STAFFING SAFE STAFFING SAFE STAFFING SAFE STAFFING SAFE STAFFING
California Sets Nation's First Safe Nursing Standards
Gov. Davis Announces Nurse-to-Patient Ratios
California has opened a new era for safe and effective patient care with the introduction of minimum nurse-to-patient ratios for California's acute care hospitals - an innovative step that the California Nurses Association terms "the most comprehensive and effective approach in the nation to reduce the nursing shortage and improve patient care protections."
Governor Gray Davis announced the new standards in a Los Angeles press conference Tuesday morning, standing shoulder to shoulder with top officials of the CNA which has campaigned for 10 years for enactment of this sweeping reform.
California is the first state in the nation to establish minimum nurse-to-patient ratios, and nurses and policy makers across the U.S. have been closely watching the announcement of the ratios which are expected to be a model for the country.
"With these ratios, patients will be much safer, they will get much better care, we will be able to do the job we want to do, and nurses everywhere who have left will feel they can come back into the profession," said CNA President Kay McVay, RN.
In his statement, Gov. Davis called the ratios a "big step forward. We have to provide better care for people who come into the hospital, and more nurses means better care."
The new rules spell out minimum numbers of licensed nurses needed to assure patient safety throughout the hospital setting, depending on the unit. For example, the ratios would be at least one nurse for every four patients in Emergency Rooms, and one nurse for every five patients in Medical and Surgical units after an initial phase in period of one year to 18 months. Next up is a public comment period, probably over several months, after which the ratios will be finalized.
McVay noted that the ER ratios, which are effectively 1:3 because the rules specify that the triage nurse is not to be counted in the numbers, are especially significant due to "an alarming crisis in emergency care with closures and long patient waits often because of poor staffing."
The ratios are mandated by AB 394, the CNA-sponsored Safe Staffing Law signed by Governor Gray Davis in October 1999. Next up will be a public comment period probably including statewide public hearings over the next few months after which the ratios will be finalized.
CNA President Kay McVay, RN, said the new ratios a "will produce profound improvements in the hospital patient safety net. Ratios will make a dramatic difference to patients and their families who live in fear of long waits for access to medical care or whether there will be safe nursing care when they need to go to the hospital."
With ratios, there will be a minimum, consistent, enforceable standard for all hospital units. California has had ratios for intensive care units for a quarter century - and the law has worked spectacularly well. Now all hospital patients can expect the same level of protection.
"Safe ratios should also have a substantial impact on the hospital nursing shortage," McVay continued. "Dissatisfaction with unsafe hospital conditions has produced an exodus of nurses who are no longer willing to work in hospitals they believe have unsafe staffing and other deteriorating conditions. With safe, enforceable, and effective ratios, we finally have a basis to stabilize the nursing infrastructure, retain current hospital nurses, and recruit additional nurses."
California's Governor Gray Davis Unveils Long-Anticipated Nurse-to-Patient Ratios For California Hospitals, Making California the First State in the Nation to Regulate Staffing
LOS ANGELES, CA. - California Governor Gray Davis held a press conference in Los Angeles today to announce the release of nurse-to-patient staffing ratios for California's acute care hospitals. California is the first state in the nation to regulate nurse staffing by mandating nurse-to-patient ratios, a development that is being hailed by staff nurses in Massachusetts who see the regulation of nurse staffing ratios as an essential protection for patients, as well as a vehicle for ensuring working conditions that will end the growing nursing shortage.
"The ratios I am releasing today are designed to improve patient care. They also acknowledge that nurses are the backbone of the health care workforce and reflect my commitment to improving health care in California," Governor Davis said. "California is the first state in the nation to set minimum nurse-to-patient ratios."
Nurses in Massachusetts have been fighting for similar regulations for more than five years, and this year have a bill before the legislature that would mirror legislation filed by the California Nurses Association and passed by the California legislature in 1999 (AB 394) requiring the California Department of Health Services (CDHS) to establish minimum nurse-to-patient ratios by licensed nurses and by hospital unit.
