This year marks the 15th anniversary of the implementation of nurse staffing ratios in California. Unsurprisingly, coordinated and cohesive labor interests are pushing to enhance the penalties for infractions and expand oversight for staffing ratio compliance.

Their claim is that increased penalties — an additional $30,000 for the first infraction (even with zero threat of patient harm) and $60,000 (again, with zero threat of patient harm) for subsequent infractions — will improve patient safety.

You all know better.

California’s $213 billion annual budget is something of a litmus test. Its value hinges greatly on one’s point of view, and depending on how you look at things, you can find plenty to be pleased with and plenty to be upset about.

In the latest iteration of Gov. Newsom’s spending plan, released earlier this month, health care leaders should find much to be happy about. Newsom makes significant new investments in care — hundreds of millions of dollars for priorities shared by hospitals. Among his noteworthy allocations:

Over the past several weeks, as the 2019 legislative session has kicked into high gear and the political realities for some of our top priorities have become clear, we’ve begun to hone our positions on hot-button issues.

When we talk about “the hospital story,” we often think about it in aggregate, the one that yields huge statewide numbers and powerful data:

Late last month, key members of Congress heard important testimony kicking off a national public forum on Medicare for All.

A little more than a week ago, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would reconfigure the calculations for the Medicare area wage index.

The area wage index is essential to ensure that hospitals’ resources for patient care reflect geographic disparities in labor costs. This is a particular concern for California’s hospitals given our state’s high labor costs (as an example, California pays the highest nurse salaries in the nation).

Today marks the deadline for committees in the state Legislature to move bills that have a financial impact to the appropriate fiscal committees. Or, if you’re a baseball fan, we’re in roughly the third inning of this 2019 advocacy game.

Assessing where we stand at this point on the hottest issues, there are some promising developments, but also several dangerous bills that will be a fight to the end to stave off. To recap where things stand on several priority matters:

We all know that hospitals are more than just buildings, but sometimes the bricks and mortar matter — and hospital leaders know better than anyone that our buildings are among the safest in the world.

Since the 1992 Northridge earthquake, you’ve invested billions to meet world-class seismic safety requirements. As a result, communities across the state can rest assured that every patient, employee, and visitor in a hospital will be safe when the next earthquake strikes.

Earlier this week, nearly 50 of California’s hospital and health system leaders trekked almost 3,000 miles to Washington, D.C. Their purpose: to share with members of Congress the legislative changes they need to successfully meet their mission of care back home.

It was an impressive showing for this year’s joint advocacy program, hosted by your California Hospital Association and the American Hospital Association. I am grateful to have been able to spend time with John Muir Health President & CEO Cal Knight, CHA’s Board Chair, along with Stanford Health Care President and CEO David Entwistle, and Alameda Health System CEO Delvecchio Finley, California’s representatives on AHA’s Board of Trustees.