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Voters face three ballot questions on Election Day

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Three questions will appear on the ballot paper on Nov. 6. These are concerned with the issue of nurse-to-patient quotas, campaign financing regulation and transgender rights. Below are three more comprehensive summaries and explanations of what a “yes” or “no” vote will mean for each question.

Question #1

Do you approve of a law summarized below, on which no vote was taken by the Senate or the House of Representatives on or before May 2, 2018?

Summary: This proposed law would limit how many patients could be assigned to each registered nurse in Massachusetts hospitals and certain other health care facilities. The maximum number of patients per registered nurse would vary by type of unit and level of care, as follows:

  •  In units with intermediate care patients: 3 patients assigned per nurse
  • In units with post-anesthesia care or operating room patients: 1 patient under anesthesia per nurse and 2 patients post-anesthesia per nurse
  • In the emergency services department: 1 critical or intensive care patient per nurse (or 2 if the nurse has assessed each patient’s condition as stable), 2 urgent non-stable patients per nurse, 3 urgent stable patients per nurse, or 5 non-urgent stable patients per nurse
  • In units with maternity patients:

A. Active labor patients: 1 patient per nurse

B. During birth and for up to two hours immediately postpartum: 1 mother per nurse and 1 baby per nurse

C. When the condition of the mother and baby are determined to be stable: 1 mother and her baby or babies per nurse

D. Postpartum: 6 patients per nurse

E. Intermediate care or continuing care babies: 2 babies per nurse

F. Well-babies: 6 babies per nurse

  •  In units with pediatric, medical, surgical or observational/outpatient treatment patients, or any other unit: 4 patients per nurse
  •  In units with psychiatric or rehabilitation patients: 5 patients per nurse

The proposed law would require a covered facility to comply with the patient assignment limits without reducing its level of nursing, service, maintenance, clerical, professional, and other staff.

The proposed law would also require every covered facility to develop a reporting tool to evaluate the condition of each patient. This tool would be used by nurses in deciding whether patient limits should be lower than the limits of the proposed law at any given time.

The proposed law would not override any contract in effect on January 1, 2019 that set higher patient limits. The proposed law’s limits would take effect after any such contract expired, on January 1, 2019.

The state Health Policy Commission would be required to publicize these regulations in implementing the proposed law. The Commission could conduct inspections to ensure compliance with the law. Any facility receiving written notice from the Commission of a complaint or a violation would be required to submit a written compliance plan to the Commission. The Commission could report violations to the state attorney general, who could seek a civil penalty of up to $25,000 per violation, as well as up to $25,000 for each day a violation continued after the Commission notified the covered facility of the violation. The Health Policy Commission would be required to establish a toll-free telephone number for complaints and a website where complaints, compliance plans, and violations would appear.

The proposed law would prohibit discipline or retaliation against any employee for complying with the patient assignment limits of the law. The proposed law would require every covered facility to post within each unit, patient room, and waiting area a notice explaining the patient limits and how to report violations. Each day of a facility’s non-compliance with the posting requirement would be punishable by a civil penalty between $250 and $2,500.

The proposed law’s requirements would be suspended during a state or nationally declared public health emergency.

A YES VOTE would limit the number of patients that could be assigned to one registered nurse in hospitals and certain other health care facilities.

A NO VOTE would make no change in current laws relative to patient-to-nurse limits.

Question #2

Do you approve of a law summarized below, on which no vote was taken by the Senate or the House of Representatives on or before May 2, 2018?

Summary: This proposed law would create a citizens commission to consider and recommend potential amendments to the United States Constitution, to establish that corporations do not have the same Constitutional rights as human beings and that campaign contributions and expenditures may be regulated.

Any resident of Massachusetts who is a United States citizen would be able to apply for appointment to the 15-member commission, and members would serve without compensation. The governor, the secretary of the Commonwealth, the state attorney general, the speaker of the state House of Representatives, and the president of the state Senate would each appoint three members of the commission and, in making these appointments, would seek to ensure that the commission reflects a range of geographic, political, and demographic backgrounds.

The commission would be required to research and take testimony, and then issue a report regarding:

  •  The impact of political spending in Massachusetts
  •  Any limitations on the state’s ability to regulate corporations and other entities in light of Supreme Court decisions that allow corporations to assert certain constitutional rights
  •  Recommendations for constitutional amendments
  •  An analysis of constitutional amendments introduced to Congress
  •  Recommendations for advancing proposed amendments to the United States Constitution

The commission would be subject to the state Open Meeting Law and Public Records Law. The commission’s first report would be due Dec. 31, 2019, and the secretary of the Commonwealth would be required to deliver the commission’s report to the state Legislature, the United States Congress, and the president of the United States.

The proposed law states that, if any of its parts were declared invalid, the other parts would stay in effect. The proposed law would take effect on January 1, 2019.

A YES VOTE would create a citizens commission to advance an amendment to the United States Constitution to limit the influence of money in elections and establish that corporations do not have the same rights as human beings.

A NO VOTE would not create this commission.

Question #3

Do you approve of a law summarized below, which was approved by the House of Representatives and the Senate on July 7, 2016?

Summary: This law makes discrimination on the basis of gender identity illegal in public spaces, in any place that is open to and accepts or solicits the patronage of the general public, such as hotels, stores, restaurants, theaters, sports facilities, and hospitals. Prohibited grounds for discrimination also include race, color, religious creed, national origin, sex, disability, and ancestry.

“Gender identity” is defined as a person’s sincerely held gender-related identity, appearance, or behavior, whether or not it is different from that traditionally associated with the person’s physiology or assigned sex at birth.

The law requires any such place that has separate areas for males and females (such as restrooms) to allow access to and full use of those areas consistent with a person’s gender identity. The law also prohibits the owner or manager of a place of public accommodation from using advertising or signage that discriminates on the basis of gender identity.

This law directs the state Commission Against Discrimination to adopt rules or policies and make recommendations to carry out this law. The law also directs the state attorney general to issue regulations or guidance on referring for legal action any person who asserts gender identity for an improper purpose.

The provisions of this law governing access to places of public accommodation are effective as of October 1, 2016. The remaining provisions are effective as of July 8, 2016.

A YES VOTE would keep in place the current law, which prohibits discrimination on the basis of gender identity in places of public accommodation.

A NO VOTE would repeal this provision of the public accommodation law.

Source: Secretary of State William Galvin

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