By Mara O'Malley / Broadcast version by Farah Siddiqi reporting for the Kent State-Ohio News Connection Collaboration.

The Ohio Nurses Association has undertaken a so-called Code Red campaign to call attention to the shortage of nurses in Ohio hospitals, which could lead to a patient care crisis.

The campaign focuses on five areas, including staffing levels, working conditions, the nursing workforce pipeline, corporate trends and trust and agency within the profession. They hope to encourage employers and lawmakers to implement the staffing ratios their nurses need.

"That is our sounding the alarm and putting forward real workable strategies to address the nurse staffing crisis in Ohio," said Rick Lucas, president and executive director of the Ohio Nurses Association and himself a registered nurse.

The ONA conducted a survey in 2023 that received over 11,000 responses from licensed nurses in Ohio, seeking to find out why nurses are leaving bedside care positions.

They found:

• 58% of nurses who left bedside roles did so because of their patient care load.


• 70% of direct care nurses are currently considering leaving bedside roles because of their patient care load.


• 88% of nurses would consider staying in bedside roles if Ohio had legally enforceable minimum staffing standards.

"Nurses need help. We needed help before the pandemic," Lucas said. "After enduring that and dealing with the exacerbated staffing shortage, we really need help. And we need for people to know what's happening in our hospitals so that they can help fight for the change that they need as well."


Ohio House Bill 285, the Nurse Workforce and Safe Patient Care Act, was introduced in September 2023. If enacted, the bill would establish minimum staffing standards in Ohio hospitals, create a loan-to-grant program to support nurses in training, ensure accountability in hospital compliance, establish nurse staffing committees with direct caregivers, and create whistleblower protections for patients, nurses and hospital staff.


The Ohio Nurses Association supports H.B. 285.


"It's a way for us to attract and retain those nurses here," said Rep. Elgin Rogers (D-Toledo), a co-sponsor of the bill. "We want to make sure that we have nurses who are qualified. Nurses are in high demand, but we want to make sure that they are trained properly and they remain in Ohio."


The nursing shortage around Ohio hospitals started before the COVID-19 and is expected to get worse, peaking in early 2027, Lucas said. Nurses now have more responsibilities than ever, ranging from caring for patients to taking out the trash and changing the linens.


"There were barely enough nurses scheduled already, and then when COVID hit, things only got worse, with stressing an already broken system," Lucas said.


Beyond that, Lucas said hospitals are relying heavily on travel nurses - nurses who aren't based in any one location, but instead work for several months at hospitals in need of staff before moving on.


The $20 million loan-to-grant in H.B. 285 is designed to help encourage nurses to stay in Ohio. Nurses could be eligible for up to $12,000 in forgivable loans if they stay in Ohio for at least five years of work.


"In this particular item, there is significantly a higher value than some of those other programs," said Dr. Wendy Batch-Wilson, Dean of Nursing Cuyahoga Community College. "With the $5,000 that's available, but then also the ability for that to turn into a grant for the full amount."


Rogers, a Democrat, and his Republican co-sponsor hope the bill will go to the floor for a vote before the General Assembly session ends.


"They went to college, they went to school, they sacrificed," said Rogers. "So we want to make sure we're creating an atmosphere where they can do what they were called to do in this great state."




This collaboration is produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.


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World Hepatitis Day is this Sunday, and for the Oregon Health Authority, it's an opportunity to promote its plan to eliminate hepatitis across the state.

Released in March, the plan includes major goals and strategies to limit the spread of hepatitis A, B and C over the next six years. It's gotten new attention after 2,400 patients in Oregon hospitals were potentially exposed to hepatitis and HIV earlier this month.

Concerns are high, but epidemiologist Dr. Dean Sidelinger, Oregon's state health officer, said people should be aware of the threats of hepatitis, but not anxious.

"In day-to-day times, people should feel safe and confident in going to the doctor," he said. "The risk of exposure to these viruses is extremely low in most cases."

Hepatitis is inflammation of the liver, and contagious viruses are among the causes. Sidelinger said he's confident Oregon has the technology and resources to fully eliminate the threat.

While many people may have heard of hepatitis, they may not fully understand how prevalent it is in their communities. According to OHA data, the proportion of chronic hepatitis C cases among people in their 20s tripled between 2010 and 2019.

Sidelinger said there's a good chance most Oregonians know someone who is affected by chronic hepatitis.

"It can seem out of the blue to be talking about hepatitis and [a] hepatitis awareness day, but this is a disease that affects many individuals," he said. "But the good news is, everyone can take steps to protect themselves."

The OHA says you can help prevent the spread of hepatitis by washing hands and fresh produce, staying current on vaccinations, avoiding sharing needles, and getting tested regularly. These tips and more are part of the state's plan to eliminate hepatitis by 2030.


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CoveredCA announced Wednesday that the average premium for plans on the marketplace will rise 7.9% in 2025, but subsidies are expected to blunt the impact and even lower costs for many consumers.

The Biden-Harris administration's Inflation Reduction Act caps premiums at 8.5% of income for many, and goes even further for those with low incomes.

Rachel Linn Gish, director of communications for the nonprofit Health Access California, said the state has put the federal funds to good use.

"Because of this financial help," she said, "California has been able to take even further steps to lower costs for many CoveredCA enrollees by eliminating deductibles and reducing copays for many health services such as doctors' visits, lab work, generic drugs."

However, the enhanced premium subsidies in the IRA will expire next year, sending costs soaring unless Congress extends them. If not, Gish said, she expects premiums to rise 60% to 80%, costing thousands more per year. Opponents of the extension have cited the need to limit federal spending.

Gish said if the federal premium help ends, people could start seeing much higher deductibles.

"Without the federal assistance, California stands to lose $1.7 billion in assistance, which the state can only backfill a fraction of," she said, "which means consumers could again see deductibles of $5,000 or more."

Other big changes are on the way. Starting Nov. 1, about 40,000 income-eligible DACA recipients in California will be able to apply for premium subsidies through Covered California.

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Connecticut insurance companies are requesting rate increases. Companies want a more than 8% increase for individuals and an almost 12% increase for small groups. However, insurance costs are already problematic for residents. A 2022 survey shows 46% of people delayed important medical care due to coverage costs.

Liz Dupont-Diehl, associate director of the Connecticut Citizen Action Group, said unaffordable insurance is all too common.

"It is an unfortunate American right of passage to spend hours a week appealing claims denials, or dealing with rising copays, and surprise costs. Even those of us lucky enough to think we have good coverage are continually surprised by hings that are not covered," she said.

Of the legislative solutions lawmakers can take, polls show voters across party lines support the government setting limits on out-of-pocket medical care costs for people with insurance.

Connecticut's Insurance Department will host an informational meeting for people to share their experiences and hear testimony. It will be held from 9 a.m. to 1 p.m. on August 20 at the Legislative Office Building in Hartford and over Zoom.

One way Connecticut's General Assembly can better regulate insurance companies is by increasing transparency surrounding pharmacy benefit managers. A recent Federal Trade Commission report finds the six largest pharmacy benefit managers manage 95% of the country's prescriptions.

Dupont-Diehl said this can help people better understand why certain claims get denied.

"We would be interested in knowing exactly which claims are denied based on ZIP code, based on race and ethnicity, based on age, based on gender," she continued.

She notes that much of what needs to be done to fix health care can be done at the federal level, although states can take the lead. Part of Connecticut's 2023 budget calls for the state's Insurance Department to work with the Office of Health Strategy to study ways to make care more affordable.

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