HCS HB 264 -- NURSE STAFFING PLANS

SPONSOR:  Holand

COMMITTEE ACTION:  Voted "do pass" by the Committee on Health
Care Policy by a vote of 12 to 2.

This substitute contains provisions pertaining to overtime
requirements for nurses employed at licensed acute care hospitals
in Missouri.

The substitute:

(1)  Contains various definitions, including "overtime,"
"hospital," "reasonable effort," "on-call time," and
"unforeseeable emergent circumstances."  Non-acute care
facilities and state psychiatric hospitals are excluded from the
definition of "hospital";

(2)  Prohibits licensed hospitals from requiring, compelling, or
forcing an employee to work overtime as a condition of
employment.  Any contractual arrangement or agreement containing
a mandatory overtime provision is voidable;

(3)  Allows any employee to voluntarily work overtime.  Refusal
of an employee to work overtime is not grounds for termination,
discrimination, discipline, or adverse employment decisions
affecting the employee; and

(4)  Contains exceptions which do not prohibit an employee from
working overtime.  The exceptions include unforeseeable emergent
circumstances, pre-scheduled on-call hours, completion of patient
care already in progress, and when an employer can document that
reasonable efforts have been made to obtain additional staffing.

FISCAL NOTE:  Not available at time of printing.

PROPONENTS:  Supporters say that a growing number of nurses are
required to work unplanned or mandatory overtime, which could
endanger patient safety.  At least 25 states have introduced or
passed legislation pertaining to nurse staffing plans for
licensed hospitals.  Greater safeguards are needed to protect
nurses from retaliation if they refuse to work overtime.
Safeguards were added to the substitute.  The bill is not
punitive, but provides alternatives for hospitals to address
nurse staffing shortages.

Testifying for the bill were Representative Holand; and Missouri
Nurses Association.

OPPONENTS:  Those testifying against the bill state that some of
the definitions such as "acuity system" would be difficult to
apply and implement in certain nursing or medical units such as
surgery, obstetrics, and emergency medicine.  This definition is
not in the substitute.  Current law requires hospitals to develop
and implement a plan which requires adequate nurse staffing.  The
bill could cause some hospitals to relocate from areas within
Missouri.

Testifying against the bill was Missouri Hospital Association.

Joseph Deering, Legislative Analyst

Missouri House of Representatives
Last Updated July 25, 2003 at 10:11 am