Washington 2023-2024 Regular Session Status: Enacted 14 D cosponsors

SB 5236 — Concerning hospital staffing standards.

Last action — Effective date 7/1/2024*.

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Senate
  4. ✓
    Passed House
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced January 10, 2023. Enacted.

Odds of enactment

High chance

Based on the sponsor, cosponsors, and committee posture, this bill has a high chance of becoming law.

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A statistical estimate from our own model of past outcomes — an insight, not a guarantee. Policymaking is volatile.

Prognosis

Likely to advance 82% · moderate confidence

  • Enacted

    Current position in the legislative process.

  • 15 sponsors

    1 primary, 14 co-sponsors signed on.

  • Single-party support

    Sponsorship is currently within one party (14 D).

  • Cleared a recorded vote

    Passed 2 recorded votes so far.

Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.

Bill Text

What changed in the latest version

765 added · 961 removed

Plain-language change summary

In the latest version of Bill SB 5236, the definition of "reasonable efforts" was modified. The new definition emphasizes that employers must actively seek additional staffing without indicating that chronic understaffing is an acceptable excuse for failing to do so. This change is significant because it ensures that employers are held accountable for making genuine attempts to meet staffing needs, potentially leading to better patient care and working conditions.

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S-1234.2 SUBSTITUTE SENATE BILL 5236 State of Washington 68th Legislature 2023 Regular Session By Senate Labor & Commerce (originally sponsored by Senators Robinson, Keiser, Conway, Frame, Hunt, Kauffman, Lovelett, Nguyen, Nobles, Pedersen, Shewmake, Stanford, Trudeau, Valdez, and C.
S-0505.1 SENATE BILL 5236 State of Washington 68th Legislature 2023 Regular Session By Senators Robinson, Keiser, Conway, Frame, Hunt, Kauffman, Lovelett, Nguyen, Nobles, Pedersen, Shewmake, Stanford, Trudeau, Valdez, and C.
Wilson) READ FIRST TIME 02/08/23.
Wilson Read first time 01/10/23.
Referred to Committee on Labor & Commerce.
1 SSB 5236 patient care.
1 SB 5236 patient care.
(((6))) (8)(a) "Reasonable efforts" means that the employer exhausts and documents all of the following but is unable to obtain staffing coverage:
(((6))) (8) "Reasonable efforts" means that the employer exhausts and documents all of the following but is unable to obtain staffing coverage:
(i) Seeks individuals to consent to work additional time from all available qualified staff who are working;
(a) Seeks individuals to consent to work extra time from all available qualified staff who are working;
2 SSB 5236 (ii) Contacts qualified employees who have made themselves available to work additional time;
2 SB 5236 (b) Contacts qualified employees who have made themselves available to work extra time;
(iii) Seeks the use of per diem staff;
(c) Seeks the use of per diem staff;
and (iv) Seeks personnel from a contracted temporary agency when such staffing is permitted by law or an applicable collective bargaining agreement, and when the employer regularly uses a contracted temporary agency.
and (d) Seeks personnel from a contracted temporary agency when such staffing is permitted by law or an applicable collective bargaining agreement, and when the employer regularly uses a contracted temporary agency.
(b) "Reasonable efforts" does not mean circumstances when an employer is chronically short staffed with vacancies that persist longer than 90 days or have frequently recurring absences.
(10)(a) "Unforeseeable emergent circumstance" means:
(10) "Unforeseeable emergent circumstance" means:
(i) Any unforeseen declared national, state, or municipal emergency;
(a) Any unforeseen declared national, state, or municipal emergency;
or (ii) When a hospital disaster plan is activated.
or (b) When a hospital disaster plan is activated.
(b) "Unforeseeable emergent circumstance" does not mean a declared national, state, or municipal emergency or when a health care facility disaster plan is activated, if the events persist longer than 90 days.
Hospital staffing committees must be comprised of:
If there is no ((applicable)) collective bargaining p.
If there is no ((applicable)) collective bargaining ((agreement)) representative, the members of the ((nurse)) hospital staffing committee who are ((registered nurses)) nursing and patient care staff providing direct patient care shall be selected by their peers.
3 SSB 5236 ((agreement)) representative, the members of the ((nurse)) hospital staffing committee who are ((registered nurses)) nursing and patient care staff providing direct patient care shall be selected by their peers.
(b) Up to 50 percent of the members of the hospital staffing committee shall be determined by the hospital administration and shall include but not be limited to the chief financial officer, the p.
(b) Up to 50 percent of the members of the hospital staffing committee shall be determined by the hospital administration and shall include but not be limited to the chief financial officer, the chief nursing officers, and patient care unit directors or managers or their designees.
3 SB 5236 chief nursing officers, and patient care unit directors or managers or their designees.
The hospital staffing committee shall use a uniform format or form, created by the department in consultation with the advisory committee established in section 6 of this act, for complying with the requirement to submit the annual staffing plan.
The hospital staffing committee shall use a uniform format or form, created by the department in consultation with stakeholders from hospitals and labor organizations, for complying with the requirement to submit the annual staffing plan.
The uniform format or form must allow for variations in service offerings, facility design, and other differences between hospitals, but must allow patients and the public to clearly understand and compare staffing plans.
The uniform format or form must provide space to include the factors considered under this section and allow patients and the public to clearly understand and compare staffing plans.
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(iv) Level of experience and specialty certification or training of nursing ((personnel)) and patient care staff providing care;
4 SSB 5236 (iv) Level of experience and specialty certification or training of nursing ((personnel)) and patient care staff providing care;
(vii) Staffing guidelines adopted or published by national nursing professional associations, specialty nursing organizations, and other health professional organizations;
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4 SB 5236 (vii) Staffing guidelines adopted or published by national nursing professional associations, specialty nursing organizations, and other health professional organizations;
