7/1/03 UPDATE: Calif Nurse Ratios info here

  1. Forwarded by PSNA.org:

    The California Department of Health Services (DHS) announced this week that its revised nurse-to-patient staffing regulations will be published on June 30 or July 1.

    The comment period will begin the same date and end on July 17. Comments will be accepted only on the revisions, and there will be no public forum for comments. Instead, all comments should be sent to DHS at the address
    published with the revisions.

    The California Healthcare Association (CHA) and the Association of California Nurse Leaders (ACNL) are planning a series
    of educational programs throughout the state in September that will focus on the final nurse-to-patient regulations. (SOURCE: CHA News, June 20, 2003)
    •  
  2. 28 Comments

  3. by   pickledpepperRN
  4. by   NRSKarenRN
    forwarded by psna.org to me. karen

    for immediate release july 1, 2003

    california nurses assn. applauds final rn ratios plan
    hospital industry proposals to erode ratios rejected by state


    the california nurses association today welcomed the release of the final regulations to establish new minimum registered nurse staffing ratios that all hospitals must meet by january 1, 2004 as a significant step towards improving patient care conditions in california hospitals and protecting patient safety.

    "a new era is dawning in which all california families should expect safer standards in california hospitals," said kay mcvay, rn, president of the 50,000-member cna which sponsored the safe staffing law and worked for 10 years to enact it. "the finish line is finally near. every patient should be able to demand and count on receiving the registered nursing care they need, when they need it."

    in the package approved by gov. gray davis and the department of health services, state officials made critical decisions on some hotly contested issues regarding implementation of the cna-sponsored law, the first such law in the nation which has been a model for rns and legislators in other states. among key decisions in the plan:

    proposals by the hospital industry to erode the ratios in emergency rooms, post-surgical recovery units, and for evening, night, and weekend shifts, were all rejected. state officials also rebuffed hospital efforts for further delays in implementation.

    phased-in, improved ratios (fewer patients to nurses) in three hospital areas. as of 2008, ratios will be lowered in step down units, typically housing patients just transferred from critical or intensive care, telemetry, where patients are on monitors, and other specialty care units, such as oncology and rehab. cna was the only organization to present scientific data - based on 22 million patient discharge records, the drg designations and patient acuity - along with thousands of rn testimonials to make the case for these reductions.

    assurances that hospitals must adhere to scope of practice laws to protect patient safety. no rn may be assigned, or be responsible for more patients than the specified ratios. the regulations clarify the respective roles of rns and lvns, make it apparent that rns and lvns are not inter-changeable, and require that additional nurses must be assigned, as needed, by severity of patient illness.
    hospitals are required to document staffing assignments, including the licensure of the direct caregiver for every patient for every unit for every shift, and keep the records for one year, steps that will help the state monitor and assure compliance with the law.

    mcvay noted that many cna-represented hospitals have already hired hundreds of additional rns in preparation for implementing the law, and as a result of unprecedented cna gains in compensation, retirement security, and workplace improvements intended to enhance retention of current experienced rns and recruitment of new rns.

    cna, which has campaigned since 1992 to enact safe rn staffing ratios, will work with rns across the state to monitor enforcement of the law and encourage hospital compliance. cna has also sponsored a new bill, ab 253, to help assure compliance.

    introduced by assembly introduced by assembly member darrell steinberg (d-sacramento), the bill authorizes state health officials to conduct unannounced inspections, and provides for fines of up to $5,000 a day, on hospitals that continue to maintain unsafe rn staffing after final implementation of the ratio law.

    the specific ratios by hospital unit, and more background on the law, are available on the cna website, www.calnurse.org <http://www.calnurse.org/>.
  5. by   NRSKarenRN
    The Ratios1
    Intensive/Critical Care ..........1:2
    Neo-natal Intensive Care......1:2
    Operating Room....................1:1
    Post-anesthesia recovery.....1:2
    Labor and Delivery................1:2
    Antepartum..........................1:4
    Postpartum couplets.............1:4
    Postpartum women only.........1:6
    Pediatrics.............................1:4
    Emergency Room..................1:4
    ICU patients in the ER..........1:2
    Trauma patients in the ER....1:1
    Step Down Initial..................1:4
    Step Down in 2008...............1:3
    Telemetry Initial....................1:5
    Telemetry in 2008.................1:4
    Medical/Surgical Initial...........1:6
    Medical/Surgical in 2005........1:5
    Other Specialty Care Initial....1:5
    Other Specialty Care in 2008...1:4
    Psychiatric............................1:6

    All ratios are minimums. Hospitals
    must increase staffing as needed by
    patient acuity.

