Recap: June 12 Member Briefing on Nurse Staffing Ratio Legislation

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On Wednesday of last week, nearly 200 hospital CEOs, government relations executives, and nurse leaders joined CHA to discuss a highly controversial bill on nurse staffing penalties, Senate Bill 227 (Leyva, D-Chino). The call included a status update, our strategy, and next steps to beat back this short-sighted and potentially harmful legislation. Materials shared during the call are available online.

Kathryn Scott, CHA’s senior vice president, state relations and advocacy, shared background on the bill, including the following key points:

  • The bill would impose hefty fines ($30,000 for the first ratio compliance infraction and $60,000 for subsequent infractions).
  • In imposing the penalties, the bill would not allow for discretion or consideration of whether patients were harmed or placed at risk of harm.
  • This is similar to a bill that moved through both houses of the Legislature last year and was only stymied by a gubernatorial veto.
  • The math is against us; 41 votes are needed to pass the bill, and there are 61 Democrats in the Assembly, many of whom voted for last year’s bill.
  • Hospital voices are key if we are to defend against this bill.


As hospital leaders begin to send letters opposing the bill and schedule in-district meetings with members of the Assembly, they were asked to incorporate the following messages into their communications:

  • The bill is a solution in search of a problem. Over a 10-year period, a mere 634 infractions were found among more than 35 million hours of hospital care (less than 1/500th of 1%).
  • Clinical staffing decisions — which can change by the minute based on patient conditions, surge events, and other factors — should be made by clinicians.
  • No evidence suggests staffing ratios actually improve patient care.
  • MOST IMPORTANTLY: Legislators need to hear directly from hospital nurse leaders, who can offer a different perspective on the unique challenges that staffing ratios present for clinical operations and share real stories of patient care and how regulatory burdens can impede their work.

Next Steps

Your voice is critical to our collective effort to stop SB 227. We will reconvene attendees of the June 12 call to discuss messages that resonated with legislators and key points to continue to press at the Capitol in Sacramento. If you have questions, contact Kathryn Scottt at

—​ Carmela