National Nurses United

A s the state was about to implement nurse-to- patient ratios in 2004, the California Hospital Association's lawyers were ready to step in at the eleventh hour and file a lawsuit that sought to nullify the landmark law by arguing that hos- pitals did not have to meet the standards all the time. The association had already fought against passage of the law for years, and later even ran workshops advis- ing hospital executives how to circumvent the law. Last year, when CNA was trying to pass a bill that would have required most hospitals to provide lift teams to prevent back injuries among their staff, hospital association lobbyists were waiting in the Capitol's halls to dissuade legislators from voting yes. When that didn't work, they convinced the governor to veto the bill the Legislature passed. When Gov. Arnold Schwarzenegger took heat from nurses, patients, and other consumer activists for issuing in November an emergency order that delayed the 1:5 medical surgical ratio and excused emergency departments from ratios entirely, the hospital association was happy to do damage control by spend- ing the estimated $6 million in production costs and airtime it took to run TV ads thanking the governor for his actions. From ratios to lift teams to politics, CHA is the face of California's hospital industry and has in recent years been the well-funded foe that CNA often finds itself fighting, whether in a courtroom, in the State Capitol, or in the media. While describing itself as a Sacramento-based organization whose vision is an "optimally health society" and whose goal is "for every Californian to have equitable access to affordable, high- quality, medically necessary health care," CHA is at its essence a trade group for bottom line-oriented hospital executives who have vigorously opposed reforms and regulations that RNs and CNA believe are necessary to provide good and safe healthcare to patients. "The hospitals always put us down as a union, but the hos- pital association is like a union for hospitals," said Deborah Burger, RN and CNA president. "Under the guise of being this friendly group that's lobbying the Legislature on healthcare issues, it's actually trying to destroy the public safety net and all of the patient protections that we've accomplished." According to a document posted on CHA's website titled "2005 State Advocacy Priorities," the association supports any efforts that help hospitals' bottom lines, such as defending them from cuts in federal reimbursements, but opposes any efforts to hold them to certain safety standards, such as maintaining min- imum RN staffing ratios, rebuilding their facilities to meet seis- mic codes, or restricting their ability to close hospitals or make service cuts. To carry out its program, CHA uses an intricate network of non-profit groups, lobbyists, political committees, law firms, and Cover | Story HOSPITAL HEA 10 J U N E 2 0 0 5 C A L I F O R N I A N U R S E

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