    1 Charge RNs and managers are not counted in
    the ratios.
    2 RN license only.
    3 Triage or Base Radio RNs shall not be included in
    the ratios. Every ER must have an RN, with
    experience in emergency care, on duty at all times.
    4 Such as Oncology and Rehab.
  6. by   oramar
    This is really amazing, when you think how dark everything looked 5 years ago. I got tears in my eyes. Hope floats!
  7. by   Desert Rat
    These ratios specify that the charge RN is not to be counted in the staffing ratio, but what about other ancillary personnel? Our small ICU has a great pt/RN ratio, but we are it. No CNAs, no secretaries...We answer phones, take off orders, do traffic control with visitors...the whole nine yards. You can imagine the HIPPA nightmares when you and your only co-worker are doing patient care, leaving the station unguarded.

    Our administrators say the California idea (and hospitals locally who advertise good nurse/patient ratios) are actually making the RN do more work because they are getting rid of CNAs and secretaries. Who can clarify this for me?
  8. by   rebelwaclause
    I still ask...If an RN is "covering" (Yeah...right) an LVN, and the LVN has 8 patients...What will the RN's ratio be then?
  9. by   pickledpepperRN
    http://www.applications.dhs.ca.gov/p...ses/03-47.html



    STATE HEALTH DEPARTMENT RELEASES REVISED
    NURSE-TO-PATIENT RATIOS FOR PUBLIC COMMENT


    SACRAMENTO - The California Department of Health Services
    (CDHS) today released for public comment revised nurse-to-patient
    ratio regulations for general acute care hospitals. The ratios will be the
    first of their kind in the nation.

    "The high interest in this issue is reflected in the fact that CDHS
    received more than 24,000 letters from organizations and individuals
    across the state during the initial public comment period," noted State
    Health Director Diana M. Bont, R.N., Dr.P.H. "In signing the
    legislation that led to the development of these ratios, Gov. Gray Davis
    demonstrated his commitment to quality patient care and recognition
    of the key role nurses play in providing that care."

    While most of the revisions are technical in nature or clarifications to
    make the regulations more clear, ratios for step-down, step-down
    telemetry, telemetry and specialty care units were changed in
    response to comments received during the initial public comment
    period in late 2002 (chart attached). The ratios would be implemented
    in stages beginning in 2005 to enable hospitals, especially those in
    rural areas, to develop strategies to meet the new ratios.

    In 1999, Gov. Gray Davis signed AB 394, which required CDHS to
    establish minimum nurse-to-patient ratios by licensed nurse
    classification and by hospital unit for the state's general acute care
    hospitals.

    The proposed ratios are based on a complex number of factors,
    including information collected by state regulators during
    unannounced visits to 80 acute care hospitals and 10 state-operated
    hospitals that began in May 2001. CDHS used data from the on-site
    hospital visits to determine the licensed nurse-to-patient ratios in the
    nursing units at the hospitals.

    The proposed ratios also reflect the results of a literature search, an
    analysis of data from the state Office of Statewide Health Planning
    and Development, comments from professional organizations and over
    24,000 letters received from individuals across the state.

    Only intensive and critical care, acute respiratory care, coronary care,
    well-baby nursery, neonatal intensive care unit and operating rooms
    currently have minimum ratios. The proposed ratios cover all other
    areas of a hospital, including medical/surgical units. The proposed
    ratios vary from 1:1 for trauma patients to 1:6 (reduced one year later
    to 1:5) in medical/surgical units.

    The regulations are expected to take effect Jan. 1, 2004. Five years
    after their adoption, CDHS will evaluate the regulations and provide a
    report to the Legislature, as required by law.

    The draft regulations, research findings and information about the
    process for submitting comments are available on CDHS' Web site at
    http://www.dhs.ca.gov

    CDHS will summarize all comments received and provide a formal
    response to each one. The regulatory package, including the
    responses, will be submitted to the Office of Administrative Law for
    approval. After approval, the regulatory package, including the
    responses, will be published on the CDHS Web site.

