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SACRAMENTO - The California Department of Health Services (CDHS)
today released for public comment revised nurse-to-patient
ratio regulations for general acute care hospitals. The
ratios will be the first of their kind in the nation.
"The high interest in this issue
is reflected in the fact that CDHS received more than 24,000
letters from organizations and individuals across the state
during the initial public comment period," noted State
Health Director Diana M. Bontá, R.N., Dr.P.H. "In signing
the legislation that led to the development of these ratios,
Gov. Gray Davis demonstrated his commitment to quality
patient care and recognition of the key role nurses play in
providing that care."
While most of the revisions
are technical in nature or clarifications to make the
regulations more clear, ratios for step-down, step-down
telemetry, telemetry and specialty care units were changed
in response to comments received during the initial public
comment period in late 2002 (chart attached). The ratios
would be implemented in stages beginning in 2005 to enable
hospitals, especially those in rural areas, to develop
strategies to meet the new ratios.
In 1999, Gov. Gray Davis
signed AB 394, which required CDHS to establish minimum
nurse-to-patient ratios by licensed nurse classification and
by hospital unit for the state's general acute care
hospitals.
The proposed ratios are based
on a complex number of factors, including information
collected by state regulators during unannounced visits to
80 acute care hospitals and 10 state-operated hospitals that
began in May 2001. CDHS used data from the on-site hospital
visits to determine the licensed nurse-to-patient ratios in
the nursing units at the hospitals.
The proposed ratios also
reflect the results of a literature search, an analysis of
data from the state Office of Statewide Health Planning and
Development, comments from professional organizations and
over 24,000 letters received from individuals across the
state.
Only intensive and critical
care, acute respiratory care, coronary care, well-baby
nursery, neonatal intensive care unit and operating rooms
currently have minimum ratios. The proposed ratios cover all
other areas of a hospital, including medical/surgical units.
The proposed ratios vary from 1:1 for trauma patients to 1:6
(reduced one year later to 1:5) in medical/surgical units.
The regulations are expected
to take effect Jan. 1, 2004. Five years after their
adoption, CDHS will evaluate the regulations and provide a
report to the Legislature, as required by law.
The draft regulations,
research findings and information about the process for
submitting comments are available on CDHS' Web site at
http://www.dhs.ca.gov
CDHS will summarize all
comments received and provide a formal response to each one.
The regulatory package, including the responses, will be
submitted to the Office of Administrative Law for approval.
After approval, the regulatory package, including the
responses, will be published on the CDHS Web site.
The deadline for public
comments is 5 p.m. July 17. Written comments can be
submitted via fax at (916) 440-7714, e-mail at
mailto:regulation@dhs.ca.gov or
through the "Making Comments"
link on the CDHS' Web site at
http://www.dhs.ca.gov/regulation. Comments can also be
mailed to the Office of Regulations, Department of Health
Services, MS 0015, P.O. Box 942732, Sacramento CA
94234-7320. (Please note that CDHS has moved to a new
location in the East End Complex in Sacramento and that the
U.S. Postal Service requires the use of a post office box
for the delivery of mailed items. |
1-877-79-NIUSA