MNA re-files safe staffing legislation

Comprehensive set of additional health care bills also submitted

This past legislative session resulted in historic progress on the MNA's bill to ensure safe RN staffing. The Massachusetts House of Representatives voted overwhelmingly, 133-20, in favor of compromise legislation that would have directed the Department of Public Health to create ideal standards and limits on how many patients a registered nurse would have to care for at one time. In addition, a majority of senators signed on as sponsors of H.2663, the original version of the MNA's safe RN staffing bill. But despite this resounding victory in the House, broad backing in the Senate and comprehensive research supporting the bill, Senate leadership would not allow the bill on the floor for a vote.

We now look to the next legislative session as we plan to continue our pursuit of safe RN staffing legislation. We are encouraged by our successes in the previous session, by the overwhelming re-election and election rates of supporters of the legislation in both the House and Senate as well as the election of Deval Patrick as governor and Tim Murray as lieutenant governor.

Over 97 percent of the 147 candidates endorsed by the MNA took the oath of office in early January. Tim Murray has been a strong ally and supporter of the nurses during his tenure as a city councilor and mayor of Worcester, and Deval Patrick has publicly declared his support for our compromise legislation. Governor Patrick has stated:

"I do support the compromise bill that won passage in the House, but failed to win passage in the Senate. I look forward to working with the Massachusetts Nurses Association, legislators and others to revive it."

It is your work that has enabled this critical legislation to advance this far. And it will be your continued dedication to this issue that ensures its passage in the upcoming session. Our coalition has grown to over 100 health care, consumer and labor groups. More RNs than ever are communicating with their fellow RNs, their communities and their legislators about how essential this bill is to ensuring the quality of patient care in the commonwealth. We will be mounting a significant grassroots campaign in key districts and will once again need your help lobbying legislators.

Other 2006 successes
This past legislative session also saw tremendous progress on a number of other issues advocated for by our nurses and health care professionals.

H.1087, the school nurse parity bill, was passed in both the House and Senate and the governor's veto was overridden on July 24. This legislation gives school nurses professional status that will provide them with due process and professional recognition.

The Sexual Assault Nurse Examiner (SANE) program was also written into law during this past session. The SANE program helps victims of sexual assault obtain medical services, utilizing nurses who are specially trained to deal with the emotional and physical state of victims in this process. By codifying SANE into law, legislators and the former governor made this program a permanent resource in assisting those victimized by sexual assault.

Looking ahead and re-filing
The MNA also filed a number of other pieces of legislation in early January, including:

Safe Patient Handling/Lifting Legislation: H.2662, legislation aimed at ensuring safe patient handling, was reported out of the House Public Health Committee favorably this past session but no further action was taken. The MNA looks forward to re-filing this critical legislation that would set acceptable standards for the lifting and handling of patients to curb the high rate of injuries incurred by the RNs and health care professionals who perform such activities. According to The Bureau of Labor Statistics, direct patient care RNs get injured from lifting, moving and repositioning their patients at a higher injury rate than that of laborers, movers and truck drivers. Work-related lifting injuries, in turn, lead many nurses to leave the profession, with 52 percent of all nurses suffering chronic back pain and 38 percent of nurses experiencing pain severe enough to cause them to leave work at some point.

This issue has become particularly problematic in Massachusetts. Back injury claims have contributed to giving the health care industry in the state of the ominous reputation of being one of the most dangerous industries, with a total recordable case rate in 2004 of 8.0 for hospitals and of 9.4 for nursing homes—statistics that are notably higher than those found in the manufacturing, textile and utility industries.

Practically one health care worker in 10 in Massachusetts files a claim for injury, and the greater percentage of these claims are related to back injuries. This rate also makes Massachusetts' hospitals more unsafe for patients by contributing to the statewide loss of nurses from the bedside. At a time when we are trying to retain and recruit more nurses, this legislation is critical in order to ensure that we do not lose quality nursing staff to otherwise preventable injuries. The bill also features a component that would provide financial incentives to hospitals to aid in costs incurred due to compliance.

An Act Relative to a Patient's Report Card of Nursing: This bill would require hospitals, nursing homes, clinics etc., licensed or registered by the Department of Public Health and health maintenance organizations to report appropriate data. This would include, but would not be limited to, measures which differentiate between severity of patient illness; readmission rates; lengths-of-stay; patient/family satisfaction; indicators of the nature and amount of nursing care directly provided by licensed nurses; the number of patients (on average) cared for by a nurse; and documentation of defined nursing interventions and patient safety measures. This would enable purchasers of group health insurance policies/health care services and the public to make meaningful financial and quality-of-care comparisons.

An Act to Ensure Safe Medication Administration: This bill would prohibit unlicensed personnel from distributing medications for which they have not received sufficient education and training as approved by the state.

An Act Relative to Improvements in Private Duty Nursing Care for Developmentally Disabled Children: This bill would provide expert nursing care to all developmentally disabled children eligible to receive private duty nursing care.

An Act Relative to a Nurse Deputy Commissioner at the Department of Public Health: This bill would direct the Department of Public Health to appoint a registered nurse to be nurse deputy commissioner responsible for statewide planning, policy development and the coordination, communication and resource management for programs and district health officers within the department.

An Act Relative to a Registered Nurse Seat on the Public Health Council: This bill would add an additional seat on the Public Health Council for a registered nurse from the state's largest organization of RNs.

An Act Requiring Health Care Employers to Develop and Implement Programs to Prevent Workplace Violence: This bill would require health care employers to annually perform a risk assessment, and based on those findings, develop and implement programs to minimize the danger of workplace violence to employees.

An Act Relative to Assault and Battery on Health Care Providers: This bill would punish those patients/clients who assault any health care provider treating, transporting or otherwise performing their duty. The punishment would be imprisonment in the house of correction for between ninety days and two and one half years, or by a fine between $500 and $5,000 dollars, or both.

An Act Relative to Group 4 for Health Care Professionals: This bill would include in Group 4, for purposes of retirement, state employees whose duties require them to be licensed health care professionals for ten or more years and who care for prisoners or the mentally ill, mentally retarded, chronically psychologically impaired or those with chronic infectious diseases.

An Act Relative to Group 2 Employees (state): This bill would include in Group 2, for purposes of retirement, state employees who care for the mentally ill, mentally retarded, chronically psychologically impaired or those with chronic infectious disease.

An Act Related to Interest Arbitration for Health Care Professionals: This bill would make arbitration for a bargaining unit employed by the commonwealth of Massachusetts binding, provided that the scope is limited to wages, hours and conditions of employment.

An Act to Include Certain Municipal Employees of the Commonwealth in Group 2 of the Contributory Retirement System for Public Employees: This bill would entail classifying licensed nursing care employees of cities and towns in Group 2 of the Public Employees Retirement System.

An Act Regarding Insurance Equity for Registered Nurse First Assistants: This bill would require insurance coverage for registered nurse first assistant services in insurance policies and health service contracts issued in the Commonwealth.

An Act Authorizing the Sale of "RN" Distinctive Registration Plates: This bill would direct the Registrar of Motor Vehicles to issue distinctive license plates whose proceeds would establish a fund for the future of nursing.

An Act Relative to Creating a Difficult to Manage Unit within the Department of Mental Health: This bill would create a "Difficult to Manage" unit for women within the Department of Mental Health that would be equivalent to the "Difficult to Manage" unit already in place for men.

If you have any questions or would like to become involved in the MNA's legislative, community action and/or government affairs work, please contact the MNA's political organizer Riley Ohlson at rohlson@mnarn.org or by phone at 781.830.5740.