and (c) Review, assessment, and response to staffing variations or ((concerns)) complaints presented to the committee.
(c) Review, assessment, and response to staffing variations or ((concerns)) complaints presented to the committee.
If this staffing plan is not adopted by 50 percent plus one vote of the hospital((, the)) staffing committee, the prior annual staffing plan remains in effect and the hospital is subject to daily fines of $5,000 for hospitals licensed under chapter 70.41 RCW or daily fines of $100 for:
If this staffing plan is not adopted by consensus of the hospital((, the)) staffing committee, the prior annual staffing plan remains in effect and the hospital is subject to daily fines of $5,000 for hospitals licensed under chapter 70.41 RCW or daily fines of $100 for:
have a level III adult trauma service p.
have a level III adult trauma service designation from the department of health as of January 1, 2014;
5 SSB 5236 designation from the department of health as of January 1, 2014;
(b) The chief executive officer or their designee shall provide ((a written explanation of the reasons why the plan was not adopted to the committee)) written feedback to the hospital staffing committee on a semiannual basis, prior to the committee's semiannual review and adoption of an annual staffing plan.
(b) The chief executive officer or their designee shall provide ((a written explanation of the reasons why the plan was not adopted p.
5 SB 5236 to the committee)) written feedback to the hospital staffing committee on a semiannual basis, prior to the committee's semiannual review and adoption of an annual staffing plan.
(c) ((Staffing)) Hospital staffing committees shall develop a process to examine and respond to data submitted under (a) and (b) of this subsection, including the ability to determine if a specific complaint is resolved or dismissing a complaint based on p.
(c) ((Staffing)) Hospital staffing committees shall develop a process to examine and respond to data submitted under (a) and (b) of this subsection, including the ability to determine if a specific complaint is resolved or dismissing a complaint based on unsubstantiated data.
6 SSB 5236 unsubstantiated data.
(d) In the event of an unforeseeable emergent circumstance, the hospital incident command shall report within 30 days to the cochairs of the hospital staffing committee an assessment of the staffing needs arising from the unforeseeable emergent circumstance and the hospital's plan to address those identified staffing needs.
(d) In the event of an unforeseeable emergent circumstance, the hospital incident command shall report within 30 days to the cochairs p.
6 SB 5236 of the hospital staffing committee an assessment of the staffing needs arising from the unforeseeable emergent circumstance and the hospital's plan to address those identified staffing needs.
(9) A hospital may not retaliate against or engage in any form of intimidation ((of)) or otherwise take any adverse action against:
(9) A hospital may not retaliate against or engage in any form of intimidation of:
(11) By January 1, 2025, the hospital staffing committee shall file with the department a charter that must include, but is not limited to:
(11) The hospital staffing committee shall file with the department a charter that must include, but is not limited to:
(a) A process for electing cochairs and their terms;
(a) Roles, responsibilities, and processes by which the hospital staffing committee functions, including processes to ensure adequate quorum and ability of committee members to attend;
(b) Roles, responsibilities, and processes by which the hospital staffing committee functions, including which job classes will be represented on the committee, how many members will serve on the p.
(b) Schedule for monthly meetings with more frequent meetings as needed that ensures committee members have 30 days' notice of meetings;
7 SSB 5236 committee, processes to ensure adequate quorum and ability of committee members to attend, and processes for replacing members who do not regularly attend;
(c) Processes by which all staffing complaints will be reviewed, investigated, and resolved, noting the date received as well as initial, contingent, and final disposition of complaints and corrective action plan where applicable;
(c) Schedule for monthly meetings with more frequent meetings as needed that ensures committee members have 30 days' notice of meetings;
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(d) Processes by which all staffing complaints will be reviewed, investigated, and resolved, noting the date received as well as initial, contingent, and final disposition of complaints and corrective action plan where applicable;
7 SB 5236 (d) Processes by which complaints will be resolved within 90 days of receipt, or longer with majority approval of the committee, and processes to ensure the complainant receives a letter stating the outcome of the complaint;
(e) Processes by which complaints will be resolved within 90 days of receipt, or longer with majority approval of the committee, and processes to ensure the complainant receives a letter stating the outcome of the complaint;
(e) Processes for attendance by any employee, and a labor representative if requested by the employee, who is involved in a complaint;
(f) Processes for attendance by any employee, and a labor representative if requested by the employee, who is involved in a complaint;
(f) Processes for the hospital staffing committee to conduct quarterly reviews of:
(g) Processes for the hospital staffing committee to conduct quarterly reviews of:
(h) Standards for hospital staffing committee approval of meeting documentation including meeting minutes, attendance, and actions taken;
(g) Standards for hospital staffing committee approval of meeting documentation including meeting minutes, attendance, and actions taken;
(i) Policies for retention of meeting documentation for a minimum of three years and consistent with each hospital's document retention policies;
(h) Policies for retention of meeting documentation for a minimum of three years and consistent with each hospital's document retention policies;
and (j) Processes for the hospital to provide the hospital staffing committee with information regarding patient complaints involving staffing made to the hospital through the patient grievance process required under 42 C.F.R.
and (i) Processes for the hospital to provide the hospital staffing committee with information regarding patient complaints involving staffing made to the hospital through the patient grievance process required under 42 C.F.R.
(12) The department must provide technical assistance to hospital staffing committees to assist with compliance with this section.
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(i) Form or establish a hospital staffing committee;
