DHS Hearing in San Francisco Debates Hospital Nurse Staffing Ratios
Hospital officials from across the state and representatives from two nurses' unions yesterday debated California's proposed nurse staffing ratios at a Department of Health Services public hearing in San Francisco, the San Francisco Chronicle reports (Russell, San Francisco Chronicle, 11/20). The first-in-the-nation rules, released by Gov. Gray Davis (D) in January, establish mandatory minimum nurse-to-patient ratios at general acute care hospitals and are set to take effect in 2004. The law will cost hospitals in the state nearly $500 million annually at a time when many hospitals are losing money from operations. The proposal calls for hospitals to have one nurse for every six patients in medical/surgical units; after one year, the ratio would decrease to one nurse for every five patients (California Healthline, 11/18). The California Nurses Association, representing some 45,000 registered nurses in the state, supports the current ratio proposal but "strongly denounces" a clause that would allow up to 50% of nurses to be licensed vocational nurses. The Service Employees International Union, which represents 30,000 registered nurses and 5,000 licensed vocational nurses in the state, says the regulations are "too weak" and calls for a one-to-four nurse-to-patient ratio for medical/surgical units (San Francisco Chronicle, 11/20).
Hospital administrators said the statewide nursing shortage may "undercut efforts to implement" the ratios. Jan Emerson, a California Healthcare Association spokesperson, said, "Our biggest concern is the fact that we have in California the biggest shortage of nurses in the country" (Fletcher, Sacramento Bee, 11/20). In addition, hospitals are calling for "more flexibility" in the current proposal's requirement that hospitals "must comply with the ratios at all times," the Contra Costa Times reports. That stipulation could prove difficult to meet in hospital emergency rooms, where "patient numbers and their need for care is constantly changing," according to Joan Smith, associate director of Santa Clara Valley Health & Hospital System (Siber, Contra Costa Times, 11/20). DHS will hold an additional hearing Dec. 4 in Fresno (California Healthline, 11/18).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.