A. 8623 2
HEALTH CARE SERVICES WHICH IS OPERATED AND LICENSED PURSUANT TO THE
MENTAL HYGIENE LAW, THE EDUCATION LAW, THE CORRECTION LAW OR SECTION
FIVE HUNDRED FOUR OF THE EXECUTIVE LAW AND WHICH REQUIRES TWO OR MORE
REGISTERED NURSES OR LICENSED PRACTICAL NURSES TO BE PRESENT WITHIN THE
FACILITY AT ANY GIVEN TIME shall establish and maintain a clinical
staffing committee, either by creating a new committee or assigning the
functions of the clinical staffing committee to an existing committee,
no later than January first, two thousand twenty-two.
(b) Where a collective bargaining agreement provides for a staffing
committee, the required functions of the clinical staffing committee
established pursuant to this section shall be incorporated into that
committee. Any staffing or non-staffing committees established by a
collective bargaining agreement, shall continue to function in accord-
ance with the terms of the agreement, and the clinical staffing commit-
tee established by this section shall not limit or otherwise supplant
the collective bargaining agreement.
(c) At least one-half of the members of the clinical staffing commit-
tee shall be registered nurses, licensed practical nurses, and ancillary
members of the frontline team currently providing or supporting direct
patient care and up to one-half of the members shall be selected by the
general hospital administration OR THE ADMINISTRATION REPRESENTING A
STATE-OPERATED FACILITY THAT DELIVERS HEALTH CARE SERVICES and shall
include but not be limited to the chief financial officer, the chief
nursing officer, and patient care unit directors or managers or their
designees. The selection of the registered nurses, licensed practical
nurses, and ancillary frontline team members of the committee shall be
according to their respective collective bargaining agreements if there
is one in effect at the general hospital OR STATE-OPERATED FACILITY
DELIVERING HEALTH CARE SERVICES for their bargaining unit. If there is
no applicable collective bargaining agreement, the members of the clin-
ical staffing committee who are registered nurses, licensed practical
nurses, and ancillary members providing direct patient care shall be
selected by their peers. Ancillary members of the frontline team on the
committee shall include but are not limited to patient care technicians,
certified nursing assistants, other non-licensed staff assisting with
nursing or clerical tasks, and unit clerks.
3. Employee participation. Participation in the clinical staffing
committee by a general hospital employee OR AN EMPLOYEE OF THE STATE-OP-
ERATED FACILITY THAT DELIVERS HEALTH CARE SERVICES shall be on scheduled
work time and compensated at the appropriate rate of pay. Clinical
staffing committee members shall be fully relieved of all other work
duties during meetings of the committee and shall not have work duties
added or displaced to other times as a result of their committee respon-
sibilities.
4. Primary responsibilities. Primary responsibilities of the clinical
staffing committee shall include the following functions:
(a) Development and oversight of implementation of an annual clinical
staffing plan. The clinical staffing plan shall include specific staff-
ing for each patient care unit and work shift and shall be based on the
needs of patients. Staffing plans shall include specific guidelines or
ratios, matrices, or grids indicating how many patients are assigned to
each registered nurse and the number of nurses and ancillary staff to be
present on each unit and shift and shall be used as the primary compo-
nent of the general hospital OR STATE-OPERATED FACILITY DELIVERING
HEALTH CARE SERVICES staffing budget.
