Davis Submits New Rules on Nurse Staffing

SACRAMENTO —  After a two-year delay, Gov. Gray Davis proposed regulations Sunday that would make California the first state to limit the number of patients who could be assigned to each hospital nurse.

At the same time, the governor approved $21 million in grants as the initial phase of a $52-million, three-year effort to ease the state’s acute nursing shortage by financing the training of at least 5,000 new nurses.

In a third action involving nurses, Davis signed legislation, Assembly Bill 2314 by Assemblywoman Helen Thomson (D-Davis), designed to speed up the education of nursing students at California community colleges and state universities.

“These moves make California a national leader in nursing and patient care,” Davis said. “They address the quality of patient care and help meet the nursing work-force needs of the 21st century.”

Davis has until midnight to sign or veto the remaining pile of bills sent to him by the Legislature, which ended its session Aug. 31.

Still awaiting action are several politically sensitive measures, including one that would allow undocumented immigrants to obtain California driver’s licenses, another to give farm workers the right to get third-party mediation during contract negotiations and a third that would let Indian tribes have greater say over areas they consider sacred sites.

Davis’ decision to begin establishing regulations requiring hospitals to comply with specific nurse-patient ratios was a triumph for the California Nurses Assn. and the Service Employees International Union, labor organizations that represent nurses and have contributed heavily to Davis’ campaign. The regulations were opposed by California hospital officials, who predict that they will increase costs and force cutbacks elsewhere.

Under the proposal, the ratios would vary according to the level of care required by each type of patient. In trauma units, the ratio would be as high as one nurse for each patient, but in medical-surgical units it would be one nurse for every six patients. After a year, those units would have one nurse for every five patients.

In 1999, Davis signed legislation requiring him to set nurse-patient ratios effective Jan. 1, 2001. A year later, another bill changed that date to Jan. 1, 2002.

In January, Davis provided a preview of what the regulations would require, but it wasn’t until Sunday that he announced the proposal was being forwarded for approval to the state’s administrative law judges.

A series of public hearings will be held across the state, including one in Los Angeles on Nov. 15. If approved, the regulations will go into effect in January 2004.

The two unions said the new ratios will help ease the nursing shortage. But the California Healthcare Assn., which represents the state’s hospitals, saw it as a simplistic solution that could have “unintended consequences.”

“Whatever the ratios are determined to be, hospitals will comply,” said Jan Emerson, an association vice president. “But to do that, we may have to shut down beds, we may have to shut down entire units; emergency room patients may have to wait longer for care.”

Even with 5,000 newly trained nurses, she added, California will still be short about 25,000.

“It’s going to take us years to dig out of that shortage,” Emerson said, “and nursing ratios aren’t going to create more nurses magically overnight.”

But Beth Capell, a lobbyist for the Service Employees International Union, argued that the ratios would improve working conditions for overworked nurses and make the job more attractive.

In other action Sunday, Davis signed a bill to help former braceros recover millions of dollars in lost wages from work on American farms and railroads more than 50 years ago.

From 1942 to 1950, nearly 400,000 Mexican guest workers--known as braceros--were invited to the United States to relieve a labor shortage caused by World War II.

As part of the guest worker program, the U.S. and Mexico agreed that 10% of the workers’ wages be withheld as savings and paid to the braceros upon their return home.

But thousands of surviving migrants and their descendants--many of whom now live in the United States--claim they never received the money. They have formed a growing reparations movement that has triggered international protests, a Mexican congressional investigation and legal action in both countries.

Attorneys for the men, mostly in their 70s and 80s, have filed federal lawsuits seeking the back wages from the U.S., Mexico and several banks. In August, a San Francisco judge dismissed one class-action suit, concluding in part that the statute of limitations for filing a complaint had expired.

The bill signed Sunday, AB 2913 by Assemblyman Marco Firebaugh (D-East Los Angeles), would extend the applicable California statute of limitations, perhaps enabling the plaintiffs to refile.

But even its author admitted that the bill is mostly a symbolic gesture because it cannot alter federal time limits on the suits.

“This is a significant policy comment by the Legislature and the governor of this state that we believe the braceros ought to have their day in court,” Firebaugh said.

Activists, including Baldomero Capiz of Los Angeles, hailed the governor’s action as a morale boost to the movement.

“We will keep fighting this fight, and the Gray Davis signature gives us fuel to fight with more confidence,” said Capiz, a leader in the reparations movement whose uncles built rail lines during the bracero program, and who is a former migrant worker himself. “We hope the U.S. Congress takes notice.”

A spokesman for the United Farm Workers, Marc Grossman, echoed those sentiments.

“We supported this bill because it’s about remedying some old injustices,” he said. The braceros “were abused and exploited when they worked here, and became victims by being defrauded out of their own wages.”

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Times staff writer Daniel Hernandez in Los Angeles contributed to this report.