Final bill removes 8-hour shift limit, does not exempt rural hospitals
On April 24, the Washington State House and Senate passed Substitute House Bill 1155, implementing new restrictions on hospital staffing, with most elements of the bill taking effect Jan. 1, 2020. The final bill passed after lawmakers formed a conference committee to determine the bill’s final details. SHB 1155 now awaits the governor’s signature to become law.
The bill’s final iteration removes a mandatory eight-hour cap on nurse shifts, a Senate amendment that WSHA strongly opposed. However, the bill does not exempt Critical Access Hospitals from the new staffing requirements, which could be detrimental to rural health care. Critical Access Hospitals are located in rural communities and have less than 25 beds. These hospitals will be subject to the new law July 1, 2021.
“We are pleased that the eight-hour shift limit for nurses was removed after our hospitals mobilized nurses, who sent more than 25,000 letters to lawmakers in opposition to that amendment, but we are disappointed that the legislature fails to recognize the challenges of providing health care to rural communities,” WSHA President and CEO Cassie Sauer said. “We remain committed to addressing nurse fatigue and we will continue to work toward solutions that protect access to care in all communities and address the constantly changing needs of patients.”
Prior to the formation of the conference committee, WSHA supported SHB 1155 with an amendment from Sen. Curtis King that exempted rural hospitals from the new requirements, as rural facilities will likely face the greatest difficulty complying with the new regulations. This difficulty is due to staffing shortages and low or negative operating margins. New regulations threaten the financial stability of these facilities, which are often the largest employers and only source of health care access for their community.
In its final form, SHB 1155 includes instances in which a break can be interrupted to address patient care needs. It prohibits mandatory on-call from being used to cover regularly scheduled shifts (as identified by hospital staffing plans), and it prohibits prescheduled on-call from being used to address regular changes in patient census or acuity, or expected increases in the number of employees not reporting for a predetermined scheduled shift. It also adds an option for rest between consecutive shifts when nurses or technicians accept overtime.
WSHA will develop an implementation plan to help Washington hospitals comply with the new law prior to Jan. 1, when most of the provisions take effect.