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staffing decisions are best left to administrators

lead to additional annual costs on the health care system of $200 million to $500 million that will be shared by all of us. The impact will put services and access to care in peril in every community of the Commonwealth. This is a catastrophic and ill-timed $1 Billion effort that would directly threaten the state’s health care reform efforts and would sink any hope to achieve meaningful payment reform.

Conclusion

Quality not quantity.
BOSTON

It takes a team, not a ratio. Effective patient care is dependent on a full team of competent, qualified health care professionals and assistive staff and must be based on the individual needs of each patient and site-specific hospital, not an arbitrary, mandated, universal number. In fact, in California, other caregiving positions were reduced to meet mandated ratios for RNs.

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Mandating nurse staffing levels would be the wrong prescription for Massachusetts.
At a time that policymakers and healthcare stakeholders are working together creatively and collaboratively to transform the healthcare delivery system to provide more integrated, coordinated, patient-centered care, a legislatively mandated staffing number is the wrong prescription. It is a step in the wrong direction at the wrong time. Since the late 90s, one union, the Massachusetts Nurses Association (MNA), has repeatedly filed legislation aimed at the establishment of one-size-fits-all mandatory staffing levels for registered nurses. Last year, the Senate rejected that route and offered compromise legislation that is based on data-driven evidence that wisely accounts for patient condition and the valuable contributions of every member of the care team – key components to determining the safest staffing levels. The Senate bill would have given Massachusetts the strongest regulation of nurse staffing in the country – yet the union rejected the legislation and has once again filed their rigid staffing proposal (HB3912/SB890).

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Staffing decisions should always be based on the best interest of the patient— not a number. One fixed ratio cannot be applied to every caregiving model and no study has ever produced a workable one-sizefits-all number. No two patients, nurses, or hospitals are alike - they can’t – and shouldn’t – be treated as such. As a nurse who experienced the failure of the California ratios first hand has stated publicly in opposition to ratios: “Nurses don’t treat numbers, we treat people.”
...staffing decisions are best left to administrators

Oppose HB3912/SB890. It’s the wrong prescription for our healthcare system.

RN employment since 1995

— Genevieve M. Clavreul, RN, PhD Pasadena, CA

Massachusetts hospitals are competently and adequately staffed.
There’s no documented evidence that Massachusetts hospitals are understaffed. In fact, since 1995, RN employment has increased 24.8% while patient days have declined.

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RN employment since 1995

Massachusetts Hospital Association

The leading voice for hospitals.
5 New England Executive Park Burlington, MA 01803-5096 www.mhalink.org

(Source: DHCFP 403 database)

This legislative session it’s finally time to put the nurse staffing issue permanently to rest. Imposing mandatory staffing ratios in the hospitals across the commonwealth would be the wrong prescription for our state and the healthcare system. Here’s some important background on the issue.

Can every other state in the U.S. be wrong?

bureaucrats in the state Department of Public Health to make decisions on nurse staffing that properly belong to hospital administrators.”

Only one state—California—has adopted mandatory staffing levels. More than eight years later, No other state has mandated staffing levels, with 16* rejecting prescriptive ratios for better alternatives. Since the implementation of its law eight years ago, it is estimated that California health care costs have increased by close to one billion dollars annually with no measurable improvement in $1 Billion quality of care. Every other state realizes that mandated ratios are not the way to staff hospitals. A collective approach that takes into account the resources of the full caregiving team has worked well in other states.
BOSTON

— Lawrence Eagle-Tribune
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“It makes far more sense to us for hospital staffing needs to continue to be assessed on a shift-by-shift basis, taking into consideration the number of patients and their specific needs as well as the skills and experience of the staff.”

Greater Milford Chamber of Commerce Franklin County Chamber of Commerce Greater Westfield Chamber of Commerce Stoneham Chamber of Commerce Beverly Chamber of Commerce North Suburban Chamber of Commerce

OTHER HEALTHCARE PROVIDERS
These providers, on the front line of health care in our state, know the true impact a mandated ratios bill would have and have been united against the MNA bill: Massachusetts Organization of Nurse Executives National Association for Practical Nurse Education and Service, Inc. Massachusetts Association of Peri-Anesthesia Nurses Massachusetts Hospital Association Conference of Boston Teaching Hospitals Home Care Alliance of Massachusetts Massachusetts Association of Behavioral Health Systems Massachusetts College of Emergency Physicians Massachusetts Council of Community Hospitals Massachusetts Extended Care Federation Massachusetts Healthcare Human Resources Association $1 Massachusetts League of Community Health Centers Billion Massachusetts Medical Society Massachusetts Psychiatric Society Massachusetts Society of Health-System Pharmacists Massachusetts Assisted Living Facilities Association Massachusetts Association of Registered Nurses

— Lowell Sun EMPLOYERS

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Our state’s employer community is strongly united against the MNA ratio bill. As leaders and guardians of our fiscal health, they understand the catastrophic financial burden this bill would have on our healthcare community and in the pockets of every citizen, as well $1 Billion nonexistent benefits ratios have failed to deliver as the in the only other state to adopt them. Before we pay the irrevocable high price ratios have imposed on Califor*Since 2001, 48 states have rejected mandatory ratios, while these 16 have adopted more nia, the following business leaders urged you last reasonable approaches: Arizona, Colorado, Connecticut, Illinois, Kentucky, Maine, Missouri, session to know the facts about the union bill: Nevada, New Jersey, New York, Ohio, Oregon, Rhode Island, Texas, Vermont, and Washington.

Opinion leaders have united against the union’s bill. $
...staffing decisions are best left to administrators

EDITORIAL BOARDS

BOSTON

Editorial boards have spoken out against ratios. Major daily newspapers in Massachusetts— from Boston to the Berkshires—have editorialized against the ratio bill. Here’s what some had to say:
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...staffing decisions are best left to administrators

“…staffing decisions are best left to the administrators of [hospitals], not state government.”

— The Boston Globe
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“Decisions about staffing in hospitals should be made by administrators, not by union officials.”

— The Springfield Republican
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“The state Senate should reject nurse staffing mandates that would drive upRN employment costs while threatening the quality of patient since 1995 care.”

— Worcester Telegram & Gazette
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“The misnamed “Patient Safety Bill” would allow

Associated Industries of Massachusetts Greater Boston Chamber of Commerce Massachusetts Business Roundtable Massachusetts Taxpayers Foundation Massachusetts High Technology Council, Inc. Economic Development Council of Western MA, National Federation of Independent Business South Shore Chamber of Commerce Cape Cod Chamber of Commerce Nashoba Valley Chamber of Commerce Plymouth Area Chamber of Commerce Malden Chamber of Commerce Medford Chamber of Commerce Wakefield Chamber of Commerce Greater Gardner Chamber of Commerce Holyoke Chamber of Commerce Quaboag Chamber of Commerce Cranberry Country Chamber of Commerce Taunton Area Chamber of Commerce Marlborough Regional Chamber of Commerce Tri-Community Area Chamber of Commerce MetroWest Chamber of Commerce

$ 200 to 500 million annually
BOSTON

...staffing decisions are best left to administrators

Ratios will have a catastrophic economic impact.

Ratios will impact every hospital, health care provider, insurance payer, and citizen in Massachusetts. If the union’s staffing bill is approved, HB3912/SB890 could

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