Escalating the ‘Code Red’ Campaign: A Mandate for National Safe Staffing Ratios

WHEREAS, the AFT’s “Code Red” campaign has successfully moved the needle on patient safety, securing historic legislative victories in states like Oregon, Washington and Connecticut, proving that enforceable ratios are both achievable and essential; and

WHEREAS, despite this progress, healthcare workers across the nation continue to suffer from “moral injury” caused by chronic understaffing, leading to record levels of burnout and professionals leaving the bedside; and

WHEREAS, the recent repeal of federal nursing home staffing standards in late 2025 underscores the fragility of administrative protections and the urgent need for permanent, codified state and federal laws; and

WHEREAS, data consistently shows that mandated nurse-to-patient ratios significantly reduce patient mortality, decrease nurse turnover and improve overall quality of care:

RESOLVED, that the AFT celebrates the achievement of its previous goal of passing safe staffing protections in five key states and now officially doubles that goal, committing to passing enforceable, ratio-based safe staffing laws in at least 10 additional states by 2028; and

RESOLVED, that the AFT will use the Oregon model¹ as its primary legislative model, advocating for laws that include not just nurses, but the entire care team—including assistive, service, technical and professional personnel; and

RESOLVED, that the AFT will aggressively support the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act^2,3 at the federal level to set a national floor for patient safety that cannot be rescinded by administrative whim; and

RESOLVED, that the AFT will provide increased strategic and financial support to state affiliates to run “Code Red” legislative and bargaining campaigns, advocating for every healthcare contract and state law to include meaningful enforcement—specifically, transparent public reporting and significant financial penalties for healthcare organizations/employers that fail to meet mandated limits.

Adopted July 19, 2026

1Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act, 2023 Or. Laws ch. 507. 

2Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2025, H.R. 3415, 119th Cong. (2025). 

3 Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2023, S. 1113, 118th Cong. (2023).