NEW BEDFORD —Southcoast Health on Thursday urged a "no" vote on Question 1, the ballot question that mandates nurse-patient ratios.

The nonprofit hospital corporation held a press conference with Mayor Jon Mitchell, the SouthCoast Chamber of Commerce and others. The union-backed proposal limits the number of patients assigned to a hospital nurse. Numbers vary depending on the type of unit, but in many cases, the limit would be four.

President and CEO Keith Hovan said the initiative would force Southcoast to hire 255 more nurses at a cost of $38 million a year. Demand for more than 3,000 new nursing positions statewide, on top of some 1,200 existing vacancies, would create a nursing shortage and further increase costs, he said.

 

Hovan said hospitals might need to recruit nurses outside the United States and would definitely make cuts to fund nurses.

"Layoffs and cutbacks, I can assure you, will take place," he said.

The largest employer in the region, Southcoast Health owns Charlton, St. Luke's and Tobey hospitals, visiting nurse and hospice services and physicians' offices.

The Massachusetts Nurses Association, the main supporter of Question 1, claims that nurses opposed to Question 1 are managers whose careers depend on agreeing with the administration.

"The executives hide behind these folks," said David Schildmeier, a spokesman for the MNA.

Nurse manager Lee Pacheco, a nurse at St. Luke's Hospital for 40 years, spoke at the press conference, which took place in a first-floor board room at the hospital.

"As a nurse at the bedside for many years, and now a manager, I know the kind of flexibility that is needed to ensure each patient gets the best possible care based on their acuity and their level of illness," she said. "Question 1 will take that flexibility away."

She said a nurse who has four patients may be the best person to take an additional patient if other nurses' patients need more critical care. She said the policy would also cause backups in the emergency room.

The Greater New Bedford Community Health Center, which is not owned by the hospital group, participated in the event. President and CEO Cheryl Bartlett said community health centers would be hit hard by Question 1, because hospitals would raise nurses' pay higher than the health center can, and the health center would lose nurses who provide primary care in the community.

She urged the public to consider the question carefully.

"It sounds good," she said. "More nurses is a good thing, right? I mean, nurses are one of the most beloved professions in our country, and they do great work. But nurses need to make professional judgements about the care of their patients."

Proponents of Question 1 say current staffing levels are inadequate, and that if hospitals had more nurses, nurses could spend more time with each patient. Opponents argue that once nurses reached their patient limits, other patients would have to wait.

Additional speakers at the press conference included Mitchell, Rick Kidder of the Chamber and state Rep. Christopher Markey, D-Dartmouth.

Mitchell said he is a Democratic mayor and cares about workers' rights, but he believes opponents are not exaggerating their predictions of dire consequences from Question 1.

Markey said legislation similar to Question 1 has been introduced in the Legislature year after year, but never passed, because the body has determined that the policy's implications for costs and hiring mean it's not a good idea.

He compared it to mandating that a plumbing company hire 400 more people.

"The quality of plumbing would go down," he said. "Who wants to hire the bottom 20?"

Kidder, president and CEO of the Chamber, said Question 1 is one of "an alarming proliferation" of ballot initiatives pushed by special interest groups.

"The threshold for getting on the ballot is low," he said. "The issues are fringe issues. Bypassing our elected officials and going directly to the people often creates intended, or unintended consequences, when a full vetting by our Legislature and governor would have revealed the remarkable and expensive flaws in attempting to legislate through political campaigns."

State political finance records show that as of Oct. 15, the "yes" campaign had raised $11.6 million, while the "no" campaign had raised $19.4 million. The Massachusetts Nurses Association and other unions made the largest donations on the "yes" side, but hundreds of nurses made individual contributions between $5 and $500.

On the "no" side, virtually all of the money came from the Massachusetts Health and Hospital Association, individual hospital companies, and, to a lesser degree, the Organization of Nurse Leaders.

The opposition carries a long list of endorsements from health care organizations, including the Massachusetts Medical Society and Massachusetts chapter of the American Nurses Association, a professional group for registered nurses.

Gov. Charlie Baker has said he will vote against it.

The campaign in favor of Question 1 has support from Senators Elizabeth Warren and Edward Markey and Boston Mayor Marty Walsh.

Schildmeier, the MNA spokesman, said hospitals turn big profits and can afford to hire more nurses. Southcoast cleared $51 million last year, he said.

In response, Hovan told The Standard-Times that those profits do not include Southcoast's non-hospital services, which run at a loss, leaving the overall company with a $37 million loss last year, although last year's loss was unusually high because of spending to implement electronic medical records.

The Massachusetts Health Policy Commission reported earlier this month that Question 1 could cost between $676 million and $949 million.

Judith Shindul-Rothschild, an associate professor in nursing at Boston College, has pegged the cost much lower, at $47 million to $150 million. She was president of the MNA in 1985, but the collective bargaining unit was completely separate from her position at the time, she said.