Health Policy Commission to assess ballot question

A state agency is preparing to play the role of fact checker in a bitter, high-stakes campaign over a ballot question that would mandate nurse-patient staffing ratios in hospitals across the state.

The Health Policy Commission, after weeks of hedging when asked whether it would analyze the impact of Question 1, revealed that it had been studying the issue for several months and will release its findings on October 3.

It’s rare for a state agency to attempt to sort out the facts in a ballot question fight, but this situation is even more unusual because the Health Policy Commission would play an instrumental role in implementing the law if it is approved by voters. According to the language of the ballot question, the commission would be required to promulgate regulations to implement the law and conduct inspections to ensure compliance.

Stuart Altman, the chair of the Health Policy Commission, said the agency’s analysis of Question 1 “is consistent with the HPC’s role as an independent watchdog of health care costs, quality, and access in the state.”

The commission said it has been studying California’s experience with a mandated nurse staffing law, existing nurse staffing levels at Massachusetts hospitals, and costs associated with the proposed law’s requirement that the various units inside hospitals comply with designated nurse-patient ratios.

The commission said it hired Dr. Joanne Spetz from the University of California-San Francisco as a consultant in August. Spetz was a coauthor of a 2013 article in Health Services Research that found California’s law boosted nurse staffing significantly with “mixed effects on quality.”

The Massachusetts Nurses Association, the union that represents many nurses across the state, is leading the fight for Question 1. The association nearly took a similar question to the ballot in 2014, but backed off when the Legislature passed a law establishing minimum staffing levels in intensive care units.

The fight over nurse staffing ratios is contentious — and expensive. The Massachusetts Nurses Association, citing a study done by a Boston College researcher, said the ballot question would improve care and cost the state’s hospitals a total of $47 million a year. A study done by the Massachusetts Health & Hospital Association estimated the cost at $1.3 billion in the first year and $900 million a year after that.

The committee supporting the ballot question had raised $5.7 million and spent $4.9 million as of September 10, according to campaign finance records. The hospital group opposed to the ballot question had raised $10.5 million and spent $9.2 million.

Polls have provided conflicting results on Question 1. A Boston Globe survey conducted from September 13 to September 17 indicated the yes campaign was ahead 51.8 percent to 33 percent. A WBUR survey conducted between September 17 and September 21 showed the race in a dead-heat at 44 percent apiece.



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