Statement of the New York State Nurses Association before the Joint Hearing of the Assembly Ways & Means Committee and Senate Finance Committee on the Executive Budget Relating to Health, February 6, 2008.
Good afternoon. My name is Tina Gerardi, and I am a registered nurse and the CEO of the New York State Nurses Association. Joining me today is Shaun Flynn, Director of Governmental Affairs for the Association. The Nurses Association is the oldest and largest professional organization for registered nurses in New York State. It represents the interests of more than 200,000 registered nurses and serves as the collective bargaining agent for more than 35,000 RNs at 150 healthcare facilities. On behalf of our members and the patients they serve, I appreciate the opportunity to address the Governor’s 2008-2009 Executive Budget as it relates to health issues.
While the Governor’s proposals include initiatives that reflect a commitment to healthcare reform and an investment in improving access to quality care that we appreciate and support, there are a number of proposals that could have a negative impact on both the practice of registered nurses and the health and well-being of New York’s residents.
The New York State Nurses Association appreciates Governor Spitzer’s commitment to reforming the state’s publicly-funded health care programs.
The Nurses Association is opposed to the Governor’s proposed cuts to the Medicaid program for services such as inpatient hospital care, drug and alcohol detoxification, home care and nursing home care.
Cuts in funding for hospitals and nursing homes have the potential of severely limiting access to care and endangering patient safety. Historically, when provider reimbursement rates are cut, facilities often react by reducing direct-care staff, including RNs. Research has shown that these reductions result in poorer patient outcomes. As our state has no nurse-to-patient staffing standards, less money for hospitals would likely result in staff cutbacks and a riskier environment for patients.
The Executive Budget contains $980 million in healthcare cuts and new “savings.” The Governor’s plan for reducing Medicaid costs includes changes to the reimbursement structure that would favor primary care and preventive services. The Nurses Association is concerned about the potential for further cuts that may result from reform proposals.
While nursing education may not appear to be a health budget issue, there is a direct correlation between the status of New York’s nursing workforce and the health outcomes of the state’s citizens. Nothing is more critical to the health and well-being of New Yorkers than having access to safe, quality health care delivered by highly qualified, competent RNs. To that end, we must address New York’s decade-long, worsening nursing shortage.
According to the New York State Department of Labor, nursing is among the top 25 occupations with the highest number of vacant positions. The demand for new RNs will continue to rise as the "baby boomer" generation reaches retirement age over the next three decades. In fact, the Health Resources Services Administration has predicted that New York State will have a shortage of 30,000 registered nurses by the year 2020.
It is clear that New York needs more newly licensed RNs. Accordingly, the Governor’s budget must more firmly address New York’s inadequate nursing workforce to maintain the public’s health.
While we know that the demand for nursing education programs has increased over recent years, there still are not enough programs to meet that growing need. New York’s nursing programs have limited capacity.
It is estimated that 10,000 registered nurses must graduate each year in New York State to meet workforce demands (HRSA). In 2005, fewer than 7,000 RNs graduated from New York programs. For that same year, the state's Center for Health Workforce Studies reported that nursing schools turned away 3,000 qualified applicants.
An increased supply of newly licensed registered nurses is critical to meet current shortages and future demands in New York State. An infusion of funds is critically needed to assist individuals who wish to enroll in nursing education programs.
The average age of a nursing student is 31, as many non-traditional students (second career, adult learners) are entering nursing school. Adult learners often have outstanding personal debt (cars, homes, child care, and college loans) that makes it difficult for them to pursue higher education opportunities. With the additional expenses unique to nursing students, such as the purchase of uniforms and transportation to clinical sites, the need for financial support grows.
A key contributing factor to the nursing shortage in New York State is high turnover rates due to job dissatisfaction. The state’s Center for Health Workforce Studies recently reported that nearly 50 per cent of RNs younger than 25 said they planned to leave their nursing position within the next three years. New graduates clearly need assistance in developing the necessary skills and expertise to become effective practitioners within a short period of time.
We also strongly urge that $1 million in funding for nursing programs at independent colleges and universities be restored to the budget. These schools are an important part of New York’s nursing education infrastructure and require funding to expand their ability to educate new RNs.
Without this type of investment in nursing education, New York State will continue to experience a nursing shortage and patients’ access to quality health care will suffer.
The Nurses Association supports the following 2008-2009 Executive Budget health proposals and will work with both the Governor and State legislature to ensure their implementation:
As you continue your deliberations on the state budget, the New York State Nurses Association urges you to consider the aforementioned recommendations for the Executive Budget as a means to ensuring that New Yorkers’ access to quality health care is not lost in efforts to contain costs.
Thank you for your time and consideration.
For more information, contact the New York State Nurses Association Governmental Affairs Department at 518.782.9400, ext. 283 or by e-mail.