The proposed ratios are based on a complex number of factors, including information collected by CDHS specialists during unannounced visits that began in May 2001 to 80 acute care hospitals and 10 state-operated hospitals. CDHS staff used data from the on-site hospital surveys to determine the staff-to patient ratios documented at those hospitals. In the coming months, the CDHS will be developing an implementation plan for the ratios, including developing penalties for hospitals that fail to comply. The ratios are expected to go into effect by July.
The proposed ratios cover all areas of the hospital including general medical/surgical wards. The proposed ratios vary from 1:1 in a trauma unit to 1:6 (reduced one year later to 1:5) in medical/surgical. The complete listing of ratios can be found at the end of this press release.
While the ratios establish a minimum staffing level, AB 394 also emphasized that hospitals must continue to comply with current statutory requirements to base staffing upon patient acuity, even if that means increasing staff above the minimum ratio.
"These are outstanding ratios that will dramatically improve the care patients receive in California Hospitals," said Karen Higgins, president of the Massachusetts Nurses Association and an intensive care unit nurse who works at Boston Medical Center. "The most important factor contributing to a nurse's ability to deliver safe, quality care is the number of patients he or she is assigned. In recent years, nurses' patient assignments have reached dangerous levels. It's not uncommon for Massachusetts medical/surgical nurses to be assigned 7 to as many as 12 patients, which is patently dangerous."
Massachusetts nurses' call for passage of legislation (HB 1186) developing nurse to patient ratios for the Commonwealth will be given a boost by the California law, according to Higgins, who points out the Massachusetts legislature has already examined the issue and highlighted nurse staffing as a major problem. A special legislative commission recently issued its report on the state of nursing and nursing practice in the Commonwealth, in which they identified a nursing crisis in our health care system, primarily driven by issues of poor staffing and mandatory overtime in Massachusetts Hospitals.
Higgins also points to the impact the regulation of nurse staffing will have on the growing nursing shortage, as poor working/staffing conditions is one of the key factors contributing to the shortage of nurses. A number of recent surveys of nurses has demonstrated that as many as one in five nurses is considering leaving the profession in the next year. A majority said they would remain at the bedside if conditions were improved.
"In Massachusetts we have the highest per capita population of nurses in the nation, yet we are facing a shortage," Higgins said. "The reason is nurses are walking away from the bedside because they don't feel safe practicing in the current environment. The best means of getting these nurses back is to impose ratios as has been done in California."
In Victoria Australia, similar staffing ratios were passed over a year ago. During that time, more than 2,100 nurses who were on the sidelines, came back to the bedside to work under the improved conditions.
Governor announces mandated nurse-to-patient ratios
<http://www.sfgate.com/cgi-bin/article.cgi?file=/news/archive/2002/01/22/state1906EST0119.DTL>
Simon Avery, Associated Press, January 22, 2002
LOS ANGELES (AP) -- Gov. Gray Davis released proposed government ratios Tuesday that would mandate the number of nurses to patients in California hospitals.
The new rules, still to go through a normal regulatory review process, will make California the first state in the nation to set minimum nurse staffing levels.
Officials from the Department of Health Services have spent more than two years developing the ratios, which were legislated in a 1999 bill.
Nurses responded enthusiastically to the requirements, saying they will improve patient care and stem the tide of nurses leaving hospital jobs because of poor work conditions.
"This is the most sweeping systemic health care reform that you're going to see," said Rose Ann DeMoro, executive director of the California Nurses Association, which represents some 40,000 nurses. "This measure will effect every hospital in the state of California."
Some other states are watching California's lead, including Massachusetts, where law makers have discussed a similar plan.
Julie Pinkham, executive director of the Massachusetts Nurses Association, said the California regulations will likely have a national impact.
