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    A ballot initiative campaign last fall broke the state record for spending

    A ballot committee bank-rolled by hospitals spent more money last year than any committee in state history to defeat a ballot measure that would have regulated nurse staffing levels.
    David L. Ryan/Globe Staff/File 2018
    A ballot committee bank-rolled by hospitals spent more money last year than any committee in state history to defeat a ballot measure that would have regulated nurse staffing levels.

    A ballot committee bank-rolled by hospitals spent more money last year than any committee in state history to defeat a ballot measure that would have regulated nurse staffing levels.

    The Coalition to Protect Patient Safety dropped $24.7 million into efforts opposing Question 1 on the November ballot, topping the previous record by more than $3 million, according to state campaign finance officials. All but 1 percent of its funding — about $24.6 million in total — came from the Massachusetts Health and Hospital Association, the powerful trade group that represents hospitals’ interests on Beacon Hill.

    The committee’s spending topped the $21.6 million laid down by the Great Schools Massachusetts Committee, which pushed an unsuccessful ballot question in 2016 to expand charter schools in Massachusetts. That group’s primary donor, Families for Excellent Schools-Advocacy, was later hit with the largest fine in state campaign history in 2017 after officials found the nonprofit was illegally hiding the identities of its donors.

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    Michael Sroczynski, a senior vice president for government advocacy for the Massachusetts Health & Hospital Association, said the group “invested the resources necessary” against what he called a “misguided” ballot question.

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    The committee’s lofty spending total, however, does not include a $1 million liability from — surprise, surprise — the Mass. Health and Hospital Association, which if repaid, could further balloon the record spending. Catherine Bromberg, a spokeswoman for the trade group, said the committee isn’t soliciting additional donations but said there’s been no decision as to whether the Mass. Health and Hospital Association will ultimately forgive the loan.

    Not surprisingly, Question 1, which would have set strict limits on the numbers of patients assigned to nurses working in hospitals, was the most hotly contested measure leading up to the November 2018 vote, with both sides combining to spend $36.7 million. It ultimately turned into a lopsided affair at the ballot box, with 70 percent of voters rejecting it.

    The question’s supporters, dubbed the Committee to Ensure Safe Patient Care, spent about half of what its opponents did, with 87 percent of its funding — about $10.5 million — coming from the Massachusetts Nurses Association.

    Question 3, which asked voters whether to keep the state’s transgender antidiscrimination law, drew $5.6 million, the vast majority from proponents for the law, who raised and spent about $5.2 million through the Freedom for All Massachusetts Committee. That, too, passed overwhelmingly, keeping intact the 2016 law that bars discrimination of transgender people in public places such as stores, restaurants, and hotels.

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    Another ballot question creating a commission to consider a constitutional amendment to void the 2010 Citizens United court decision also passed, albeit with little financial muscle behind or against it. Only The People Govern, Not Money Committee, which supported the measure, reported raising or spending money, with about $214,000 going toward the effort.

    Matt Stout can be reached at matt.stout@globe.com. Follow him on Twitter @mattpstout.