The California Department of Public Health delayed emergency staffing rules for acute psychiatric hospitals after significant outcry from hospitals, nurses, law enforcement and lawmakers, CalMatters, a nonprofit newsroom, reported Jan. 28. The proposed rules, which would increase the required number of health workers on staff, were set to take effect Jan. 31, roughly one month after the department first published them. Instead, the department said in a letter to health care facilities that the rules will go into effect June 1. The emergency rules stem from a San Francisco Chronicle investigation that linked cases of physical assault, sexual assault and death to low staffing levels at for‐profit acute psychiatric hospitals. The investigation revealed a loophole in state regulations that allowed acute psychiatric hospitals to employ fewer staff than general hospitals. Acute psychiatric hospitals treat people — sometimes involuntarily — experiencing mental health crises and who pose an immediate threat to themselves or others. The proposed rules would require acute psychiatric hospitals to have at all times at least one licensed nurse per six adult patients or one licensed nurse per five pediatric patients. The health department would also fine hospitals 15, 000 to 30, 000 for each day they are out of compliance. But hospitals, law enforcement organizations and behavioral health groups say the state's aggressive implementation timeline will inadvertently lead to the closure of dozens, if not hundreds, of psychiatric beds throughout the state. Carmela Coyle, president and chief executive of the California Hospital Association, said the four‐month delay “averts an immediate crisis in the availability of psychiatric hospital care in California” but still leaves the system vulnerable to closures.
Valerie A. Canady (Fri,) studied this question.