Nurses’ union stages sit-in outside Minnesota governor’s office over staffing bill
The demonstration ramps up pressure on the governor as hospital leaders and lawmakers negotiate behind-the-scenes
Minnesota Nurses Association President Mary Turner (center right) speaks with Rep. Tina Liebling, DFL-Rochester, (right) during a sit-in outside the governor’s office in the Capitol on May 9, 2023. Photo by Max Nesterak/Minnesota Reformer.
The Minnesota nurses’ union began a sit-in outside the office of Democratic Gov. Tim Walz in the state Capitol on Tuesday, saying they will continue the demonstration until legislation is passed giving them more control over hospital staffing levels.
The sit-in comes after Mayo Clinic sent an email to Walz’s office and legislative leaders, saying the hospital would move multi-billion dollar investments out of state if lawmakers passed two bills aimed at increasing nurse staffing levels and reducing rising health care costs. Mayo Clinic has not provided details on what specific investments they would pull from the state.
Minnesota Nurses Association President Mary Turner called the ultimatum an “attack on democracy” and said submitting to Mayo’s demands would send the wrong message to Minnesotans about who controls their government.
“If Mayo wins … you know what it tells everybody? It doesn’t matter,” Turner said, standing outside the governor’s closed office doors. “That’s what this story tells the people. Just don’t bother.”
Democratic state lawmakers, who control the House and Senate, have signaled they will hang tough against the threat by the state’s largest private employer — with over 48,000 workers in Minnesota.
The governor has avoided wading too deeply into the conflict between two powerful interests: the labor unions that helped him win re-election and one of the state’s most prized medical institutions.
Walz met with some of the nurses sitting outside his office on Tuesday afternoon and told them he supports the union’s and Mayo Clinic’s right to be apart of the legislative process, said Rachel Hanneman, a member of the union’s governmental affairs commission and nurse at Fairview Southdale.
Walz told them that Mayo Clinic doesn’t bluff, Hanneman said. But nurses say they also don’t bluff.
“There are tens of thousands of nurses in the state, so each of us has power,” Hanneman said. “It’s not just Mayo here that holds all the cards.”
It was the first time the governor spoke with the nurses’ union since news broke about the Mayo’s ultimatum on Friday. The governor’s office did not respond to a request for comment on the meeting.
The Mayo Clinic has not responded to requests for comment.
The authors of the staffing bill, called Keeping Nurses at the Bedside, say the Mayo Clinic shouldn’t be exempt from the legislation and urged the nonprofit hospital to collaborate with them and the nurses’ union.
“Mayo should be part of the solution and not try to undermine our bill,” said Rep. Sandra Feist, DFL-New Brighton, during a Monday news conference. “We worked with them extensively. And all of a sudden, we were very surprised to hear their demands.”
Versions of the bill have already passed both the House and Senate in larger health and human services bills. The two chambers were beginning to iron out their differences when the Mayo Clinic issued its ultimatum to state leaders.
The email from a Mayo Clinic executive last Wednesday said the hospital board would be considering investments this week “four times the size of the investment in U.S. Bank Stadium” — a $1.1 billion project.
“Because these bills continue to proceed without meaningful and necessary changes to avert their harms to Minnesotans, we cannot proceed with seeking approval to make this investment in Minnesota. We will need to direct this enormous investment to other states,” Kate Johansen, vice chair of external engagement, wrote in an email obtained by the Reformer.
This isn’t the first time Mayo Clinic has raised the specter of moving operations out-of-state. In 2013, the Mayo Clinic also made a last-minute threat that it would bring billions in investments for Destination Medical Center to another state if lawmakers didn’t contribute $500 million toward the project. The public money has thus far been matched by about $1.25 billion in private investment.
The Keeping Nurses at the Bedside bill and a second bill to create a health care affordability board are also fiercely opposed by hospitals across the state, who say it will lead them to raise prices and shutter hospital units.
“These proposals will worsen an already unsustainable path for the future of hospitals in our state, endanger access to care, and may spell the beginning of the end of Minnesota’s nonprofit hospital model,” a group of more than five dozen hospital leaders wrote in a statement published by the Star Tribune.
The union-backed Keeping Nurses at the Bedside Act would require hospitals to form committees with at least half of the members being nurses and other direct care staff to create “core staffing plans.” Those plans would include the minimum number of full-time care staff that will be assigned to each inpatient unit, and the maximum number of patients each nurse can typically safely care for.
Union nurses say the bill would reduce burnout, which has exacerbated the staffing shortage, and lead to better patient care, pointing to rising rates of adverse patient events they say are driven by short staffing.
The nurses’ union attempted to get similar powers through contract negotiations with seven of the state’s largest health systems last year. Some 15,000 nurses went on a three-day strike in the largest private-sector nurses strike in U.S. history, and the governor joined them on the picket lines.
While the nurses succeeded in winning substantial pay increases and some concessions on staffing levels, they failed to get everything they were seeking. Mayo Clinic was not part of those negotiations since its flagship Rochester campus is not unionized.
The nurses turned their attention to the state Capitol to claim an equal voice over staffing levels, which would apply to union and non-unionized hospitals.
If signed into law, Minnesota would join eight other states with similar requirements for staffing committees, according to the American Nurses Association. Two states – California and Massachusetts — have even more stringent nurse staffing ratios written in law.
The committees would also be responsible for reviewing reports of staffing level concerns from patients and staff members; conducting trend analyses of the reports; and maintaining “dispute resolution procedures” surrounding staffing concerns. If the committees can’t resolve concerns, the case will be forwarded to an arbitrator with expertise in patient care. Hospital leaders said that would move staffing decisions outside of a hospital.
Under the bill, the health commissioner must also develop a public grading system to judge how well each hospital complies with its staffing plans. The bill also includes incentives aimed at recruiting more nurses to work in hospitals, including loan forgiveness and a workplace violence prevention program.
The second bill opposed by Mayo (HF2202/SF2002) aims to tackle the ongoing problem of skyrocketing health care costs — likely to worsen as the population ages — requiring ever increasing portions of the state budget to care for people in need.
The bill’s author Rep. Liz Reyer, DFL-Eagan, said negotiations on the bill are ongoing. The current version of the bill would create a board made up of health care experts who would track health care costs, set spending growth targets and make recommendations to reduce costs.
“This bill is extremely problematic and poses a huge threat to the well-being of Minnesota’s health care system as drafted,” the email from Mayo Clinic says. “It must be removed from the HHS omnibus bill and consideration for Mayo to move forward with the previously stated investment.”
*This story has been updated since Gov. Tim Walz met with members of the nurses’ union.
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