    The deadline for public comments is 5 p.m. July 17. Written
    comments can be submitted via fax at (916) 440-7714, e-mail at
    mailto:regulation@dhs.ca.gov or

    through the "Making Comments" link on the CDHS' Web site at
    http://www.dhs.ca.gov/regulation. Comments can also be mailed to the
    Office of Regulations, Department of Health Services, MS 0015, P.O.
    Box 942732, Sacramento CA 94234-7320. (Please note that CDHS
    has moved to a new location in the East End Complex in Sacramento
    and that the U.S. Postal Service requires the use of a post office box
    for the delivery of mailed items.
    Hospital Unit
    CDHS Proposal
    10/18/02
    Revised CDHS
    Proposal
    07/01/03
    Intensive/Critical Care Unit
    1:2*
    1:2*
    Operating Room
    1:1*
    1:1*
    Neonatal ICU
    1:2*
    1:2*
    Well-Baby Nursery
    1:8*
    1:8*
    Postpartum

    (When multiple births, the number of
    newborns plus the number of mothers shall
    never exceed 8 per nurse)
    1:8 (1:4 couplets)

    1:6 (mothers only)
    1:8 (1:4 couplets)

    1:6 (mothers only)

    Antepartum 1:4
    Labor and Delivery
    1:2
    1:2
    Post Anesthesia Care Unit
    1:2
    1:2
    Emergency Departments

    (Triage, Base Radio, and other specialty
    nurses are to be added as additional workforce
    and not included in the ratio)
    1:4

    Critical Care Patients
    1:2

    Critical Trauma
    Patients 1:1
    1:4

    Critical Care
    Patients 1:2

    Critical Trauma
    Patients 1:1
    Burn Units (considered a CCU)
    1:2
    1:2
    Pediatrics Units
    1:4
    1:4
    Behavioral Health Psychiatric Units
    1:6
    1:6
    Step-Down and Step-Down/Telemetry Units
    1:4
    1:4

    1:3 on 01/01/08
    Specialty Care (Oncology) Units
    1:5
    1:5

    1:4 on 01/01/08
    Telemetry Units
    1:5
    1:5

    1:4 on 01/01/08
    Medical, Surgical and Medical/Surgical Units
    1:6

    1:5 on 01/01/05
    1:6

    1:5 on 01/01/05
    Mixed Units
    1:6

    1:5 on 01/01/05
    1:6

    1:5 on 01/01/05
  10. by   Desert Rat
    Sounds good on paper, but I agree with rebel..so you are covering for LVN/SNT etc, what is your ratio then? Are they really going to cut out other staff to keep the licensed ratio?
  11. by   pickledpepperRN
    Originally posted by Desert Rat
    Sounds good on paper, but I agree with rebel..so you are covering for LVN/SNT etc, what is your ratio then? Are they really going to cut out other staff to keep the licensed ratio?
    Simple answer is NO!
    Complex answer is that the RNs, other hospital staff, and the public (patients & visitors) will have to help enforce the ratios. U dom't expect most facilities to comply unless forced by their staff or the DHS. Who would stay at a poorly staffed hospital when a safely staffed one is nearby?
    For answers to many questions soch as why laying off other workers will not be acceptable click the PDF files on the links:

    http://www.calnurse.org/
    http://www.calnurse.org/cna/press/7103.html
    California Nurses Assn. Applauds Final RN Ratios Plan
    Hospital Industry Proposals to Erode Ratios Rejected by State


    The California Nurses Association today welcomed the release of the final regulations to establish new
    minimum registered nurse staffing ratios that all hospitals must meet by January 1, 2004 as a
    significant step towards improving patient care conditions in California hospitals and protecting patient
    safety.

    "A new era is dawning in which all California families should expect safer standards in California
    hospitals," said Kay McVay, RN, president of the 50,000-member CNA which sponsored the Safe
    Staffing Law and worked for 10 years to enact it. "The finish line is finally near. Every patient should be
    able to demand and count on receiving the registered nursing care they need, when they need it."

    In the package approved by Gov. Gray Davis and the Department of Health Services, state officials
    made critical decisions on some hotly contested issues regarding implementation of the
    CNA-sponsored law, the first such law in the nation which has been a model for RNs and legislators in
    other states. Among key decisions in the plan:

    Proposals by the hospital industry to erode the ratios in Emergency Rooms, Post-Surgical
    Recovery units, and for evening, night, and weekend shifts, were all rejected. State officials also
    rebuffed hospital efforts for further delays in implementation.

