Chamber Urges “No” on Question 1

On the surface, Question 1’s proposal to implement nurse staffing ratios seems like a good idea. Assigning fewer patients per nurse sounds good, but the reality is that the provisions of this proposed mandate would have devastating unintended consequences for our community hospitals and patients.

Should this measure pass, hospitals in Massachusetts would be held to rigid, no-exceptions nurse staffing ratios imposed by the government that would have a profound impact on their ability to provide care.  Just imagine what would occur under these mandates if an emergency department were to reach its full legal allowance of patients.  New arrivals would be sent to alternative hospitals, compromising their care and risking their safety in the process.

Of the 50 states, only one, California, has adopted mandated nurse staffing ratios and that was over ten years ago.  If government mandated nursing ratios were such a good idea, why haven’t more states adopted them since then?  The reason is that there is no evidence that it has led to improved care.  According to 2018 Leapfrog patient safety data, the gold standard for assessing quality outcomes, California hospitals rank 25th for patient safety.  Massachusetts ranks fourth.  Likewise, United Health Foundation ranks California seventeenth nationally in terms of statewide health, while Massachusetts ranks first.  Our hospitals equal or in many cases exceed California’s in nearly every meaningful measure of quality patient care and safety.

If voters pass Question 1 it would also raise costs substantially for hospitals and patients.  The independent, non-partisan Massachusetts Health Policy Commission has estimated that passage of Question 1 would cost the state up to $949 million annually.  Patients, employers and taxpayers will end up footing the bill for these new government mandates through increased taxes and higher premiums.  Most of our community hospitals operate now on razor thin margins. UMass Memorial HealthAllianceClinton Hospital reports that this will add $8.9 million more to their cost structure year over year moving forward.  Likewise, Heywood Hospital will see $5.6 million in additional costs and Athol Hospital an additional $1.9 million.  The pressures on them to break even are immense, and it is likely that they will be forced to make deep cuts to critical programs, such as opioid treatment and mental health services, in order to implement these mandates.  In some parts of the state, local community hospitals could close altogether, creating a significant hardship for those dependent upon them.

Staffing decisions should be left to the experienced doctors and nurses who operate our hospitals, and not imposed upon them by the state through a rigid set of mandates.  Nursing is a well-organized and respected profession, whose members are protected by their elevated skillset and long established union representation.  Concerns about working conditions and patient loads should – and regularly are – negotiated at the hospital level and should not be imposed via the ballot box.  This produces the best results for each institution, and is perhaps why many doctors and nurses have come out openly in opposition to this ballot proposal.

On November 6, voters will decide whether to tie the hands of our experienced health care professionals by voting ‘Yes’ or allow them to make the right decisions for patients with the flexibility in staffing that is essential to their important work.

On behalf of the North Central Massachusetts Chamber of Commerce, we urge you to vote “No” on Question 1.  For more information, please go to


Roy M. Nascimento, CCE, IOM

President & CEO, North Central Massachusetts Chamber of Commerce

Question 1 Briefing

On November 6th, voters in Massachusetts will be asked to vote on a series of ballot questions, including Question 1 – a proposal to mandate nurse staffing levels in hospitals in the state.  Your support is desperately needed in helping voters understand the negative impact Question 1 will have on patient care, our communities and North Central Massachusetts.

Please consider sharing the following message and join the statewide effort to raise awareness and provide education regarding Question 1.

