BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2155
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 2155 (Ridley-Thomas)
          As Amended August 19, 2014
          Majority
           
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          |ASSEMBLY:  |53-24|(May 28, 2014)  |SENATE: |25-10|(August 21,    |
          |           |     |                |        |     |2014)          |
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           Original Committee Reference:    L. & E.

          SUMMARY  :  Prohibits, beginning January 1, 2016, mandatory  
          overtime for registered nurses, licensed vocational nurses  
          (LVNs), or certified nursing assistants (CNAs) who are employed  
          in state hospitals and facilities.  Specifically,  this bill  :  

          1)Defines a "nurse" as all classifications of registered nurses  
            represented by State Bargaining Unit (BU) 17, or the LVN  
            classifications represented by BU 20.

          2)Defines a "certified nursing assistant" as all CNA  
            classifications represented by BU 20.

          3)Defines "on call or standby" to mean alternative staff who are  
            not currently working on the premises of the facility and who  
            satisfy certain criteria, as specified.

          4)Defines a "facility" as a facility providing clinically  
            related health services that is operated by specified state  
            departments in which a nurse or CNA works as an employee of  
            the state.

          5)Defines "emergency situation" as an unforeseeable declared  
            national, state, or municipal emergency or a highly unusual  
            event that is unpredictable or unavoidable that affects the  
            health care services, as specified.

          6)Prohibits a facility from requiring a nurse or CNA to work in  
            excess of a regularly scheduled workweek or work shift, except  
            as provided.

          7)Authorizes a nurse or CNA to volunteer to work extra hours,  
            but the refusal by a nurse or CNA to work such hours shall not  
            be grounds for discrimination, dismissal, discharge or other  








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            penalty or patient abandonment or neglect, as specified.

          8)Requires management and supervisors, in order to avoid the use  
            of mandatory overtime, to consider employees to fulfill the  
            additional staffing needs in a specified order of priority.

          9)Provides that the overtime prohibition does not apply in the  
            following situations:

             a)   To any nurse or CNA participating in a surgical  
               procedure, as specified; 

             b)   If a catastrophic event occurs in a facility where both  
               of the following apply:

               i)     The catastrophic event results in such a large  
                 number of patients in need of immediate medical treatment  
                 that the facility is incapable of providing sufficient  
                 nurses or CNAs to attend to the patients without  
                 resorting to mandatory overtime; and,

               ii)    The catastrophic event is an unanticipated and  
                 nonrecurring event.

             c)   If an emergency situation occurs.

          10)Specifies that nothing in these provisions shall be construed  
            to do any of the following:

             a)   Affect the Nursing Practice Act, the Vocational Nursing  
               Practice Act, or a registered nurse's duty under the  
               standards of competent performance.

             b)   Prevent the hiring of part-time or intermittent  
               employees.

             c)   Prevent a facility from providing more protections  
               against mandatory overtime than the minimum protections  
               established by this bill.

           The Senate amendments  add legislative intent language; define  
          and clarify various terms for purposes of the bill; establish a  
          priority order for the scheduling of nurses; delay the effective  
          date of bill's provisions until January 1, 2016; and, make other  
          technical and clarifying changes. 








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           EXISTING LAW  :

          1)Establishes, as the general policy of the state, the workweek  
            of state employees to be 40 hours, and the workday of state  
            employees eight hours, except that workweeks and workdays of a  
            different number of hours may be established in order to meet  
            the varying needs of the different state agencies. 

          2)States that it is the policy of the state to avoid the  
            necessity for overtime work whenever possible. This policy  
            does not restrict the extension of regular working-hour  
            schedules on an overtime basis in those activities and  
            agencies where it is necessary to carry on the state business  
            properly during a manpower shortage.

           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee:

          1)Net costs of approximately $1.2 million annually to the  
            Department of State Hospitals (General Fund).  Unknown  
            staffing costs annually to the Department of Corrections and  
            Rehabilitation and Department of Veteran Affairs (General  
            Fund).

          2)During 2013, the Department of State Hospitals mandated a  
            total of 53,973 overtime hours for registered nurses and  
            licensed vocational nurses.  The total cost of this overtime  
            pay calculated at the mid-step was $2.33 million.  It is  
            estimated that an additional 23.5 nurses and 3.9 LVN's would  
            need to be hired if mandatory overtime was eliminated at an  
            estimated cost of $3.5 million.  The actual cost would likely  
            be less since presumably some nurses would voluntarily accept  
            to work the overtime hours.

           COMMENTS  :  According to the author, "Mandatory overtime is the  
          practice of hospitals and health care institutions to maintain  
          adequate numbers of staff nurses through forced overtime,  
          usually with a total of 12 to 16 hours worked, and with as  
          little as one hour's notice.  This bill seeks to ban mandatory  
          overtime for public sector RNs, LVNs, and CNAs.  The use of  
          mandatory overtime for nurses in the private sector has been  
          banned since 2001 through wage orders from the Industrial  
          Welfare Commission.  State and public sector nurses were  
          exempted from this order".








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          "Mandatory overtime may cause or lead to increased stress on the  
          job, less patient comfort and mental and physical fatigue that  
          can contribute to errors and 'near-misses' with medications and  
          case-related procedures.  The practice of mandatory overtime  
          ignores the responsibilities nurses may have at home with  
          children, other family members, or other obligations.  Being  
          forced into excessive overtime can cause an exhausted RN to  
          practice unsafe patient care, jeopardizing her nursing licensure  
          status."

          According to information provided by the author, the states of  
          West Virginia, Illinois, Connecticut, Washington, Oregon, New  
          Jersey, Minnesota, Maine, Maryland, Alaska and Massachusetts all  
          have laws prohibiting the use of mandatory overtime as a general  
          staffing tool.

          The author concludes, "AB 2155 is needed to promote an optimum  
          quality of patient care, decrease potential workplace or health  
          and safety errors; and increase the ability of the state in its  
          recruitment and retention of nurses." 

          This bill is similar to AB 1184 (Koretz) of 2005, which was  
          vetoed by the Governor.  In his veto message, Governor  
          Schwarzenegger stated, in part:

               California is facing a nursing shortage and there are  
               not enough nurses and certified nursing assistants to  
               provide coverage in State hospitals and health care  
               facilities.  Because the State has difficulty  
               recruiting a sufficient number of these dedicated  
               professionals for its hospitals and other health care  
               facilities, the State relies on mandatory overtime  
               staff to meet minimum level-of-care staffing  
               requirements.  My administration has made the training  
               and recruitment of new nursing professionals a high  
               priority, with the added goal of filling vacant  
               nursing positions and reducing the resulting overtime  
               throughout state service.

               Additionally, the Ralph C. Dills Act requires that the  
               state employer and the exclusive representative of  
               rank-and-file state employees meet and confer in good  
               faith over employee wages, hours of work, and terms  
               and conditions of employment.  This bill would  








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               unilaterally establish provisions governing hours of  
               work for represented health care employees, thereby  
               circumventing the collective bargaining process and  
               the good faith collective bargaining agreements  
               negotiated between the parties.  If the State is to  
               have good faith collective bargaining, then wages,  
               hours and terms and conditions of employment must  
               remain subject to negotiation.

          There is no registered opposition to this bill.


           Analysis Prepared by  :    Karon Green / P.E., R. & S.S. / (916)  
          319-3957 


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