State |
No. hours of nurse staffing required |
Efforts to change for CNA in 2000? |
Efforts to change in 1999 |
Through Legislation, Regulation, or Budget |
Description |
Status |
AL |
? |
N |
N |
|
|
|
AZ |
No ratios. Staff to meet the needs of residents. |
Y |
|
Legislation |
To lower allowable age of CNAs to 16. |
Legislation was included in ltc initiative that was a “strike all” |
CA |
3.2 hours per pt. day |
Y |
Y for CNA |
C.N.A. through Budget, PCW through legislation |
Increase wages and lower staff ratio per resident. Increase wages for PCW |
Commission to make recommendations by 2004. If not, automatic deferral to 3.5 minimum |
CO |
2 hours per pt. day. |
Y |
Some for C.N.A., nothing for HHA, PCW |
|
Discussion with legislators re staffing ratios |
Nothing yet |
D.C. |
fed. requirement |
Y |
Y for C.N.A. |
through regulation |
NCCNHR recommended fixed staffing ratios |
Regs. not yet finalized. staffing ratios may or not be accepted |
DE |
2.25 hours daily |
Y. |
Y for C.N.A., N for HHA, PCW |
legislation |
proposal for 3.0 contact hours per resident, year one, and 3.33 year two. |
Passed 3.0 hours for 2001, with Medicaid funds appropriated. Commission to report by 12/1/01 to increase to 3.2 hours, and by 1/1/03 to increase to 3.67 hours. |
GA |
2.5 hours daily |
Y |
Y |
legislation |
Resolution passed to assign members to study committee to look at all ltc staffing. |
Appointment of members |
HI |
No staffing ratios, |
N |
N |
2 bills died. HI Nursing Assn concern re hospital increasing No. of C.N.A. |
2 bills died. No real advocate for staffing ratios. |
|
IA |
2 hours daily |
N |
N for C.N.A., HHA |
|
|
|
ID |
Up to 59 residents .4 hours per resident day. Hours shall not include DON, but Supervising nurse may be counted. 60 + residents at 2.4 hours per resident day, and not include DON or supervising nurse. |
N |
N- C.N.A., HHA, PCW |
|
|
|
IL |
“Staffing shall be based on the needs of the residents…” Ill. state code. |
Y |
Y-C.N.A. |
Legislation |
NCCNHR ratios. |
Remained in committee. |
IN |
Sufficient to meet needs of residents |
Y |
|
Legislation |
NCCNHR standards |
Study commission assigned |
KY |
No specific number “adequate staff” |
Y |
Y – C.N.A. |
Public committee meetings |
NCCNHR ratios |
Task force named by KY legislature to examine issues. will look at HHA, too |
LA |
2.6 skilled, 2.35 intermediate |
Y |
Y – C.N.A. |
Legislation |
same staffing ratio as AR law |
Bill not pushed beyond introduction, but senator still interested. Will be raised in 2001 |
ME |
1:8 day shift, 1:12 evening, 1:20 night |
Y |
Y – C.N.A., N- HHA |
Legislation |
Bill to enrich NH staffing ratios.. Sets up pilot projects to determine appropriate staffing ratios for mealtimes. Report due to legislature Jan. 2001, mandates Me. develop acuity based staffing ratios, with report to leg. 5/2001. |
Bill passed with $1,336,000 in state funds, with matching fed. funds of $2,610,000 to increase minimum staffing ratios in NH to 1:5, 1:10, 1:18. Signed by governor in April 2000, P.L. chapter 731. |
MD. |
2 hrs. daily |
Y |
Y |
|
NCCNHR standards |
Bill went to study. Task force estabd. Legis. introduced in 2000 |
MI |
2.25 hrs daily now (1:8, 1:12, 1:15) |
Y |
Y |
Legislation to increase to 3.0 hours per day |
3.0 hrs direct resident. care and staff: resident ratio cannot fall below 1:15 on average during day |
Legislation passed |
MT |
“meet the needs” |
N |
Y – C.N.A., |
Legislation |
|
|
NH |
|
Y |
|
Legislation |
NCCNHR recommended minimum. |
|
NJ |
2.5 hrs. daily plus extra time for residents with complex needs |
Y |
Y |
Legislation and, Regulations. Increased staffing levels with simplified calculations. |
Legislation to stop overtime by nurses, C.N.A.s and other direct care workers |
Passed both houses, but vetoed by governor. |
NM |
2.25 hrs. daily |
Y |
Y |
Legislation |
Staffing based on acuity. Include only staff who actually provide hands-on service. Medicaid recoupment when minimum standards unmet. |
Legislation died in Senate. |
NV |
|
N |
|
|
|
|
NY |
“sufficient staffing” |
Y |
Y |
Legislation |
NCCNHR ratios |
Introduced in State Senate and State Assembly. Not passed. |
NC |
2.1 hours daily |
Y |
Y |
Legis, Reg and Budget. |
1999 increased staff on Special Care Units in adult care homes. |
|
ND |
Fed. “meet res. needs” |
N |
N |
|
|
|
OH |
3.2 hours daily |
Y |
? |
|
As part of 5 year rule revision for all nursing homes, DOH established commission to look at different proposals. Study of proposal to increase to 4.0 hours daily care due in 8 months. |
Public Health Council will report out in eight months. Advocates will revisit in 2001. |
OK |
1.75 hours daily |
Y |
Y |
Legislation. Raise ratio required of direct care staff to residents. Penalty for facilities who understaff. Raise wages of direct care staff. More to improve quality of care and quality of life. |
Not passed in 1999. Passed both houses in 2000, and governor signed. |
Raise ratios to 1:8, 1:12, 1:17 by 8/31/01; to 1:7, 1:10, 1:16 by 8/31/02 and to 1:6, 1:8, 1:15 by 9//1/02. By 9/1/02 ratios to include only CNAs, not activities or social services. Legislation also raised all staff but administrators by $1/hour. With minimum wage in NF set at $6.65/hour. |
PA |
2.7 hours daily |
Y |
Y |
Auditor General’s office has been studying issue. |
|
|
RI |
1.9 hours daily |
Y |
Y |
Legislation |
NCCNHR ratios. |
Will die in 2000 session. Looks good for 2001 |
TN |
2 hours daily |
Discussions |
N |
Legislation |
|
|
TX |
? |
Y |
Y |
Legislation |
Similar to NCCNHR. |
Unsuccessful 1999 |
UT |
No ratio, just “sufficient to meet their needs” |
Y |
Y |
Health Facility Committee. |
Priority - Specific ratios for all staff and residents |
Advocates must submit specific proposal |
VA |
|
N |
|
|
|
|
VT |
|
N |
N |
|
|
|
WA |
|
Y |
Y |
Legislation. |
NCCNHR recn. |
Very little progress |
WV |
2 hrs. daily |
Y |
Y |
Legislation, Regulation |
AARP wants 2.75, licensure department requests 2.25. state Health Care Assn wants category of workers (valets) to assume increased responsibility without certif. |
AARP proposal died in legislature. . Optimistic that 2.25 will be implemented. |
WI |
N |
N |
|
|
|
|