8 SSB 5236 (i) Form or establish a hospital staffing committee;
(((B) The department may only investigate a complaint under this subsection (1)(a)(iv) after making an assessment that the submitted evidence indicates a continuing pattern of unresolved violations of RCW 70.41.420(7) (a) or (b), that were submitted to the nurse staffing committee excluding complaints determined by the nurse staffing committee to be resolved or dismissed.
(((B) The department may only investigate a complaint under this subsection (1)(a)(iv) after making an assessment that the submitted evidence indicates a continuing pattern of unresolved violations of RCW 70.41.420(7) (a) or (b), that were submitted to the nurse p.
8 SB 5236 staffing committee excluding complaints determined by the nurse staffing committee to be resolved or dismissed.
(C) The department may not investigate a complaint under this subsection (1)(a)(iv) in the event of unforeseeable emergency circumstances or if the hospital, after consultation with the nurse staffing committee, documents it has made reasonable efforts to obtain staffing to meet required assignments but has been unable to do so.)) (b) The department may investigate and take appropriate enforcement action without any complaint if the department discovers information suggesting any violation of RCW 70.41.420 (as recodified by this act).
(C) The department may not investigate a complaint under this subsection (1)(a)(iv) in the event of unforeseeable emergency circumstances or if the hospital, after consultation with the nurse staffing committee, documents it has made reasonable efforts to obtain staffing to meet required assignments but has been unable to do so.)) (b) After an investigation conducted under (a) of this subsection, if the department determines that there has been a violation, the department shall require the hospital to submit a corrective plan of action within ((forty-five)) 45 days of the presentation of findings from the department to the hospital.
(c) After an investigation conducted under (a) of this subsection, if the department determines that there has been a violation, the department shall require the hospital to submit a corrective plan of action within ((forty-five)) 45 days of the presentation of findings from the department to the hospital.
(c) Hospitals will not be found in violation of RCW 70.41.420 (as recodified by this act) if it has been determined, following an investigation, that:
(d) Hospitals will not be found in violation of RCW 70.41.420 (as recodified by this act) if it has been determined, following an investigation, that:
(i) There were unforeseeable emergent circumstances and the process under (d) of this subsection has been followed, if applicable;
(i) There were unforeseeable emergent circumstances and the process under (e) of this subsection has been followed, if applicable;
or (ii) The hospital, after consultation with the hospital staffing committee, documents that the hospital has made reasonable efforts to obtain and retain staffing to meet required personnel assignments but has been unable to do so.
or p.
However, reasonable efforts cannot be used if the employer has chronic staff shortages that persist longer than three months or has frequently reoccurring staff shortages.
9 SSB 5236 (ii) The hospital, after consultation with the hospital staffing committee, documents that the hospital has made reasonable efforts to obtain and retain staffing to meet required personnel assignments but has been unable to do so.
(d) No later than 30 days after a hospital deviates from its staffing plan as adopted by the hospital staffing committee under RCW 70.41.420 (as recodified by this act), the hospital incident command shall report to the cochairs of the hospital staffing committee an assessment of the staffing needs arising from the unforeseeable emergent circumstance and the hospital's plan to address those identified staffing needs.
(e) No later than 30 days after a hospital deviates from its staffing plan as adopted by the hospital staffing committee under RCW 70.41.420 (as recodified by this act), the hospital incident command shall report to the cochairs of the hospital staffing committee an assessment of the staffing needs arising from the unforeseeable emergent circumstance and the hospital's plan to address those identified staffing needs.
The hospital's deviation from its staffing plan may not be in effect for more than 90 days without the approval of the hospital staffing committee.
The hospital's deviation from its staffing plan may not p.
9 SB 5236 be in effect for more than 90 days without the approval of the hospital staffing committee.
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(3) The department shall maintain for public inspection records of any civil penalties((,)) and administrative actions((, or license suspensions or revocations)) imposed on hospitals under this section.
10 SSB 5236 (3) The department shall maintain for public inspection records of any civil penalties((,)) and administrative actions((, or license suspensions or revocations)) imposed on hospitals under this section.
In addition, the department must report violations of this section on its website.
In addition, the department must post violations of this section on its website.
(5))) Nothing in this section shall be construed to preclude the ability to otherwise submit a complaint to the department for failure to follow RCW 70.41.420 (as recodified by this act).
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10 SB 5236 (5))) Nothing in this section shall be construed to preclude the ability to otherwise submit a complaint to the department for failure to follow RCW 70.41.420 (as recodified by this act).
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(b) "Direct care nursing assistant-certified" means an individual certified under chapter 18.88A RCW who provides direct care to patients.
11 SSB 5236 (b) "Direct care nursing assistant-certified" means an individual certified under chapter 18.88A RCW who provides direct care to patients.
(g) "Patient care unit" means any unit or area of the hospital that provides patient care by registered nurses, including but not limited to a critical care unit, burn unit, labor and delivery room, postanesthesia service area, emergency department, operating room, pediatric unit, step-down/intermediate care unit, specialty care unit, telemetry unit, general medical care unit, subacute care unit, and transitional inpatient care unit.
(g) "Patient care unit" means any unit or area of the hospital that provides patient care by registered nurses, including but not limited to a critical care unit, burn unit, labor and delivery room, postanesthesia service area, emergency department, operating room, p.
(h)(i) "Unforeseeable emergent circumstances" means:
11 SB 5236 pediatric unit, step-down/intermediate care unit, specialty care unit, telemetry unit, general medical care unit, subacute care unit, and transitional inpatient care unit.
