The California Nurses Association made its political bones, so to speak, in 1999 when it persuaded the Legislature and a newly inaugurated, union-allied Democratic governor, Gray Davis, to impose strict nurse-to-patient ratios on hospitals.

The organization, hoping to become a nationwide union, wanted to prove that its aggressive political tactics could deliver with a staffing law that would ease nurses’ workloads and indirectly compel hospitals to hire more, which would drive their wages upward.

Nearly two decades later, the CNA’s nationwide organizational campaign (via National Nurses United) and its push to pass similar staffing laws in other states are still works in progress. But in California, the nurses became a political powerhouse.

Their leaders thwarted an effort by Davis’ successor, Republican Arnold Schwarzenegger, to overturn the staffing law – a conflict marked by weeks of sharply personal exchanges – and played a leading role in the union coalition that defeated Schwarzenegger’s efforts to overhaul public employee pensions and make other major changes.

The CNA is still fully engaged in political warfare, currently taking on the state’s Democratic establishment as a strenuous advocate of universal health care and as the chief sponsor of a rebellion questioning the legitimacy of Eric Bauman’s recent election as state party chairman.

Meanwhile, the 1999 nurse staffing law has spawned annual efforts by other California unions to bypass collective bargaining and pursue working condition goals via political decree from a Legislature whose majority Democrats are closely aligned with labor.

Two bills moving through the Legislature this year are examples of the syndrome, one affecting dialysis clinics that treat kidney failure patients by periodically filtering wastes from their blood, and the other affecting private ambulance companies.

Union advocates contend, as the CNA did in 1999, that they would safeguard patients and, therefore, justify the bypassing of contract negotiations.

However, both would also directly raise employers’ costs and indirectly tilt future labor negotiations by taking key financial items off the table. Not surprisingly, therefore, employers oppose them as gratuitous and unrealistically rigid and argue that they will eventually increase medical costs borne by patients and their insurers and/or restrict access to medical services.

During Tuesday’s Assembly Health Committee hearing, some dialysis patients and their advocates also spoke in opposition to Senate Bill 349, which would set minimum staffing standards for dialysis clinics and require 45-minute breaks between procedures.

They said they fear the bill would make access more difficult, but the committee approved the bill, which is carried by Democratic Sen. Ricardo Lara of Bell Gardens on behalf of a union coalition.

The ambulance measure, Assembly Bill 263, by Assemblyman Freddie Rodriguez, a Pomona Democrat, likewise whisked through the Senate Labor and Industrial Relations Committee on Wednesday. It’s aimed largely at American Medical Response, California’s largest provider of ambulance services, but would affect other companies and exempt government ambulance services.

Rodriguez – a former emergency medical technician himself – and union lobbyists argued that it’s fair to mandate rest and meal periods for ambulance crews and to require hefty extra payments to workers if breaks are interrupted for the most urgent “Code 3” emergency calls. But American Medical Response contends that the bill’s inflexibility – banning interruptions for “Code 2” calls – could endanger patients by delaying responses.

Their specifics notwithstanding, these bills represent the Legislature’s increasing willingness to undermine traditional bargaining between unions and employers over wages and working conditions. And someday that could backfire.