Regardless of your party affiliation, the fact is, ever since the New York State Senate flipped to Democratic control, Upstate New York has lost power in the New York State Legislature. Throughout Rochester and the Finger Lakes, not a single senator is in the majority—a complete reverse from the past decade. This is unfortunate because legislation has been proposed in Albany that would be detrimental to upstate New York hospitals, which have unique needs and special circumstances. We cannot let our hospitals be overshadowed by downstate interests.
The most concerning issue in upstate New York is the negative impact that government-mandated staffing ratios would have on local hospitals and nursing homes. Additionally, we’re increasingly concerned about how future funding is distributed across the state via “Transformation Funds,” or through capital grants to healthcare providers, or via disproportionate share funds, that there is regional equity for Upstate New York. Legislation proposed by the New York State Nurses Association, a downstate labor union, would impose rigid nurse-to-patient ratios in every New York hospital and nursing home, overriding the professional judgement of nurses and healthcare professionals (A.2054/S.1032). These rigid, one-size-fits-all ratios would apply to all facilities regardless of size, location, or the needs of their patients.
Government-mandated nurse staffing ratios would disproportionally impact upstate New York. A survey conducted by the hospital associations representing Rochester, Syracuse and Albany revealed that government-mandated staffing ratios, combined with existing vacancies, would require a grand total of 2,441 additional nurses. There simply aren’t enough nurses to fill the demand. Upstate New York hospitals are so desperate to fill vacancies that they’re using temporary staffing agencies for help, which is expensive and less than ideal in the long run.
Unlike New York City, which has plenty of nurses, upstate New York simply can’t attract enough nurses or nursing professors. The University of Rochester, St. John Fischer, Monroe Community College and many other schools have excellent nursing programs; however, there are hundreds of students applying for only a few slots. Nurses do not have a financial incentive to pursue doctorates in order to teach at colleges, which has led to a shortage of nursing classes—and therefore, nurses—in the upstate New York region.
To add insult to injury, government-mandated nurse staffing would not improve patient care. No research has found a direct link between mandated ratios and improved patient care. California was the only state to implement mandated ratios, despite zero evidence of improved quality of care for patients. It’s inconceivable that the government would be put in charge of deciding how to care for patients.
This year, Gov. Andrew Cuomo directed the Department of Health (DOH) to conduct a study on hospital staffing by Dec. 31, 2019. However, the study did not require the DOH to study the cost of filling those positions. Therefore, Pandion Optimization Alliance and its counterpart in Upstate New York (Iroquois Healthcare Association) conducted their own study to measure the impact it would have on Upstate New York. The Upstate Healthcare Coalition revealed that government-mandated staffing ratios would cost our hospitals over $180 million dollars to implement.
Pandion Optimization Alliance recently traveled to Albany to lobby against the ill-advised staffing ratios. In partnership with HANYS, Pandion representatives and Rochester-area nurses explained to lawmakers how the bill would increase costs statewide by $2 billion for hospitals and $1 billion for long-term care and skilled nursing facilities. Several nurses from UR Medicine-affiliated hospitals provided real-world, first-hand testimony about how it would negatively impact their jobs. Testimonials are available on the Coalition for Safe & Affordable Care website: http://coalitionforsafeandaffordablecare.org.
If government-manded staffing ratios are implanted, critical care programs would decrease, hospital departments would downsize, and some community hospitals and nursing homes would close their doors for good when they could no longer remain financially viable. Access to care for New York’s most vulnerable residents will be seriously impacted. Upstate New York’s health care systems would suffer irreparable harm.
To make matters worse, upstate New York hospitals lost Graduate Medical Education (GME) funding. The University of Rochester Medical Center and Albany Medical Center, both unique assets in upstate New York, offer residency programs across a broad range of disciplines to train the next generation of physicians. Unbelievably, in the FY2020 state budget, the Legislature cut $24.5 million for Graduate Medical Education for Academic Centers of Excellence, and Strong Memorial Hospital lost $4.1 million. URMC is the largest source of new physicians for Upstate New York, and more than 50% of the physicians stay in Upstate New York after their residencies are complete. That’s why Pandion and HANYS support the Resident Physician Shortage Reduction Act (H.R. 1763/S.348) to increase Medicare-supported residency slots in teaching hospitals.
Rural areas in the Finger Lakes have a poor, aging population, with significant health needs. Most rural hospitals have merged with one of the two large health systems (UR Medicine and Rochester Regional Health) in order to keep their doors open. Rural hospitals are often one of the largest job providers in their areas. GME funding and government-mandated nurse staffing ratios would force rural hospitals to close for good and put thousands of people out of work.
The bottom line is that upstate New York has unique healthcare needs and it cannot be subject to one-size-fits-all legislation. Robert Duffy, president and CEO of the Greater Rochester Chamber of Commerce, was right when he called for an Upstate Caucus on these pages some time ago, as a vehicle to support the unique complexities of our region. It should be bipartisan in nature and be made up of members in both the New York State Senate and Assembly. We need our partners in government to speak up and tell the New York State Senate that these proposals simply aren’t sustainable. Hospital associations in Greater Rochester and Upstate New York are speaking out on behalf of the region, but we could use your help. Please visit the Coalition for Safe & Affordable Care website to get involved in the campaign.
Travis Heider is president and CEO of Pandion Healthcare: Education and Advocacy, a not-for-profit 501(c)3 association whose membership comprises 17 hospitals and their related health systems in the nine counties of Monroe, Livingston, Ontario, Wayne, Seneca, Yates, Allegany, Steuben and Chemung. The association works closely with the Healthcare Association of New York State (HANYS) and the American Hospital Association (AHA), collaborating on many issues and activities.