Friedman: Advocates push for mandatory minimum nurse staffing ratios at Illinois hospitals

Trade groups say mandates could strain hospitals with fewer health care workers available  

By GRACE FRIEDMAN
Medill Illinois News Bureau
news@capitolnewsillinois.com 

SPRINGFIELD — Health care unions continue to rally for legislation to address understaffing they say strains hospitals and threatens both patient safety and staff well-being.  

Lawmakers are considering the Hospital Worker Staff and Safety bill, which would establish mandatory nurse-to-patient staffing ratios and increase support for underfunded hospitals. 

The proposed legislation, Senate Bill 21 and House Bill 3512, aims to establish minimum staffing ratios in hospitals and fund critical safety-net hospitals across the state. Advocates with health care worker unions have been holding a series of rallies at the Capitol in support of the legislation in recent weeks.  

“Our hospitals are staffed unsafely,” Kawana Gant, a certified nursing assistant at UChicago Medicine Ingalls Memorial Hospital in Harvey, said at a recent Statehouse rally. “I have worked short shifts where there are 30 patients and only one CNA on the floor. How can you give quality care? It is not safe.” 

Gant, who has worked at Ingalls Hospital for nearly 30 years, says she has watched many of her colleagues quit due to the mental and physical toll the short staffing has had on their bodies. 

“This is an opportunity for legislators to hear us, to know that these hospitals are not safe.” Gant said. 

But similar versions of the proposed legislation have been introduced at the Statehouse for recent years and have failed to gain traction. Generally backed by unions representing nurses, such as the Service Employees International Union, previous staffing ratio measures have run into opposition from hospital groups that say they’re unworkable.  

The proposed legislation filed this year has yet to receive a hearing in a substantive committee, meaning it will be an uphill battle for it to move by the time the legislature adjourns at the end of the month.  

Like previous versions, it would mandate that hospitals “employ and schedule sufficient staff to ensure quality patient care and safety.” In addition, hospitals would have to share annual staffing metrics with the Illinois Department of Public Health to help ensure they are at proper staffing levels.  

“This bill gives you a real voice,” Rep. Kam Buckner, D-Chicago, said to rallygoers. “It gives you a way to speak up when things are unsafe for you and the people who you care for.”  

However, not all lawmakers are convinced that now is the right time to implement staffing ratios.  

“You can mandate the staffing ratios, but if those professionals don’t exist, what have you really done?” said Rep. Norine Hammond, R-Macomb. “We’ve been trying for years to get more people into the health care field, especially after COVID, and we’re just not there yet.” 

Hammond expressed concern that enforcing strict staffing requirements without enough qualified workers in the pipeline could place unrealistic burdens on hospitals. She warned that such mandates might unintentionally strain facilities already struggling with labor shortages and lead to adverse financial consequences, especially for smaller or rural hospitals. 

Hospital trade groups echo those concerns, calling the legislation unworkable, burdensome and an ineffective way to solve a problem that should be addressed by the specific needs of each hospital or care center. The Illinois Health and Hospital Association, the Association of Safety Net Community Hospitals and the Illinois Critical Access Hospital Network issued a statement saying they strongly oppose HB 3512.  

They said it was introduced “as a backdoor effort pushed by organized labor to impose unworkable, government-imposed health care staffing ratios in Illinois.”  

“This proposal would relegate the essential, complex and nuanced protocols established to safely and efficiently staff a hospital 24/7/365, to a series of burdensome forms and onerous paperwork that hospitals would be required to submit to the (IDPH) to establish minimum staffing standards for every hospital worker, in each hospital unit,” the groups said in the statement. 

Still, according to a recent Service Employees International Union survey of Chicago area hospital workers, 70% of respondents reported understaffing, and over 25% reported unsafe or unmanageable workloads. Additionally, in the same survey, 47% of the respondents stated an intent to leave their jobs soon.  

To help enforce safety standards, the legislation introduces “assignment despite objection forms” that give hospital workers the opportunity to document and report any assignments that they believe are unsafe. Hospitals are then required to provide this information to IDPH, which would have to publish an annual report on all these staffing metrics. The legislation would also require IDPH to “make recommendations for minimum staffing standards for hospital workers in each hospital unit.” 

In addition to protecting staff, advocates said this bill would allocate proper essential resources to underfunded hospitals around the state, including Mount Sinai Hospital on Chicago’s West Side, a Level 1 trauma center that helps underserved and violence-impacted communities.  

“Mount Sinai saved my son’s life,” said Sonya Brown, who traveled from Chicago to Springfield recently to advocate for the safety-net hospital that treated her son after he was shot seven times in 2020. 

“He was shot in the head, he was shot in the neck, he was shot in the chest, the abdomen and shoulder, and the arm,” Brown said. “If they wouldn’t have gotten to him in time, he would have died.”  

Mount Sinai serves as a health care provider for communities on both the South and West sides of Chicago, areas that experience some of Chicago’s highest rates of gun violence. If the hospitals are not protected by measures in this legislation, advocates said, the victims in these neighborhoods risk longer travel times to alternative trauma centers.  

They said the bills would help allocate essential resources and enforce staffing standards at safety-net hospitals to continue effectively serving vulnerable communities.  

“All of our staff is overworked,” said Jessica Mendoza, a nursing assistant at Edward Hines Jr. VA Hospital in Hines. “A lot of our veterans are coming into the VA to get help with their health, but we do not have the staff to provide it.” 

Mendoza, who has worked at the Hines VA Hospital for nearly two years, said that due to the low number of staff, they rarely get a break. She noted that the lack of sufficient staffing makes it difficult to provide the level of care that the veterans need.   

The health care workers and advocates gathering in Springfield at the recent rally emphasized that without sufficient staffing and resources, the quality of patient care throughout Illinois hospitals will continue declining, and worker burnout will escalate.  

“They expect you to do the job of five or six people but pay you for one.” Sen. Lakesia Collins, D-Chicago, said at the rally. Prior to joining the General Assembly, Collins was a CNA in nursing homes.   

As the legislation stagnates at the Capitol, hospital workers and advocates said they plan to keep organizing and sharing their stories. They said they’re calling on lawmakers to prioritize frontline health care workers and the patients who depend on them. 

Grace Friedman is a student in the Medill Illinois News Bureau, a program at the Medill School of Journalism that provides local news outlets with state legislature and government coverage. She can be reached at gracefriedman2025@u.northwestern.edu  

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