Testimonies/Reports

Executive Budget Relating to Health

Testimony of the New York State Nurses Association delivered by Deputy Executive Officer Deborah Elliott, MBA, RN, to the joint hearing of Assembly Ways & Means and Senate Finance Committees, February 02, 2009.

Good afternoon. My name is Deborah Elliott, and I am a registered nurse and the Deputy Executive Officer 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, representing the interests of thousands of registered nurses across the State and serving 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 discuss the Governor’s 2009-2010 Executive Budget as it relates to healthcare issues.

While we appreciate and support certain initiatives in the Governor’s budget that reflect a commitment to healthcare reform and an investment in improving access to quality care, 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 residents.

Medicaid

The New York State Nurses Association appreciates Governor Paterson’s commitment to reforming the state’s publicly-funded health care programs, however, we strongly urge the restoration of $1.3 billion in Medicaid reductions to providers and the restoration of cuts to other public health programs.

While NYSNA supports the Governor’s proposal to expand Child Health Plus and his efforts to expand Family Health Plus contingent upon Federal approval, we are concerned about changes in reimbursements which would result in cuts to in-patient hospital care, home care and nursing home care services. For example:

• The Executive Budget relies on generating savings by changing the reimbursement structure to favor primary care and preventative services. While the Nurses Association supports a focus on preventive care, we are concerned about the impact such a redistribution of funds will have on hospitals and nursing homes.
• Cuts to these essential facilities and services have the potential to severely limit access and endanger patient safety. In the past, when provider reimbursement rates were cut, healthcare facilities mitigated budget shortfalls by reducing vital direct care staff, primarily nursing staff.
• Research has shown that reductions in nursing staff result in negative patient outcomes such as an increase in infection rates, an increase in the number of patient falls and bedsores, and an increase in costly medication errors which endanger the lives of the New Yorkers.
• If the legislature cannot restore these cuts, NYSNA requests that at the very least, language to accompany these budget provisions be added to ensure that facilities do not close budget gaps by eliminating staff positions that are essential to safe patient care.
• Currently, New York State does not regulate or require minimum nurse-to-patient ratios. Nor are healthcare facilities required to disclose their staffing ratio information. The Nurses Association strongly supports the passage of legislation to establish such standards and to require facilities to disclose nurse-to-patient ratios. We would like to thank the Assembly for their support in passing a disclosure bill in the 2008 session and we look forward to working with both houses to achieve this goal in the 2009 session.
  

Support for Nursing Education

While nursing education may not appear to be a health budget issue, there is a direct correlation between adequately maintaining New York’s nursing workforce and the health outcomes of the state’s citizen’s. Nothing is more crucial to New Yorkers’ well-being than having access to quality health care delivered by competent, well education and highly qualified RNs. To that end, it is important to understand the connection between the lack of access to affordable nursing education programs and the State’s worsening nursing shortage.

We know that the demand for nursing education programs has increased in recent years. However, not enough programs exist to meet that growing need and those that do exist 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.

• The Nurses Association supports the Governor’s inclusion of continued funding for the Senator Patricia K. McGee Nursing Faculty Scholarship and Loan Forgiveness Programs, but we urge the restoration of $1.5 million to fund the programs at last year’s levels.
• We also commend the Governor’s continued funding for the improvement and expansion of nursing programs at the State University of New York. Once again, however, we must urge the legislature to restore the proposed $300,000 cut. The $2 million provided for the program in the 2008-2009 budget enabled SUNY to educate an additional 250 RNs at 18 different nursing education programs throughout the state.
• Cuts to this program coupled with $167.8 million in cuts to SUNY’s operating aid may cripple the system’s ability to maintain those programs and produce the additional nurses New York so badly needs.
• Although funding for CUNY’s nursing programs remained flat, that system sustained operating aid cuts totaling $63 million which will lead to a reduction in student services, including student healthcare services which could displace many of the non-instructor nurses employed by the system.
• Furthermore, funding for New York’s private college and university nursing programs has been reduced and a 10% cut to Bundy aid has been proposed. The combined loss of revenue may force the private sector to limit or eliminate their more expensive programs. Nursing programs are among the most costly to maintain and are therefore vulnerable. NYSNA seeks the full restoration of funds to support private-sector nursing programs.
• Finally, the Nurses Association commends the Governor on the creation of the Long Term Care Nursing Scholarship and Loan Repayment program.

As you continue your deliberations on the state budget, the New York State Nurses Association urges you to consider our recommendations as a means to ensure 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.