(A) Any unforeseen declared national, state, or municipal emergency;
(h) "Unforeseeable emergent circumstances" means:
or (B) When a health care facility disaster plan is activated.
(i) Any unforeseen declared national, state, or municipal emergency;
(ii) "Unforeseeable emergent circumstance" does not mean a declared national, state, or municipal emergency or when a health care facility disaster plan is activated, if the events persist longer than 90 days.
or (ii) when a health care facility disaster plan is activated.
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(3)(a) A hospital shall comply with minimum staffing standards in accordance with this section no later than July 1, 2027.
12 SSB 5236 (3)(a) A hospital shall comply with minimum staffing standards in accordance with this section no later than July 1, 2027.
(b) The department shall enforce compliance with this section under sections 11 through 13 of this act.
(b) The department shall enforce compliance with this section under sections 12 through 14 of this act.
(5) The minimum staffing standards established in this section may not replace any more favorable nurse-to-patient staffing levels:
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(a) Established pursuant to a collective bargaining agreement;
12 SB 5236 (5) The staffing standards established in this section do not decrease any nurse-to-patient staffing levels:
or (b) Established under a hospital's staffing plan in effect as of January 1, 2022, unless a hospital staffing committee in full compliance with the standards under RCW 70.41.420 (as recodified by this act) takes a 50 percent plus one vote after January 1, 2027.
(a) In effect pursuant to a collective bargaining agreement;
or (b) Established under a hospital's staffing plan in effect as of January 1, 2022, except with a 50-percent-plus-one vote taken after January 1, 2027, by a hospital staffing committee in full compliance with the standards under RCW 70.41.420 (as recodified by this act).
(7) The department must adopt and implement rules to define variance and innovative hospital staffing and care delivery criteria.
(7) The department must adopt and implement rules to define variance criteria.
Requests for variances and innovative staffing and care delivery models to this section that do not jeopardize the health, safety, and well-being of patients affected and that are needed for increased operational efficiency may be granted by the department to hospitals in accordance with rules adopted by the department.
Requests for variances to this section that do not jeopardize the health, safety, and well-being of patients affected and that are needed for increased operational efficiency may be granted by the department to hospitals in accordance with rules adopted by the department.
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13 SSB 5236 (8) The director shall engage in negotiated rule making under RCW 34.05.310(2)(a) to adopt the rules required by this section.
The negotiated rule-making topics must include the nurse staffing ratios and the requirements for variances and innovative hospital staffing and care delivery models as required by this section.
(a) The department must convene a group of affected stakeholders to ensure balanced representation of individuals who have direct expertise in hospital staffing and working conditions and should reflect a diversity of hospital settings.
(b) The negotiated rule-making committee shall hold its first meeting by January 1, 2025.
(c) Membership of the negotiated rule-making committee must include:
(i) Six members representing hospitals and hospital systems and their alternates, selected from a list of nominees submitted by the Washington state hospital association;
(ii) Six members representing frontline hospital patient care staff and their alternates, selected from a list of nominees submitted by collective bargaining representatives of frontline hospital nursing staff;
(iii) A representative from the department, serving as a voting member;
(iv) A representative from the department of health, serving as a nonvoting ex officio member;
and (v) A representative from the Washington state institute for public policy, serving as a nonvoting ex officio member.
(d) Any list submitted to the department for the initial appointment of members pursuant to this subsection (8) must be provided by November 1, 2024.
(e) If any member of the negotiated rule-making committee is unable to continue to serve on the committee, the director must select a new member based on the recommendations of either the hospital association for members appointed under (c)(i) of this subsection (8) or the collective bargaining representative for members appointed under (c)(ii) of this subsection (8).
(f)(i) The negotiated rule-making committee shall discuss and propose rules on the topics required by this section and shall attempt to reach unanimous consensus on these matters.
(ii) If unanimous consensus cannot be reached, then a vote from the department and a two-thirds majority of the rest of the p.
14 SSB 5236 committee, with at least four votes from the members appointed pursuant to (c)(i) of this subsection (8) and at least four votes from members appointed pursuant to (c)(ii) of this subsection (8) is required to reach a consensus.
(iii) If a consensus is reached, the committee must provide the department with a report containing the proposed rule and the department must file proposed rules based on the consensus draft.
(iv) In the event the committee is unable to reach a consensus, the committee must provide a report on any topics in which there is agreement as well as details on the areas of disagreement to inform the department in their rule making.
The department must draft rules considering the information provided by the committee, the advisory committee established in section 6 of this act, the Washington institute for public policy, and any additional relevant information.
(g)(i) The department must provide administrative support for the negotiated rule making.
(ii) The department may hire a facilitator to chair the negotiated rule-making meetings, impartially assist the members of the committee in conducting discussions and negotiations, and manage the keeping of minutes and records.
(h) If changes or updates are needed to the rules adopted under this section, the department may conduct additional rule making as needed.
(1) The department must establish an advisory committee on hospital staffing by September 1, 2023.
(2) Appointments to the advisory committee on hospital staffing shall be made by the director.
Members of the committee must have expertise in hospital staffing and working conditions and should reflect a diversity of hospital settings.
The committee must include the following membership:
