Oregon’s hospital association, health care unions reach compromise on staffing bill

Oregon’s hospital industry and key unions have been wrangling over legislation on health care staffing since February.

The Oregon Nurses Association, which represents about 15,000 registered nurses and nurse practitioners, has been pushing House Bill 2697 which would impose nurse-to-patient ratios, something the Oregon Association of Hospitals and Health Systems has opposed. 

But after weeks of negotiations, the association, which represents all of the state’s hospitals, relented.

In a joint news release issued late Tuesday, the nurses association, two other unions and the hospital group said they had reached a consensus on amendments to the bill that include “first-in-the-nation patient ratios in state statute.”

Matt Swanson, a lobbyist for Service Employees International Union, which represents 9,000 health care workers in Oregon, told the Capital Chronicle that the ratios apply to nurses, certified nursing assistants and some licensed practical nurses. They also would apply to a range of hospital settings, including emergency departments, intensive care units, labor and delivery units and operating rooms. 

He said the compromise is good for health care staff – and patients.

“This will ensure you will have enough staff who attend to your needs who are not overwhelmed, tired, burned out, to really give you the care you deserve,” Swanson said. “That’s been one of the challenges in many facilities to scheduling enough staff to meet the needs of our patients.”

The compromise also includes a range of health care professionals. It also would create committees to establish staffing standards for respiratory therapists, psychologists, pharmacists, environmental services workers and others.

The committees will give staff a say in patient care, Meg Niemi, president of SEIU Local 49, said in the release. 

Besides the nurses association and SEIU, the Oregon Federation of Nurses and Health Professionals took part in the negotiations. The federation’s Local 5017 represents 5,000 nurses and health professionals in Oregon and southwest Washington.

Supporters hailed the compromise as historic.

“These amendments will make significant, historic advances towards safe hospital staffing and quality patient care throughout the state and, if passed by the Oregon Legislature, will put Oregon at the forefront of hospital staffing laws in the nation,” the release said.

The House bill has four chief sponsors. They’re all Democrats and include a nurse, Rep. Travis Nelson of Portland, and Rep. Rob Nosse of Portland, also chair of the House Committee on Behavioral Health and Health Care. Earlier this year, Nosse told the unions and industry association to negotiate a compromise, calling the bill one of the most important pieces of legislation this session.

His committee heard a presentation about the compromise on Tuesday. The amendments will be drafted and shared with the committee – and the House Ways and Means Committee – by April 4. The bill is scheduled for a vote by the health care committee on April 3.

The agreement comes during a prolonged shortage of nurses, with too few students graduating and veteran nurses retiring early or leaving the profession. Nurses and other health care workers have been under three years of stress during the pandemic, with repeated surges in ill patients as COVID cases spiked, forcing hospitals to temporarily curtail some services. In December, with COVID, flu and cases of RSV or respiratory syncytial virus surging, four large hospitals in the Portland area adopted emergency procedures for adult and pediatric patients – crisis standards of care – that allowed them to assign nurses, for example, to more patients than usual.

At the same time, hospitals reported millions of dollars in losses last year. Industry experts indicated that imposing ratios in law would hurt their finances.

During a discussion of the bill in February in the House health care committee, Andi Easton, the hospital association’s vice president of government affairs, said it “would be devastating  to impose these ratios at a time when many hospitals are in dire straits.”

A spokesman for the hospital association, Dave Northfield, declined Tuesday to comment about the agreement. 

“We’re grateful for the collective efforts that led to this agreement,” Becky Hultberg, president of the hospital association, said in the release. “The bill supports our hardworking frontline staff and reduces many of the administrative burdens hospitals currently face.”

Swanson said it includes some flexibility for hospitals, allowing them to be out of compliance with the ratios in certain crisis situations.

“Everyone recognized that we have to do something to improve staffing in our hospitals,” Swanson said.

The release said the bill amendments will be shared with the state House Committee on Behavioral Health and Health Care and the House Ways and Means Committee by April 4. The bill is scheduled for a vote by the health care committee on April 3.