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Press Release: AB 1422 signed; new law will ensure patients' 'right to know' about dangerously low hospital staffing.

October 9, 2021



CONTACT: Hal Weiss (213) 247-4585


New California law will ensure patients ‘right to know’ about dangerously low hospital staffing.

Sacramento, CA—Governor Gavin Newsom signed AB 1422 (Gabriel) into law on Friday, handing a political victory to Nurses unions which supported the legislation. The law aims to increase public transparency on California hospitals’ practice of skirting safe staffing law through program flexibility requests, a process by which health facilities may be granted temporary waivers from requirements to comply with California’s mandatory nurse-to-patient ratios. Proponents argue hospitals have frequently abused the program flexibility process to sidestep the law, undermining the safety of nurses and their patients. The law will go into effect on January 1, 2023.

Among the law’s key provisions is a requirement that health facilities and the California Department of Public Health make requests and approvals of program flexibility waivers publicly available. It will also require that hospitals provide documentary evidence exemplifying the need for a waiver, and show that patient care will not be impacted.

Throughout the pandemic, Nurses have advocated for their inclusion in decisions on hospital staffing—something that AB1422 delivers. Under the new law, hospital administrators must immediately notify affected employees and their union representatives of program flexibility requests, as well as direct them to the official request and supporting evidence. In addition, the California Department of Public Health shall provide a method to electronically collect public comment on the application for a period of 30 days.

Nurses with SEIU 121RN, the union that pushed the measure through the legislative process, have signaled that they intend to make full use of the law’s sunlight and public comment provisions.

“Program flexibility allows hospitals to operate in the dark as they cut corners and slash staffing levels, which endangers patients and puts RNs’ licenses at risk,” said SEIU Local 121RN President Dr. Nina Wells, DNP, MSN-NE, RN, PHN, at St. John's Regional Medical Center in Oxnard. “Nurses believe that patients deserve to know that hospital administrators too often—and with unnecessary risk—fail to ensure there are enough RNs on duty to safely staff the number of hospital beds.”

“Long before the COVID-19 pandemic, our hospitals cut corners in extremely dangerous ways. The pandemic—and our nation’s uneven response, our hospitals’ lack of preparedness, and the sluggish responses from enforcing agencies—just made it worse,” said SEIU Local 121RN Executive Director Rosanna Mendez. “California has some of the strongest regulations to protect patients. Union Nurses fought for these laws and rules. The trouble is, there continues to be a lack of enforcement, transparency, or a willingness to listen to Nurses on the front lines. AB 1422 will finally give Nurses a voice in the process that has allowed hospitals to make Nurses responsible for a dangerous number of beds—endangering patients and putting RNs’ licenses at risk.”

Union nurses have been engaged in an ongoing effort to strengthen Title 22, which regulates the number of patients that can be assigned to hospital nurses. The law signed on Friday builds on SB 227, the “Stop Repeat Offender Hospitals” bill, also championed by SEIU 121RN, which became law in 2019. SB 227 sought to enforce safe staffing laws by levying stiff penalties on hospitals which repeatedly violated them, and by mandating random hospital inspections.

California is currently the only state in the country that mandates nurse to patient ratios by law.


SEIU Local 121RN represents registered nurses and other healthcare professionals in California. This member-led organization is committed to supporting optimum working conditions that allow nurses to provide quality patient care and safety