(a) Six members representing hospitals and hospital systems and their alternates, selected from a list of nominees submitted by the Washington state hospital association;
(b) Six members representing frontline hospital patient care staff and their alternates, selected from a list of nominees submitted by collective bargaining representatives of frontline hospital nursing staff;
and (c) A representative from the department of health, serving as a nonvoting ex officio member.
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15 SSB 5236 (3) Any list submitted to the department for the initial appointment under this section must be provided by July 1, 2023.
(4) If any member of the negotiated rule-making committee is unable to continue to serve on the committee the director shall select a new member based on the recommendations of either the hospital association for members appointed under subsection (2)(a) of this section or the collective bargaining representative for members appointed under subsection (2)(b) of this section.
(5) The advisory committee on hospital staffing shall meet at least once per month until the hospital staffing plan uniform form is developed.
(6) The advisory committee on hospital staffing shall advise the department on its development of the uniform hospital staffing plan form.
(7) At the discretion of the department, the advisory committee on hospital staffing may advise on any rule making undertaken by the department that is not covered by the negotiated rule-making committee established under section 5 of this act.
(8) The department shall provide any necessary documentation to the advisory committee on hospital staffing in advance of the meetings to discuss technical assistance so that the advisory committee may consider areas of needed information.
(9) After January 1, 2027, when the forms and rules are developed and effective, the advisory committee on hospital staffing may meet on a quarterly basis as needed, if it is determined by the department and committee members that such meetings are necessary.
(10) The advisory committee on hospital staffing may review and make recommendations on variances or innovative hospital staffing and care delivery models.
These recommendations are not final, the final determination of the variance or innovative hospital staffing and care delivery model approval lies solely with the department.
(11) The department must provide the advisory committee on hospital staffing with data on a quarterly basis related to compliance with this chapter, complaint filing and disposition trends, and reporting metrics on any approved variances and innovative hospital staffing and care delivery models.
(12) By December 1, 2023, the Washington state hospital association shall survey hospitals in Washington state and report to the advisory committee on hospital staffing on Washington hospitals' existing use of innovative hospital staffing and care delivery models p.
16 SSB 5236 including, but not limited to, integration of patient monitoring equipment, remote patient monitoring, team-based care models, apprenticeship and career ladder programs, and virtual or remote care delivery models, and any challenges with implementing the models.
(13) By December 1, 2024, the advisory committee on hospital staffing must review the report prepared by the Washington state institute for public policy as required by section 17 of this act.
NEW SECTION.
Sec.
7.
(a) Hospital staffing plans;
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13 SB 5236 (a) Hospital staffing plans;
(4) The department must apply the civil penalties described in this section and enforce any violation of this section using the procedures in sections 12 through 14 of this act and any applicable rules.
The department may also investigate and take appropriate enforcement action under sections 12 through 14 of this act without any complaint if the department discovers information suggesting any violation of this section.
8.
7.
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(1) An employer shall provide employees with meal and rest periods as required by law, subject to the following:
17 SSB 5236 (1) An employer shall provide employees with meal and rest periods as required by law, subject to the following:
If the employee is required to remain on duty during the combined meal and rest period, the time shall be paid.
If the employee is required to remain on duty during the combined meal p.
14 SB 5236 and rest period, the time shall be paid.
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(3) For purposes of this section, the following terms have the following meanings:
18 SSB 5236 (3) For purposes of this section, the following terms have the following meanings:
and (iii) Receives an hourly wage or is covered by a collective bargaining agreement ((;
and (iii) Receives an hourly wage or is covered by a collective bargaining agreement((;
9.
8.
(i) Is employed by a health care facility;
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15 SB 5236 (i) Is employed by a health care facility;
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(A) A licensed practical nurse or registered nurse licensed under chapter 18.79 RCW;
19 SSB 5236 (A) A licensed practical nurse or registered nurse licensed under chapter 18.79 RCW;
Have had less than one hundred fifty acute care licensed beds in fiscal year 2011;
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16 SB 5236 Have had less than one hundred fifty acute care licensed beds in fiscal year 2011;
or p.
or (v) Facilities owned and operated by the department of corrections or by a governing unit as defined in RCW 70.48.020 in a correctional institution as defined in RCW 9.94.049 that provide health care services.
20 SSB 5236 (v) Facilities owned and operated by the department of corrections or by a governing unit as defined in RCW 70.48.020 in a correctional institution as defined in RCW 9.94.049 that provide health care services.
(4) "Overtime" means ((the hours)) any of the following:
(4) "Overtime" means the hours worked in excess of an agreed upon, predetermined, regularly scheduled shift within a twenty-four hour period not to exceed twelve hours in a twenty-four hour period or eighty hours in a consecutive fourteen-day period.
(a) Hours worked in excess of an agreed upon, predetermined, regularly scheduled shift ((within a twenty-four hour period not to exceed twelve hours in a twenty-four hour period or eighty hours in a consecutive fourteen-day period));
(b) Hours worked in excess of 12 hours in a 24-hour period;
or (c) Hours worked in excess of 80 hours in a consecutive 14-day period.
(a) Seeks individuals to volunteer to work ((extra)) additional time from all available qualified staff who are working;
(a) Seeks individuals to volunteer to work extra time from all available qualified staff who are working;
(b) Contacts qualified employees who have made themselves available to work ((extra)) additional time;