A. 8623 3
(b) Factors to be considered and incorporated in the development of
the plan shall include, but are not limited to:
(i) Census, including total numbers of patients on the unit on each
shift and activity such as patient discharges, admissions, and trans-
fers;
(ii) Measures of acuity and intensity of all patients and nature of
the care to be delivered on each unit and shift;
(iii) Skill mix;
(iv) The availability, level of experience, and specialty certif-
ication or training of nursing personnel providing patient care, includ-
ing charge nurses, on each unit and shift;
(v) The need for specialized or intensive equipment;
(vi) The architecture and geography of the patient care unit, includ-
ing but not limited to placement of patient rooms, treatment areas,
nursing stations, medication preparation areas, and equipment;
(vii) Mechanisms and procedures to provide for one-to-one patient
observation, when needed, for patients on psychiatric or other units as
appropriate;
(viii) Other special characteristics of the unit or community patient
population, including age, cultural and linguistic diversity and needs,
functional ability, communication skills, and other relevant social or
socio-economic factors;
(ix) Measures to increase worker and patient safety, which could
include measures to improve patient throughput;
(x) Staffing guidelines adopted or published by other states or local
jurisdictions, national nursing professional associations, specialty
nursing organizations, and other health professional organizations;
(xi) Availability of other personnel supporting nursing services on
the unit;
(xii) Waiver of plan requirements in the case of unforeseeable emer-
gency circumstances as defined in subdivision fourteen of this section;
(xiii) Coverage to enable registered nurses, licensed practical nurs-
es, and ancillary staff to take meal and rest breaks, planned time off,
and unplanned absences that are reasonably foreseeable as required by
law or the terms of an applicable collective bargaining agreement, if
any, between the general hospital OR STATE-OPERATED FACILITY THAT DELIV-
ERS HEALTH CARE SERVICES and a representative of the nursing or ancil-
lary staff;
(xiv) The nursing quality indicators required under subdivision seven-
teen of this section;
(xv) General hospital OR STATE-OPERATED FACILITY THAT DELIVERS HEALTH
CARE SERVICES finances and resources; and
(xvi) Provisions for limited short-term adjustments made by appropri-
ate general hospital OR STATE-OPERATED FACILITY THAT DELIVERS HEALTH
CARE SERVICES personnel overseeing patient care operations to the staff-
ing levels required by the plan, necessary to account for unexpected
changes in circumstances that are to be of limited duration.
(c) Semiannual review of the staffing plan against patient needs and
known evidence-based staffing information, including the nursing sensi-
tive quality indicators collected by the general hospital OR STATE-OPER-
ATED FACILITY THAT DELIVERS HEALTH CARE SERVICES.
(d) Review, assessment, and response to complaints regarding potential
violations of the adopted staffing plan, staffing variations, or other
concerns regarding the implementation of the staffing plan and within
the purview of the committee.
A. 8623 4
5. Compliance provisions. (a) The clinical staffing plan shall comply
with all federal and state laws and regulations and shall not diminish
other standards contained in state or federal law and regulations, or
the terms of an applicable collective bargaining agreement, if any.
(b) The clinical staffing plan shall comply with applicable laws and
regulations, including, but not limited to:
(i) Regulations made by the department on burn unit staffing, liver
transplant staffing, and operating room circulating nurse staffing;
(ii) Staffing regulations to be promulgated by the commissioner relat-
ing to staffing in intensive care and critical care units no later than
January first, two thousand twenty-two. Such regulations shall consider
the factors set forth in paragraph (b) of subdivision four of this
section, standards in place in neighboring states, and a minimum stand-
ard of twelve hours of registered nurse care per patient per day;
(iii) Such other staffing standards or regulations as are currently in
effect or may hereafter be established by the department or enacted by
the legislature; and
(iv) The provisions of section one hundred sixty-seven of the labor
law and any related regulations.
(c) The clinical staffing plan shall comply with and incorporate any
minimum staffing levels provided for in any applicable collective
bargaining agreement, including but not limited to nurse-to-patient
ratios, caregiver-to-patient ratios, staffing grids, staffing matrices,
or other staffing provisions.
6. Process for adoption of clinical staffing plans. (a) The clinical
staffing committee shall produce the general hospital's OR STATE-OPERAT-
ED FACILITY THAT DELIVERS HEALTH CARE SERVICE'S annual clinical staffing
plan by July first of each year.
(b) Clinical staffing plans shall be developed and adopted by consen-
sus of the clinical staffing committee. For the purposes of determining
whether there is a consensus, the management members of the committee
shall have one vote and the employee members of the committee shall have
one vote, regardless of the actual number of members of the committee.
Each side may determine its own method of casting its vote to adopt all
or part of the clinical staffing plan.
(c) The general hospital OR STATE-OPERATED FACILITY THAT DELIVERS
HEALTH CARE SERVICES shall adopt any clinical staffing plan that is
wholly or partially recommended by a consensus of the clinical staffing
committee. If there is no consensus on the recommended staffing plan or
any of its parts, the chief executive officer of the general hospital OR
STATE-OPERATED FACILITY THAT DELIVERS HEALTH CARE SERVICES shall use the
officer's discretion to adopt a plan or partial plan for which there is
no consensus. In this case, the chief executive officer shall provide a
written explanation of the elements of the clinical staffing plan that
the committee was unable to agree on, including the final written
proposals from the two parties and their rationales. In no event may a
chief executive officer fail to include in the adopted plan any staffing
related terms and conditions of the plan that has previously been
adopted through any applicable collective bargaining agreement.