  • Staffing decisions should be left to the judgement of qualified healthcare professionals in our hospitals, not imposed via the ballot box. These new government mandated nurse staffing ratios would be enforced at all hospitals, on all units, at all times with no flexibility.  A rigid, one-size-fits-all approach threatens the quality of care for patients and would have a detrimental impact on the state’s healthcare system.
  • Virtually every major health care group, including the Massachusetts Medical Society, American Nurses Association, Emergency Nurses Association, Massachusetts League of Community Health Centers, American Academy of Pediatrics, Academy of Medical-Surgical Nurses and Massachusetts Senior Care Association, opposes Question 1 and feels that it would have devastating consequences for patients. Consider what would happen under the new law if an emergency department were to reach its full legal allowance of patients under the new mandates.  The hospital would not be able to admit any more patients, forcing patients and ambulances to waste valuable time in life and death situations searching for an alternative hospital.
  • Every hospital in the state, including our three community hospitals located here in North Central Massachusetts – UMass Memorial HealthAlliance Clinton Hospital, Heywood Hospital and Nashoba Valley Medical Center – also oppose Question 1.  Question 1 would raise costs substantially for these hospitals and negatively impact their ability to provide care.  To implement this costly unfunded mandate, they will be forced to make deep cuts to critical programs, such as opioid treatment and mental health services.  Statewide, Question 1 is projected to lead to the reduction of 1,000 behavioral health beds (38% of the total supply).[i]  In addition, many smaller community hospitals are already struggling financially and will not be able to absorb the added cost and will be forced to close.
  • The independent, non-partisan Massachusetts Health Policy Commission has estimated that passage of Question 1 would cost the Commonwealth up to $949 million annually.[ii] Patients, employers and taxpayers will end up footing the bill for these new government mandates through increased taxes and higher premiums.
  • There is no evidence that Question 1 will improve the quality of care. Out of all 50 states only one other state (California) has mandated nurse staffing ratios and there is no evidence that it has led to improved care.  United Health Foundation ranks California seventeenth nationally in terms of statewide health.  Massachusetts ranks first.[iii]  In addition, a study conducted in 2018 of hospital patient safety ranks Massachusetts fourth in the nation for percentage of hospitals with top patient safety rating, while California ranks twenty-fifth.[iv]

We would encourage you to vote against this measure.  Patient safety should always be the primary concern of the Commonwealth’s healthcare system.  While proponents of this question may be well intentioned, its severe cost and detrimental impact on the state’s healthcare system cannot be ignored.

For more information, please contact Christopher McDermott, Public Affairs Manager at 978.353.7600 ext. 224 or email

Click here to view the Chamber’s positions on the Ballot Questions.

Click here to view our Op-Ed on Question 1

[i] (Coalition to Protect Patient Safety)

[ii] (Massachusetts Health Policy Commission, 2018)

[iii] (Attorney General of Massachusetts)

[iv] (The Leapfrog Group, 2018)

Government Affairs Alert

Over the past year, we have heard from some members about the state’s Employer Medical Assistance Contribution, or EMAC. Last year, the Baker Administration attempted to simultaneously address MassHealth’s growing deficit and encourage employers to offer private alternatives by levying a quarterly tax against the payroll of any employee who utilized the state’s health insurance program. Applying to any business with six or more employees, including part time and seasonal labor, this new assessment could run as high as $750 per relevant worker.

Understandably, reaction to this policy has been strong. Having drawn sharp criticism for the shockingly high bills the measure gave rise to, the Department of Unemployment Assistance recently announced it would award waivers based upon financial hardship to a narrow band of employers. To qualify, a business must illustrate that:

  • It has acted in good faith in all its relations with the Department, and certifies that it is current on state taxes and assessments, including, where applicable, the nursing facility user fee assessment; and
  • provide evidence of one or more of the following:
    1. The business is unable to pay the EMAC Supplement because of financial hardship and failure to obtain a hardship waiver is likely to result in termination of the employer’s business or in substantial loss of employment;
    2. The business has paid an Employer Shared Responsibility Payment and been assessed an EMAC Supplement in the same calendar year; or
    3. The business has paid an Employer Shared Responsibility Payment and been assessed an EMAC Supplement in the same calendar year; or
    4. The business experienced a turnover rate of at least 300% over the four quarters immediately preceding the application. (

Waiver applications are due Friday, October 12th, and application forms can be found here. While still applied too narrowly, providing far too short a window for submission, and offering no opportunity for appeal if rejected, this step does represent a positive development. We encourage any employer who believes they qualify to apply and to do so quickly. Meanwhile, the Chamber and its partners across the Commonwealth will continue to advocate on behalf of regional businesses in an effort to repeal this punitive measure.

