Nurse staffing ratio and other Ohio health legislation don’t make it out of committees

Community Pharmacy Protection Act, ‘pink slip’ update also won’t see passage
A group of nurses and advocates gathered on Wednesday, April 24, 2024, in the Ohio Statehouse Atrium to pressure lawmakers into passing a bill that would require mandatory nurse-to-patient minimums in Ohio hospitals. AVERY KREEMER/STAFF

Credit: Avery Kreemer

Credit: Avery Kreemer

A group of nurses and advocates gathered on Wednesday, April 24, 2024, in the Ohio Statehouse Atrium to pressure lawmakers into passing a bill that would require mandatory nurse-to-patient minimums in Ohio hospitals. AVERY KREEMER/STAFF

With the end of the 135th Ohio General Assembly comes the end of a number of health care-related bills, including ones that would have mandated the maximum number of patients a nurse can have assigned to them in certain settings in hospitals.

“Safe staffing should never be optional—we can’t keep burying our loved ones while hospital executives, driven by greed, put profits above lives,” said said Rick Lucas, a nurse and president and executive director of the Ohio Nurses Association.

The Ohio Nurses Association plans to continue advocating for staffing ratios between nurses and hospital patients, like those that were included in House Bill 285.

The proposed legislation would have set the maximum number of patients per nurse depending on the hospital setting, ranging from one patient per nurse up to six patients per nurse, according to the bill’s analysis. It would have also established a $20 million forgivable loan program to incentivize people to enter the profession.

House Bill 285 never made it past the House Health Provider Services Committee after receiving two hearings.

Ron Smith, of Oakwood, was a frequent advocate for nursing-related legislation during this recent Ohio General Assembly session. His daughter Tristin Kate Smith was a Dayton nurse who died by suicide on Aug. 7, 2023. She left behind a letter detailing the strain the nursing profession had on her.

Ron Smith (front row, black suit), the father of the late Tristin Kate Smith, a Dayton nurse who died by suicide last year, poses beside Rep. Haraz Ghanbari (blue suit, yellow tie) and Rep. Elgin Rogers (blue suit, blue tie) on Wednesday, April 24, 2024. The bipartisan state reps are behind a bill to establish mandatory nurse-to-patient ratios in Ohio hospitals. AVERY KREEMER/STAFF

Credit: Avery Kreemer

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Credit: Avery Kreemer

“From a young age, Tristin always wanted to take care of people,” Smith said during testimony for House Bill 285. “She fulfilled that a dream―a dream that ended up taking her life.”

Numerous proponents described working conditions for nurses that included infrequent breaks during 12-hour shifts to violence and harassment from patients. More nurses could lead to better health outcomes for patients, supporters said.

Exacerbating staffing shortages

Opponents leaned on the staffing shortages currently faced in the health care field while also suggesting hospitals may have to cut back on services in order to comply with the staffing mandates.

“Hospitals could be forced to increase reliance on temporary or travel nurses and reduce positions from auxiliary services and other staff members,” Emma Cardone, director of advocacy at the Ohio Hospital Association, said in that organization’s submitted testimony.

Ohio Sen. Sherrod Brown fist pumps Wexner Medical Center at OSU nurse, Rick Lucas at a press conference Tuesday April 11, 2023 at Central State West Campus. Senator Brown is co-sponsoring a bill in congress, S.1113, called the nurse staffing standards for hospital patient safety and quality act. It also did not make it past getting introduced in Congress. JIM NOELKER/STAFF

Credit: JIM NOELKER

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Credit: JIM NOELKER

Other business leaders said it was an unfair regulation on hospital operations.

“The Ohio Chamber believes hospitals – and all employers – should be free from burdensome government mandates on employment practices that fail to consider what is practical or makes sense for each individual hospital,” said Kevin Shimp, an associate attorney at the law firm Dickinson Wright testifying on behalf of the Ohio Chamber of Commerce.

The Ohio Nurses Association plans to continue to advocate for staffing ratios and hopes to see this bill reintroduced in the new Ohio General Assembly session that starts next year.

In the same vein, House Bill 154, which also would have mandated nurse-to-patient staffing ratios, did not make it past being introduced in the House Health Provider Services Committee.

Both House Bills 154 and 285 only included minor differences in the recommended staffing ratios. House Bill 154 did not include the forgiveable loan program that was in House Bill 285.

Bill tackling PBMs fails

The Community Pharmacy Protection Act, or House Bill 505, never made it past the House Insurance Committee.

This bill would have imposed regulations on pharmacy benefit managers, or PBMS, to increase transparency, as well as to increase the reimbursements pharmacies receive for dispensing drugs.

PBMs say their practices decrease drug costs, but pharmacists say those practices threaten their ability to stay open.

A local pharmacist testified in favor of House Bill 505, saying multiple pharmacies have already closed in Champaign County and nearby counties.

“In Champaign County...and the four contiguous counties in this year alone, 11 independent pharmacies have closed, shutting their doors, leaving just five left and they are hanging on a thread,” said Dennis Blank, a pharmacist currently practicing part-time for the Medicine Shoppe of Urbana.

The Community Pharmacy Protection Act included proposed benefits for pharmacies, such as requiring insurers to pay pharmacies the actual acquisition cost plus a minimum dispensing fee for drug claims. This measure was an attempt to prevent pharmacies from paying more for the drug than the cost they get for dispensing the drug.

Dennis Blank, a pharmacist currently practicing part-time for the Medicine Shoppe of Urbana, testifying before the Ohio House Insurance Committee on Dec. 4, 2024, in favor of H.B. 505, or the Community Pharmacy Protection Act. COURTESY OF THE OHIO CHANNEL

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‘Psychiatric deterioration’ still won’t be added to ‘pink-slipping’ rules

An update to Ohio ‘pink-slipping’ system failed for a second time in the 135th session of the Ohio General Assembly after it had to be reintroduced following its failure to pass in the 134th session.

House Bill 249 would have added a category of “psychiatric deterioration” to the list of reasons why a person a could be “pink-slipped,” or undergo an involuntary mental health assessment. During the 134th session, it was House Bill 439.

This additional category would reach people suffering from severe mental illness to get them into treatment or receiving services sooner, lawmakers and supporters of bill say. Critics worried it could potentially violate a person’s rights due to stigma around mental health.

The failed bills will need to be refiled next year if lawmakers want to continue pushing for staffing ratios between nurses and patients, as well as for regulations on PBMs and updates to the pink-slipping system in Ohio.

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