Provisions included in a must-pass budget bill will make significant changes for Connecticut hospitals. These changes, which were embedded in the nearly 900-page Public Act 23-204 signed into law on June 12, 2023,¹ revise current law regarding mandatory overtime for registered nurses, and relieve unions and RNs from complying with longstanding contracts about scheduling and overtime. The changes take effect October 1, 2023.

Existing Law

Connecticut General Statute 19a-490l currently limits mandatory overtime but allows hospitals to require nurses to work overtime or additional shifts in five circumstances:

• When nurses are participating in a surgical procedure, until it is completed;
• When nurses are working in critical care units, until they are relieved by another nurse starting a scheduled work shift;
• During public health emergencies;
• During institutional emergencies, such as adverse weather conditions or widespread illness, that the hospital administrator determines will significantly reduce the number of nurses available to work; and
• When nurses are covered by a collective bargaining agreement that addresses mandatory overtime.

Based on the last bullet point, a number of Connecticut hospitals have collective bargaining agreements with RN unions that authorize mandatory overtime either when the hospital determines it is necessary for patient care or under other circumstances specifically defined in the contract.

Expanded Definition of Overtime

Existing law defines overtime as work exceeding scheduled shifts, regardless of length, if the shift was determined and communicated to the RN at least 48 hours in advance. The revised law expands this definition of overtime to include any situation where a nurse works more than 12 hours in a 24-hour period or more than 48 hours in any hospital-defined work week.

New Threshold Requirements for RN Overtime

Revising section 19a-490l, the new law provides that none of the statutory exceptions applies unless patient safety requires mandatory overtime and there is no reasonable alternative.  The revision also provides that to justify required overtime a hospital must first “make a good faith effort to have such overtime hours covered on a voluntary basis.”

In addition, the new law bars hospitals from mandating overtime as a regular practice to meet staffing levels necessary for patient care or to address routine staffing needs caused by typical staffing patterns, expected levels of absenteeism, or time off typically approved by the hospital for vacation, holidays, sick leave and personal leave.

Effects on Collectively Bargained Agreements

Perhaps the most notable effect of the new law is its limitation on the right of private-sector hospitals to reach agreements about mandatory overtime in union negotiations or to enforce contract provisions to which RN unions previously agreed. As revised, the statutory exception permitting mandatory overtime pursuant to a collectively bargained agreement will be limited to nurses “employed at a behavioral health facility operated by a state agency.” Private-sector hospitals will no longer be able to bargain for mandatory overtime in future contracts, but will be able to enforce existing rights to mandate overtime in contracts that take effect before October 1, 2023.² Such contractual rights to mandate overtime will cease, however, on the expiration date of the agreement. The revised law expressly preserves any contract provision that places additional restrictions or limitations on the use of mandatory overtime in excess of those in the statute.

New Prohibition Against Retaliation

The legislation adds new prohibitions stating that no hospital shall discriminate against, discipline, threaten to discipline or discharge, or otherwise retaliate against a nurse for refusing to work overtime. The bill does not expressly create a private right of action for a nurse who claims retaliation, however, or designate a state agency to receive complaints of alleged violations.

Takeaways: Future Collective Bargaining

Hospitals whose existing union contracts include mandatory overtime as part of overall scheduling and compensation systems need to reconsider scheduling logistics, particularly how to adjust staffing on short notice to meet changes in patient census and acuity when mandatory RN overtime is no longer available. Any significant scheduling adjustment will have to be bargained for with the RN union, and the hospital should expect the dynamics of such bargaining to differ from past negotiations. Previously, a union would have had to trade something of value to obtain the restrictions on mandation that the legislature has now provided as a matter of law. Creativity, cooperation and a joint commitment to patients by hospitals and RN unions will be needed to develop systems that entice RNs to work overtime “voluntarily” when required by patient needs. To accomplish this without serious budget repercussions could be a formidable challenge. With the statutory effective date of October 1, 2023, looming, hospitals that have not done so already should turn their attention to these matters promptly.