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SJC clears measure on nurse staffing ratio for November ballot

A nurse runs during her shift at the Clinic Center at Beth Israel Deaconess Hospital West Campus. The Supreme Judicial Court ruled Monday in favor of a ballot petition about nurse staffing levels in Massachusetts that is backed by the Massachusetts Nurses Association.Bill Greene/Globe Staff/Globe Staff

The state's highest court cleared the way on Monday for voters to express their views on nurse staffing levels in Massachusetts hospitals, ruling in favor of a ballot petition backed by the Massachusetts Nurses Association.

In a unanimous ruling, the Supreme Judicial Court said that the question as written by the association met the constitutional requirements for ballot petitions — they must be narrowly drawn, not overly broad. Writing for the court, Justice Barbara Lenk said the proposal's call for staffing ratios meets that rigorous legal standard.

The petition sets strict limits on the number of patients assigned to a nurse at one time.


The nurses union has long pushed for staffing ratios and called the court decision "a vitally important step in an effort . . . to improve patient safety in Massachusetts hospitals." Union nurses say they are often overburdened, leaving them unable to give the best possible care and increasing the risk of patient falls, infections, and other complications.

"We applaud the SJC for their decision to allow the Patient Safety Act to go before the voters of Massachusetts," Kate Norton, a spokeswoman for the union's ballot campaign, said in a statement. "This measure will positively impact the quality and safety of hospital care for every patient cared for in our state's acute care hospitals."

Opponents, including the Massachusetts hospital industry, had sought to exclude the question from the ballot. Hospital executives have called the measure unreasonable and said it would do nothing to improve patient care. They also warned that the cost to hire additional nurses would force some hospitals to turn away patients, shut down services, or perhaps close entirely.

The Massachusetts Health & Hospital Association, an industry trade group, is spending heavily to try to defeat the measure, including with television ads.

A report commissioned by the hospital association found that the ballot measure would require hospitals to hire thousands of new nurses in a short time, costing $1.3 billion in the first year and more than $900 million per year after that.


Dan Cence, a spokesman for the hospital industry's coalition to defeat the ballot question, said, "It's unfortunate that any version of this measure passed technical legal muster, but we understand that the justices' hands were tied and note their reasoning, 'That the full consequences of the proposed act would be fleshed out after its passage does not render its form improper.' "

Cence added: "Our campaign is dedicated to presenting the full consequences of this question."

The nurses union must submit another round of signatures by July 3 before its question can appear on the statewide ballot in November.

State lawmakers have not indicated that they will try to broker any kind of compromise legislation to avert the ballot question.

Also on Monday, the Supreme Judicial Court rejected a second version of the union's ballot measure, which would have required hospitals to publicly report information about their financial assets. Justices said this version of the question should not be on the ballot because it includes two provisions — financial disclosures and nurse staffing levels — that are not sufficiently related to each other.

Priyanka Dayal McCluskey can be reached at Follow her on Twitter @priyanka_dayal. John R. Ellement can be reached at Follow him on Twitter @JREbosglobe.