(d) Each general hospital OR STATE-OPERATED FACILITY THAT DELIVERS
HEALTH CARE SERVICES shall adopt and submit its first hospital clinical
staffing plan under this section to the department no later than July
first, two thousand twenty-two and annually thereafter. The plan submit-
ted to the department shall, where applicable, include the written
explanation from the chief executive officer and written proposals from
the two parties regarding elements that the committee did not agree on
A. 8623 5
as required in paragraph (c) of this subdivision. The submitted clinical
staffing plan shall include data, from at least the previous year, on
the frequency and duration of variations from the adopted clinical
staffing plan, the number of complaints relating to the clinical staff-
ing plan and their disposition, as well as descriptions of unresolved
complaints submitted pursuant to paragraph (b) of subdivision seven of
this section. The department shall post the plan as part of each indi-
vidual general hospital's OR STATE-OPERATED FACILITY'S health profile on
the website of the department, IF APPLICABLE, no later than July thir-
ty-first of each year. If the adopted clinical staffing plan is subse-
quently amended, the amended plan shall be submitted to the department
within thirty days of adoption. Adopted staffing plans shall be amended
to include newly created units and existing units that undergo clinical
or programmatic changes that fundamentally alter their character or
nature. The department shall post amended staffing plans upon receipt.
7. Implementation of clinical staffing plans. (a) Beginning January
first, two thousand twenty-three, and annually thereafter, each general
hospital OR STATE-OPERATED FACILITY THAT DELIVERS HEALTH CARE SERVICES
shall implement the clinical staffing plan adopted by July first of the
prior calendar year, and any subsequent amendments, and assign personnel
to each patient care unit in accordance with the plan.
(b) A registered nurse, licensed practical nurse, ancillary member of
the frontline team, or collective bargaining representative may report
to the clinical staffing committee any variations where the personnel
assignment in a patient care unit is not in accordance with the adopted
staffing plan and may make a complaint to the committee based on the
variations.
(c) The clinical staffing committee shall develop a process to exam-
ine, respond to, and track data submitted under paragraph (b) of this
subdivision. The clinical staffing committee may by consensus, as
described in paragraph (b) of subdivision six of this section, determine
a complaint resolved or dismissed. The clinical staffing committee shall
also establish agreed upon rules and criteria to provide for confiden-
tiality of complaints that are in the process of being examined or are
found to be unsubstantiated. This subdivision does not infringe upon or
limit the rights of any collective bargaining representative of employ-
ees, or of any employee or group of employees pursuant to applicable
law, including without limitation any applicable state or federal labor
laws.
8. Posting of staffing information. Each general hospital AND EACH
STATE-OPERATED FACILITY DELIVERING HEALTH CARE SERVICES shall post, in a
publicly conspicuous area on each patient care unit, the clinical staff-
ing plan for that unit and the actual daily staffing for that shift on
that unit as well as the relevant clinical staffing.
9. Retaliation and intimidation prohibited. A general hospital OR
STATE-OPERATED FACILITY THAT DELIVERS HEALTH CARE SERVICES shall not
retaliate against or engage in any form of intimidation of:
(a) An employee for performing any duties or responsibilities in
connection with the clinical staffing committee; or
(b) An employee, patient, or other individual who notifies the clin-
ical staffing committee or the hospital OR FACILITY administration of
the individual's staffing concerns.
10. Special considerations. Nothing in this section is intended to
create unreasonable burdens on critical access hospitals under 42 U.S.C.
Sec. 1395i-4 and sole community hospitals under 42 U.S.C. Sec.
1395ww(d)(5) related to the operation of their clinical staffing commit-
A. 8623 6
tees. Critical access and sole community hospitals may develop flexible
approaches to accomplish the requirements of this section. Clinical
staffing plans from such entities submitted to the department shall
contain a description of any ways in which the general hospital's OR
STATE-OPERATED FACILITY'S approach to creating the plan differed from
the process outlined in this section. This subdivision does not relieve
such entities from compliance with other provisions of this section
related to the adoption, implementation and adherence to an adopted
clinical staffing plan, reporting and disclosure, or other requirements
of this section.
11. Investigations. (a) The department shall investigate potential
violations of this section following receipt of a complaint with
supporting evidence, of failure to:
(i) Form or establish a clinical staffing committee;
(ii) Comply with the requirements of this section in creating a clin-
ical staffing plan;
(iii) Adopt all or part of a clinical staffing plan that is approved
by consensus of the clinical staffing committee and submitted to the
department;
(iv) Conduct a semiannual review of a clinical staffing plan; or
(v) Submit to the department a clinical staffing plan on an annual
basis and any updates.
