In "Is nursing ready for 2006?" (December 2005), the author references a piece of legislation passed by the Massachusetts Senate, leading readers to believe that Massachusetts is phasing in minimum nurse-to-patient ratios over a 3-year period. In 2004, the Massachusetts Senate, as an outside section to the state budget, attached the language cited in the article as an amendment to the senate version of the FY'05 budget. The language wasn't written into the House version, and the provision wasn't included in the final version of the state budget released by a joint conference committee and passed by the legislature. For the record, Massachusetts hasn't enacted staffing ratio legislation into law.
In the current legislative year (2005/2006), there are two competing bills before the Massachusetts legislature. The Massachusetts Organization of Nurse Executives and the Massachusetts Hospital Association are supporting Senate Bill 1260, a comprehensive piece of legislation filed by Sen. Richard Moore. This bill includes provisions that require all hospitals to create-in collaboration with staff-a staffing plan for every unit; file every shift with the Department of Public Health; publicly post, evaluate annually, and choose three nurse-sensitive indicators, including hours per patient day, from the National Quality Forum's list; and publicly report hospital-specific outcomes.
The bill also establishes the Clara Barton Trust Fund to award scholarships to nursing students and nurse mentors and grants to hospitals and college nursing programs to address nurse faculty issues. House Bill 2663, a bill filed by Rep. Christine Canavan and supported by the Massachusetts Nurses Association, is legislation that will create fixed mandated nurse-staffing ratios on every nursing unit in every hospital in the state.
Public hearings were held on both bills in July 2005; the bills are currently sitting in the Joint Committee on Public Health. The debate continues in Massachusetts. To date, California is the only state to enact staffing ratio legislation.