October Legislative Update

September was a busy month for the Chamber on the legislative front and October promises to continue that trend. In recent weeks, our staff helped organize a workshop to educate members about the recent “Grand Bargain” legislation, reconvened monthly meetings with the region’s mayors, and published an updated Public Affairs Agenda for the new fiscal year. This last item was approved unanimously by the Chamber’s Board of Directors and includes a new section addressing the debate over international trade and tariffs in Washington.  The month culminated with the Chamber’s Annual Legislative and Candidates Reception, held at the Chocksett Inn in Sterling.

Though this event always draws a crowd, we set records for attendance this year, attracting nearly sixty public officials and candidates and close to one hundred members of the general public. Illustrating the Chamber’s strong presence at all levels of government, the public officials who participated included Congressman McGovern; State Auditor Bump; the region’s entire state senate delegation; the vast majority of its state representatives; the mayors of Fitchburg and Leominster; councilors from Fitchburg, Leominster, and Gardner; and numerous town managers, administrators, and select-people from throughout North Central Massachusetts.  The first in the Chamber’s fall series of public policy related events, the reception will be followed this month by our Annual Congressional Luncheon on Friday, October 5th and a special congressional debate scheduled for Thursday, October 18th between the final contenders in the race for the Commonwealth’s Third Congressional District seat. It is especially fitting that the luncheon precedes the debate, as the former will be Congresswoman Tsongas’s final Chamber appearance before voters identify one of the debate’s three contenders as her successor.

While that election unfolds, the Chamber has also been working hard to monitor ongoing developments. For many of our members, the recently implemented Employer Medical Assistance Contribution (EMAC) has been an issue of pressing concern. After considerable criticism following its rollout, the state has chosen to provide waivers to businesses facing a disproportionate impact from this new tax. While still applied too narrowly, providing far too short a window to apply, and offering no opportunity for appeal if rejected, this step does represent a positive development. Employers can learn more about the hardship exemptions here and have until Friday, October 12th, to apply. Applications can be found here.

At the local level, several communities in our region will conduct annual reviews of their respective assessor’s tax rates this month. As always, the Chamber will be actively advocating in those communities for policies that treat both commercial and residential property owners fairly. Such efforts have proven successful in recent years, with Leominster maintaining a common rate and Fitchburg moving towards one with increasing speed. These successes illustrate just how important this work is and lead us to believe there will be further progress in the weeks ahead. If you own a business in Fitchburg, Leominster, or Clinton and would like to make your voice heard on this tax issue, or you are interested in any of the other topics discussed above, feel free to reach out to Christopher McDermott, the Chamber’s Public Affairs Manager, at 978.353.7600 ext. 224 or

Become a Season Ticket Holder for 2018-2019

Season Tickets for one of our most popular programs, Good Morning North Central, are now on sale! New this year, we have expanded the season tickets to also include three of our other popular breakfast events. We have added the Economic Forecast Breakfast, Tourism Update Breakfast and the Real Estate Summit to the season tickets.

Season Ticket holders enjoy a 20% discount as well as the convenience of being automatically registered for each of these popular events. Season Tickets can be transferred to another colleague within a business as well. Season tickets are on sale at  at $160 for members and $260 for non members.

New Chamber Tourism Website Fall Launch

Stay tuned! The Chamber’s tourism affiliate, Visit North Central Massachusetts will be launching a dynamic new tourism website this fall. The new website will have a fresh new look and feature a number of enhancements to help better promote members and North Central Massachusetts. This is part of our efforts around continuous improvements to strengthen our communications, member services and operations.

Legislative Report

The last few months have been some of the most active any on Beacon or Capitol Hill can remember, and the Chamber’s staff has worked hard to keep pace. Well before the supposed “Grand Bargain” made headlines, the Chamber had reviewed the list of initiatives likely to move forward at that time and developed a concise voter’s guide explaining how passage of each would impact the business community.  As events took shape in the days and weeks that followed, the staff ensured that this community remained informed. The Chamber hosted Senate President Chandler at a breakfast forum the morning after the Bargain was announced and issued a statement urging both parties to withdraw their petitions shortly after. Now, with only one of the original five key issues remaining, the Chamber continues to advocate on behalf of local healthcare providers and against arbitrary, government imposed staffing requirements in our hospitals.

