For the first time, the California State Assembly passes a bill (AB 695, Kuehl-D) to require the Department of Health Services (DHS) to develop and implement comprehensive nurse-patient staffing ratios. Unfortunately, the bill dies in the Senate Appropriations Committee on a 6-6 tie vote. Only seven votes are needed to pass.
Undaunted, another bill already passed by the Senate Appropriations Committee, SB 1125 (Alpert-D), is amended to require nurse-patient staffing ratios when it reaches the Assembly. Governor Pete Wilson (R) vetoes the bill at the request of the California Hospital Association (CHA).
1999
UNAC/UHCP supports a new nurse-patient staffing bill, AB 394 (Kuehl-D), which requires DHS to establish appropriate nurse-to-patient ratios by January 1, 2001 A new legislature passes the bill and new Governor Gray Davis (D) signs it into law.
2000
DHS needs more time and requests a one year extension of the implementation of the nurse-patient ratios to January 1, 2002 The extension legislation, AB 1760 (Kuehl-D), passes and is signed into law.
2001
UNAC and SEIU propose nurse-patient staffing ratios to DHS after an extensive study of frontline nurses. Simultaneously, UNAC/UHCP and SEIU negotiate with Kaiser Hospitals through the Labor Management Partnership to establish and implement nurse-patient staffing ratios beyond what DHS eventually recommends. This agreement helps undermine CHA’s claim that ratios are unworkable and would bankrupt hospitals.
2002
DHS announces “draft nurse-to-patient ratios” in January and undergoes the extensive review and comment process requiredunder California law. UNAC/UHCP works closely behind the scenes with DHS staff to craft good ratios. Meanwhile, the Hospital Association proposes ridiculously high ratios and seeks further delays in implementation. On September 29th, Gov. Davis announces the opening of the official public comment period on the ratio law.
2003
UNAC/UHCP supports additional legislation, AB 253 (Steinberg – D), to impose fines on hospitals failing to meet the nurse-patient staffing ratios established by DHS. The legislation passes both houses in different forms, but dies when the Assembly refuses to concur in the amendments made in the Senate.
Fall 03 CHA files a lawsuit seeking a court order to block full implementation of the ratios, which were to take effect in January of 2004 They lose the case and every appeal afterwards.
2004
Newly Governor Arnold Schwarzenegger (R) issues emergency regulations delaying full implementation of the nurse-patient ratios on November 4th, at the urging of CHA. Within days, UNAC/UHCP and Kaiser Permanente send letters to all represented Registered Nurses informing them of Kaiser’s continued support of the LMP staffing ratios.
2005
Governor Schwarzenegger (R) drops both his emergency regulations and the appeal of the case. The emergency regulations are later struck down in court.
Nurse-patient ratios are now well established in California and serve as a model for nurses in other states throughout the nation.
2012
SB 1246, UNAC/UHCP-sponsored legislation, would have strengthened the existing nurse-to-patient staffing ratios in California Hospitals by requiring the Department of Public Health (DPH) to check for compliance during regular, periodic inspections and by putting into effect existing statutory fine authority for DPH by removing the requirement that DPH issue regulations.
While the bill passed all legislative hurdles and landed on the Governor’s desk, Gov. Brown ultimately vetoed the legislation. In his veto message, the Governor’s described how DPH was on track to propose new regulations on administrative penalties on a broad range of violations by next year.
