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Nurse-to-patient ratio passes House committee

Legislation would make Illinois the second state to set a limit

SPRINGFIELD – A bill moving through the Legislature sets limits on the number of patients Illinois nurses can care for at any one time.

To comply with the limits, health care facilities in the state would likely have to hire more nurses to treat the same number of patients.

Advocates say insufficient nurse staffing leads to high stress and poor workplace conditions, where medical mistakes are more likely to occur.

More nurses assigned to fewer patients would improve patient care and lead to higher nurse retention rates, they say.

Opponents question how hospitals could pay for all the new nurses required, and say a rigid “one-size-fits-all” ratio would lead to less health care access, especially for rural, safety-net, and “magnet” hospitals that take patients from many different counties.

Both sides’ arguments are further complicated by the growing shortage of nurses in the state and the skyrocketing costs of health care.

House Bill 2604, sponsored by Rep. Fred Crespo (D-Hoffman Estates), advanced out of the House Labor and Commerce Committee on Wednesday evening. The vote was 17-8, with one voting present.

It requires at least one nurse for every four patients in medical-surgical units; every three patients in intermediate care; and every two patients in intensive care.

The model is based on a similar law passed in California in 2004, the only state to mandate specific nurse-patient ratios.

“Safe patient limits reduce the likelihood of patient death and reduce adverse outcomes like hospital acquired infections, cardiac arrest, pneumonia and readmission rates,” said Alice Johnson, executive director of the Illinois Nurses Association, the bill’s main backer. “The limits are also better for nurses, reducing the likelihood of workplace violence and occupational injuries.”

Johnson joined several other nurses and nursing labor groups in Wednesday’s hearing to testify in support of the bill.

HB 2604’s main opponents are hospital associations, nursing administrators and businesses.

“Hospitals today are already struggling financially. We don’t have enough nurses, if this bill were to pass, to meet the mandate without seeing services and other jobs eliminated,” said A.J. Wilhelmi, president and CEO of the Illinois Health and Hospital Association. “There’s a reason no other state has passed it since California.”

Already, Illinois is facing an estimated shortage of 19,000 nurses over the next 10 years, according to a study this month by the Illinois Economic Policy Institute and the Project for Middle Class Renewal at the University of Illinois at Urbana-Champaign.

A third of the state’s almost 183,000 nurses are set to retire in the next five years also, according to a 2018 survey by the Illinois Nursing Workforce Center.

Proponents of Crespo’s bill, like Johnson, say the nursing shortage is really a lack of attractive nursing jobs that are not overburdened and in understaffed settings.

Opponents pin the cause on an aging baby boomer population with increasing medical needs and a lack of young people joining the nursing workforce, which nurse-patient limits wouldexacerbate.

HB 2604 is now headed to the House, where lawmakers can debate it and add amendments.

Danny Chun, spokesman for the Illinois Health and Hospital Association, said Wednesday’s committee vote is not an accurate barometer of the full chamber’s support.

Editor's note: Capitol News Illinois is a nonprofit news service operated by the Illinois Press Foundation that provides coverage of state government to newspapers throughout Illinois. The mission of Capitol News Illinois is to provide credible and unbiased coverage of state government to the more than 400 daily and weekly newspapers that are members of the Illinois Press Association.

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