"Nurses across the country are waiting for this. California has put it out there. Now it's going to go across the nation. It's long overdue," she said.
Under the California proposal, every four patients put through triage in an emergency room will be assured at least one nurse between them. Currently, the ratio averages between 1-to-6 and 1-to-8, DeMoro said.
In general medical and surgical wards, there will eventually be a minimum of five nurses per patient, compared with a wide range of existing ratios, that vary from 1-to-3 to 1-to-20, she said.
California already imposes staffing requirements in some hospital units, including intensive and critical care, operating rooms and nurseries, but hospitals have been free to assign nurses as they wanted in other areas.
The hospital industry said the new rules will be a financial burden and could actually hurt patient care because of a severe nurse shortage in the state.
"Although hospitals will obey the law, the way we meet the law may have unintended consequences," said Jan Emerson, vice president of external affairs for the California Healthcare Association, which represents nearly 500 hospitals in the state.
If a hospital has 10 available beds in its emergency room, but only enough nurses to staff five of them under the new law, the remaining beds will have to be taken out of service, Emerson said.
Already, California hospitals are operating with 15 percent fewer nurses than they need, and by 2006, the state is forecast to have a shortage of 25,000 registered nurses. California ranks second last among all states in terms of nurses per capita, she said.
Davis said 5,000 additional nurses will be needed to implement the staffing ratios. That represents the total number of new nurses the state trains each year just to keep up with attrition and population growth, Emerson said.
The California Nurses Association, however, said there are already enough nurses in the state to meet the proposed ratios.
"They just won't work in the hospitals," said DeMoro. "We must make hospitals an appealing place for nurses to come back."
Almost two-thirds of California hospitals lose money today, and some said the new mandated ratios bring an additional financial burden.
"This is one of those unfunded mandates that can have a negative impact on our industry. It's difficult to pass the costs on," said Bill Gleeson, spokesman for Sutter Health, a not-for-profit network of 26 hospitals in Northern California.
The California Healthcare Association estimates that the new regulations will cost hospitals a minimum of $400 million a year in extra wages and benefits.
İ2002 Associated Press
Nurses approve staffing ratios
<http://www.contracostatimes.com/news/stories_loc_break/nurseweb_20020122.htm>
Judy Silber, Contra Costa Times, January 22, 2002
Nurses enthusiastically embraced proposed nurse staffing ratios for hospitals released today by Gov. Gray Davis at a Los Angeles press conference. While falling short of ratios proposed by two major nurse unions, the ratios come closer to those suggested by nurses than those urged by hospitals. Nurses expressed satisfaction with the state's proposed 1:5 ratio for medical surgical units, often considered a burn-out unit by nurses because of what they say has been chronic understaffing. Hospitals had requested ratios of 1:10 in the medical surgical units, while the nurse unions had suggested ratios of 1:3.
"We're really excited that they are finally setting ratios for every department in the hospital, said Joan Weber, a California Nurses Association board member and a retired nurse at Mt. Diablo Medical Center in Concord. "We think that nurses will feel that at least they can give safe care with these numbers."
Weber also said the new ratios will help stem the exodus of nurses from acute care hospitals. California currently has one of the highest rates of registered nurse vacancies in the country. But with the ratios, frustrated nurses are more likely to remain at hospitals and nurses who have already left hospitals because they felt like they couldn't care for their patients, are more likely to return, she said.
Davis calls for more nurses at California hospitals
<http://www0.mercurycenter.com/local/center/nurse0123.htm>
Barbara Feder, Mercury News, January 22, 2002
In a healthcare experiment likely to be watched closely by the rest of the nation, Gov. Gray Davis on Tuesday proposed nurse staffing standards that would force hospitals to keep more nurses on hand to care for patients. ³Nurses are overworked and over-stressed,² Davis told an audience of cheering nurses at a Los Angeles hospital. ³We simply have to have more nurses in California hospitals if we're going to do justice to the patients who come in for critical care.² The new standards, the first of their kind in the country, call for one nurse for every six patients in medical-surgical wards, increasing to one nurse for every five patients within 12 to 18 months. The recommendations must go through a lengthy review process and likely won't take effect until July 2003. California's nurses hailed the standards as the decisive victory they had sought for more than a decade, saying they would improve patient care and reduce the crushing workloads that have driven many nurses out of the profession. ...
