Officials From Los Angeles, Orange Counties To Request Help With State Mandates for Hospitals
Officials from Los Angeles and Orange counties plan to send a letter to Gov. Arnold Schwarzenegger (R) to request help in efforts to meet state seismic retrofit requirements and nurse-to-patient ratio rules for hospitals, the Los Angeles Times reports (Pfeifer, Los Angeles Times, 2/25). Under the seismic retrofit requirements, hospitals must guarantee by 2008 -- or by 2013 if they expect to continue to use their buildings for an additional 30 years -- that their buildings will not collapse in a major earthquake. By 2030, hospitals must guarantee that their buildings will not collapse in a major earthquake and will to continue to function immediately afterward (California Healthline, 2/24). Under the nurse-to-patient ratio rules, which took effect Jan. 1, nurses do not have to care for more than eight patients at a time. The rules also call for one nurse per five patients in medical-surgical units by 2005, as well as one nurse per four patients in specialty care and telemetry units and one nurse per three patients in step-down units by 2008. In addition, the regulations state that licensed vocational nurses can comprise no more than 50% of the licensed nurses assigned to patient care and that only registered nurses can care for critical trauma patients. The rules also require at least one registered nurse to serve as a triage nurse in emergency departments (California Healthline, 1/15).
In the letter, officials from Orange and Los Angeles counties will ask Schwarzenegger to establish a program to help hospitals cover the estimated $24 billion cost of seismic retrofits needed to meet the state requirements, the Times reports. In addition, they will ask the governor to order state health officials to waive penalties for hospitals found not in compliance with the nurse-to-patient ratio rules. The letter also will raise concerns that a disaster, such as a bioterrorist attack, could "inundate hospitals with patients and push them into a violation" of the nurse-to-patient ratio rules, the Times reports. According to officials from both counties, the financial effects of the two state mandates could prompt hospitals to close. Orange County Supervisor Chuck Smith said that the mandates have the potential of "demolishing health care in Orange County," adding, "Let's use a little reasonableness and common sense in Sacramento. That's all we're asking for." Orange County Supervisor Bill Campbell said that the Legislature should not "tell hospitals how many nurses they need on duty," adding that the seismic retrofit requirements make "no sense" because they apply to "all hospitals, even though some are less susceptible to earthquakes than others," the Times reports (Los Angeles Times, 2/25).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.