(b) Contacts qualified employees who have made themselves available to work extra time;
(7)(a) "Unforeseeable emergent circumstance" means (((a))) (i) any unforeseen declared national, state, or municipal emergency;
(7) "Unforeseeable emergent circumstance" means (a) any unforeseen declared national, state, or municipal emergency;
(((b))) or (ii) when a health care facility disaster plan is activated((;
or (b) when a health care facility disaster plan is activated((;
or (c) any unforeseen disaster or other catastrophic event which substantially affects or increases the need for health care services)).
or (c) any p.
p.
17 SB 5236 unforeseen disaster or other catastrophic event which substantially affects or increases the need for health care services)).
21 SSB 5236 (b) "Unforeseeable emergent circumstance" does not mean a declared national, state, or municipal emergency or when a health care facility disaster plan is activated, if the events persist longer than 90 days.
10.
9.
(i) Mandatory prescheduled on-call time may not be used in lieu of scheduling employees to work regularly scheduled shifts when a staffing plan indicates the need for a scheduled shift unless the classification of the worker is not subject to an annual staffing plan;
(i) Mandatory prescheduled on-call time may not be used in lieu of scheduling employees to work regularly scheduled shifts when a staffing plan indicates the need for a scheduled shift;
An employer has not used reasonable efforts if overtime work is used to fill vacancies resulting from chronic staff shortages;
An employer has not used reasonable efforts if overtime work is used to fill vacancies resulting from chronic staff shortages that persist longer than three months or frequently reoccurring staff shortages;
(4) An employee accepting overtime who works more than twelve consecutive hours shall be provided the option to have at least eight consecutive hours of uninterrupted time off from work following the time worked.
22 SSB 5236 (4) An employee accepting overtime who works more than twelve consecutive hours shall be provided the option to have at least eight consecutive hours of uninterrupted time off from work following the time worked.
18 SB 5236 Sec.
Sec.
10.
11.
The department of labor and industries shall investigate complaints of violations of RCW 49.28.140 (as recodified by this act) as provided under sections 12 through 14 of this act.
The department of labor and industries shall investigate complaints of violations of RCW 49.28.140 (as recodified by this act) as provided under sections 11 through 13 of this act.
12.
11.
(2) If the department of labor and industry's investigation finds that the complainant's allegation cannot be substantiated, the department shall issue a closure letter to the complainant and the employer detailing such finding.
23 SSB 5236 (2) If the department of labor and industry's investigation finds that the complainant's allegation cannot be substantiated, the department shall issue a closure letter to the complainant and the employer detailing such finding.
19 SB 5236 (3)(a) If the department of labor and industries finds a violation of this chapter, the department shall order the employer to pay the department a civil penalty.
(3)(a) If the department of labor and industries finds a violation of this chapter, the department shall order the employer to pay the department a civil penalty.
13.
12.
Any p.
Any party who seeks to challenge an initial order shall file a petition for administrative review with the director within 30 days after service of the initial order.
24 SSB 5236 party who seeks to challenge an initial order shall file a petition for administrative review with the director within 30 days after service of the initial order.
(4) The director of the department of labor and industries shall issue all final orders after appeal of the initial order.
p.
20 SB 5236 (4) The director of the department of labor and industries shall issue all final orders after appeal of the initial order.
14.
13.
15.
14.
15.
2017 c 249 s 4 (uncodified) is repealed.
NEW SECTION.
Sec.
The department may contract with consultants to support administration of its responsibilities under this chapter.
Sections 5, 6, and 11 through 14 of this act constitute a new chapter in Title 49 RCW.
The department may not contract with any entity that has financial interests that may create a potential conflict of interest.
The Washington state institute for public policy shall conduct a study on hospital staffing standards for direct care registered nurses and direct care nursing assistants.
RCW 70.41.410, 70.41.420, and 70.41.425 are each recodified as sections in chapter 49.--- RCW (the new chapter created in section 16 of this act).
(1) The institute must review current and historical staffing plans filed with the department of health under chapter 70.41 RCW and describe:
(a) Timeliness and completeness of filed forms;
(b) Format of filed forms;
p.
25 SSB 5236 (c) Staffing ratios related to the maximum number of patients to which a direct care nursing or nursing assistant may be assigned;
(d) Descriptive statistics on submissions by hospital unit type;
(e) Trends over time, if any;
(f) Legal minimum staffing standards for registered nurses and nursing assistants in other jurisdictions;
and (g) Relevant professional association guidance, recommendations, or best practices.
(2) The institute must provide a report on its findings to the department and relevant committees of the legislature by June 30, 2024.
(3) In addition to the report, the institute must participate on the negotiated rule-making committee established under section 5 of this act and provide consultation to help inform the negotiated rule- making committee's work.
2017 c 249 s 4 (uncodified) is repealed.
RCW 49.12.480, 49.28.130, 49.28.140, and 49.28.150 are each recodified as sections in chapter 49.--- RCW (the new chapter created in section 16 of this act).
Sections 5 through 7 and 12 through 17 of this act constitute a new chapter in Title 49 RCW.
Except for section 15 of this act, this act takes effect January 1, 2024.
RCW 70.41.410, 70.41.420, and 70.41.425 are each recodified as sections in chapter 49.--- RCW (the new chapter created in section 19 of this act).
Section 15 of this act is necessary for the immediate preservation of the public peace, health, or safety, or p.
NEW SECTION.
21 SB 5236 support of the state government and its existing public institutions, and takes effect June 1, 2023.
Sec.
21.
RCW 49.12.480, 49.28.130, 49.28.140, and 49.28.150 are each recodified as sections in chapter 49.--- RCW (the new chapter created in section 19 of this act).
NEW SECTION.
Sec.
22.
Except for section 18 of this act, this act takes effect July 1, 2024.
NEW SECTION.
Sec.
23.
Section 18 of this act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect June 1, 2023.
26 SSB 5236
22 SB 5236
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Action History

