House Bill 1155, granting uninterrupted breaks and mandatory overtime limitations to health care employees, has passed in the state Senate but the work to turn the bill into law isn’t over yet.
After a committee meeting with representatives from the House and the Senate, a version of the bill without the Senate’s previous amendments will appear before both chambers for a simple majority vote.
On April 16, the Washington State Senate debated the bill, passing two impactful amendments before final passage of the bill itself. HB 1155 was amended to exempt Critical Access Hospitals, rural facilities with less than 25 acute care beds, from the uninterrupted breaks granted by the base legislation. A further amendment was passed to limit nurse shifts to 8-hours per day.
The state House responded to the Senate’s bill on Monday, April 22. The House refused to concur with the amendments made by the Senate and have asked the Senate for a conference on the matter. Representatives Eileen Cody, Gina Mosbrucker and Mike Sells were appointed to the Conference Committee to meet with Senate representatives.
Critical Access Hospitals being exempt from the bill drew division in the Senate, with supporters of the amendment stating that the exemption would protect those designated rural hospitals from further financial strain. With mandatory uninterrupted rest breaks, hospitals may need to hire additional nursing staff, which supporters of the amendment say would drive up costs.
Opponents of the amendment were adamant that the language in the bill apply across all hospitals in the state and that nurse fatigue and workload are not less demanding in rural areas than they are at larger hospitals. Sen. Manka Dhingra also noted that the other 17 states that do have the rest break and overtime protections in place do not exempt any class of hospital from the regulations.
The exemption for Critical Access Hospitals passed and a second amendment limiting shifts to eight hour at maximum was also introduced and passed. Senators in support justified their decision to vote for the amendment as a way to address fatigue and prevent nurses from burning out due to extensive overtime. Despite comment from opponents of the amendment who said the change in shift length does not fit within the current industry standard of 12-hour shifts, the amendment passed.
After the Senate passed the amended bill, both the nurses unions and the Washington State Hospital Association voiced opposition to the 8-hour restriction. The primary reason behind both groups oppositions surround nurse hand off of patient care. The restriction is seen as a possible point from which errors and reduction in patient care could stem.
Having two nurses hand off patients between 12-hour shifts, covering a full 24-hour period, has become the standard in hospitals. Nurses work with the patients’ needs and communicate the important information to the person taking over for their shift. With shorter shifts, a third nurse would need to be take on patient care each day, introducing two more instances where information and care would need to be juggled between nurses. The amendment also restricts nurses from voluntary overtime work as well.
On Tuesday, April 23, the Senate granted the request of the House for a conference and appointed Senators Dhingra, Curtis King and Kevin Van De Wege. The committees met on Tuesday night and agreed that the base bill, without the two senate amendments would go back to both chambers for a simple majority vote. The only change is the returning bill would include a two-year delay for Critical Access Hospitals.
If HB 1155 becomes law, Critical Access Hospitals and certified Sole Community Hospitals will receive the rest break and overtime provisions beginning on July 1, 2021.