California sets nurse-patient ratios
<http://www.chicagotribune.com/news/nationworld/chi-0201230317jan23.story>
Michael J. Berens, Chicago Tribune, January 23, 2002
Citing overwhelming evidence of patient harm linked to inadequate hospital care, California Gov. Gray Davis on Tuesday unveiled the nation's first mandatory nurse-staffing law, requiring more registered nurses in emergency rooms and at the bedside. To the jubilation of nurses and dismay of many hospital officials, the unprecedented staffing standards are expected to reverberate in Illinois and nationally where similar measures are pending before legislatures. "This will save patient lives," said Rose Ann DeMoro, executive director of the California Nurses Association, representing 40,000 nurses. The law was passed in 1999, but the state delayed implementation until it could determine what the ratios should be. ...
Davis Reveals Plan to Limit Hospital Nurses to 5 Patients
California would become the first state in the nation to limit the number of hospital patients assigned to each nurse under regulations proposed Tuesday by Gov. Gray Davis. The new rules ultimately would prohibit hospitals from assigning a nurse to more than five patients in large hospital units devoted to patients recovering from surgery and serious illnesses. That's half the number typically assigned in many facilities, and half what the hospital industry had proposed. The rules would be phased in; initially nurses would be allowed to treat six patients. The proposed standards also limit nurses in emergency rooms to one trauma patient, pediatric nurses to four child patients, and obstetrics nurses to two mothers in labor. Nurses' unions and consumer advocates applauded the proposal. ...
More nurses, state directs
Gov. Gray Davis proposed nurse-to-patient ratios Tuesday for California's acute care hospitals, rekindling debate in the health care industry over whether the nation's first such staffing law will improve quality and at what cost. The governor's numbers dictate how many patients each nurse can treat in each unit, including emergency rooms, pediatric floors and general medical wards, where most people recover from surgery and illness. Davis said the mandatory minimum staffing levels -- years in the making -- will help California recruit and retain nurses amid a nationwide nursing shortage. "We can't have nurses straining to provide care to a growing population," Davis said. "California will become the first state in America to establish ratios of nurses to patients. We're doing it for a simple reason: To improve care. The more nurses, the better the care." ...
Maine State Nurses Association Welcomes First Step in Ensuring Safe Staffing Levels in Maine Hospitals
<http://www.mainenurse.org>
Unsafe staffing is one of the major reasons that nurses are leaving nursing for jobs in other professions.
LD 1085 is a bill that was introduced by Nurse Senator Peggy Pendleton and initiated by the Maine State Nurses Association as an attempt to address unsafe staffing practices that put Maine patients in jeopardy.
Due to the interest and concern for the safety of patients; Maine legislators directed interested parties to identify and correct the problem of unsafe staffing during the last Legislative session. Meeting of all interested parties began this past summer and ran through January 2002. A compromise was agreed to and was presented to the 121st Legislature. The compromise instructs this issue to be addressed through rule making instead of statues. The rule making changes will occur within the Department of Licensing and Certification and will be the first step taken to address unsafe staffing in Maine. A public hearing addressing proposed changes is expected to take place sometime in March or April.
The Division of Licensing and Certification, DHS, will schedule a hearing on expanding rules that address the staffing plans of Maine hospitals. There is hope this mechanism will work; already there is agreement that ³direct care² nurses will be involved with the validation of staffing plans. The use of direct care nurses in this process will ensure that the nurses giving the care have a voice in the process of creating staffing plans for their facilities.
