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Mayo Clinic poised for exemption from nurses bill

The Nurses at the Bedside Act was pulled from the state's wider health finance bill Thursday and was taken up by a conference committee to try to push it forward.

ST PAUL, Minn. — Editor's note: The video above first aired on KARE 11 on May 15, 2023.

After weeks of back and forth between Minnesota's nurses and health systems, Rochester's Mayo Clinic is now all but exempt from a bill aiming to improve nurse staffing levels and retention. 

Late Thursday afternoon, the Nurses at the Bedside Act was pulled from the state's larger health finance bill and taken up by a conference committee to try and push the exemption forward.

In a press conference following the move, Sen. Erin Murphy, a St. Paul Democrat and lead author of the bill's Senate version, said it was important to pull it from the wider health bill to give it a better chance of passing before the session ends Monday.

“This intention of this legislation is to make sure nurses want to safely practice in our hospitals," Murphy said. "They are saying with their words and with their feet that it feels unsafe to practice now, and meet the standards of licensure and our own professional standards in caring for patients.”

Rep. Sandra Feist, a New Brighton Democrat who is the lead author of the House version, said supporters went out of their way to make sure the bill reflected the voices of health care industry experts.

“This is a practical, workable, easily implementable bill. This is a streamlined bill, this is a very thoughtful bill and this bill deserves to pass into law — and these nurses deserve our support.”

The lawmakers were then asked why they agreed to a Mayo Clinic carveout that they opposed initially, saying it was clear to them that Gov. Tim Walz wouldn’t sign the bill without the exception, and this was the only way to make it happen this year.

“It’s crystal clear that the governor has said that he wants to make sure, and he’s making a judgment from his perspective as the governor, that it is better for Mayo to be carved out of this provision,” Murphy explained. “I don’t agree but I want, for the 90 percent of the hospitals that are going to benefit from this legislation, I want us to proceed.”

Feist said her rationalization for the exception included a lot of factors that apply to all hospitals, which is why she opposed the carveout initially.

“It was actually a list of things every single hospital is required under law, to get their accreditation, to do. So we decided we did not want this bill to reflect a misunderstanding that the carveout was based on an unusual, exceptional standard," she said. "It was based on politics, and so that is the way the language reads."

Republican Sen. Jim Abeler of Anoka will serve on the conference committee for the bill. He said he’s glad it's going back to stand-alone legislation because it will be easier to sort out the pros and cons.

“I’m not sure of the final language yet that makes the most sense, but I’m committed to safe nursing and to a functional health care system that’s under stress like it’s never seen before,” he said.

Earlier this month, Mayo threatened to pull billions of dollars in investments out of Minnesota if it were to be required to follow the nurse staffing standards laid out in the bill.

While the Minnesota Nurses Association is fighting for the legislation, and the Minnesota Hospital Association is fighting against it, both bodies oppose the sudden move toward a compromise that will only apply to Mayo Clinic. 

In a statement Thursday, MNA President Mary Turner called the proposed legislation "historic," while accusing Mayo executives of "silencing" and "sidelining" nurses' voices and concerns.

"The Keeping Nurses at the Bedside Act is a historic step forward that will give nurses a seat at the table and a voice in the process to improve staffing levels, bring nurses back to the bedside, and protect patient care throughout the state...To the nurses and patients at Mayo, please know: the brave nurses of MNA fought for you, while Mayo executives fought to silence, sideline, and subvert your voice, your concerns, and your wellbeing."

Although the MNA is against the Mayo exception, the association says it's willing to forge ahead if Gov. Walz signs the wider bill into law.

“Nurses denounce Governor Tim Walz for his abdication of good government and acquiescence to anti-democratic and anti-labor corporate bullies...By siding with the profits and power of corporate executives over the rights and needs of patients and workers, Governor Walz has made clear he will only side with labor when corporate interests concede."

While MNA nurses first tried to stymie the Mayo exception with sit-ins and rallies at the Capitol, they conceded in Thursday's statement that the overall legislation will "provide critical protections" should it be signed into law.

"Despite this anticipated exemption for Mayo Clinic Health System facilities, the legislation will provide critical new protections to patients and nurses at more than ninety percent of Minnesota hospitals," the statement read.

Meanwhile, the MHA, which has steadfastly challenged the bill since its proposal, said the new Mayo Clinic revisions were hastily devised and agreed that health care solutions that work for one hospital system in Minnesota must work for them all.

"A solution that benefits one large health system at the expense of every other Minnesota patient is not a solution at all. It undermines the statewide partnership that we have spent years building and undermines our shared mission to serve all patients," the statement said.

On the other side of the coin, Mayo Clinic argues the bill creates an inefficient bureaucracy that would severely limit their flexibility to hire the staff they need and invest in new equipment and technology.

While it's worth noting that none of Mayo's current nursing staff are represented by MNA, a representative from the hospital had this to say about the proposed measure last week:

"This bill imposes a government-mandated staffing model and complex regulatory structure that will limit the autonomy and flexibility needed to allow Mayo to do what it does best — innovate and meet the needs of our patients, our staff and the communities we serve."

With the amended bill, lawmakers in both the House and Senate will need to once again debate its provisions and vote to approve it before it can be sent to the governor for his signature.

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