Nurse staffing ballot question survives court challenge

  • The Supreme Judicial Court rejected a challenge brought by a hospital-backed group, which argued that state Attorney General Maura Healey should not have certified a ballot initiative supported by a major nurses union. Above, Healey, right, speaks during a town hall meeting last year at the University of Massachusetts Student Union. FILE PHOTO

State House News Service
Published: 6/18/2018 5:14:48 PM

BOSTON — The initiative petition seeking to impose limits on the number of patients a nurse can be assigned to care for at a time can go to voters on the November ballot, the Supreme Judicial Court ruled Monday.

The Supreme Judicial Court rejected a challenge brought by a hospital-backed group, which argued that Attorney General Maura Healey should not have certified the ballot initiative supported by a major nurses union because it contained two provisions that did not relate closely enough to each other.

After hearing arguments on April 3, the court determined the two elements of the initiative “form a unified statement of public policy ... and therefore are related.” The high court on Monday struck a proposed income surtax from the ballot, saying it did not meet the “relatedness” test.

Supporters of the ballot initiative, which is backed by the Massachusetts Nurses Association, say it is necessary because nurses often are overburdened. Opponents say the rigid staffing mandates will further contribute to rising health care costs without actually improving patient safety.

Final round of signatures

Kate Norton, spokesperson for the Committee to Ensure Safe Patient Care, said the committee plans to submit a final round of about 26,000 signatures to local elections officials on Tuesday to ensure the question makes it onto the November ballot. At least 10,792 signatures must be certified by local officials and submitted to the secretary of state by July 3.

A survey commissioned earlier this year by the MNA and conducted by Anderson Robbins Research found that 77 percent of nurses reported they are assigned “too many patients to care for at one time” and 86 percent of the nurses surveyed support changing the law to mandate “safe patient limits.”

A report commissioned by the Massachusetts Health and Hospital Association found earlier this year that the change in policy would cost the health care system $1.3 billion the first year and $900 million in subsequent years while adding an additional $100 million in state obligations. The report by Mass Insight Global Partnerships and BW Research Partnership found implementation would require the hiring of 5,911 registered nurses within 37 business days.

Request to keep off the ballot

In asking the high court to keep the question off the November ballot, the Coalition to Protect Patient Safety argued that the attorney general should not have certified the question because “it contains multiple subjects which are not related or mutually dependent.”

Specifically, the coalition argued the ballot initiative’s two main provisions — the patient limits and a prohibition on any “reduction in the staffing levels of the health care workforce” due to the implementation of the patient limits — are not linked closely enough to be part of one ballot question.

“The ostensible purpose of the entire petition is ‘patient safety.’ The Patient Assignment Limits for registered nurses may, arguably, advance that purpose. But the Workforce Reduction Ban is not limited to nurses, bedside caregivers, or any similarly tailored category,” the coalition wrote in its argument to the court. “Instead, the Ban dictates the retention of virtually everybody who works for or at a subject facility, including many workers (e.g., lawyers and marketers) whose job functions could not possibly have an impact on the quality of nursing care in particular, or on patient safety in general.”

In the state’s response to the court, Healey’s office wrote that the proposed ballot question was determined to be acceptable for the ballot because “all of its parts are operationally related to its common purpose of implementing patient-to-nurse assignment limits in hospitals” and because the workforce reduction ban “relates to the remainder of the law.”

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