Photo provided to the Times Observer Nurses from around the state held a “solemn funeral procession and memorial” last summer that ended at Rep. Kathy Rapp’s office on Market St. in opposition to her decision as Health Committee chair to not move the Patient Safety Act out of Committee. The bill was reintroduced last week.

Last year, then-chair of the House Health Committee Rep. Kathy Rapp promised that a bill that would have mandated staffing ratios in hospitals – the Patient Safety Act – wouldn’t get out of her committee.

She was right. It didn’t.

But the bill has been reintroduced.

It was referred to the Health Committee last week.

It’s guaranteed to receive a different reception in the committee this time around as the Democratic Party took a slim majority in the House during the midterm elections. One of the co-sponsors of the legislation – Rep. Dan Frankel – now chairs the House Health Committee.

The prime sponsors of the bill — Reps. Thomas Mehaffie (R), Kathleen Tomlinson (R) and Bridge Kosierowski (D) — explain in a legislative memo that the bill “would establish safe patient limits under the care of an individual nurse in Pennsylvania hospitals….”

“Nurses have been on the front lines of the COVID-19 pandemic putting their lives on the line to keep patients in our communities safe,” they assert. “Unfortunately, nurses across the state are being assigned an increasing number of patients as staffing levels continue to decline, resulting in nearly 300 surgical patient deaths per year in Pennsylvania. Now, in this crisis, more than ever, our patients need the protection of the Patient Safety Act.”

The bill would set ratios “dependent upon the acuity of the unit’s patient’s needs.” It was referred to the Health Committee on April 28. It has over 100 co-sponsors. That represents a majority of the members of the House.

The Committee heard testimony on the bill in a session on Tuesday.

Rapp, now the Republican chair of the committee (essentially the minority chair), called it a “hammer being brought down on the hospitals that are still struggling from the pandemic” during that hearing.

She went through many steps that have been taken to recruit nurses throughout the state.

“Is there still more work to do? Yes,” she said. “We heard that there are conditions that the hospitals and the nurses should work together on at every single hospital individually to try to solve those issues.

“This bill is not the solution that some portray it to be,” Rapp argued. “(It) sounds good on paper but is anything but in practice.”

The legislation outlines specific rations for many types of hospital units – one nurse to one patient in the operating room, one-to-two in an ICU and one-to-four in an ER, for example.

A “nurse staffing committee” would be required in each hospital, tasked with the development of a “hospital-wide staffing plan.”

Penalties to hospitals for violations include a warning for a first offense, $7,500 for a second offense and the maximum penalty – $15,000 – for third and subsequent offenses.

Rapp said in a Jan. 2022 committee hearing – during the General Assembly’s last session – that the legislation would not be getting out of her committee.

During that hearing, Warren General Hospital CEO Rick Allen said the bill is “something that would not benefit small and rural hospitals…. We need the ability to operate our organization.”

“This is a bill that I cannot in good conscience support,” Rapp said during that hearing. “In my mind, this is a contractual issue. I don’t believe legislators should really get involved with contractual issues.”

Her comments in that hearing triggered a firestorm of pushback from nurses’ organizations that included a wealth of political signage as well as a protest event that culminated outside of her Market St. office.