This November, Massachusetts voters will be asked to vote on a ballot initiative about nurse staffing at hospitals in the Bay State. The information about Question 1 can be confusing, with both sides making similar claims. However, a group of voters from around the state studies the issue intensely and came up with a statement to help voters make up their mind.
Twenty Massachusetts voters gathered at the Watertown Free Public Library a couple weeks ago and got the the chance to hear from the campaigns for and against Question 1.
The effort, known as the Citizens Initiative Review, was a organized by Watertown State Rep. Jonathan Hecht in partnership with Tufts University’s Jonathan M. Tisch College of Civic Life and Healthy Democracy, the organization that pioneered CIR in Oregon and others states.
The nurse staffing ballot question seemed to be one that would benefit from a deeper examination, Hecht said.
“This one is especially well suited to this type of process,” Hecht said. “Most people get their information from commercials and sound bites, and it is hard to sift through the information.”
While complicated, the main aim of Question 1 is to set up required nurse to patient ratios in Massachusetts hospitals. The Citizen Initiative Review panel came up with a statement in favor, a statement against the ballot question, and presented a set of findings, or facts, that voters could find useful. See the CIR panel’s statement by clicking here. The text of the ballot question is available on the Secretary of State’s website (click here).
The 20 voters, known as the citizen panel, gathered for four days packed with activities. Their days went from 8 a.m. to as late as 5:30 p.m. On the first day, after learning about the process, they heard opening statements from the pro and con sides. The second day the group got to come up with questions for the two sides, each of which got 60 seconds to respond.
The answers given by the pro and con groups claimed that patient care and waits at hospitals, particularly in emergency rooms, would improve if their side wins. And, on the flip side, would get much worse if their side loses.
The pro Question 1 side compared the initiative to the rules used in California, which also has required nurse/patient ratios for many years. They said the ratios have led to shorter wait times in California.
Those against the question said ratios are too rigid. They say the requirement would lead to longer wait times if there is a sudden influx of patients at a time when there are not enough nurses working at the time. They prefer to staff based on average number of patients for the day and even time of day.
Later on the second day, the panelists got to speak to two independent panels of experts.
On the third day the panelists wrote up the claims from both sides and ranked them, and on the final day the group wrote up the panel’s statement that is available for voters to review (see it below).
The panelists were selected from people who responded to a mailer sent to 15,000 randomly-selected voters in the Commonwealth.
“It went very well. Once again the panelists were great,” Hecht said. “They worked incredibly hard for four straight days. They were really so committed to the task, and think about this complex questions.”
Organizers tried to make a panel that reflects the demographics of Massachusetts, and included women and men from diverse racial and ethnic backgrounds. There were Democrats, Republicans and unenrolled voters in similar proportions to the state as a whole. The panelists came from every congressional district in the state; they came from urban areas and small towns; their educational background ranged from high school to graduate degrees; and they ranged in age from 20 to 73.
Interest in CIR
This is the second time the CIR has been run in Massachusetts, Hecht said, after the legalization of recreational marijuana was examined in 2016. Hecht has sponsored legislation on Beacon Hill that would make the CIR a state law.
“A bill on Citizen Initiative Reviews got favorable response from the Joint Committee on Election Laws,” said Hecht.
CIR has been used in a number of states, including Oregon, where it has been an official part of the election process since 2011. The 2016 and 2018 Citizen Initiative Reviews are part of a pilot program in Massachusetts.
The bill had been submitted in previous sessions, and Hecht said he will continue to advocate for it. He noted that bills often take several legislative sessions until they are approved.
The interest in the Citizen Initiative Review goes far beyond Massachusetts. This year’s panel was observed by two documentary film crews, including one from Brazil.
There were also observers from other countries.
“They wanted to see how the process works, and see if it would help address political issues in their country,” Hecht said.
Where to View It
The result of the panel’s work will not be sent to every voter. For now, they will just get the full text in the voter guide mailed out by the Secretary of State’s office.
You can read the Citizen Initiative Review’s statement here: https://www.cirmass.org/the-2018-citizens-statement, and find more more about the process at www.cirmass.org.
Hecht said he and his colleagues will also be sharing it on social media.