Health care staffing level legislation heard in Olympia


Aaron Kunkler


A proposed minimum staffing level bill for hospitals was heard today in the Washington State House Labor and Workplace Standards Committee. 

The bill would move oversight of staffing committee statutes from the Department of Health, where it currently resides, to the Department of Labor and Industries. It would also increase the daily penalty for noncompliance with state staffing orders from $100 to $10,000 a day. 


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HB 1868 would specifically create minimum staffing standards for specific patient units. In emergency departments, it would create a staff to patient ratio of one-to-three for nontrauma and noncritical care patients, and a one-to-one ratio for trauma and critical care patients. 

In INCUs, there would be a one-to-two ratio, or a one-to-one ratio, depending on the stability of the patients, as assessed by the nurse. It also sets staffing standards for labor and delivery, postpartum, operating room, oncology, postanesthesia care, progressive care, medical-surgery, telemetry, psychiatric, and pediatric care units. 

Additionally, the bill deals with staffing levels for nursing assistants in a broad range of units. 

If approved, most hospitals would be required to implement the minimum staffing level standards no later than two years after the bill became effective. Exceptions would be created for critical access hospitals, hospitals with fewer than 25 acute care beds, and certain sole community hospitals certified by the Centers for Medicare and Medicaid Services, which would have up to four years to implement the standards. 

Hospitals would also be required to have staffing committees where half of the members would be drawn from nurses and health care personnel who are not managers. The other half would be appointed by hospital administration. 

The bill is supported by WA Safe + Healthy, a campaign coalition between three Washington unions representing health care workers. The campaign was formed in December between the Washington State Nurses Association, UFCW 21, and SEIU Healthcare 1199NW, which collective represent more than 71,000 health care workers in the state. 

In previous coverage, campaign representatives told State of Reform that stress and understaffing have led nurses to leave the field, or become traveling nurses. 

Last week, the unions also announced that in 2021, health care workers they represent filed nearly 8,700 safety complaint forms, far higher than the roughly 2,800 filed in 2019. 

A companion bill to the House legislation, SB 5751, has been filed in the Senate.