  1. Effective date 7/1/2024*.

  2. Chapter 114, 2023 Laws.

  3. Governor signed.

  4. Delivered to Governor.

  5. Speaker signed.

  6. President signed.

  7. Third reading, passed; yeas, 92; nays, 6; absent, 0; excused, 0.

  8. Rules suspended. Placed on Third Reading.

  9. Rules Committee relieved of further consideration. Placed on second reading.

  10. Referred to Rules 2 Review.

  11. Minority; without recommendation.

  12. APP - Majority; do pass.

  13. Executive action taken in the House Committee on Appropriations at 1:30 PM.

  14. Public hearing in the House Committee on Appropriations at 1:30 PM.

  15. Referred to Appropriations.

  16. LAWS - Majority; do pass.

  17. Executive action taken in the House Committee on Labor & Workplace Standards at 10:30 AM.

  18. Public hearing in the House Committee on Labor & Workplace Standards at 8:00 AM.

  19. First reading, referred to Labor & Workplace Standards.

  20. Third reading, passed; yeas, 35; nays, 13; absent, 0; excused, 1.

  21. Rules suspended. Placed on Third Reading.

  22. Floor amendment(s) adopted.

  23. 2nd substitute bill substituted (WM 23).

  24. Placed on second reading by Rules Committee.

  25. Passed to Rules Committee for second reading.

  26. Minority; without recommendation.

  27. Minority; do not pass.

  28. WM - Majority; 2nd substitute bill be substituted, do pass.

  29. Executive action taken in the Senate Committee on Ways & Means at 9:00 AM.

  30. Public hearing in the Senate Committee on Ways & Means at 4:00 PM.

  31. Referred to Ways & Means.

  32. Minority; do not pass.

  33. And refer to Ways & Means.

  34. LC - Majority; 1st substitute bill be substituted, do pass.

  35. Executive action taken in the Senate Committee on Labor & Commerce at 10:30 AM.

  36. Public hearing in the Senate Committee on Labor & Commerce at 10:30 AM.

  37. First reading, referred to Labor & Commerce.

Sponsors

Sponsorship breakdown

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1 sponsors · 14 co-sponsors · 136 not signed on · 17 voted No

Sponsors (1)

Co-sponsors (14)

Not signed on (136)

136 members have not signed on to this bill.

Show all 136 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

3rd Reading & Final Passage (#7)

