2 nurse staffing bills signed into law, others in limbo

Healthcare staffing legislation remains under consideration in some state legislatures and in limbo in others, although two governors recently signed such bills into law. Here are six updates from across the U.S.: 

Editor's Note: This article was updated on May 31 at 9:20 a.m.

1. Minnesota: Staffing legislation recently made headlines after Mayo Clinic's CEO said the health system would pull billions of investment dollars from the state if its Keeping Nurses at the Bedside Act was passed. 

The original bill would have required hospitals to form staffing committees of equal parts direct care workers and hospital leaders. Each committee would establish nurse-to-patient staffing ratios for its hospital, which the state would require them to uphold. Hospitals insisted this measure would lead to service cuts. 

Mayo Clinic was granted an exemption from the staffing rule — to other health systems' dismay. The union-backed bill was revised in its final hour to cut staffing legislation altogether. The bill's replacement, the Nurse and Patient Safety Act, focuses on workplace violence prevention, nurse burnout and loan forgiveness. 

The compromise bill was signed into law May 26.

2. New Jersey: Nurses are continuing to rally for safe staffing ratios in the state, and their efforts have led to legislation. If passed, the bill — which currently sits in the state's Health, Human Services and Senior Services Committee — will establish minimum registered nurse staffing standards for hospitals, ambulatory surgery facilities and certain Department of Human Services facilities. 

Modeled after California's staffing law, the bill would require one nurse for every five patients in medical/surgical units; a one-nurse-to-four-patient ratio in intermediate and emergency units; and a 1-to-2 ratio in the ICU. On May 11, hundreds of nurses rallied at the state House in Trenton to show support for the legislation. 

3. Washington: On April 20, Gov. Jay Inslee signed SB 5236. The law requires hospitals to report at least 80 percent compliance with a nurse-to-patient staffing ratio assigned by its internal staffing committee, composed of equal parts front-line staff and hospital administration. Hospitals that do not comply are subject to corrective action plans and fines of up to $50,000 per month.

"By creating an enforcement mechanism with real penalties, we can ensure safe staffing standards are followed rather than ignored, allowing workers to do their jobs safely and provide our loved ones the quality care they deserve," state Sen. June Robinson, the bill's sponsor, said in a statement. "Washington should be a place healthcare workers want to come and have long, successful careers — this is a necessary, meaningful step toward that goal."

4. Connecticut: Lawmakers in the state were considering a bill that would mandate nurse staffing ratios in hospitals across the state. However, legislators now are focusing instead on strengthening hospital staffing committees, the Hartford Courant reported.

The latest proposed amendment would require hospital administrators to receive approval from the hospital staffing committee before sending annual staffing plans to Connecticut officials, according to the publication. 

As of May 17, negotiations over the bill were ongoing. The state's legislative session ends June 7. 

5. Oregon: Proposed staffing legislation remains in limbo, according to Oregon Public Broadcasting

In March, three Oregon labor unions and the state hospital association announced a consensus on a series of amendments to the bill. The announcement came after months of negotiations on the legislation, which would establish enforceable nurse-to-patient ratios in state statute, for various hospital settings, as well as committees for other hospital workers.

In addition to the staffing bill, the parties agreed on a legislative package that they say "builds a pipeline of healthcare workers, addresses hospital capacity and discharge challenges, and improves the state's cost growth target to support investment in front-line caregivers."

With the compromise, the amendments to the staffing proposal and the additional components of the agreement were shared with the state House Committee on Behavioral Health and Health Care and the state House Ways and Means Committee earlier in the spring. 

Most recently, the legislation is in limbo after Senate Republicans and Independents announced they will deny the chamber a quorum until June 25, the last day of the legislative session, according to Oregon Public Broadcasting. The walkout to protest abortion, gun and transgender healthcare bills began May 3. 

6. Massachusetts: In January, Massachusetts lawmakers filed legislation that would mandate nurse-to-patient ratios. The bill, titled "An Act promoting patient safety and equitable access to care," was referred to the state Legislature's Joint Committee on Public Health on Feb. 16. No additional action has occurred.

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