Our “Stop Repeat Offender Hospitals” bill — stay updated on its progress!

California is the only state in the nation with minimum nurse-to-patient ratio standards for every unit. These regulations are intended to keep our patients safe.

The trouble is the penalties for violating the law are nearly nonexistent. Hospitals claim Title 22 regulations are just “recommendations” or “guidelines.” Most are never fined unless there’s a patient death or serious injury. By then, it’s too late.

As it currently stands:

  • The California Department of Public Health (CDPH) does not routinely inspect for safe staffing and, if there is a complaint, hospitals pay no fines.
  • Hospitals simply submit a “plan of correction”—often copy/pasted from their last one!
  • Hospitals are not held accountable for following this plan.
  • To make matters worse, many hospitals retaliate against RNs who refuse unsafe assignments.

If the Governor had signed SB 1288 into law:

  • CDPH would conduct mandatory, unannounced inspections specifically verifying adherence to Title 22’s nurse-to-patient ratios.
  • Fines begin with the very first offense ($15,000) and double (to $30,000) with each subsequent offense.
  • It remains more important than ever for us to report all Title 22 violations so that repeat offender hospitals feel the sting of ignoring safe staffing laws.

We will continue to introduce legislation and regulations that strengthen enforcement of Title 22 nurse-to-patient ratio regulations. We won’t stop until these ratios are enforced as bare minimum safe staffing standards—not a ceiling…not a “recommendation”…not a “suggestion.”


  • February 16, 2018—State Senator Connie M. Leyva (D—Chino) introduced SB 1288, which the RNs of SEIU Local 121RN co-sponsored to help California enforce its safe staffing regulations. SB 1288 will protect patient safety by fining hospitals that constantly put our patients’ care in danger.
  • April 18, 2018—The bill cleared its first hurdle, winning nearly unanimous support in the Senate Health Committee. (Click here to watch some great news coverage and our press conference that day and click here to see how legislators voted.)
  • May 22, 2018—SB 1288 again won overwhelmingly in the Senate Appropriations Committee. (Click here to see how legislators voted.)
  • May 29, 2018—Great news! Our bill just passed the full Senate. Now it goes to the Assembly side. Learn more here.
  • June 19, 2018—More great news: the Assembly Health Committee approved our bill. This was our first step on the Assembly side. (Click here to see how legislators voted.)
  • August 15, 2018—Getting closer as SB 1288 won in the Assembly Appropriations Committee. (Click here to see how legislators voted.) Next steps: Assembly floor vote; if it passes, then back to Senate side for final concurrence vote; if Senate also passes, then on to the Governor’s desk! Stay tuned!
  • August 28, 2018—The full Assembly just passed our amended bill. (Click here to see how legislators voted.)
  • August 29, 2018—The Senate approves in its concurrence vote and sends SB 1288 to Governor Jerry Brown’s desk
  • September 30, 2018—Governor Brown vetoes the bill after aggressive lobbying by the California Hospital Association .

Click here for a complete list of the bill’s official supporters.

SEIU Local 121RN nurses like…

Kathy Montanino

Kathy Montanino - headshotREAD KATHY’S STORY
Joyce Powell

Joyce Powell - headshotREAD JOYCE’S STORY



Alvin Nadal

Alvin Nadal - headshotREAD ALVIN’S STORY



Yolanda Tominac

Yolanda Tominac - headshotREAD YOLANDA’S STORY

…worked with Senator Connie M. Leyva (District 20, Inland Empire) to examine ways to raise standards and challenge hospitals to be real partners with us and all Californians as we work together to strengthen patient care.

LAST YEAR, we successfully strengthened California’s Whistleblower Protection laws. Signed into law in September, Assembly Bill 1102 (which amends Section 1278.5 of the Health & Safety Code) increases the fines on our employers if they retaliate against us for reporting unlawful assignments that put patient safety and our RN license at risk.

THIS YEAR, we continued our work on safe staffing, this time with Senator Leyva who authored SB 1288. The bill would put some real teeth into the regulations that set staffing levels in our hospitals. We frequently report that our hospitals ignore the laws that set minimum staffing levels in our Emergency Rooms, Intensive Care Units, Labor & Delivery Floors and other patient care areas. This endangers patients, is an unnecessary stress on families, and puts our licenses and livelihoods at risk.

What would the bill have done?

SB 1288 would have mandated unannounced inspections of hospitals with a special focus on adherence to California’s nurse-to-patient ratios as regulated by Title 22. This bill would also increase the penalties assessed against repeat offender hospitals who continue to ignore these regulations. No longer would hospitals be able to simply submit a plan when they are cited for staffing violations. Repeat offender hospitals would be subject to increasing fines.

As Senator Leyva said, “SB 1288 is important legislation that will help to improve patient health and safety by ensuring that hospitals comply with legally mandated nurse-to-patient staffing ratios. The state needs to take a more proactive role by conducting unannounced visits at hospitals across California. We must do everything we can to make sure that we fully enforce existing law, since the stakes are simply too high for patients. I thank SEIU Local 121RN and SEIU California for co-sponsoring SB 1288 and standing alongside me in our fight to protect patients and making sure that nurses are able to properly care for their patients.”

If you didn’t have a chance yet, be sure to watch the ABC News report on our new “Stop Repeat Offender Hospitals” bill, SB 1288. It was exciting to see this coverage state our case so clearly and not even mention the false message the hospitals are putting out there: that it’s our fault because we call in sick (good grief) or that staffing just isn’t an issue at our hospitals. Some more great news: the same day we got this news story, our bill also sailed through the Senate Health Committee 7-to-2. That was our first of several victories!


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