Passed 92 Yea · 6 Nay
Party YeaNayPresentNot Voting
Republican 24600
Democrat 57000
Unaffiliated 11000
Total 92600
% of votes cast 94%6%0%0%
How each member voted (98)
Member Party Vote
Chambers — Yea
Chandler — Yea
Cheney — Yea
Chopp — Yea
Hutchins — Yea
Kretz — Yea
Maycumber — Yea
Mosbrucker — Yea
Robertson — Yea
Sandlin — Yea
Wilcox — Yea
Alex Ramel Democrat Yea
Alicia Rule Democrat Yea
Amy Walen Democrat Yea
April Berg Democrat Yea
Beth Doglio Democrat Yea
Bill Ramos Democrat Yea
Brandy Donaghy Democrat Yea
Chipalo Street Democrat Yea
Chris Stearns Democrat Yea
Cindy Ryu Democrat Yea
Clyde Shavers Democrat Yea
Dan Bronoske Democrat Yea
Darya Farivar Democrat Yea
Dave Paul Democrat Yea
David Hackney Democrat Yea
Davina Duerr Democrat Yea
Debra Entenman Democrat Yea
Debra Lekanoff Democrat Yea
Drew Hansen Democrat Yea
Emily Alvarado Democrat Yea
Gerry Pollet Democrat Yea
Jake Fey Democrat Yea
Jamila Taylor Democrat Yea
Jessica Bateman Democrat Yea
Joe Fitzgibbon Democrat Yea
Joe Timmons Democrat Yea
Julia Reed Democrat Yea
Julio Cortes Democrat Yea
Kristine Reeves Democrat Yea
Larry Springer Democrat Yea
Lauren Davis Democrat Yea
Laurie Jinkins Democrat Yea
Lillian Ortiz-Self Democrat Yea
Lisa Callan Democrat Yea
Liz Berry Democrat Yea
Marcus Riccelli Democrat Yea
Mari Leavitt Democrat Yea
Mary Fosse Democrat Yea
Melanie Morgan Democrat Yea
Mia Gregerson Democrat Yea
Mike Chapman Democrat Yea
Monica Jurado Stonier Democrat Yea
My-Linh Thai Democrat Yea
Nicole Macri Democrat Yea
Roger Goodman Democrat Yea
Sharlett Mena Democrat Yea
Sharon Tomiko Santos Democrat Yea
Sharon Wylie Democrat Yea
Shelley Kloba Democrat Yea
Steve Bergquist Democrat Yea
Steve Tharinger Democrat Yea
Strom Peterson Democrat Yea
Tana Senn Democrat Yea
Tarra Simmons Democrat Yea
Timm Ormsby Democrat Yea
Tina Orwall Democrat Yea
Vandana Slatter Democrat Yea
Alex Ybarra Republican Yea
Andrew Barkis Republican Yea
April Connors Republican Yea
Carolyn Eslick Republican Yea
Chris Corry Republican Yea
Cyndy Jacobsen Republican Yea
Dan Griffey Republican Yea
Drew Stokesbary Republican Yea
Ed Orcutt Republican Nay
Jenny Graham Republican Yea
Jim Walsh Republican Nay
Joe Schmick Republican Nay
Joel McEntire Republican Nay
Keith Goehner Republican Yea
Kevin Waters Republican Yea
Leonard Christian Republican Yea
Mark Klicker Republican Yea
Mary Dye Republican Nay
Michelle Valdez Republican Yea
Mike Steele Republican Yea
Mike Volz Republican Yea
Paul Harris Republican Yea
Peter Abbarno Republican Yea
Sam Low Republican Yea
Skyler Rude Republican Yea
Stephanie Barnard Republican Yea
Stephanie McClintock Republican Yea
Suzanne Schmidt Republican Yea
Tom Dent Republican Nay
Travis Couture Republican Yea

Official roll call →

3rd Reading & Final Passage (#22)

Passed 35 Yea · 13 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 7400
Republican 7900
Democrat 21001
Total 351301
% of votes cast 71%27%0%2%
How each member voted (49)
Member Party Vote
Billig — Yea
Hawkins — Nay
Keiser — Yea
Kuderer — Yea
Mullet — Yea
Padden — Nay
Randall — Yea
Rivers — Yea
Rolfes — Yea
Van De Wege — Nay
Wilson, L. — Nay
Annette Cleveland Democrat Yea
Bob Hasegawa Democrat Yea
Claire Wilson Democrat Yea
Claudia Kauffman Democrat Yea
Derek Stanford Democrat Yea
Jamie Pedersen Democrat Yea
Javier Valdez Democrat Yea
Jesse Salomon Democrat Yea
Joe Nguyen Democrat Yea
John Lovick Democrat Yea
June Robinson Democrat Yea
Lisa Wellman Democrat Yea
Liz Lovelett Democrat Yea
Manka Dhingra Democrat Yea
Marko Liias Democrat Not Voting
Noel Frame Democrat Yea
Rebecca Saldaña Democrat Yea
Sharon Shewmake Democrat Yea
Steve Conway Democrat Yea
T'wina Nobles Democrat Yea
Victoria Hunt Democrat Yea
Yasmin Trudeau Democrat Yea
Chris Gildon Republican Yea
Curtis King Republican Yea
Drew MacEwen Republican Nay
Jeff Holy Republican Yea
Jeff Wilson Republican Yea
Jim McCune Republican Nay
John Braun Republican Nay
Judy Warnick Republican Nay
Keith Wagoner Republican Nay
Mark Schoesler Republican Nay
Matt Boehnke Republican Yea
Nikki Torres Republican Yea
Perry Dozier Republican Nay
Phil Fortunato Republican Nay
Ron Muzzall Republican Yea
Shelly Short Republican Nay

Official roll call →

Subjects

healthcare labor
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

Who sponsors SB 5236?
SB 5236 is sponsored by Claire Wilson (Democrat), Javier Valdez (Democrat), Yasmin Trudeau (Democrat), Derek Stanford (Democrat), Sharon Shewmake (Democrat), Jamie Pedersen (Democrat), T'wina Nobles (Democrat), Liz Lovelett (Democrat), Claudia Kauffman (Democrat), Noel Frame (Democrat), Steve Conway (Democrat), Keiser, June Robinson (Democrat), Victoria Hunt (Democrat), and Joe Nguyen (Democrat).
What is the current status of SB 5236?
This bill has been enacted into law. Introduced January 10, 2023. Enacted.
Where can I track SB 5236?
Track SB 5236 free on One Click Politics — get push/email alerts when it moves.

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