1. Address Healthcare Disparities Through Fair Funding of Hospitals and Healthcare
NYSNA believes we need to do more to end racial and social disparities in healthcare. We have a two-tiered system in which some hospitals are flush with cash while public and private safety net hospitals barely stay afloat. This is a major cause of inequities in access to care, quality of care and health outcomes.
- NYSNA supports the increased Medicaid funding authority proposed by the Governor (HMH, Art. VII, Part H), but urges eliminating the Medicaid cap entirely;
- NYSNA supports the recission of a prior 1.5% cut and an additional 1% increase in Medicaid reimbursements (Art. VII, HMH, Part I), but this is not enough – we urge further increases targeted to reduce disparities in care;
- NYSNA supports added capital funding for safety net providers (Art. VII, HMH, Part K), but there should be specific criteria for eligibility;
- NYSNA supports increasing the current fund from $250 million to $350 million, seeking federal matching funds, and providing $700 million annually to safety net hospitals (HMH, Art. VII, Part CC) – we urge adding $500 million in state funds (+$500 million in federal match) to provide $1.7 billion annually and making public safety net hospitals eligible;
- NYSNA supports additional measures to address disparities, equalize hospital reimbursements, and fix low Medicaid rates for psychiatric, obstetric and other services, including creating a uniform hospital reimbursement rate system, and/or revising the DSH/ICP funding structure to target that supplemental funding to address disparities in care and to address safety-net hospital financial needs.
2. Provide Safe Staffing for All Patients
A centerpiece of the Governor’s budget proposals is to increase the nursing and direct care workforce by 20% over the next five years. Poor staffing is a major cause of nurses leaving their jobs. The state must ensure safe patient care and implement the new staffing laws to stabilize and grow the workforce.
- Create a substantial dedicated fund to assist hospitals that need support to achieve safe staffing levels and grow their nursing workforce – provide funding for competitive wages and benefits, targeting underfunded safety net hospitals in particular;
- Increase DOH funding to oversee and implement the new Hospital Staffing Law; and
- Amend the new Hospital Staffing Law (PHL 2805-t) to include additional minimum staffing ratios for pediatrics, emergency rooms, and other critical units or areas.
3. Expand the RN Workforce: Recruitment, Retention, and Improved Working Conditions
To address the continuing nursing shortage and meet the goal of increasing the workforce by 20% in the next five years, we must stop the exodus of nurses, try to win those who left back, and make nursing the attractive and fulfilling profession it deserves to be.
- Fix the Healthcare Workforce Bonuses proposal (Art. VII, HMH, Part D) to include all nurses and healthcare workers by removing the $100,000 salary cap and changing the definition of full-time from 40 hours to 37 ½ hours a week;
- Expand the funding and scale of the Nurses Across New York proposal (Art. VII, HMH Part A) to support recruitment, retention and nursing school capacity – $3 million in loan forgiveness is not enough, and the program should be broader in its reach, while also including support for preceptor and residency programs to help new nurses transition to the bedside and further expanding nursing school capacity;
- Implement and enforce minimum infectious disease protocols and standards in healthcare workplaces under the HERO Act to protect nurses from COVID at work;
- Classify COVID as an occupational disease for Workers Compensation claims filed by nurses and other front line essential workers;
- Improve the Tier 6 pension to recruit and retain public sector nurses.
4. Strengthen the Safety Net and Expand Coverage
NYSNA welcomes and supports the budget proposals to expand health coverage and improve services available for children, low-income seniors and the disabled in the Governor’s Medicaid, the Essential Plan and Child Health Plus programs (Art. VII, HMH, Parts N, O, Q, R, S, T, U and V).
- We also support the proposals to reign in abusive for-profit practices by Medicaid Managed Care organizations (Art. VII, HMH, Part P) and to expand the scope of surprise billing rules to include not just doctors and hospitals, but all providers (Art. VII, HMH, Part AA).
- NYSNA believes, however, that these positive steps are not sufficient to provide equal health coverage to all New Yorkers, including the more than 1 million uninsured. We support passage of the New York Health Act (A6058/S5474) to create a single payer universal coverage system. We also support the appropriation of state funds to include undocumented immigrants who are not Medicaid eligible in the Essential Plan.