Running head: POLICY BRIEFING DOCUMENT 1
Policy Brief on California RN Staffing Ratio Law
Rasmussen College
NUR4327: Influence on Policy, Finance, and Law on Healthcare
Date
, POLICY BRIEFING DOCUMENT 2
Executive Summary
Patient-to-nurse staffing ratios have grown at an unsafe rate for both nurses and their
patients. “Nurses are increasingly put into unmanageable situations by their management who
demand they care for more patients than is safe,” (NNU, 2019). Staffing affects the ability of all
nurses to deliver safe, quality care to patients in all practice settings. The quality of patient care
decreases as the number of patients in a nurse’s care increases. For these reasons, it is imperative
that more nursing staff is hired in order for patient-to-nurse ratios to be kept to a safe level.
California became the first state to establish minimum RN-to-patient ratios for hospitals,
(Kasprak, 2004).
Context and Importance of the Problem
Assembly bill 394, which is now known as the California RN staffing ratio law, was
authored by California State Senator Sheila Kuehl and sponsored by CNA/NNOC (California
Nurses Association/National Nurses of California), (IHSP, 2001). It was first introduced in
February of 1999 and signed into law by Governor Gray Davis in fall of 1999, (IHSP, 2001). The
implementation of the law did not come about until 2003, with hospitals being required to meet
the new staffing regulations in January 2004, (IHSP, 2001). The first attempts of this legislation
were introduced into the Assembly in 1993, but the bill died in committee, (IHSP, 2001).
Another attempt was in 1997 with AB 695, which was passed by the legislature, but vetoed by
former Governor Wilson, (IHSP, 2001). It took over a decade for this legislation to be adopted
and for hospitals to begin implementing this policy.
AB 394 was created to address concerns for the safety and health of the increasing
number of patients being admitted into hospitals, alongside the demand on nurses to care for
these patients. California realized that the growing demand on nurses had become unsustainable
Policy Brief on California RN Staffing Ratio Law
Rasmussen College
NUR4327: Influence on Policy, Finance, and Law on Healthcare
Date
, POLICY BRIEFING DOCUMENT 2
Executive Summary
Patient-to-nurse staffing ratios have grown at an unsafe rate for both nurses and their
patients. “Nurses are increasingly put into unmanageable situations by their management who
demand they care for more patients than is safe,” (NNU, 2019). Staffing affects the ability of all
nurses to deliver safe, quality care to patients in all practice settings. The quality of patient care
decreases as the number of patients in a nurse’s care increases. For these reasons, it is imperative
that more nursing staff is hired in order for patient-to-nurse ratios to be kept to a safe level.
California became the first state to establish minimum RN-to-patient ratios for hospitals,
(Kasprak, 2004).
Context and Importance of the Problem
Assembly bill 394, which is now known as the California RN staffing ratio law, was
authored by California State Senator Sheila Kuehl and sponsored by CNA/NNOC (California
Nurses Association/National Nurses of California), (IHSP, 2001). It was first introduced in
February of 1999 and signed into law by Governor Gray Davis in fall of 1999, (IHSP, 2001). The
implementation of the law did not come about until 2003, with hospitals being required to meet
the new staffing regulations in January 2004, (IHSP, 2001). The first attempts of this legislation
were introduced into the Assembly in 1993, but the bill died in committee, (IHSP, 2001).
Another attempt was in 1997 with AB 695, which was passed by the legislature, but vetoed by
former Governor Wilson, (IHSP, 2001). It took over a decade for this legislation to be adopted
and for hospitals to begin implementing this policy.
AB 394 was created to address concerns for the safety and health of the increasing
number of patients being admitted into hospitals, alongside the demand on nurses to care for
these patients. California realized that the growing demand on nurses had become unsustainable