The Maine State Nurses Association, on behalf of all patients and nurses in Maine, will vigilantly monitor the results of the rule changes. Maine nurses will be an active part in the process and will continue to advocate for all Maine patients. While we are hopeful that the rule changes will be effective, the Maine State Nurses Association is prepared to continue this effort if the results show no significant changes in staffing conditions.
Noreen Comeau, RN and Pat Donahue, CNM testified that they could not find full-time work in Central Maine. They were offered 24 hours a week but would be expected to work 40 hours without benefits. This practice of hiring part-time workers doing full-time work also contributes to unsafe staffing levels and why nurses are seeking employment elsewhere in non-nursing jobs.
During the testimony of a direct care nurse before Maine Legislators, Judy Eastham, RN commented that direct care nurses will be back in front of Maine Legislators for their support in mandating safer staffing levels if staffing does not improve with the current compromise.
The Maine State Nurses Association, incorporated in 1914, is the only professional organization representing all 18,000 registered nurses in the State of Maine.
Nurses, hospitals reach staffing deal
AUGUSTA A legislative committee rejected a bill Wednesday that would have set the ratio of patients to nurses in hospitals after both sides in the dispute agreed to a compromise. The plan would result in revised state staffing regulations that would give direct care nurses a say in determining how many nurses are required to care for the number of patients on hand, said Sandy Bethanis of the Department of Human Servicesı licensing and registration division. Bethanis, who said many of the details have yet to be worked out, outlined parts of the plan during an interview. Nurses would be able to consider patientsı overall health in making decisions about the severity of their condition. For instance, instead of assessing a patientıs needs solely on his broken leg, a nurse would be able to look at other health factors in determining the level of care needed. This information plus information about other patients would be used in determining how many nurses should be on duty at a given time. The plan was hammered out in negotiations among the Maine Hospital Association, nursing groups and DHS officials. ³Itıs a first step and if it works great,² said Pat Philbrook, executive director of the Maine State Nurses Association. But if it doesnıt work, ³weıll be back.² ...
Legislators question Medicaid cuts
<http://www.bangornews.com/editorialnews/article.html?ID=49516>
Michael O'D. Moore, Bangor News, January 23, 2002
AUGUSTA Proposed cuts to state Medicaid funding that would turn away tens of millions of federal matching dollars from Maineıs health care system were greeted with resistance by some legislators Tuesday. Members of the Appropriations and Health and Human Services committees questioned the true cost of Gov. Angus Kingıs plan to balance the stateıs budget by cutting Medicaid at a time when health care is in crisis, especially among the poor who benefit from the program. As the committees were hearing dire stories about the impact, House Speaker Michael Saxl, D-Portland, held a press conference down the hall, announcing he wonıt go along with Kingıs plan. ³We are here to say that we will not balance the stateıs budget on the backs of those least able to afford it,² Saxl said. ...
MASSACHUSETTS MELTDOWN MASSACHUSETTS MELTDOWN MASSACHUSETTS
Hospital's closing part of statewide health crisis
<http://www.metrowestdailynews.com/news/local_regional/hospitalclose01202002.htm>
Michelle Hillman, MetroWest Daily News, January 20, 2002
Big or small. Independent or for-profit. Teaching or academic. There's no single correct size or shape that can keep some local hospitals from falling prey to the volatile health care system, where both major Boston teaching hospitals and small state-run hospitals are going broke. Deaconess-Waltham is the latest community hospital to make headlines. With $7 million in losses last year and a projected $8 million in losses this year, the hospital's corporate parent, CareGroup, last week voted to close the facility. "It's not as if we're the only hospital that's doing poorly," said Allen Danis, the chief financial officer at Deaconess-Waltham. "It's a combination of competitive markets." ...
