ST. PAUL — As the Minnesota Legislature's 2023 session came to a close Monday night, both chambers passed a significantly amended nursing bill once known as the Keeping Nurses at the Bedside Act.
The major change was announced by bill co-authors Sen. Erin Murphy, DFL-St. Paul, and Rep. Sandra Feist, DFL-New Brighton, along with Sens. Liz Boldon, DFL-Rochester, and Jim Abler, R-Anoka, in a news conference Monday evening. The new version of the bill, titled the Nurse and Patient Safety Act, does not include the nurse staffing committee requirement opposed by the Minnesota Hospital Association and Mayo Clinic.
"We came to this session of course, as you know, fighting for our efforts to keep nurses at the bedside," Murphy said. "We came here for that. We didn't get everything that we wanted. We're not going to get everything that we need. But what we have in this provision that is going to go to the floor of the House and the Senate tonight and become law is important and transformative work for nurses, for direct care workers and the patients in their care."
The new bill language replaces the staffing committee requirement for hospitals with an order for the state Commissioner of Health to publish a nursing workforce report that studies why nurses are leaving the profession. The bill retains its provisions that will establish a loan forgiveness program for specific health care workers and will direct health systems to implement written action plans to address workplace violence.
The major compromise on the staffing committee portion of the former Keeping Nurses at the Bedside Act comes almost three weeks after Mayo Clinic lobbyist Kate Johansen said in a May 3 email to lawmakers and gubernatorial staff that if the KNABA became law without a way for Mayo Clinic to be exempt, the health system would cancel about $4.4 billion in investment in Minnesota.
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Murphy said that corporate opposition to the bill had "dominated and replaced the debate that we've been having about nursing and patient safety."
"The last couple of weeks, we've run headlong into a large corporation. Mayo insisted on being, demanded on being excluded from this legislation," Murphy said. "The work that we have been doing to keep nurses focused in this legislation and patients focused in this legislation really got subsumed by a fight among corporate entities, Mayo and the other corporate hospitals."
Late last week, the bill's authors had introduced an amendment that would have required that hospitals form those staffing committees, except for Mayo Clinic. But Murphy said on Monday that multiple senators did not like the exemption for Mayo Clinic, creating a barrier to passing the bill.
The nursing bill passed the Senate 40-25, with Boldon voting for and Sen. Carla Nelson, R-Rochester, voting against the bill. The House passed the Nurse and Patient Safety Act 112-17. Rochester-area Reps. Kim Hicks, Tina Liebling and Andy Smith, all DFL, and Duane Quam, R-Byron, voted "yes" on the bill.
Advancing the Nurse and Patient Safety Act to Gov. Tim Walz's desk was one of the Legislature's last acts of the 2023 regular session, which was constitutionally mandated to end at midnight.
In a statement, Minnesota Nurses Association president Mary C. Turner said her "heart breaks for the patients in Minnesota."
"We came here to pass the Keeping Nurses at the Bedside Act. Because of the power and influence of corporate health care executives, that bill has died," Turner said.
Turner, however, championed the portion of the bill that addresses workplace violence against health care workers.
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"The strong protections against workplace violence are especially critical," Turner said. "These strongest-in-the-nation protections will be a godsend to many of our nurses on the most understaffed units."
Feist said Mayo Clinic is "comfortable" with the changes.
"Not that we should have to ask the people that we regulate are comfortable with us regulating them," Feist said. "But they are aware that they would be covered by this law. ... Everyone is on the same page that this is important, meaningful legislation that will be beneficial to hospitals, nurses and patients."
"Throughout the legislative session, Mayo Clinic remained steadfast in our position to ensure we can continue to meet the needs of our patients and staff and lead the transformation of health care," Mayo Clinic president and CEO Dr. Gianrico Farrugia said in a statement provided to the Post Bulletin.
"Mayo Clinic would like to express our gratitude to everyone who embraced that commitment with us. In particular, we are thankful to Gov. Walz and his team for their exceptional partnership and leadership. Gov. Walz, Speaker Hortman and Majority Leader Dziedzic have expressed firm support for Mayo Clinic and for our desire to grow and invest in health care and our communities. We share the goal of making Minnesota the state that leads the future transformation of health care.
"We remain grateful for our nurses, and all health care workers, who serve patients with dedication and compassion every day," Farrugia continued. "We share the governor’s and legislature’s commitment to continue addressing the challenges facing nurses — including nationwide staffing shortages and increasing violence against health care workers — just as we remain committed to pushing the boundaries of innovation to cure, connect and transform health care for patients in Minnesota and around the world.”
The other bill that Mayo Clinic opposed in its May 3 email, the Health Care Affordability Board, did not advance. Instead, the health and human services omnibus legislation passed by the House and Senate on Monday includes the creation of a Health Subcabinet that "shall coordinate state agency and, as applicable, private sector efforts to reform the health care delivery and payment systems." The bill also requires that the Minnesota Department of Health establish a center for health care affordability to research and analyze health care cost growth factors.
Those provisions do not require hospitals abide by a set spending growth target, which would have been required under the Health Care Affordability Board.
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