The Michigan Nurses Association became the fourth state nurses' union this year that's launched a campaign for state legislation mandating minimum nurse-patient ratios at hospitals.

The MNA on Monday held a conference call with reporters trumpeting its support of House Bill No. 4311 (PDF) and the Senate version, Senate Bill No. 0228. Both were introduced last week in the Legislature in Lansing, Mich. It's not the first time state lawmakers have seen such a bill, as on three occasions similar legislation has failed.

The Michigan Safe Patient Care Act calls for hospitals to develop nursing-staffing plans and to implement those plans within two years. By the third year, hospitals are expected to adhere to specific nurse-patient ratios by department or service. That includes a 1-to-1 ratio for the operating room, adult and pediatric critical care, and trauma or critical care. The plan also detailed specific ratios for labor and delivery, including a ratio of 1 nurse to 2 patients for the first stage of labor and a 1-to-6 ratio for postpartum or well-baby care. Medical/surgical, pediatrics and behavioral health would be mandated to have 1-to-4 ratios.

If passed, the measure would likely require hospitals to hire more nurses, said Michigan State Rep. Jon Switalski, the bill’s sponsor in the House: “We probably need more nurses, why is that a bad thing?” Switalski, a Democrat, said on the conference call.

MNA officials reasoned that more nurses and lower ratios would lead to fewer readmissions and improved care, which they said could save hospitals money. They also said hospitals would save money because smaller ratios would lead to fewer nurses leaving their jobs.

The Michigan Hospital Association opposes the legislation, saying such ratios won’t necessarily improve patient safety and quality.

“Michigan hospitals have demonstrated their commitment to patient safety and quality through a decade of voluntary, collaborative, large-scale patient safety and quality improvement initiatives that have saved thousands of lives and hundreds of millions of healthcare dollars,” said MHA senior director of advocacy Chris Mitchell in a statement.

California is the only state that’s adopted similar legislation. The Golden State is the headquarters of National Nurses United, and the Michigan Nurses Association join fellow NNU affiliates in Washington, Massachusetts and Minnesota in pushing for minimum nurse-patient ratios.

The MNA has been pushing for such legislation since 2004, before joining the NNU in 2009, an MNA spokeswoman said. The union represents more than 10,000 in Michigan, and where most nurses in the state aren’t union members.