The State Senate took the appalling and dangerous step today of approving S. 2805, a bill that will gut our safe staffing bill and codify the deadly status quo in Massachusetts hospitals that is harming more than 45,000 patients a year, and killing another 2,000. The vote was 23 - 13 in favor of the measure. We will be releasing a more detailed statement later, and you can expect more communications from our legislative staff on next steps in the days that follow. The bill will now move to a conference committee of House and Senate members, along with H. 4783, our reasonable solution to the health care crisis. Thanks to all for working so hard to generate so many calls and emails into the Senate over the last two days.
State House News Service Story on the Vote
CALL FOR CALM ON NURSE STAFFING DEBATE IS MET BY INCREASED FERVOR
By Kyle Cheney and Michael Norton
STATE HOUSE NEWS SERVICE STATE HOUSE, BOSTON, JULY 17, 2008...On a rare vote that fell short of a veto-proof majority, the Senate passed by a 23-13 margin a bill aimed at assuring appropriate nurse staffing levels, legislation backed by hospital officials but decried by a large nurses union as insufficient.
Although late-afternoon Senate debate on the bill was brief, emotions in the State House's halls ran high all day, as nurses railed against the bill's lack of limits on the number of patients a nurse is allowed to oversee. Patients die every day, they argued, due to hospitals' unilateral discretion over staffing levels.
Limits on nurse-patient ratios were contained in a House bill passed last month but were stripped in the Senate version by the Senate Ways and Means Committee.
The bill's chief sponsor, a champion of the legislation favored by the nurses union, was traveling in Portugal as the Senate brought the bill to the floor and told the News Service he had not been consulted by the committee about the bill and had sought a delay in the vote, unsuccessfully.
Hospitals were generally more supportive of the Senate bill, although they called it "one of the most stringent in the country for addressing regulation of hospital staffing."
"While we are confident that Massachusetts hospitals are already safely and appropriately staffed, and while we have advocated for a different approach than the Senate adopted, we recognize that the Senate has based its bill on principles hospitals support: primary focus on patient care, support for the entire caregiving team, and a balance between public accountability and respect for sound clinical judgment," the Massachusetts Hospital Association said in a statement. A House-Senate conference committee is now likely, although time may be the biggest roadblock to a compromise, with formal sessions ending on July 31, after which bills may not advance without the unanimous consent of members present in the House and Senate.
In a nod to the tension between supporters and opponents, Sen. Stanley Rosenberg (D-Amherst) urged both sides to "lower the decibel level" and engage in a more civil discourse to reach a compromise.
After the session, one nurse told the News Service that rather than calming down the debate, "it needs to be ratcheted up."
"One patient's life is more important," said Donna Kelly-Williams, vice president of the Massachusetts Nurses Association and a pediatric nurse at Cambridge Health Alliance.
The Senate bill requires every hospital to develop and make public a staffing plan that considers the complexity of patient care, the skill necessary to perform various tasks, the number of patients with acute illness and a process to adjust nurse staffing levels for unexpected needs.
Under the bill, hospitals must also form nursing care committees to recommend such staffing plans. Hospitals would have to monitor their quality of care and would be ranked.
Nurses would be prohibited from working more than 12 hours in any one shift and more than 16 hours in a day. In addition, a nurse working a 12-hour shift must be given an eight-hour break before a new shift.
The bill requires the Department of Public Health to develop guidelines for the safe "handling and movement" of patients within hospitals, cited by senators as a frequent cause of injury.
As the Senate took up the legislation, the bill's chief sponsor Sen. Marc Pacheco (D-Taunton) was in Portugal, on the island of Sao Miguel, at a forum on the future of transatlantic relations. Pacheco's version of the bill was strongly backed by nurses.
"I'm disappointed in the political process at this time," said Massachusetts Nurses Association President Beth Picknick, when asked by the News Service about Pacheco's absence and the Senate's decision to take up the bill while he is away.
Pacheco is in Portugal to speak at the first biannual Franklin D. Roosevelt Transatlantic Forum, which is hosted by the Azores Regional Government and the Luso-American Development Foundation. His aides say he was one of a "select handful" of Americans chosen to speak at the conference.
Representatives and senators have been advised by legislative leaders to stay close to home this month, the last available to the branches to act on controversial bills during this two-year meeting of the General Court.
Senate President Therese Murray's office said that was good advice but wouldn't comment further. Picknick said nurses knew that Pacheco had planned his trip to Portugal this week, believing that the staffing legislation would surface for a Senate vote next week. She said she didn't know whether senators would offer an amendment recommending that the Senate adopt an alternative to the Ways and Means bill.
Picknick said she was "not at all" disappointed that Pacheco was out of the country on Thursday and that she had hoped for a "more respectful" and "more courteous" approach to the bill's scheduling.
Association executive director Julie Pinkham said Pacheco tried to see the bill scheduled for floor debate next week.
"There is no reason why it couldn't have been done that way," she said. "Leadership is choosing for that not to happen. He has been absolutely stonewalled on that. He is being absolutely shut out of this discussion. Part of the outrage is the process."
Reached in the Azores, Pacheco said he hoped there was not a deliberate attempt to take the bill up for a vote while he was away and said that historically, chief sponsors of bills have been granted requests for delays on their bills to accommodate their schedules. Pacheco said he was not consulted on the bill that emerged from Senate Ways and Means and said it was his understanding that if the bill came up on Thursday, it would likely be delayed further and scheduled for a vote next week. Pacheco said he expressed his frustration to Senate President Therese Murray after the bill emerged from the Senate committee and requested a delay.
"I was told everything would be taken under consideration," he said.
Asked about the conventional wisdom on the Hill that lawmakers should stay nearby during the last month of formal sessions because anything could happen, Pacheco said, "There's no question about that."
But he added: "This is not rocket science in terms of scheduling. We've always been able to work those schedules out."
Pacheco said his district is heavily Portuguese and described his attendance at the forum as important to his constituents.