SACRAMENTO — On Aug. 31, a group of California Assemblymembers announced that they have sent a letter to California Health and Human Services Agency Secretary Mark Ghaly asking the state to grant staffing ratio waivers to hospitals in order to accept patients amid a nationwide nursing shortage and COVID-19 surge.

“Hospital leaders have told us that they cannot find nurses to fill vacancies, as there is a nationwide shortage. In fact, there are over 30,000 requests for nurses nationwide, with an inadequate supply to fill that need,” the legislators state in the letter. “Even if replacement nurses can be found, they take weeks to arrive, on-board, and train. Such a timeline does not allow hospitals to quickly respond to rapidly increasing patient needs.”

California is the only state to set a standard nurse-to-patient ratio. For example, a hospital cannot have more than 2 ICU patients assigned to one nurse. This mandatory ratio could inhibit a hospital’s ability to accept a patient, especially during a medical surge or a staffing shortage.

During last winter’s surge, California made it simple for hospitals to get a staffing waiver and accept additional patients. Now, during the latest COVID-19 surge, HHS requires hospitals to go through an onerous, costly, and timely process to acquire a staffing waiver. As a result, hospitals – especially those in rural or geographically isolated communities – are being forced to choose between being out of compliance with nurse staffing ratios and serving patients in their community who need acute care interventions to survive.


“Given the nursing shortage across the country, and the need for California hospitals to continue to accept patients, CDPH should reinstate its policy of granting staffing waivers where there is a demonstrated need. Our medical system’s ability to care for patients depends on it.”

The letter was signed by Assemblymembers Jordan Cunningham (R-San Luis Obispo), Chad Mayes (I-Yucca Valley), Tom Lackey (R-Palmdale), and Heath Flora (R-Ripon). A copy of the letter can be downloaded here.