Court KOs Schwarzenegger plan

SACRAMENTO, Calif. (AP) — In a significant blow to Gov. Arnold Schwarzenegger, a judge has ruled that he acted illegally when he delayed implementation of a state law requiring hospitals to have at least one nurse for every five patients.

Administration officials promised to appeal Friday’s ruling by Superior Court Judge Judy Holzer Hersher, who issued a preliminary injunction canceling the emergency delay imposed by Mr. Schwarzenegger on Nov. 4.

The attorney general’s office and California Hospital Association (CHA) argued that invalidating the governor’s action endangers public health as well as hospital finances.

Hospitals have been required to have one nurse for each six patients in medical and surgical wings and one nurse for each four patients in emergency rooms, but a 1999 law required a new one-to-five ratio by Jan. 1.

Mr. Schwarzenegger’s emergency order delayed that ratio until 2008 while the state Department of Health Services conducted new studies. His action also gave hospitals flexibility to temporarily override emergency room patient ratios during sudden, unexpected arrivals of patients.

The 60,000-member California Nurses Association (CNA) sued Mr. Schwarzenegger on Dec. 21. CNA attorney James Eggleston told the judge Friday that the association had sought the one-in-five ratio — the nation’s first — to combat “the managed care philosophy of staffing, to make it so lean it becomes dangerous.” The state has about 300,000 nurses, the hospital association says.

Hospital officials have argued the requirements would force California’s 400 hospitals to turn away patients during crises and boost their staffs by an estimated 4,000 nurses — a feat they claim will be nearly impossible as the state already has 14,000 hospital nursing vacancies.

The hospital industry says thousands of nurses have left the state, and the state estimates California will need 42,000 more nurses within five years.

Deputy Attorney General Janie Daigle and CHA attorney Robert Leventhal said problems arose almost immediately after implementation of the one-in-six ratios in 2004 and hospitals require more time than originally expected before beginning the tougher requirements.

“We thought one year would be enough, but almost immediately upon implementation [in 2004], reports started coming in,” Mr. Daigle told the judge. Hospitals were turning away patients because of nursing shortages, and some hospitals even closed because the one-in-six ratio damaged their financial conditions, the attorneys said.

The judge, however, held that the hospitals’ financial state didn’t give the state the right to delay the law, saying its intent was to improve patient safety.

The administration “strongly rejects” the ruling, said Kim Belshe, Mr. Schwarzenegger’s secretary of health and human services. “We’re confident in our actions, and we’re not backing down.”