House Passes Staffing Ratios Mandate

June 28, 2023

The state House of Representatives today approved legislation that would impose government-mandated nurse staffing ratios in Pennsylvania hospitals, sending the measure to the Senate.

HAP, hospitals, and nursing leaders have warned that the mandate would force facilities to close beds and reduce services as they struggle to meet staffing ratios amid a historic health care workforce shortage. Instead, they’ve urged lawmakers to focus on solutions that support health care teams and bring more nurses to the bedside.

“We need your help. We need more nurses,” a group of 466 nurse leaders from throughout the state said in a letter to lawmakers earlier this month. “But, we implore you to take meaningful steps that will actually develop more nurses for the bedside, not tie our hands with ineffective legal mandates as we strive to provide the highest quality care for our patients.”

Representatives approved House Bill 106 with a 119-84 vote after adopting changes related to fines, implementation dates, and emergency exceptions. HAP continues to raise concerns as the legislative process advances.

“HAP stands ready to partner with the General Assembly and Shapiro administration on strategies that build the health care workforce and bring more nurses to the bedside. This approach will support safe and high-quality care for Pennsylvanians and reduce stress on health care teams,” HAP President and CEO Nicole Stallings said. “We continue to emphasize that government-mandated nurse staffing ratios are not a solution and will hurt Pennsylvanians’ access to care.”

Despite aggressively working to recruit and retain nurses—offering extraordinary pay raises, bonuses, loan repayment, schedule flexibility, and other incentives—hospitals report being unable to fill, on average, more than 30 percent of open bedside registered nurse positions and cite finding qualified candidates as their top barrier.

Earlier this year, HAP shared comprehensive policy recommendations for growing and supporting the health care workforce. Among other initiatives, HAP is calling for:

• Making health care education more affordable and accessible by funding nursing scholarships and tuition assistance, expanding student loan forgiveness for nurses, investing in health care education programs, and offering incentives for clinicians to work as health care faculty and preceptors.
• Helping nurses quickly get to work by addressing licensing delays and administrative barriers.
• Empowering registered nurses to practice at the top of their abilities by supporting innovative care models like virtual nursing and team-based care.
• Prioritizing efforts to grow the health care workforce by establishing a health care workforce council that coordinates across state agencies.

For more information, contact Heather Tyler, HAP’s vice president, state legislative advocacy.