    Phased-in, improved ratios (fewer patients to nurses) in three hospital areas. As of 2008, ratios
    will be lowered in Step Down units, typically housing patients just transferred from critical or
    intensive care, Telemetry, where patients are on monitors, and other specialty care units, such
    as Oncology and Rehab. CNA was the only organization to present scientific data - based on
    22 million patient discharge records, the DRG designations and patient acuity - along with
    thousands of RN testimonials to make the case for these reductions.

    Assurances that hospitals must adhere to scope of practice laws to protect patient safety. No
    RN may be assigned, or be responsible for more patients than the specified ratios. The
    regulations clarify the respective roles of RNs and LVNs, make it apparent that RNs and LVNs
    are not inter-changeable, and require that additional nurses must be assigned, as needed, by
    severity of patient illness.

    Hospitals are required to document staffing assignments, including the licensure of the direct
    caregiver for every patient for every unit for every shift, and keep the records for one year, steps
    that will help the state monitor and assure compliance with the law.

    McVay noted that many CNA-represented hospitals have already hired hundreds of additional RNs in
    preparation for implementing the law, and as a result of unprecedented CNA gains in compensation,
    retirement security, and workplace improvements intended to enhance retention of current experienced
    RNs and recruitment of new RNs.

    CNA, which has campaigned since 1992 to enact safe RN staffing ratios, will work with RNs across
    the state to monitor enforcement of the law and encourage hospital compliance. CNA has also
    sponsored a new bill, AB 253, to help assure compliance.

    Introduced by Assembly introduced by Assembly member Darrell Steinberg (D-Sacramento), the bill
    authorizes state health officials to conduct unannounced inspections, and provides for fines of up to
    $5,000 a day, on hospitals that continue to maintain unsafe RN staffing after final implementation of
    the ratio law.

    For the specific ratios by hospital unit Click here.
    For the specific ratios by hospital unit and more background on the law, Click Here

    Fact Sheet on RN Staffing Ratio Law


    California is the first state in the U.S. to establish minimum RN-to-patient ratios for hospitals. The
    ratios are based on AB 394, sponsored by the California Nurses Association and signed by Gov. Gray
    Davis in October, 1999.

    Today's announcement of the final regulations to implement AB 394 culminates a 10-year campaign
    by CNA to improve RN staffing in California hospitals to protect patient safety, and reverse the effects
    of a decade of hospital restructuring that eroded patient care conditions and produced a hospital
    nursing shortage.

    All hospitals must be staffing with the minimum ratios as of January 1, 2004. Many CNA represented
    hospitals have already hired hundreds of additional RNs in preparation for implementing the law, and
    as a result of unprecedented CNA gains in compensation, retirement security, and workplace
    improvements intended to enhance retention of current experienced RNs and recruitment of new RNs.

    What the Law Does

    AB 394 establishes specific numerical nurse-to-patient ratios for acute care, acute psychiatric and
    specialty hospitals in California. The ratios are the maximum number of patients that may be assigned
    to an RN during one shift. The law requires additional RNs be assigned based on a documented
    patient classification system that measures patient needs and nursing care, including severity of
    illness and complexity of clinical judgment.

    AB 394 also restricts the unsafe assignment of unlicensed staff and the unsafe assignment of nursing
    staff to hospital clinical areas where they do not have demonstrated competency, training, and
    orientation.

    The specific ratios:

    AB 394 required the state Department of Health Services to establish the specific ratios for specific
    hospital units. In 2002, the DHS issued the proposed regulation to implement AB 394, including the
    specific ratios for every hospital unit, and held public hearings.

    On July 1, 2003, Gov. Davis and the DHS issued the final regulations incorporating extensive
    testimony presented during the hearings and public comment, including from 500 CNA RNs who
    testified in the hearings, and nearly 25,000 RNs whose letters were submitted by CNA to the DHS.

    Why the Law was needed

    The purpose of the law was to address the growing crisis in patient care in California hospitals caused
    by managed care and market based decisions on hospital care that resulted in California having
    among the worst RN staffing in the nation and a growing exodus of RNs out of hospitals creating a
    serious nursing shortage.

    CNA campaigned for 10 years to get the law enacted, including the largest gatherings of RNs in
    California history, major rallies drawing thousands of RNs to the Capitol.

    California's law was the first (and still only) ratio law in the nation. It is the single most effective
    response to protecting patient safety in hospitals and reducing the nursing shortage. The California law
    is considered a national, even international model, and has generated extensive attention from the
    national media and RN organizations around the world.