Emotions run high at save-hospital rally
<http://www.dailynewstribune.com/news/local_regional/walthospital01232002.htm>
Nikki Misra, Daily News Tribune, January 23, 2002
WALTHAM - Emotions ran high last night as a consortium of hospital staff and residents were joined by local and state representatives at a public rally to protest the pending closure of Deaconess-Waltham Hospital.
"Waltham Hospital is open for business. We need to fight," said state Sen. Susan Fargo, D-Lincoln.
Seated on the podium next to Waltham Mayor David Gately, she was the first speaker at the event, organized by the Coalition to Save Waltham Hospital.
Coalition leaders met yesterday with lawmakers and Dr. Howard Koh, state public health commissioner. They said they want to raise awareness of their plight and are seeking state intervention.
Fargo addressed a capacity crowd at the rally in Kennedy Middle School auditorium last night.
"The office of the attorney general must investigate into the parameters of the action leading to the closure, which is very much in question. And if Tom Reilly can fight for the Red Sox, he can fight for the hospital, too," she said.
She criticized hospital owners CareGroup for making an "unethical decision," and she was cheered by the audience as she referred to the company as "Careless Group" or "I-Care-Less-Group."
Fargo went on to publicly sign a petition that rally organizers are circulating prior to CareGroup's public hearing Feb. 11.
According to the Lincoln senator, Massachusetts cannot afford to lose another hospital with 43 psychiatric beds and a state-of-the-art cancer facility and an eating disorder unit, one of the best in the state.
State Rep. Thomas Stanley, D-Waltham, also spoke. Stanley said he was shocked at CareGroup's decision to close Deaconess-Waltham when the hospital recently accepted $500,000 in state funding for distressed hospitals. At that time, he said he had met with members of the Board of Trustees who told him that closing was nowhere in sight.
The fiscal 2002 budget includes $15 million for distressed hospitals, $15 million for increased Medicaid reimbursements and $45 million for money hospitals lose from patients who cannot pay for service, Stanley said.
Koutoujian said he had never seen such a huge gathering rallying behind a cause in Waltham.
The immediate goal of the authorities, according to Koutoujian, should be buying more time before the hospital has to be closed. He has been talking to a number of companies in and outside the state, one of which he believes is willing to buy the hospital.
Signs and fliers emblazoned the hall for the rally. Members of the audience held green gas balloons with a bandage.
Derek Manor, 35, came with his 5-year-old, who was born in the hospital's maternity ward, a facility that was shut down two years ago. He held a banner that read "Give Us More Time."
Pat Irwin, a caretaker for an elderly group, wore a "Save the Hospital" button. She said she came to the rally because one of her patients is an 84-year-old senior citizen who visits the hospital regularly.
"It is major concern especially for our elderly," said Ruth Gately, the director of Waltham Council for Aging.
Deaconess-Waltham has an estimated 20,000 emergency room visits a year. If it closes, the patients would have to be absorbed by nearby hospitals including Newton-Wellesley, Burlington and Lexington's Lahey Clinic and Mount Auburn in Cambridge, she said.
"On behalf of 10,000 who are the elderly, I can imagine the number of hours they'll have to wait before getting a bed," Ruth Gately added.
"It was a decision made in haste. They could have looked to cost-cutting decisions as they have done in the past," said Peg O'Connor, who has been a nurse in the medical surgical unit for 36 years.
O'Connor heads the local chapter of Service Employees International Union, one of the two unions opposing the hospital closing.
Along with the Massachusetts Nurse Association, she is planning on meeting with Attorney General Reilly next week. So far, none of the unions are discussing a severance package with their employer because they are optimistic that state and local authorities will put enough pressure on Beacon Hill.
"We are expecting an even bigger rally at Waltham High School on Feb. 9," said Dianne Coch, a surgical materials manager.
"While hopes are up, I would still be cautious because there's insurmountable pressure at this point," Stanley said.
Material from the Boston Herald was used in this report.
