2023 New York Laws › PBH - Public Health › Article 28 - Hospitals › 2805-T - Clinical Staffing Committees and Disclosure of Nursing Quality Indicators.

§  2805-t.  Clinical  staffing  committees  and  disclosure of nursing
quality indicators. 1. Legislative intent. The legislature hereby  finds
and declares:
(a)  Research  demonstrates  that  nurses  play  a  critical  role  in
improving patient safety and quality of care;
(b) Appropriate staffing  of  general  hospital  personnel,  including
registered  nurses  available  for  patient  care,  assists  in reducing
errors, complications and adverse patient care  events,  improves  staff
safety and satisfaction, and reduces incidences of workplace injuries;
(c)  Health  care  professional, technical, and support staff comprise
vital components of the patient care  team,  bringing  their  particular
skills and services to ensuring quality patient care;
(d)  Ensuring  sufficient  staffing  of  general  hospital  personnel,
including registered nurses, is an  urgent  public  policy  priority  in
order  to  protect  patients and support greater retention of registered
nurses and safer working conditions; and
(e) It is the public policy of the  state  to  promote  evidence-based
nurse  staffing  standards and increase transparency of health care data
and decision making based on the data.
2. Clinical staffing committee. (a)  Each  general  hospital  licensed
pursuant  to  this  article  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
accordance  with  the  terms of the agreement, and the clinical staffing
committee 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
committee 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 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 for their bargaining unit. If there is no
applicable  collective bargaining agreement, the members of the clinical
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 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
responsibilities.
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
staffing 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
component of the general hospital staffing budget.
(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
transfers;
(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
certification  or  training of nursing personnel providing patient care,
including 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,
including  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
emergency circumstances as  defined  in  subdivision  fourteen  of  this
section;
(xiii)  Coverage  to  enable  registered  nurses,  licensed  practical
nurses, 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 and a representative of the nursing or
ancillary staff;
(xiv)  The  nursing  quality  indicators  required  under  subdivision
seventeen of this section;
(xv) General hospital finances and resources; and
(xvi)   Provisions   for   limited   short-term  adjustments  made  by
appropriate  general  hospital   personnel   overseeing   patient   care
operations  to  the  staffing  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
sensitive quality indicators collected by the general hospital.
(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.
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
relating  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
standard 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 annual  clinical
staffing plan by July first of each year.
(b)  Clinical  staffing  plans  shall  be  developed  and  adopted  by
consensus 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 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 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 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 submitted 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 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 staffing 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 individual general hospital's health profile on the website of  the
department  no later than July thirty-first of each year. If the adopted
clinical staffing plan is subsequently 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 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
examine, 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
confidentiality  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
employees, 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 shall  post,
in  a  publicly conspicuous area on each patient care unit, the clinical
staffing 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  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
clinical  staffing  committee  or  the  hospital  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
committees.  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
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
clinical 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,
personnel 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 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 to submit a
corrective plan of action within forty-five days of the presentation  of
findings  from  the  department  to  the  hospital.  If  the  department
determines after investigation under paragraph (c) of  this  subdivision
that  the  general  hospital  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 require
the  general  hospital  to  submit  a  corrective  action  plan   within
forty-five days of the presentation of findings to the general hospital.
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 to submit a corrective
action plan or impose a civil penalty on the general  hospital  pursuant
to subdivision twelve of this section.
12.  Civil  penalties.  In  the event that a general hospital 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,  until  the general hospital 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
hospital profile  on  the  department  website,  records  of  any  civil
penalties, administrative actions, or license suspensions or revocations
imposed on general hospitals 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 disaster plan is activated; or
(iii)  Any  unforeseen  disaster  or  other  catastrophic  event  that
immediately affects or increases the need for health care services.
(b)  In  determining  whether  a  general  hospital  has  violated its
obligations under this section to comply  with  the  general  hospital's
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,  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 agreement 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
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 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 committees 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
regulation.  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
information  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
regulatory   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 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
containing such information shall state the source and date thereof.
(c) The commissioner shall  make  regulations  to  provide  a  uniform
format  or  form  for  complying  with  the  reporting  requirements  of
subparagraphs (i), (ii) and (iii) of paragraph (a) of this  subdivision,
allowing  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 additional resources available to support unit level patient care and
a description of the  general  hospital.  The  information  required  by
subparagraphs  (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
available  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  available  to  the public no later than July first, two
thousand twenty-three.
18.  Advisory  commission.  (a)  There  is   hereby   established   an
independent  advisory  commission,  composed of nine experts in staffing
standards and quality of  patient  care,  including:  three  experts  in
nursing practice, 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
satisfaction, employee satisfaction, patient quality  of  care  metrics,
workplace  safety,  and any other metrics the commission deems relevant.
The commission shall also review the  annual  report  submitted  by  the
department  and make 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 as set forth in paragraph (d) of
this subdivision.
(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
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 failure to comply with this section
and recommend the appropriation of funding for the department to enforce
this section or to assist general hospitals in hiring  additional  staff
to comply with this section.
(d)  The  advisory  commission  shall  submit  to  the  speaker of the
assembly, 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 committees of the assembly and  senate  for  further  legislative
action,  if  any,  in order to improve working conditions and quality of
care in general hospitals 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.