CNA Says Governor Improperly Re-allocated Funds Intended To Help Increase Nurse Staffing
The California Nurses Association on Wednesday said that Gov. Arnold Schwarzenegger (R) inappropriately allocated $27.4 million in state funds to pay hospitals as part of Medi-Cal reimbursement rate increases included in the fiscal year 2004-2005 budget, funds CNA said the Legislature intended to help fund nurse staffing increases, the San Diego Union-Tribune reports (Skidmore, San Diego Union-Tribune, 3/10).
Schwarzenegger's administration in November 2004 issued an emergency order to delay a lower nurse staffing requirement that was scheduled to go into effect Jan. 1 this year.
The emergency order aimed to delay until January 2008 the implementation of a law that requires nurses to be responsible for the care of no more than five patients at one time. Under the administration's order, nurses were required to care for no more than six patients at a time.
Administration officials have said the delay was necessary to avoid fiscal emergencies at hospitals.
However, Superior Court Judge Judy Holzer Hersher on March 4 ruled in favor of CNA that the Department of Health Services illegally delayed the staffing changes because there was no evidence to support the administration's use of emergency rule-making.
Holzer Hersher denied the administration's request for a stay on the order, stating that the lower ratio should take effect immediately, regardless of an appeal.
Following the ruling, Health and Human Services Agency Secretary Kim Belshe said the administration planned to appeal the decision and ask for a delay in implementing Holzer Hersher's ruling (California Healthline, 3/9).
CNA Executive Director Rose Ann DeMoro said, "We are shocked. The specter of impropriety is unavoidable. This raises serious questions that demand investigation" (San Diego Union-Tribune, 3/10).
CNA President Deborah Burger called the diversion of funds "Ratiogate," adding that hospitals "were allowed to collect money under false pretenses."
DHS said the administration had to spend the money as part of a contract with hospitals that had been negotiated before the governor decided to suspend the ratio changes.
Lea Brooks, a DHS spokesperson, said, "The funds were committed prior to the (policy) change" (Benson, Sacramento Bee, 3/10).
DHS spokesperson Ken August added that the money was always intended for Medi-Cal rate negotiations, noting that such negotiations take into account several conditions, including nurse-staffing ratios. August said the rates were set before the administration's emergency order went into effect (San Diego Union-Tribune, 3/10).
Senate President Pro Tempore Don Perata (D-Oakland), who appeared with CNA at a news conference Wednesday, said that he will hold hearings to investigate "why the administration ignored the Legislature's wishes by diverting the money," the Sacramento Bee reports.
Perata said, "This is the most obvious and egregious example of a continual pattern of this administration to treat the Legislature as if we were a political accident" (Sacramento Bee, 3/10). He added, "This is really about one branch of government making all the decisions about public policy" (San Francisco Chronicle, 3/10).
Perata indicated that the hearings, which will be conducted "very shortly," will generally cover the Schwarzenegger administration's efforts to delay the nurse-staffing ratio change. "We're going to be like junkyard dogs on this issue," Perata said, adding, "Once we enacted it into law and it was part of the budget, it's the administration's job to implement the mandate. And since they not only didn't carry it out, they're apparently going to appeal the court decision, they're way afield of where we are" (AP/Los Angeles Times, 3/10).
KPBS' "KPBS News" on Wednesday reported on CNA's allegation. The segment includes comments from Donna Gerber, legislative director for CNA (Goldberg, "KPBS News," KPBS, 3/9). The complete transcript is available online. The complete segment is available online in RealPlayer.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.