California's Historic RN-to-Patient Hospital Staffing Ratios Upgraded Again Wit...(working with the Massachusetts NursesAss...),Health

AB 394, authored by current California State Sen. Sheila Kuehl and sponsored by CNA/NNOC, was signed in 1999 by then Gov. Gray Davis. It directed the state health department to determine the specific ratios, a process that took several years and involved multiple public hearings.

The hospitals, which lobbied extensively to block the law, filed a lawsuit in Dec. 2003 to repeal key portions of the law. The suit failed.

The hospitals then persuaded Gov. Arnold Schwarzenegger to issue an emergency regulation in Nov. 2004 to overturn emergency room ratios and improved medical/surgical ratios. In response, CNA/NNOC launched over 100 protests against Schwarzenegger in addition to a lawsuit. Subsequently a California court overturned Schwarzenegger's regulation as illegal, and a protest movement launched by CNA/NNOC defeated four Schwarzenegger-ballot initiatives in a 2005 special election.

Schwarzenegger has subsequently dropped the fight against the law, and the California Department of Public Health has sent letters to hospitals notifying them of their obligation to meet the standards and improve the ratios on Jan. 1.

The letters also reiterate that hospitals must increase staffing beyond the ratios if needed by patient acuity: "Hospitals must ensure that they are staffed to assure that the needs of the patients are met ... Hospitals are reminded that the regulations only reflect the minimum standards for staffing."

"Hospital industry efforts to overturn the law have failed due to their enormous popularity with patients and the public, support from legislators, validation from the courts, and their demonstrated success in improving patient care," Cortez said.

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