(b) The department shall initiate an investigation of unresolved
complaints, that have first been submitted to the clinical staffing
committee, regarding compliance with the clinical staffing plan, person-
nel assignments in a patient care unit or staffing levels, or any other
requirement of the adopted clinical staffing plan, excluding complaints
determined by the clinical staffing committee to be resolved or
dismissed as determined by consensus of the clinical staffing committee
as described in paragraph (b) of subdivision six of this section.
(c) The department shall initiate an investigation after making an
assessment that there is a pattern of failure to resolve complaints
submitted to the clinical staffing committee or a pattern of failure to
reach consensus on the adoption of all or part of a clinical staffing
plan. In the case of a pattern of failure to resolve complaints or to
reach consensus on the adoption of all or part of a clinical staffing
plan, the department shall determine if the pattern was due to one of
the parties routinely refusing to resolve complaints or reach consensus.
(d) Any department investigation of a complaint under this subdivision
shall consider whether unforeseeable emergency circumstances as defined
in subdivision fourteen of this section contributed to the failure of
the general hospital OR STATE-OPERATED FACILITY THAT DELIVERS HEALTH
CARE SERVICES to comply with this section.
(e) After an investigation conducted under paragraph (a) or (b) of
this subdivision, if the department determines that there has been a
violation, the department shall require the general hospital OR STATE-
OPERATED FACILITY THAT DELIVERS HEALTH CARE SERVICES to submit a correc-
tive plan of action within forty-five days of the presentation of find-
ings from the department to the hospital OR STATE-OPERATED FACILITY. If
the department determines after investigation under paragraph (c) of
this subdivision that the general hospital representatives on the clin-
ical staffing committee were responsible for a pattern of not resolving
complaints or for a pattern of not reaching consensus, the department
shall require the general hospital to submit a corrective action plan
within forty-five days of the presentation of findings to the general
hospital OR STATE-OPERATED FACILITY THAT DELIVERS HEALTH CARE SERVICES.
A. 8623 7
If the department finds that the frontline staff representatives on the
clinical staffing committee were responsible for a pattern of not
resolving complaints or for a pattern of not reaching consensus, the
department shall not require the general hospital OR STATE-OPERATED
FACILITY THAT DELIVERS HEALTH CARE SERVICES to submit a corrective
action plan or impose a civil penalty on the general hospital OR STATE-
OPERATED FACILITY THAT DELIVERS HEALTH CARE SERVICES pursuant to subdi-
vision twelve of this section.
12. Civil penalties. In the event that a general hospital OR STATE-OP-
ERATED FACILITY THAT DELIVERS HEALTH CARE SERVICES fails to submit or
submits but fails to implement a corrective action plan in response to a
violation or violations found by the department based on a complaint
filed pursuant to paragraph (a), (b) or (c) of subdivision eleven of
this section, the department may impose a civil penalty as authorized by
section twelve of this chapter for all violations asserted against the
general hospital OR STATE-OPERATED FACILITY THAT DELIVERS HEALTH CARE
SERVICES, until the general hospital OR STATE-OPERATED FACILITY THAT
DELIVERS HEALTH CARE SERVICES submits or implements a corrective action
plan or takes other action directed by the department.
13. Posting of penalties and related information. The department shall
maintain for public inspection, including posting on the general hospi-
tal profile on the department website, records of any civil penalties,
administrative actions, or license suspensions or revocations imposed on
general hospitals OR STATE-OPERATED FACILITIES THAT DELIVER HEALTH CARE
SERVICES under this section.
14. Unforeseeable emergency circumstances. (a) For purposes of this
section, "unforeseeable emergency circumstance" means:
(i) Any officially declared national, state, or municipal emergency;
(ii) When a general hospital OR STATE-OPERATED FACILITY THAT DELIVERS
HEALTH CARE SERVICES disaster plan is activated; or
(iii) Any unforeseen disaster or other catastrophic event that imme-
diately affects or increases the need for health care services.