    How the ratios will protect patients

    Safe RN staffing is the single most essential element to safe patient care in hospitals. In the last year
    alone:

    JCAHO, the Joint Commission on Accreditation of Hospital Organizations, announced that
    inadequate staffing precipitated one-fourth of all sentinel events - unexpected occurrences that
    led to patient deaths, injuries, or permanent loss of function - reported to JCAHO the past five
    years

    A New England Journal of Medicine study documented that improved RN-to-patient ratios
    reduces rates of pneumonia, urinary infections, shock, cardiac arrest, gastrointestinal bleeding,
    and other adverse outcomes. No similar links were found for LVNs or other nursing staff.

    Research in the Journal of the American Medical Association found that up to 20,000 patient
    deaths each year can be linked to preventable patient deaths. For each additional patient
    assigned to an RN the likelihood of death within 30 days increased by 7 percent. Four
    additional patients increased the risk of death by 31%. No similar findings were associated with
    improved ratios for LVNs or other staff.

    Where will the RNs come from to meet the ratios?

    DHS has projected that California will need 5,000 RNs to meet the ratios that go into effect in
    January. That is the same number of RNs who graduate every year from California's 72 schools
    of nursing.

    The approach of the ratios is already having an effect on overcoming the nursing shortage. In
    the past fiscal year, the number of RNs increased by 4% -- the largest increase since 1989,
    reports the Board of Registered Nurses. The number of exam applicants increased by 18% and
    the ratio of RNs entering and exiting the state continues to make a dramatic change with 1,664
    more RNs coming into the state than leaving.

    In the three years since the law was signed, according to BRN data, applications for RN
    licenses from new graduates and from RNs outside California, has grown from 22,372
    applications in fiscal year 1999-2000 to 27,551 in fiscal year 2000-2001 to 32,368 in fiscal year
    2001-2002.

    In Victoria, Australia, ratios were enacted in 2001. By February 2002, the full-time RN
    workforce had increased by 16.5 percent.

    The real key to meeting the ratios is for hospitals to hang on to the RNs they already have.
    Many CNA-represented hospitals have taken big strides by enacting significant improvements,
    though collective bargaining with CNA, in retirement security, compensation, and improved
    patient care conditions.

    More background information is available at www.calnurse.org

    July 1, 2003
  12. by   Desert Rat
    That's great. Too bad I'm in Arizona. We've got a long way to go.
  13. by   pickledpepperRN
    You have a way to go as do we. We do have a head start but some Arizona nurses have begun. California nurses will help our neighbors (at least some of us)!

    http://cna.igc.org/saznc/
    Southern Arizona Nurses Coalition - California Nurses
    Association
    For Justice in Health Care

    Mission Statement:

    The Southern Arizona Nurses Coalition is a grassroots, community-based
    organization of direct-care nurses and supporters seeking justice in
    healthcare. Founded in August 2001, the coalition promotes the
    organization and representation of direct-care nurses to improve working
    conditions, patient care, nurse retention and healthcare justice in the
    community.
    The coalition recently affiliated with the California Nurses Association, a
    professional organization and union with an outstanding record of
    advocacy for nurses and patients.

    SAZNC-CNA promotes and protects the legal and human right to organize
    and bargain collectively. Without contract protection, nurses are unable
    to vigorously advocate for themselves or their patients without
    jeopardizing their job security.

    Membership

    The membership-based coalition currently comprises nurses from many
    Tucson-area hospital facility, including the following:

    Northwest Medical Center
    University Medical Center
    St. Mary's Hospital
    St. Joseph's Hospital
    El Dorado Hospital
    Tucson Heart Hospital
    Tucson Medical Center
    Kino Community Hospital.

    Members also include nursing students and nurses in public health,
    long-term care, and behavioral and home health.

    ***Direct-Care Nurses***
    Help Change ICU Ratios from 1:3 to a Safer 1:2
  14. by   pickledpepperRN
    San Bernardino County Sun

