Staffing Plans

Click to see a map of state legislative action on this topic

Some states are attempting to address the nursing shortage through the use of legislation enacting nurse staffing plans.  These bills would generally require hospitals to implement nurse staffing plans with input from nurses.  The plans would lead to minimum nurse staffing requirements.

In 2005, six states introduced nurse staffing plan legislation (CT, FL, IN, NH, OR and WA).  Seven states—CA, FL, KY, NV, OR, TX and VA—have enacted some kind of nurse staffing plan legislation or regulations.  The 2002 regulations adopted in Texas require hospitals to (under the administrative authority of chief nursing officer and in accordance with an advisory committee comprised of nurse members) adopt, implement and enforce a written staffing plan.  This plan must be consistent with standards established by the Texas nurse licensing boards and based upon the nursing profession's code of ethics.  Patient outcomes related to nursing care will be evaluated to determine the adequacy of the staffing plan. 

In 2002, a Florida bill also passed that specified the establishment of a minimum staffing standards and quality requirements for a subacute pediatric transition care center to be operated as a two-year pilot program. In 2001, Oregon enacted legislation requiring hospitals to develop and implement nurse staffing plans and establish internal review processes.  Random audits of hospitals for compliance are mandatory and failure to comply will result in civil penalties or revocation of licensure.  In 1998, legislation was passed in Kentucky and Virginia to set appropriate staffing methodology and in 1995, regulations were developed in California calling for institutions to develop valid staffing systems and in Nevada regulations were adopted a few years later.

Click on the links below to learn more about which states are acting on these key issues (data is current to the end of the most recent state legislative cycle, which concluded in 2005 for most states):

• Nurse staffing ratios
• Nurse staffing plans
• Mandatory overtime ban
• Safe patient handling and movement
• Whistleblower protection
• Universal health care