As important as voicing our members’ concerns in Boston may be, the Chamber has kept a close watch on events in Washington as well. Recognizing the region’s dire need for skilled labor, the Chamber’s President and CEO, Roy Nascimento, joined business leaders from across the nation in signing a letter urging the US Senate to pass the Perkins Career and Technical Education Act. This Act represents the largest block of funding for high school education in the federal budget and would reinstate a Reagan era program that supported skills related training until it lapsed in 2016.

Like many industry groups, the Chamber is also deeply concerned by the current rhetoric surrounding trade and tariffs. With the Trump Administration levying taxes on imports from the Commonwealth’s three largest trading partners- Canada, Mexico, and China- and those nations responding in kind, the need to identify a coherent policy with which to move ahead is clear. The Staff has begun conducting research into this topic and plans to bring a platform forward with the new Public Affairs Agenda in September. In the meantime, the Chamber will continue to monitor developments at the local, state, and federal levels, ensuring that the needs and concerns of North Central Massachusetts’ businesses are accounted for in the discourse.

2018 North Central Massachusetts Congressional Luncheon scheduled for October 5, 2018

 The North Central Massachusetts Chamber of Commerce is hosting the Annual North Central Massachusetts Congressional Luncheon on Friday, October 5, 2018 featuring the Honorable Jim McGovern, United States Representative for the Second Congressional District and the Honorable Niki Tsongas, United States Representative for the Third Congressional District of Massachusetts.  The program, sponsored by Fitchburg State University, runs from 11:30 a.m. to 1:30 p.m. at the Great Wolf Lodge, 150 Great Wolf Drive, Fitchburg, MA.

This event will provide Chamber members the opportunity to hear directly from members of the U.S. House of Representatives regarding business issues and critical matters facing the nation.  Attendees will also be afforded the unique opportunity for networking and questions with members of North Central’s federal delegation.

Currently serving his eleventh term in Congress, Congressman Jim McGovern serves as the second ranking Democrat on the powerful House Rules Committee, which sets the terms for debate and amendments on most legislation; and a member of the House Agriculture Committee.  In 2014, McGovern was named Democratic Ranking Member on the House Committee on Agriculture’s Subcommittee on Nutrition.  The Subcommittee’s jurisdiction includes policies and statutes relating to nutrition, including the Supplemental Nutrition Assistance Program and domestic commodity distribution and consumer initiatives.

Before his election to Congress, McGovern spent 14 years working as a senior aide for the late U.S. Representative John Joseph Moakley (D-South Boston), former dean of the Massachusetts delegation and Chairman of the House Rules Committee.  He was born in Worcester, the son of two successful small business owners.  His two sisters are elementary school teachers in Worcester’s public school system.

McGovern earned his Bachelor of Arts (‘81) and Masters of Public Administration (‘84) degrees from The American University, working his way through college by serving as an aide in the office of U.S. Senator George McGovern (D-SD).

Congresswoman Niki Tsongas was elected to the United State House of Representatives in a 2007 special election, becoming the first woman in 25 years to serve in Congress from the Commonwealth of Massachusetts.  She represents the Massachusetts Third District (which had previously been known as the Fifth District until 2012).  Tsongas holds the same seat that was held three decades earlier by her late husband, former Congressman, U.S. Senator and presidential candidate Paul Tsongas.  Her Congressional district spans across portions of Essex, Middlesex and Worcester counties.

Tsongas serves as a senior member on the prestigious House Armed Services Committee, and having previously served in a leadership position as the top Democrat on the subcommittee for Oversight and Investigations.  Tsongas also serves on the Natural Resources Committee, which formulates federal policy related to domestic energy production, National Parks, and the environment.  In 2015, she was named to a leadership role as the top Democrat on the Federal Lands Subcommittee.  She also serves on the Energy and Natural Resources Subcommittee.  Recently Tsongas was elected by her peers to serve as the highest ranking Democrat on the largest HASC subcommittee, the Tactical Air and Land Forces Subcommittee.