    New nurse staffing law takes effect
    Hospitals aim to meet deadline
    By ANNETTE WELLS and EMILY SACHS
    Staff Writers
    Tuesday, July 01, 2003 - Hospital units will be safer and nurses won't have to cut corners when treating patients at least, those are the hopes for the state's new Safe Staffing Law.
    Implementation of Assembly Bill 394 came Tuesday as Republicans and Democrats continued their debate over the state's budget.
    The law, signed by Gov. Gray Davis in 1999, establishes minimum licensed nurse-to-patient ratios for acute-care hospitals. Most, if not all, local hospitals have prepared for the new law, officials said.
    "We're not waiting until Dec. 30 to start hiring more nurses,' said Kimberly Hillhouse-VandenBosch, a spokeswoman at St. Bernardine Medical Center in San Bernardino. "We are aggressively recruiting nurses and (preparing) for the Jan. 1 deadline, but obviously it is going to take a period of time.'
    The proposed ratios vary from 1-to-1 for trauma patients to one nurse to six patients in medical-surgical units. The latter ratio is to be reduced to 1-to-5 the following year.
    That means better care for patients and less stress for nurses in the units, said Beth Holzberger, an intensive-care nurse at St. Bernardine.
    "Patients are going to be safer, and their nurses are going to be better able to take care of them,' she said. "This was a reason why so many nurses left the profession they were no longer able to do nursing safely.'
    Under the law, no registered nurse may be assigned to, or be responsible for, more patients than the specified ratios, and additional nurses must be assigned, as needed, by severity of patient illness.
    The law also clarifies the roles of registered nurses and licensed vocation nurses. They are not interchangeable.
    Jan. 1 is the deadline for hospitals to comply with the new law, but more new nurse-patient ratios are expected by 2008 in:
    Step-down units, which house patients just transferred from critical or intensive care.
    Telemetry units, where patients are on monitors.
    other specialty care units such as oncology and rehabilitation.
    In the last three years, because of a nationwide nursing shortage and nurses retiring, many area hospitals have been trying to fill positions through recruitment at community and state colleges.
    Randy Edwards, a physical therapist who works at a local hospital, said the need for nurses is high in nearly every department.
    Although he said he has never seen a patient hurt by a lack of nurses, the shortage shows itself in stress levels.
    "Absolutely, more nurses are better,' he said. "Even patients get frustrated when they need to talk to their nurse. My job (is that) I get to talk to them a little longer, which is nice.'
    Some local residents who have spent time at area hospitals said the hospitals seemed sufficiently staffed.
    Daniella Lopez, 28, who delivered her son, George, at Loma Linda University Medical Center in March, said that although a nurse practitioner fainted when Lopez was giving birth, there were plenty of other nurses on hand. It wasn't clear why the person fainted.
    One nurse stayed with her throughout her son's birth, she said.
    Selena Parker, who gave birth to all three of her children at Kaiser Permanente Medical Center in Fontana, said the only waiting she ever does is during checkups, which she considers a normal part of the care.
    "They have maybe three or four nurses per doctor,' said Parker, 33, of Colton. "They have a lot of rooms, but just one doctor.'
    She said she wouldn't hesitate to give birth again at the hospital.
    Three months ago, Gladys Godinez, 81, of San Bernardino, had cataract surgery at Loma Linda University Medical Center.
    Nurses did everything from giving her extra blankets to fretting over her well-being, she said. "I had more nurses than I knew what to do with and every one of them was so nice,' she said.
    Holzberger, one of about 100 nurses at a celebratory news conference held Tuesday in Monrovia by the California Nurses Association, said progress at St. Bernardine is already evident.
    "I just talked to a nurse the other day, and she talked about how hard we still work, but that now it's becoming manageable,' she said. "The question now is, 'How did we do it before?''
    Since Davis' signing of the law, hospitals have started implementing the new ratios, said Liz Jacobs, a spokeswoman for the California Nurses Association.
    St. Bernardine and Kaiser Permanente in Fontana are two of them. Jennifer Resche-Silvestri, a spokeswoman for Kaiser, said the new law is "just a better deal for both the patient and the nurse.'
    Holzberger said patients and nurses on the medical-surgical floor and telemetry units will benefit the most from the law.
    Luann Sowers, a St. Bernardine telemetry-unit nurse also attending the Tuesday press conference, agreed.
    "This will help us tremendously,' said Sowers during a cellular phone conversation. "It will give us more time to spend with our patients, and more time to explain to patients about their procedures.'
    To ensure that hospitals comply with the safe-staffing law, additional bills are being introduced authorizing the state's Department of Health Services to conduct unannounced inspections, and to impose fines of up to $5,000 a day to hospitals not maintaining nursing ratios.
    One bill is being proposed by the Service Employees International Union (SEIU) Nurse Alliance.
    State health officials have no further public hearings planned on the matter, but are accepting public comments until 5 p.m. on July 17.
    Written comments may be submitted via fax at (916) 440-7714. E-mails may be sent to regulation@dhs.ca.gov, or through the "Making Comments' link at http://www.dhs.ca.gov/regulation

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