İ Copyright by the Daily News Tribune
Waltham hospital CEO resigns on eve of rally
<http://www.businesstoday.com/business/business/hosp01232002.htm>
Jennifer Heldt Powell, Boston Herald, January 23, 2002
Deaconess-Waltham Hospital's chief executive stepped down yesterday, just before doctors, staff and community leaders rallied last night to save the institution from shutting down in April.
Dana W. Ramish, who has run the hospital since July of 1999, gave up the daily operations yesterday but will remain an adviser.
Dawn Gideon of Transition Management Group will handle the closure of the 163-bed hospital or the sale if a buyer can be found, states a memo from Joseph Dionisio, chief financial officer of the hospital's parent firm, CareGroup Inc. Neither Ramish or Gideon were available yesterday for comment.
Ramish's departure was unrelated to last night's rally by supporters trying to save the hospital, officials said.
The event, expected to attract hundreds of supporters, was organized by The Coalition to Save Waltham Hospital. The growing group of doctors, nurses, other staff and community leaders seeks more time to impose cost-cutting measures.
CareGroup trustees decided earlier this month to close the hospital because losses were expected to reach up to $9 million this year. Hospital system officials tried but failed to find a buyer or financial partner.
Leaders of the group trying to save the hospital met yesterday with lawmakers and Dr. Howard Koh, state public health commissioner. They said they want to raise awareness of their plight and are seeking state intervention.
The state must hold a public hearing when essential services are slated to be closed, but has little power to intervene.
The coalition wants a chance to operate the hospital apart from CareGroup, said Dianne Coch, surgical materials manager at the hospital and a coalition leader.
³We're pretty sure CareGroup hasn't looked at everything,² she said.
The group believes there are savings to be had in cutting non-medical staff and fees to CareGroup, she said.
İ Copyright by the Boston Herald
Injunction halts closing of prenatal program
<http://www.bostonherald.com/news/local_regional/star01232002.htm>
Michael Lasalandra, Boston Herald, January 23, 2002
A Suffolk Superior Court judge yesterday issued a preliminary injunction barring the state from shutting down the Healthy Start program that provides prenatal care to poor women. ³This ruling says prenatal care is important,² said Josh Greenberg of Health Care for All, an advocacy group involved in the lawsuit that was filed by the Massachusetts Law Reform Institute. ³This is going to force them to reopen the program,² said Allison Staton of the organization. The Swift administration had closed the program to new enrollees as of Dec. 12 in a cost-cutting move. In her ruling, Judge Elizabeth Fahey said the state Department of Public Health did not seek additional funds from the Legislature to keep the program running or did not seek to get Medicaid to cover its costs. The Dec. 12 decision closed the program to new enrollees and kicked out 300 women already on the program. Some 3,100 women in the program were allowed to continue, however. Efforts to restore $2 million in the state budget to keep the program running at full force have so far failed. ...
HEALTHY START REOPENS TOMORROW (THURSDAY, JANUARY 24).
It was an eventful 8 days starting Monday, January 14 and ending yesterday, January 22:
On Monday, the Boston Globe ran a front-page Metro section article about the closure of Healthy Start and highlighted its impact on the patients of Dr. Francisco Reina in Framingham. (The piece was written by reporter Christopher Rowland.)
Later on Monday, January 14th House Ways and Means Chairman John Rogers announced Healthy Start would receive an additional $2 million in a supplemental appropriation. We had heard that over half of the House members had personally written Speaker Finneran in support of Healthy Start.
On Tuesday, January 22, the House delayed debate of the supplemental appropriation in light of the additional cuts administered by Acting Governor Swift.
Also on Tuesday, January 22, Suffolk Superior Judge Elizabeth Fahey ordered Healthy Start be reopened to women denied access to its services as well as retain the women slated to be removed. (Bravo to Vicky Pulos and her colleagues at the Massachusetts Law Reform Institute for such excellent legal work).
On Thursday, January 24, Healthy Start reopens. DPH will do the following: 1. