023 MN S.F. 406 (NS) was engrossed February 13, 2023. The bill establishes the right for a pregnant patient to have a designated support person present while receiving health care. A facility may restrict or prohibit the presence of one or more designated support persons, on the facility premises or in certain locations within the facility, if the facility determines that such restriction or prohibition is necessary to meet the appropriate standard of care for medical practice, is in the best interests of the patient's care or patient's safety, or is otherwise necessary to maintain a safe environment for patients, guests, clinicians, and other staff of the facility. 2023 MN S.F. 1384 (NS) was adopted May 26, 2023. The bill enacts the Nurse and Patient Safety Act. The bill will: modify requirements related to hospital preparedness and incident response action plans to acts of violence; modify eligibility for nursing facility employee scholarships; modify eligibility for the health professional education loan forgiveness program; and require the commissioner of health to study hospital staffing. In Missouri 2023 MO H.B. 1012 (NS) was introduced February 1, 2023. The proposed bill seeks to create provisions relating to minimum nurse staffing requirements. The bill, if passed, will require a hospital to implement a staffing plan that states the ratio of patients to direct care registered nurses to be required by the hospital. The plan must: - provide adequate, appropriate, and quality delivery of health care services; - protect patient safety; and - be consistent with the specified statutory requirements. In New Hampshire NH LEGIS 223 (2023) was approved August 4, 2023. The bill relates to optometrists administering certain vaccines. In New Jersey 2022 NJ A.B. 4017 (NS), a previously introduced bill, was amended March 23, 2023. If passed, the proposed bill will: « establish minimum NJ FamilyCare reimbursement rate for traumatic brain injury special care nursing facilities; and « establish enhanced NJ FamilyCare reimbursement rate for nursing facilities under certain circumstances; makes an appropriation. 2022 NJ S.B. 3898 (NS) was introduced June 1, 2023. If passed, the bill will require the DOH to establish a three-year Obstetric Discrimination Prevention and Mitigation Pilot Program. The bill states that it is necessary to promote and protect the health, dignity, safety, and welfare of all citizens of New Jersey by establishing a pilot program that allows maternity care hospitals and licensed birthing centers to utilize and assess a valid perinatal quality improvement measurement tool designed to: name and recognize obstetric discrimination as an adverse event that violates the quality of care provided to, and the safety of, Black mothers; provide an evidence-based evaluation of the presence and magnitude of obstetric discrimination; and highlight how obstetric discrimination informs hospital policies, procedures, and programs and impacts the birthing experiences of Black mothers. In New York NY LEGIS 815 (2022) was approved December 30, 2022. The bill is an act to amend labor law in relation to the restrictions on consecutive hours of work for nurses. The bill defines "regularly scheduled work hours", including pre-scheduled on-call time and the time spent for the purpose of communicating shift reports regarding patient status necessary to ensure patient safety, to mean those hours a nurse has agreed to work and is normally scheduled to work pursuant to the budgeted hours allocated to the nurse's position by the health care employer; and if no such allocation system exists, some other measure generally used by the health care employer to determine when an employee is minimally supposed to work, consistent with the collective bargaining agreement, if any. 2023 NY A.B. 1921 (NS) was introduced January 23, 2023. The proposed bill seeks to establish the 'Safe Staffing for Hospital Care Act'. The legislature declared that the New York has a substantial interest in assuring that delivery of healthcare services to patients in healthcare facilities located within this state is adequate and safe and that healthcare facilities retain sufficient nursing staff so as to promote optimal healthcare outcomes. Recent changes in our healthcare delivery system are resulting in a higher acuity level among THOMSON REUTERS © 2024 Thomson Reuters. No claim to original U.S. Government Works. patients in healthcare facilities. Inadequate hospital staffing results in dangerous medical errors and patient infections. Establishing staffing standards will ensure that healthcare facilities throughout the state operate in a manner that guarantees the public safety and the delivery of quality healthcare services. The intent of this act is to protect the health and safety of the residents of New York state by ensuring adequate protection and care for patients in healthcare facilities. 2023 NY A.B. 2163 (NS) was introduced January 23, 2023. If passed, the proposed bill will establish patient safety and quality assurance measures regarding the distribution of patient-specific medication from an insurer-designated pharmacy. 2023 NY S.B. 4681 (NS) was introduced on February 13, 2023. The proposed bill seeks to establish the 'Safe Staffing for Hospital Care Act'. If passed, the bill will establish minimum staffing levels for various health care workers in different health care facilities. The bill will also: * require submission of staffing plans; and « prohibit most mandatory overtime. 2023 NY S.B. 6351 (NS) was introduced April 17, 2023. If passed, the proposed bill will provide a premium reduction for physicians and other staff who complete a training strategies course relating to emergency department visits for individuals with a developmental or intellectual disability. 2023 NY A.B. 6895 (NS) was introduced May 8, 2023. If passed, the proposed bill will provide a premium reduction for physicians and other staff who complete a training strategies course relating to emergency department visits for individuals with a developmental or intellectual disability. Courses on risk management strategies during emergency visits by those with a developmental or intellectual disability shall promote evidence-based clinical guidelines and patient safety protocols, with an emphasis on perspectives from those with a developmental or intellectual disability. Options for courses should be appropriate for the respective profession and may include information and education addressing risks associated with emergency visits by individuals with a developmental or intellectual disability. Course options shall be determined by the commissioner in consultation with the office for people with developmental disabilities. 2023 NY S.B. 6652 (NS) was introduced May 3, 2023. If passed, the proposed bill will provide a premium reduction for physicians and licensed midwives who complete a risk management strategies course. Courses on risk management strategies during the prenatal through intrapartum and postpartum periods shall promote evidence-based clinical guidelines and patient safety protocols from both the midwifery and obstetrical perspectives. Options for courses should be appropriate for the respective profession and may include information and education addressing risks associated with the practice of obstetrics and midwifery. Course options may include issues such as: methods to eliminate non-medically indicated (elective) deliveries prior to thirty-nine weeks gestation including the neonatal impact of late preterm births; vaginal births after cesarean births and the applicability to a trial of labor; reductions in cesarean births; monitoring of fetal well-being; management of pain in labor; management of maternal hemorrhage, including placenta accreta, hypertension in pregnancy, including pre-eclampsia and eclampsia, vaginal breech and prevention of shoulder dystocia; and other evidence-based guideline determined issues that improve the care and outcomes of women. 2023 NY A.B. 6683 (NS}, a previously introduced bill, was amended May 12, 2023. If passed, the proposed bill will establish a community-based paramedicine demonstration program. The bill states that the department must establish a community-based paramedicine demonstration program to evaluate the concept of community paramedicine in different communities in the state. This program must only allow for mobile integrated and community paramedicine programs presently operating and approved by the department as of May eleventh, two thousand twenty-three, under the authority of Executive Order Number 4 of two thousand twenty- one, entitled 'Declaring a Statewide Disaster Emergency Due to Healthcare staffing shortages in the State of New York' to continue in the same manner and capacity as currently approved for a period of one year following the effective date of the bill. 2023 NY S.B. 5516 (NS), a previously introduced bill, was amended June 5, 2023. The proposed bill relates to the geriatric demonstration program to promote mental health and home care collaboration; authorizes the commissioner of mental health to identify barriers to participation in the program and make recommendations to address such barriers.5 2023 NY S.B. 6351 (NS), a previously introduced bill, was amended June 1, 2023. If passed, the proposed bill will direct the commissioner of health to approve professional education courses for eligible physicians, nurses and other staff that covers risk management strategies in emergency department visits for individuals with a developmental or intellectual disability; provides a premium reduction for physicians, nurses and other staff who complete such risk management strategies course. NY LEGIS 137 (2023) was approved June 22, 2023. The bill states that the department must establish a community paramedicine demonstration program to evaluate the role of emergency medical services personnel in the delivery of health care services in the community in non-emergent settings. "Emergency medical services personnel" is an emergency medical technician, or an advanced emergency medical technician as defined in this article. The program shall authorize mobile integrated and community paramedicine programs presently operating and approved by the department as of May eleventh, two thousand twenty-three, under the authority of Executive Order Number 4 of two thousand twenty-one, entitled "Declaring a Statewide Disaster Emergency Due to Healthcare staffing shortages in the State of New York" to continue in the same manner and capacity as currently approved for a period of two years following the effective date of this section. Upon the effective date of this section, the department shall convene a stakeholder advisory panel including patient representatives, health care facilities operating or utilizing community paramedicine programs, THOMSON REUTERS © 2024 Thomson Reuters. No claim to original U.S. Government Works. emergency medical services providers and labor organizations representing emergency medical services personnel, and labor organizations representing nursing and other healthcare professional titles affected by the demonstration program flexibilities to advise the department to make recommendations on regulations and guidance that will evaluate patient safety and standards of care for community paramedicine programs participating in the demonstration program. 2023 NY A.B. 7947 (NS) was introduced August 4, 2023. If passed, the proposed bill will enact the psychology interjurisdictional compact, the recognition of emergency medical services personnel licensure interstate compact and the interstate counseling compact. In Ohio 2023 OH H.B. 154 (NS) was introduced on April 18, 2023. The proposed bill relates to staffing ratios and other employment conditions for registered nurses employed by hospitals. 2023 OH H.B. 174 (NS) was introduced May 16, 2023. The proposed bill seeks to establish and operate the Ohio Health Care Plan to provide universal health care coverage to all Ohio residents. The bill will require the executive director, in consultation with the technical and medical advisory board, to determine the duties of the administrator of quality assurance. Those duties must include the following: « studying and reporting on the efficacy of health care treatments and medications for particular conditions; « identifying causes of medical errors and devising procedures to decrease medical errors; « establishing an evidence-based formulary; and « identifying treatments and medications that are unsafe or have no proven value. 2023 OH H.B. 236 (NS) was introduced July 5, 2023. The proposed bill seeks to prohibit a congregate care setting from denying a patient or resident access to an advocate and to name this act the Never Alone Act. 2023 OH H.B. 285 (NS) was introduced October 2, 2023. If passed, the bill will require hospitals to establish registered nurse staffing plans that protect patient safety, to create the Nursing Student Loan-to-Grant Program. A hospital must develop and implement a nurse staffing plan that provides adequate, appropriate, and quality delivery of health care services and protects patient safety. The plan must document the methodology that is used to determine the hospital's needs for nursing staff. In Oklahoma 2023 OK H.B. 2422 (NS) was engrossed April 27, 2023. The purpose of the bill is to protect the public through verification of competency and ensure accountability for patient care-related activities all state-licensed emergency medical services (EMS) personnel, such as emergency medical technicians (EMTs), advanced EMTs, and paramedics. This Compact is intended to facilitate the day-to-day movement of EMS personnel across state boundaries in the performance of their EMS duties as assigned by an appropriate authority and authorize state EMS offices to afford immediate legal recognition to EMS personnel licensed in a member state. This Compact recognizes that states have a vested interest in protecting the public's health and safety through their licensing and regulation of EMS personnel and that such state regulation shared among the member states will best protect public health and safety. This Compact is designed to achieve the following purposes and objectives: increase public access to EMS personnel; and enhance the states' ability to protect the public's health and safety, especially patient safety. 2023 OK H.B. 2422 (NS) was adopted May 22, 2023. The bill creates the Recognition of EMS Personnel Licensure Interstate Compact. The stated purpose of the bill is to protect the public through verification of competency and ensure accountability for patient care- related activities all state-licensed emergency medical services (EMS) personnel, such as emergency medical technicians (EMTs), advanced EMTs, and paramedics. This Compact is intended to facilitate the day-to-day movement of EMS personnel across state boundaries in the performance of their EMS duties as assigned by an appropriate authority and authorize state EMS offices to afford immediate legal recognition to EMS personnel licensed in a member state. This Compact recognizes that states have a vested interest in protecting the public's health and safety through their licensing and regulation of EMS personnel and that such state regulation shared among the member states will best protect public health and safety. This Compact is designed to achieve the following purposes and objectives: « increase public access to EMS personnel; « enhance the states' ability to protect the public's health and safety, especially patient safety; and « encourage the cooperation of member states in the areas of EMS personnel licensure and regulation. In Oregon 2023 OR S.B. 229 (NS) was adopted May 16, 2023. The bill relates to adverse event reporting programs. In Pennsylvania 2023 PA S.B. 237 (NS) was introduced January 31, 2023. The proposed bill seeks to provide for funding safety and transparency. The bill states that no nonprofit agency or nonprofit agency's subcontractors and service providers that receive funding from the Pennsylvania to promote childbirth and provide alternatives to abortion must not provide false or misleading information in the provision THOMSON REUTERS © 2024 Thomson Reuters. No claim to original U.S. Government Works. of or advertisement of services. Any advertising that uses funds provided by the Pennsylvania must comply with the Taxpayer- Funded Advertising Transparency Act, and may not provide false or misleading information. The nonprofit agency must ensure that subcontractors and service providers that administer health care services, including pregnancy tests, counseling and postdelivery support, meet the requirements of the patient safety provisions of the Medical Care Availability and Reduction of Error Act. 2023 PA S.B. 549 (NS) was introduced March 28, 2023. The proposed bill seeks to amend an act entitled 'An act reforming the law on medical professional liability; providing for patient safety and reporting; establishing the Patient Safety Authority and the Patient Safety Trust Fund; abrogating regulations; providing for medical professional liability informed consent, damages, expert qualifications, limitations of actions and medical records; establishing the Interbranch Commission on Venue; providing for medical professional liability insurance; establishing the Medical Care Availability and Reduction of Error Fund; providing for medical professional liability claims; establishing the Joint Underwriting Association; regulating medical professional liability insurance; providing for medical licensure regulation; providing for administration; imposing penalties; and making repeals,' in medical professional liability, providing for informed consent in pelvic, rectal and prostate examinations. 2023 PA H.B. 507 (NS), a previously introduced bill, was amended April 25, 2023. The proposed bill seeks to amend the Medical Care Auvailability and Reduction of Error (Mcare) Act, in medical professional liability, providing for informed consent in pelvic, rectal and prostate examinations. 2023 PA H.B. 1152 (NS) was introduced May 18, 2023. The proposed bill seeks to amend the Medical Care Availability and Reduction of Error (Mcare) Act, in medical professional liability, further providing for informed consent. The bill will require a physician performing surgery on a patient to personally disclose to the patient or the patient's authorized representative whether the physician plans to perform a concurrently scheduled surgery or render other concurrently scheduled medical care during the patient's surgery. 2023 PA S.B. 883 (NS) was introduced August 16, 2023. The proposed bill states that an entity that makes a product available in this Pennsylvania that could infect, transmit to or be absorbed in an individual in any way that would act as a medical intervention, vaccine, drug or genetic modification shall obtain fully informed consent from all individuals who could be exposed to the product before exposure could occur. Fully informed consent requires, at a minimum, that an individual is made aware of all benefits and risks, including side effects, of the product, any adverse events of special interest and any other reasonably possible impacts of the product. The proposed bill also states that a product that has been created to act as, or exposed to processes that have resulted or could result in the product potentially acting as, a gene therapy or that could otherwise possibly impact, alter or introduce genetic material or a genetic change into the user of the product, shall be prohibited from being sold for consumption in Pennsylvania. 2023 PA S.B. 938 (NS) was introduced October 3, 2023. The proposed bill is an act amending the Medical Care Availability and Reduction of Error (Mcare) Act, in insurance, providing for adverse actions against legal reproductive health care. The bill states that an insurer providing medical professional liability insurance is prohibited from taking an adverse action against a health care provider solely on the basis that the health care provider provides reproductive health care services that are permitted in Pennsylvania on a patient who is from outside this Pennsylvania. This subsection applies to a health care provider who prescribes medication permitted under the laws of Pennsylvania to terminate a pregnancy to an out-of-State patient by means of telemedicine. 2023 PA H.B. 1785 (NS) was introduced October 24, 2023. The proposed bill is an act amending the bill entitled 'An act reforming the law on medical professional liability; providing for patient safety and reporting; establishing the Patient Safety Authority and the Patient Safety Trust Fund; abrogating regulations; providing for medical professional liability informed consent, damages, expert qualifications, limitations of actions and medical records; establishing the Interbranch Commission on Venue; providing for medical professional liability insurance; establishing the Medical Care Availability and Reduction of Error Fund; providing for medical professional liability claims; establishing the Joint Underwriting Association; regulating medical professional liability insurance; providing for medical licensure regulation; providing for administration; imposing penalties; and making repeals,' in insurance, providing for adverse actions against legal reproductive health care. In Rhode Island 2023 RI S.B. 24 (NS) was introduced January 18, 2023. If passed, this bill will remove the sunset provision of all statutory law requiring coverage for the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome, thus requiring insurance coverage to continue beyond December 31, 2025. 2023 RI H.B. 5869 (NS), a previously introduced bill, was amended June 13, 2023. If passed, this bill will require the director of the department of health by February 1, 2024, to develop in coordination with the Antimicrobial Stewardship and Environmental Cleaning task force, and make available to health care practitioners, information on best practices for the treatment of patients with sepsis and septic shock. Each hospital and freestanding emergency-care facility would implement procedures and policies in accordance with this bill. 2023 RI H.B. 5869 (NS) was adopted June 24, 2023. The bill relates to the licensing of healthcare facilities and the best practices for sepsis and septic shock. The bill states that in order to enhance patient safety and protection, each hospital licensed in the state must establish a multi-disciplinary committee to implement policies, procedures and staff education in accordance with the best practices issued by the department of health. The bill also states that on or before February 1, 2024, to the extent allowable by available state and federal funding, the director of the department of health must in coordination with the department of health's Antimicrobial Stewardship and Environmental Cleaning task force, make available to hospitals, urgent care facilities, freestanding emergency rooms, THOMSON REUTERS © 2024 Thomson Reuters. No claim to original U.S. Government Works. pediatric practices and EMS agencies, information on best practices for the treatment of patients with sepsis and septic shock. The best practices shall be based on generally accepted standards of care, including, but not limited to: « an evidence-based screening tool that can be used at initial evaluation of adult and pediatric patients in these settings; « an evidence-based treatment protocol for adult and pediatric patients that includes time-specific treatment goals; « nurse-driven testing protocols to enable nurses to initiate care for patients with suspected sepsis; « incorporation of sepsis screening and treatment tools into the electronic health record where possible; « mechanisms to prompt escalation of care within these settings, and, when appropriate, to stabilize and transfer to a facility able to provide a higher level of care; « Strategies for appropriate hand-offs and communication regarding the care of patients with sepsis and for the reassessments of patients at regular intervals; « hospital specific antibiotic guidelines for use in treating patients with sepsis and a mechanism for reevaluating a patient's antibiotic treatment based on culture results that provides reassessment and de-escalation of antibiotic treatment when appropriate; and « staff education on sepsis policies and procedures during the onboarding process and at least annually and when new practice guidelines are published or existing standards are updated to ensure that care reflects current standards of practice. In Texas 2023 TX H.B. 1190 (NS), a previously introduced bill, was amended May 1, 2023. The proposed bill relates to the prescribing and ordering of Schedule Il controlled substances by certain advanced practice registered nurses and physician assistants. In Vermont 2023 VT H.B. 282 (NS) was engrossed April 6, 2023. The bill proposes that the State adopt and enter into the Psychology Interjurisdictional Compact. The compact is designed to achieve the following purposes and objectives: « increase public access to professional psychological services by allowing for telepsychological practice across state lines as well as temporary in-person, face-to-face services into a state in which the psychologist is not licensed to practice psychology; « enhance the states' ability to protect the public's health and safety, especially client and patient safety; « encourage the cooperation of Compact states in the areas of psychology licensure and regulation; « facilitate the exchange of information between Compact states regarding psychologist licensure, adverse actions, and disciplinary history; « promote compliance with the laws governing psychological practice in each Compact state; and « invest all Compact states with the authority to hold licensed psychologists accountable through the mutual recognition of Compact state licenses. In Virginia 2022 VA S.B. 827 (NS) was prefiled December 21, 2022. The proposed bill relates to hospital emergency departments. The bill directs the Board of Health to amend its regulations to require every hospital with an emergency department to have at least one off-duty law- enforcement officer or a trained security officer present at all times. Hospital protocols must ensure such officers providing security receive training in the use of weapons, defensive tactics, de-escalation techniques, appropriate physical restraint techniques, crisis intervention, and trauma-informed approaches in identifying and safely addressing situations involving patients, family members, or other persons who pose a risk of harm to themselves or others due to mental illness or substance abuse or who are experiencing a mental health crisis. 2022 VA S.B. 925 (NS) was prefiled January 6, 2023. If passed, the bill will require hospitals, nursing homes, and certified nursing facilities to allow patients to receive visits from clergy members during a declared public health emergency related to a communicable disease of public health threat. Under the bill, the hospital, nursing home, or certified nursing facility may require the clergy member to comply with all reasonable health and safety requirements and may restrict visits of a clergy member who fails a health screening measure or tests positive for a communicable disease of public health concem. If the health and safety requirement substantially burdens the clergy member's free exercise of religion, the hospital, nursing home, or certified nursing facility may require compliance only if the requirement furthers a compelling health and safety interest and imposes the least restrictive requirement. The bill provides immunity for hospitals, nursing homes, and certified nursing facilities and their employees and contractors from liability for injury or death due to exposure to a communicable disease of public health concern resulting from or related to such visitation, except in limited circumstances. The bill also allows a person or religious organization to bring a civil action against a hospital, nursing home, or certified nursing facility alleging a violation of such visitation provisions. 2022 VA S.B. 1531 (NS) was introduced January 20, 2023. If passed, the proposed bill will require the Board of Health to amend its regulations to require that every hospital participate in the Alliance for Innovation on Maternal Health patient safety bundle advanced by the Collaborative. The bill directs the Secretary of Health and Human Resources (the Secretary) to facilitate the negotiation of state THOMSON REUTERS © 2024 Thomson Reuters. No claim to original U.S. Government Works. -10- contracts that best position the Collaborative to address maternal child health issues in the Commonwealth using clinical expertise to develop evidence based best practices and recommendations to universally implement such best practices in the Commonwealth. 2022 VA H.B. 1952 (NS), a previously introduced bill, was amended February 16, 2023. The proposed bill relates to reporting of processing delays impacting patient safety. The bill requires that a pharmacy that, on average, during any one-week period is unable to process a prescription within two days of receipt of such prescription shall report the prescription backlog to the Board of Pharmacy (the Board). The bill requires any pharmacy making such report to submit a corrective action plan detailing its staffing, workflow, technology, and patient communication strategies to address the prescription backlog. 2022 VA S.B. 1531 (NS), a previously introduced bill, was amended February 20, 2023. If passed, the bill will direct the Department of Health and all other agencies of the Commonwealth to support the efforts of the Virginia Neonatal Perinatal Collaborative (the Collaborative) upon request to the fullest extent practicable and pursue opportunities for public-private partnerships with the Collaborative. The bill will require the Board of Health to amend its regulations to require that every hospital participate in any Alliance for Innovation on Maternal Health patient safety bundle and any other maternal or newborn quality improvement initiative advanced by the Collaborative. The bill directs the Secretary of Health and Human Resources (the Secretary) to facilitate the negotiation of state contracts that best position the Collaborative to address maternal child health issues in the Commonwealth using clinical expertise to develop evidence based best practices and recommendations to universally implement such best practices. 2022 VA S.B. 1531 (NS) was enrolled March 7, 2023. The bill directs the Department of Health and all other agencies of the Commonwealth to support the efforts of the Virginia Neonatal Perinatal Collaborative (the Collaborative) upon request to the fullest extent practicable and pursue opportunities for public-private partnerships with the Collaborative. The bill requires the Board of Health to amend its regulations to require that every hospital participate in any Alliance for Innovation on Maternal Health patient safety bundle and any other maternal or newborn quality improvement initiative advanced by the Collaborative. The bill directs the Secretary of Health and Human Resources (the Secretary) to facilitate the negotiation of state contracts that best position the Collaborative to address maternal child health issues in the Commonwealth using clinical expertise to develop evidence based best practices and recommendations to universally implement such best practices in the Commonwealth. The bill requires that by November 1 of each year that the Collaborative receives state funds, the Collaborative provide an annual report with recommendations for elevating the standard of care and improving outcomes for women and children in the Commonwealth to the Secretary and the Chairmen of the Senate Committee on Education and Health, the Senate Committee on Finance and Appropriations, the House Committee on Health, Welfare and Institutions, and the House Committee on Appropriations. In Washington 2023 WA H.B. 1041 (NS) was prefiled December 15, 2022. The proposed bill relates to authorized the prescriptive authority of psychologists. The bill contains a provision stating that no person may coerce a nurse into compromising patient safety by requiring the nurse to delegate if the nurse determines that it is inappropriate to do so. Nurses must not be subject to any employer reprisal or disciplinary action by the nursing care quality assurance commission for refusing to delegate tasks or refusing to provide the required training for delegation if the nurse determines delegation may compromise patient safety. 2023 WA H.B. 1073 (NS) was prefiled December 22, 2022. The proposed bill is an act relating to medical assistants. The bill states that a medical assistant-registered may perform the following duties delegated by, and under the supervision of, a health care practitioner: « telephone and in-person screening limited to intake and gathering of information without requiring the exercise of judgment based on clinical knowledge; « obtaining vital signs; « obtaining and recording patient history; « preparing and maintaining examination and treatment areas; « preparing patients for, and assisting with, routine and specialty examinations, procedures, treatments, and minor office surgeries utilizing no more than local anesthetic, unless the duties are prohibited by the department if performance of those duties by a medical assistant-registered would pose an unreasonable risk to patient safety; * maintaining medication and immunization records; and « screening and following up on test results as directed by a health care practitioner. 2023 WA S.B. 5275 (NS) was introduced January 11, 2023. The bill relates to expanding access to benefits provided by the school employees benefit board. The Washington state health care authority is created within the executive branch. The authority shall have a director appointed by the governor, with the consent of the senate. The authority's duties include, but are not limited to analyze state purchased health care programs and to explore options for cost containment and delivery alternatives for those programs that are consistent with the purposes of those programs, including, but not limited to use evidence-based medicine principles to develop common performance measures and implement financial incentives in contracts with insuring entities, health care facilities, and providers that: » reward improvements in health outcomes for individuals with chronic diseases, increased utilization of appropriate preventive health services, and reductions in medical errors; and THOMSON REUTERS © 2024 Thomson Reuters. No claim to original U.S. Government Works. -11- « increase, through appropriate incentives to insuring entities, health care facilities, and providers, the adoption and use of information technology that contributes to improved health outcomes, better coordination of care, and decreased medical errors. 2023 WA S.B. 5569 (NS) was adopted April 6, 2023. The bill relates to creating exemptions from certificate of need requirements for kidney disease centers due to temporary emergency situation. 2023 WA S.B. 5300 (NS) was enrolled April 20, 2023. The bill relates to continuity of coverage for prescription drugs prescribed for the treatment of behavioral health conditions. Health plans that include prescription drug coverage issued or renewed on or after January 1, 2025, a health carrier or its health care benefit manager may not require the substitution of a nonpreferred drug with a preferred drug in a given therapeutic class, or increase an enrollee's cost-sharing obligation mid-plan year for the drug, if the prescription is for a refill of an antipsychotic, antidepressant, antiepileptic, or other drug prescribed to the enrollee to treat a serious mental iliness, the enrollee is medically stable on the drug, and a participating provider continues to prescribe the drug. However, the carrier may remove a drug from its formulary for reasons of patient safety concems, drug recall or removal from the market, or medical evidence indicating no therapeutic effect of the drug. 2023 WA S.B. 5236 (NS) was adopted April 20, 2023. The bill relates to hospital staffing standards. The bill seeks to improve workplace standards for certain hospital staff by expanding staffing committees to include additional nursing staff, modifying staffing committee requirements, and clarifying standards and enforcement regarding mandatory overtime and uninterrupted meal and rest breaks. In West Virginia 2023 WV S.B. 521 (NS) was introduced January 31, 2023. The proposed bill seeks to improve patient safety in medical cannabis program. In Wisconsin 2023 WI S.B. 470 (NS) was introduced September 29, 2023. If passed, the proposed bill will require hospitals to develop and adhere to a plan for staffing registered nurses. Under the bill, the nurse staffing plan must meet certain standards, including being created and approved by a nurse staffing committee, the majority of which must be registered nurses in nonsupervisory positions; reviewed annually by the hospital; provided to the Department of Health Services annually, by a deadline set by DHS; and posted in every unit of the hospital and on the DHS website. The bill establishes minimum nurse-to-patient ratios that the hospital must maintain for each unit in the hospital. Under the bill, hospitals must keep for at least three years records of its nurse staffing ratios and actual staffing numbers. In addition, the bill provides that registered nurses have the right to refuse a work assignment if the nurse, in good faith and in the nurse's professional judgment, finds that the nurse is unable to fulfill the assignment without compromising patient safety or the nurse's license. The bill creates a cause of action for a nurse against a hospital that disciplines, discharges, retaliates, discriminates, takes adverse action, or files a complaint with a disciplinary agency against a nurse that refuses to complete an assignment under those circumstances. 2023 WI A.B. 489 (NS) was introduced October 12, 2023. The proposed bill relates to minimum nurse staffing ratios in hospitals, registered nurses' right to refuse a work assignment, and prohibiting mandatory overtime for registered nurses. This bill requires hospitals to develop and adhere to a plan for staffing registered nurses. Under the bill, the nurse staffing plan must meet certain standards, including being created and approved by a nurse staffing committee, the majority of which must be registered nurses in nonsupervisory positions; reviewed annually by the hospital; provided to the Department of Health Services annually, by a deadline set by DHS; and posted in every unit of the hospital and on the DHS website. The bill establishes minimum nurse-to-patient ratios that the hospital must maintain for each unit in the hospital. Under the bill, hospitals must keep for at least three years records of its nurse staffing ratios and actual staffing numbers. The bill also provides that registered nurses have the right to refuse a work assignment if the nurse, in good faith and in the nurse's professional judgment, finds that the nurse is unable to fulfill the assignment without compromising patient safety or the nurse's license. The bill creates a cause of action for a nurse against a hospital that disciplines, discharges, retaliates, discriminates, takes adverse action, or files a complaint with a disciplinary agency against a nurse that refuses to complete an assignment under those circumstances. © Copyright Thomson/West - NETSCAN's Health Policy Tracking Service Produced by Thomson Reuters Accelus Regulatory Intelligence 17-Jan-2024 THOMSON REUTERS © 2024 Thomson Reuters. No claim to original U.S. Government Works. -12-