Prior to being elected to the House of Representatives, Tsongas served as a Dean at Middlesex Community College, practiced law, and raised her three daughters all in the region she now represents.

Tsongas is not seeking re-election this year.

Make sure that you reserve your spot early to hear from our congressional delegation on the many critical issues facing the business community in Washington D.C.

Pre-registration is required and easy. Simply call the Chamber at 978.353.7600 ext. 235, email or register online at  The cost is $35 for members and $55 for non-members.

Sample Letter to Legislator: Minimum Wage


As a small business owner and job creator in your district, I urge you to provide cost relief for struggling small businesses.

My business already faces double-digit health care premium increases, highest-in-the-nation energy expenses, and a newly increased EMAC tax. Should this year’s ballot initiatives pass, I would also have to contend with the impact of a $15 minimum wage indexed to inflation, a one-size-fits-all paid family and medical leave mandate, and an income tax surcharge on pass-through businesses.

Massachusetts is one of only eleven states without a teen or training wage. Small businesses have historically served as the first job for young workers, providing an introduction to the workforce. As the cost of hiring workers increase, it grows more difficult to justify employing teenagers and students who lack entry level skills and require extensive training. Without a teen or training wage, these individuals will be continuously crowded out of the workforce.

Increasing the tipped wage to $9/hour will mean Massachusetts servers will experience the same loss of income that Maine restaurant workers experienced. The Maine legislature was forced to override the actions of a misguided state ballot question at the request of restaurant servers due to reduced take-home pay following a minimum wage increase. Massachusetts legislators may be faced with an equally uncomfortable predicament, should this initiative pass.

Massachusetts will be only one of two states with a paid family and medical leave benefit requiring an employer contribution. The other state mandated leave programs are all employee paid and often include a small business carve-out and opt-outs for businesses with an existing program. The current proposal for paid family and medical leave is estimated to be a $1 billion tax on both employers and their workers. This would be the most expensive paid family and medical leave benefit in the nation!

These new mandates will surely factor into future hiring decisions for my business and will limit my ability to increase the number of workers I employ. Therefore, as a small business owner, I ask that you recognize the extreme financial pressures being faced by job creators and understand the sacrifices we are already making to keep residents of the Commonwealth employed. Main Street businesses seek balanced relief, so we can do what small businesses do best: Create jobs and grow local economies.


Local seniors celebrated at Chamber’s Annual Scholarship Breakfast

The next edition of the North Central Massachusetts Chamber’s popular Good Morning North Central breakfast series is scheduled for Friday, May 11, 2018 from 6:45 a.m. to 9:00 a.m. at the Doubletree by Hilton, 99 Erdman Way, Leominster, MA.  The May edition is sponsored by UMass Memorial Healthcare HealthAlliance-Clinton Hospital, Inc.

The Good Morning North Central series is a high-profile, fast-paced and educational breakfast program geared towards executives, senior managers, professionals and business owners.  Each of the programs has a business-oriented focus and features popular speakers to present on topics of interest to local businesses.

The May breakfast features the presentation of the Chamber Foundation’s annual scholarships and will highlight top scholars from throughout North Central Massachusetts.  The Chamber Foundation distributes approximately twenty five (25) $2,000 scholarships to local high-achieving high school students each year. Since the establishment of its scholarship program, the North Central Massachusetts Chamber Foundation has awarded over a million dollars in scholarships.

Many of these awards are made possible through contributions from members of the North Central Massachusetts Chamber of Commerce and proceeds from the Chamber’s Annual Scholarship Golf Tournament. Scholarships endowed through the Foundation are often named in honor of prominent members of the North Central Massachusetts business community.

The Chamber’s Foundation is a 501 (c) 3 non-profit organization focused on assisting in the betterment of the region through charitable activities.  Funds raised by the Foundation are utilized primarily for education/workforce development initiatives and charitable activities in North Central Massachusetts, including scholarships to eligible applicants pursuing education and grants to support economic and community development projects.

The cost is just $25 for Chamber members/$40 non-members and includes a breakfast buffet. Season Tickets are also available for purchase.  Pre-registration is required. For more information or to register, please contact the Chamber at 978.353.7600 ext. 235 or visit