Democrat duo revives nurse safety plan
A proposal that divided nurses and hospitals last General Assembly has returned in largely the same form, with the two camps expected to maintain their stances.
Rep. Crystal Lett and Rep. Christine Cockley, both Columbus Democrats, reintroduced the "Ohio Nurse Workforce and Safe Patient Act," which requires hospitals to establish and comply with registered nurse staffing plans, gives more power to nurse staffing committees and creates a grant program (HB 521 ).
"We continue to see increased violence in the workplace toward nurses and people in direct care in health and human services," Lett said in an interview. "They're experiencing burnout, retention issues, and workplace violence has continued to be very difficult for nurses.
"It's personal for me," she continued. "My son is a very medically fragile kiddo, so I see how hard nurses work every day to take care of patients. It makes absolute sense that they should be safe in the workplace, not have hours leading to burnout and that their rights are protected."
Nurses have saved her son's life multiple times, and Lett said, "It's important to me as someone in a position of leadership on these issues now to give back and support the community I know is completely vital to our society and health care system."
She said the bill establishes a new hospital staffing framework and mandatory minimum nurse-to-patient ratios that would be phased in two years after enactment for most hospitals, with a four-year time frame for rural hospitals.
Lett said it also gives nurse staffing committees power by requiring hospital plans to address committee recommendations and does not allow plans to be implemented without committee approval.
It also sets standards to ensure hospitals do not find workarounds for ratios, like using average head counts or including managers.
She said it further provides public health emergency flexibility for temporary deviations only with staffing committee approval.
Like its predecessor (HB 285 of 2023), the bill establishes a $20 million nursing student loan-to-grant program. Students would not have to repay the grant, which could be as much as $3,000 per year if they complete a five-year, in-state service obligation.
She said there are no changes from the prior version, which was carried by Rep. Haraz Ghanbari, R-Perrysburg, and Rep. Elgin Rogers Jr., D-Toledo.
That plan received two hearings in the House Health Provider Services Committee last session where it drew support from the Ohio Nursing Association and opposition from the Ohio Hospital Association and the Ohio Chamber of Commerce. (See Gongwer Ohio Report, November 19, 2024)
Lett said she has spoken to both ONA and OHA and is trying to find a framework that works best for everyone but added that she expects the "standard opposition."
"We're open to working with both organizations and the chamber as we go through the committee process so we can make sure we have the best bill possible," she said. "[The current version] is how we felt the bill would perform best and best represents the needs of nurses, but we're open to those conversations continuing."
Rick Lucas, president and executive director of ONA called staffing ratios a "top tier need" for nurses.
"It's evidence-based, so we're not negotiating with the facts," he said. "The fact that hospitals don't like it and the chamber is opposed doesn't change the fact that this is what patients need to be safe in the hospital."
Lucas said that following conversations with OHA over the past few months, he feels there is an acknowledgement that there needs to be a change to support safe patient care and stabilize the workforce, but that OHA continues to be opposed to ratio mandates.
OHA spokesman John Palmer said that the organization has not yet fully completed its review of the proposal.
"As it moves through committee, we'll definitely be an interested party, but when it comes to state staffing standards, we want to make sure it's something that's workable and gives hospitals the ability to give the care they need."
Although the last General Assembly did not advance HB285, it did approve legislation requiring hospitals to establish a security plan for preventing workplace violence (HB 452 ).
The bill, signed by Gov. Mike DeWine in January, also requires hospitals to involve a team — 50% of which must include health care employees who provide direct patient care — while developing their plan.
Lucas called that legislation a starting point but said HB521 is still needed to address chronic staffing issues and early exits from the profession.