(b) In determining whether a general hospital OR STATE-OPERATED FACIL-
ITY THAT DELIVERS HEALTH CARE SERVICES has violated its obligations
under this section to comply with the general hospital's OR THE STATE-
OPERATED FACILITY THAT DELIVERS HEALTH CARE SERVICES' clinical staffing
plan, it shall not be a defense that it was unable to secure sufficient
staff if the lack of staffing was foreseeable and could be prudently
planned for or involved routine nurse staffing needs that arose due to
typical staffing patterns, typical levels of absenteeism, and time off
typically approved by the employer for vacation, holidays, sick leave,
and personal leave.
15. Complaints. Nothing in this section shall be construed to preclude
the ability to submit a complaint to the department as provided for
under this chapter. Nothing in this section shall be construed as
supplanting other complaint mechanisms established by a general hospital
OR STATE-OPERATED FACILITY THAT DELIVERS HEALTH CARE SERVICES, including
mechanisms designed to aid in compliance with other federal, state or
local laws. Nothing in this section shall be construed as limiting or
supplanting the rights of employees and their collective bargaining
representatives to fully enforce any and all rights under the terms of a
collective bargaining agreement. An employer shall not assert or attempt
to assert a claim that enforcement of the collective bargaining agree-
ment is barred or limited by any provisions of this section.
16. Annual report. (a) The department shall submit an annual report to
the speaker of the assembly, the temporary president of the senate, and
A. 8623 8
the chairs of the health committees of the assembly and senate and the
governor on or before December thirty-first of each year. This report
shall include the number of complaints submitted to the department, the
disposition of these complaints, the number of investigations conducted,
and the associated costs for complaint investigations, if any.
(b) Prior to the submission of the report, the commissioner shall
convene a stakeholder workgroup consisting of hospital OR STATE-OPERATED
FACILITY associations and unions representing nurses and other ancillary
members of the frontline team. The stakeholder workgroup shall review
the report prior to its submission to the speaker of the assembly, the
temporary president of the senate, and the chairs of the health commit-
tees of the assembly and senate.
17. Disclosure of nursing quality indicators. (a) Every facility with
an operating certificate pursuant to the requirements of this article
shall make available to the public information regarding nurse staffing
and patient outcomes as specified by the commissioner by rule and regu-
lation. The commissioner shall promulgate rules and regulations on the
disclosure of nursing quality indicators providing for the disclosure of
information including at least the following, as appropriate to the
reporting facility:
(i) The number of registered nurses providing direct care and the
ratio of patients per registered nurse, full-time equivalent, providing
direct care. This information shall be expressed in actual numbers, in
terms of total hours of nursing care per patient, including adjustment
for case mix and acuity, and as a percentage of patient care staff, and
shall be broken down in terms of the total patient care staff, each
unit, and each shift.
(ii) The number of licensed practical nurses providing direct care.
This information shall be expressed in actual numbers, in terms of total
hours of nursing care per patient including adjustment for case mix and
acuity, and as a percentage of patient care staff, and shall be broken
down in terms of the total patient care staff, each unit, and each
shift.
(iii) The number of unlicensed personnel utilized to provide direct
patient care, including adjustment for case mix and acuity. This infor-
mation shall be expressed both in actual numbers and as a percentage of
patient care staff and shall be broken down in terms of the total
patient care staff, each unit, and each shift.
(iv) Incidence of adverse patient care, including incidents such as
medication errors, patient injury, decubitus ulcers, nosocomial
infections, and nosocomial urinary tract infections.
(v) Methods used for determining and adjusting staffing levels and
patient care needs and the facility's compliance with these methods.
(vi) Data regarding complaints filed with any state or federal regula-
tory agency, or an accrediting agency, and data regarding investigations
and findings as a result of those complaints, degree of compliance with
acceptable standards, and the findings of scheduled inspection visits.
(b) Such information shall be provided to the commissioner of any
state agency responsible for licensing or accrediting the facility, or
responsible for overseeing the delivery of services either directly or
indirectly, to any employee of a general hospital OR STATE-OPERATED
FACILITY THAT DELIVERS HEALTH CARE SERVICES or the employee's collective
bargaining agent, if any, and to any member of the public who requests
such information directly from the facility. Written statements contain-
ing such information shall state the source and date thereof.
