1 of 1
HOUSE DOCKET, NO. 1535 FILED ON: 1/15/2025
HOUSE . . . . . . . . . . . . . . . No. 2448
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Natalie M. Higgins
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act promoting patient safety and equitable access to care.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Natalie M. Higgins4th Worcester1/15/2025Lindsay N. Sabadosa1st Hampshire1/21/2025Susannah M. Whipps2nd Franklin2/7/2025Rodney M. Elliott16th Middlesex2/10/2025James B. EldridgeMiddlesex and Worcester2/10/2025Manny Cruz7th Essex2/10/2025Colleen M. Garry36th Middlesex2/10/2025Paul R. FeeneyBristol and Norfolk2/14/2025Thomas M. Stanley9th Middlesex2/14/2025Vanna Howard17th Middlesex2/18/2025Michael D. BradySecond Plymouth and Norfolk2/27/2025Adrianne Pusateri Ramos14th Essex3/7/2025 1 of 3
HOUSE DOCKET, NO. 1535 FILED ON: 1/15/2025
HOUSE . . . . . . . . . . . . . . . No. 2448
By Representative Higgins of Leominster, a petition (accompanied by bill, House, No. 2448) of
Natalie M. Higgins and others relative to registered nurse patient assignment. Public Health.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 2196 OF 2023-2024.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
_______________
An Act promoting patient safety and equitable access to care.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 1 of chapter 111 of the General Laws, as appearing in the 2020
2Official Edition, is hereby amended by inserting before the definition of “Board of health” the
3following 2 definitions:-
4 “Hospital”, any hospital or psychiatric hospital providing inpatient care 24 hours per day,
57 days a week and including the teaching Hospital of the University of Massachusetts Medical
6School.
7 “Maternal Child Care Patients”, including antepartum, intrapartum, postpartum, and
8neonatal care.
9 SECTION 2. Said chapter 111 is hereby further amended by inserting after section 231
10the following section:- 2 of 3
11 Section 231A. (a) There shall be a specific statewide limit on the number of patients a
12registered nurse shall be assigned to provide care for at 1 time, which shall be established under
13regulations promulgated by the department of public health, along with the department of mental
14health. The limit established by the department shall apply to hospitals.
15 This limit of patients shall be specific to each hospital unit and in effect at all times for
16each of the patient care areas, including, but not limited to, emergency services departments and
17units with step-down or intermediate care patients, post-anesthesia care patients, operating room
18patients, maternal child care patients, pediatric patients, psychiatric patients, medical, surgical
19and telemetry patients, observational and outpatient treatment patients, rehabilitation patients and
20any unit not otherwise listed.
21 (b) The limits established by the department shall not include a minimum number of
22patients assigned to a registered nurse at 1 time. Additional staff shall be assigned in accordance
23with nursing care requirements, including the severity of the illness, the need for specialized
24equipment and technology, the complexity of clinical judgment needed to design, implement and
25evaluate the patient care plan and the ability for self-care and the licensure of the personnel
26required for care.
27 (c) Prior to promulgating regulations, the department shall hold a series of public
28hearings throughout the commonwealth and invite comments from stakeholders.
29 (d) The regulations shall include mechanisms for enforcement of the limits by the
30attorney general, which shall include, but not be limited to, injunctive or declaratory relief and
31civil penalties in the amount of up to $25,000 per violation. 3 of 3
32 (e) Each day during which a violation continues following notice to the facility of such
33violation shall constitute a separate and distinct violation subject to any penalties established
34pursuant to subsection (d).
35 (f) Upon written notice by the department that a complaint has been made or a violation
36has occurred, a facility receiving such notice shall submit a written compliance plan to the
37department that demonstrates the manner in which the facility will ensure future compliance with
38all of the provisions of this act within the time frame required by the department.
39 (g) No employee shall be disciplined or retaliated against in any manner for complying
40with the patient limits set forth by the regulations established and any such employee so
41disciplined or retaliated against shall be entitled to the remedies under subsection (d) of section
42185 of chapter 149 of the General Laws regardless of whether the employee satisfies any other
43terms or conditions set forth in said section 185 of said chapter 149.
44 (h) The regulations promulgated pursuant to this act shall provide for suspension during a
45state or national public health emergency.
46 SECTION 3. The department of public health shall promulgate regulations pursuant to
47section 231A of chapter 111 of the General Laws not later than 24 months after passage of this
48act.