Lawmakers unveil compromise nurse staffing bill that includes Mayo Clinic carve-out

Nurses are demanding safer working conditions. But hospitals have objected to a proposed solution — most prominently the Mayo Clinic, which campaigned successfully to receive an exemption.

A conference committee began work Thursday on the “Keeping Nurses at the Bedside Act,” a plan for addressing the working conditions of direct care nurses in hospitals and the related staffing shortages seen statewide.

The committee is using HF1522/SF1384* as a vehicle bill to carry the proposal, having pulled the language out of the health finance bill. With the measure garnering significant controversy, conferees presented a delete-everything amendment in the hopes of reaching a compromise acceptable to all stakeholders during the waning days of session.

“Nurses are asking for a voice in the process to ensure enough staff and better working conditions so that nurses can stay in the jobs they love and provide the exceptional care that all patients deserve,” said Bernie Bernham, president of the Minnesota AFL-CIO.

Co-chairs Rep. Sandra Feist (DFL-New Brighton) and Sen. Erin Murphy (DFL-St. Paul) anticipate reconvening and adopting a finalized version of the bill later tonight.

The bill’s most contentious provision calls for hospitals to create a nurse staffing committee, which would make “evidence-based written core staffing plans to guide the creation of daily staffing schedules” and guide dispute resolutions regarding staffing concerns.

Notably, direct care nurses would comprise at least 35% of committee membership.

Longtime followers of the bill may notice that the hospital nurse workload committee is absent from the bill. The workload committee’s responsibilities have instead been folded into the staffing committee’s duties.

Under current law, nurses are required to refuse a patient assignment if it is deemed unsafe for that patient. The bill would prohibit retaliation against nurses for doing so.

Feist argued this protection is needed because nurses who stand up for their license, profession, and patients are being bullied, harassed, and sometimes sent home, worsening ongoing staff shortages.

Other, less controversial, stipulations address violence against health care workers by requiring incident report action plans and developing “concern for safe staffing” forms for individuals to report unsafe staffing situations.

Appropriations during the 2024-25 biennium related to the policy changes (but traveling in the health finance bill) would total $18.7 million, including:

• $10.7 million for the health professional education loan forgiveness program, designed to increase the size of the nursing workforce;
• $6.1 million in mental health grants for healthcare professionals; and
• $232,000 for an impact evaluation of the new labor standards.

Testimony and discussion

Mayo Clinic officials previously raised strong objections to the creation of the staffing committees, even threatening to relocate a multi-billion dollar expansion project out of state if they were mandated at their facilities. Lawmakers placated these concerns by carving out an exception for the hospital system.

“While we understand the approach that’s reflected here in the committee structure, we believe that Mayo’s model is already far more advanced and frankly essential to providing the care for which we are known,” said Kate Johansen, state government relations director for Mayo Clinic.

Appeasing Mayo, however, failed to assuage many misgivings of both the Minnesota Nurses Association and the Minnesota Hospital Association. 

Mary Krinkie, vice president of government relations for the Minnesota Hospital Association, shared a preference for a patient acuity model over an exclusive Mayo carve out and a concern about nurses refusing assignments.

While hospitals may worry about nurses refusing to provide care, nurses say they often fear for their safety and advocate for the protections laid out in the bill.

“… [N]early 90% of the time when nurses sound the alarm that staffing was unsafe and patients were at risk, management did not help resolve the staffing concern or simply did not respond at all to their calls for help,” said Mary Turner, president of the Minnesota Nurses Association.

— Session Daily writer Steve Abrams contributed to this report.