A. 8623 9
(c) The commissioner shall make regulations to provide a uniform
format or form for complying with the reporting requirements of subpara-
graphs (i), (ii) and (iii) of paragraph (a) of this subdivision, allow-
ing patients and the public to clearly understand and compare staffing
patterns and actual levels of staffing across facilities. Such uniform
format or form shall allow facilities to include a description of addi-
tional resources available to support unit level patient care and a
description of the general hospital OR STATE-OPERATED FACILITY THAT
DELIVERS HEALTH CARE SERVICES. The information required by subpara-
graphs (i), (ii) and (iii) of paragraph (a) of this subdivision,
reported in a manner determined by the commissioner, shall be filed with
the department electronically on a quarterly basis and shall be avail-
able to the public on the department's website. The regulations shall
take effect no later than December thirty-first, two thousand twenty-
two. Information required to be provided pursuant to subparagraphs (i),
(ii) and (iii) of paragraph (a) of this subdivision shall be made avail-
able to the public no later than July first, two thousand twenty-three.
18. Advisory commission. (a) There is hereby established an independ-
ent advisory commission, composed of nine experts in staffing standards
and quality of patient care, including: three experts in nursing prac-
tice, quality of nursing care or patient care standards, one of whom
shall be appointed by the governor, one of whom shall be appointed by
the speaker of the assembly and one of whom shall be appointed by the
temporary president of the senate; three representatives of unions
representing nurses, one of whom shall be appointed by the governor, one
of whom shall be appointed by the speaker of the assembly and one of
whom shall be appointed by the temporary president of the senate; and
three members representing general hospitals, one of whom shall be
appointed by the governor, one of whom shall be appointed by the speaker
of the assembly and one of whom shall be appointed by the temporary
president of the senate. The members of the commission shall serve at
the pleasure of the appointing official. Members of the commission shall
keep confidential any information received in the course of their duties
and may only use such information in the course of carrying out their
duties on the commission, except those reports required to be issued by
the commission under this section, which may only include de-identified
information.
(b) The advisory commission shall convene from time to time in order
to evaluate the effectiveness of the clinical staffing committees
required by this section. Such review shall evaluate the following
metrics, including but not limited to quantitative and qualitative data
on whether staffing levels were improved and maintained, patient satis-
faction, employee satisfaction, patient quality of care metrics, work-
place safety, and any other metrics the commission deems relevant. The
commission shall also review the annual report submitted by the depart-
ment and make recommendations to the speaker of the assembly, the tempo-
rary president of the senate, and the chairs of the health committees of
the assembly and senate as set forth in paragraph (d) of this subdivi-
sion.
(c) The advisory commission may collect and shall be provided all
relevant information, necessary to carry out its functions, from the
department and other state agencies. The commission may also invite
testimony by experts in the field and from the public. In making its
recommendations to the speaker of the assembly, the temporary president
of the senate, and the chairs of the health committees of the assembly
and senate, the commission shall analyze relevant data, including data
A. 8623 10
and factors set forth in paragraph (b) of subdivision four of this
section related to clinical staffing plans. The commission may also make
recommendations for additional or enhanced enforcement mechanisms or
powers to address general hospital OR STATE-OPERATED FACILITY THAT
DELIVERS HEALTH CARE SERVICES failure to comply with this section and
recommend the appropriation of funding for the department to enforce
this section or to assist general hospitals OR STATE-OPERATED FACILITIES
THAT DELIVER HEALTH CARE SERVICES in hiring additional staff to comply
with this section.
(d) The advisory commission shall submit to the speaker of the assem-
bly, the temporary president of the senate and the chairs of the health
committees of the assembly and senate, and make available to the public
a report that makes recommendations to the speaker of the assembly, the
temporary president of the senate, and the chairs of the health commit-
tees of the assembly and senate for further legislative action, if any,
in order to improve working conditions and quality of care in general
hospitals OR STATE-OPERATED FACILITY THAT DELIVERS HEALTH CARE SERVICES
pursuant to this section and its intent.
(e) The commission shall submit its report and recommendations to the
speaker of the assembly, the temporary president of the senate, and the
chairs of the health committees of the assembly and senate no later than
October thirty-first, two thousand twenty-four, once three years of
staffing plans have been submitted to the department pursuant to this
section.
(f) Members of the commission shall receive no compensation for their
services, but shall be allowed their actual and necessary expenses
incurred in the performance of their duties hereunder.
(g) The legislature may appropriate funding for the commission to hire
staff or consultants and provide for the operation of the commission as
reasonably necessary to fulfill its functions.
§ 2. This act shall take effect January 1, 2026. Effective immediate-
ly, the addition, amendment and/or repeal of any rule or regulation
necessary for the implementation of this act on its effective date are
authorized to be made and completed on or before such effective date.