Amid manpower shortage, hospital association calls for postponing minimum staffing rules

ALBANY – A regional association representing 50 hospitals in upstate New York calls on the state Department of Health to delay implementation of new laws that will force hospitals and nursing homes in the state establish and maintain minimum staffing levels.

The Iroquois Healthcare Alliance – which represents the hospital systems of 32 northern counties, including the capital region – argues that implementing laws by January 1, 2022 is unfeasible given the shortages Widespread staffs plaguing healthcare facilities across the state.

In a letter to state health commissioner Howard Zucker last month, IHA chief executive officer Gary Fitzgerald said the organization’s main opposition to the law relates to its timeline, as hospitals are currently experiencing “unprecedented” labor shortages which he says have been exacerbated by coronavirus vaccine mandates for healthcare workers and a recent court ruling overturning religious exemptions in the country. mandate.

“The current workforce crisis facing hospitals in upstate New York is serious,” Fitzgerald wrote in the letter.

Hospitals and health systems stretching from Albany to Buffalo had more than 2,000 RN positions before the COVID-19 pandemic, he said. After the pandemic hit, some 6,000 workers were put on leave as elective surgeries were canceled to make way for a potential wave of patients, which modeling projections at the time indicated would overwhelm hospitals.

“Today vacancy rates remain extremely high and our members operate in crisis mode, unable to accept transfers, canceling elective procedures, reducing operating room capacities and a general slowdown in daily patient care,” all related and resulting directly from labor shortages, ”he wrote.

One of the new laws, which was passed this spring by the Legislature and signed by former Governor Andrew M. Cuomo, requires hospitals to form clinical staffing committees made up of at least 50% nurses and direct care staff. The committees would be responsible for developing annual staffing plans including guidelines or specific ratios to determine how many patients a nurse can be assigned at a time and how many nurses and auxiliary staff should be present in each unit and shift. of work.

Staffing plans would be due to the state health department no later than July 1 of each year, and the department would then be responsible for investigating violations of the plan and could demand corrective action or impose civil penalties. .

Another law requires the state health commissioner to establish minimum staffing standards in nursing homes that include at least 3.5 hours of nursing care per resident per day. At least 2.2 of these hours must be provided by certified nursing assistants and 1.1 hours by licensed practical nurses or registered nurses.

Facilities have until January 1, 2022 to comply and may be subject to penalties in the event of failure.

In his letter to Zucker, Fitzgerald demanded that any regulations resulting from the laws contain “safety valve” language that the department would not penalize facilities where there are significant and long-standing labor shortages. . The laws currently include language for the commissioner to take into account emergencies and acute regional labor shortages when deciding whether or not to penalize facilities, but Fitzgerald told The Times Union he thought the language was too vague.

“We hope that the commissioner’s office and the people in DOH who make the (regulations)… can be clearer about what kind of flexibility there will be,” he said.

RN vacancy rates had been on the rise for several years before the pandemic, according to IHA figures. In 2015, they were around 6% in hospitals in upstate New York, and have increased to between 8 and 10% over the next four years. They are now at 16 percent. Vacancy rates for all positions, meanwhile, have doubled in the past year, from around 7% in 2020 to over 14% currently, according to IHA figures.

Iroquois Health Care Association graphic

Iroquois Healthcare Alliance

Fitzgerald said he expects vacancy rates to worsen if courts ultimately rule that religious exemptions to the state’s vaccine mandate are not allowed. Some 1,300 employees at 33 upstate hospitals surveyed by the IHA have requested religious exemptions, he said.

“It’s like the worst time you could implement two new laws that impact staffing as we desperately try to maintain staffing levels,” he said.

Fitzgerald said he had not received a confirmation or response from the ministry regarding his letter, but his organization also met with Senate and State Assembly staff about possible changes to the date. entry into force of laws – the timing of which would require the return of the legislature. for a special session.

“We are just asking,” he said. “We’re trying to make sure they understand how desperate hospitals are for staff right now.”

Health ministry spokesman Jeffrey Hammond said his ministry had not received Fitzgerald’s letter, but added that changing the date of entry into force of the new laws is prohibited anyway. because they are legally obligatory.

Regulations regarding minimum personnel requirements for nursing homes and hospitals have been filed with the State Department and will be posted in the State Register for public comment on November 17, he said. declared.

The New York State Nurses Association, which has strongly advocated for minimum staffing laws, said employers need to step up and work with unions and nursing schools to create an agenda. massive jobs in response to staffing issues that have plagued their establishments for years.

“If we don’t take action to improve patient safety as a result of this experience, when will we ever learn? Said Pat Kane, executive director of the association. “Staffing can’t wait any longer … Employers should now understand that underpayment and understaffing are no-win strategies. Several hospitals have gone completely in the wrong direction, laying off workers after the pandemic and freezing hiring despite vacancies. Employers should create the conditions that allow workers and patients to thrive, and this law finally holds them accountable in a way the public deserves. “

Andrew B. Reiter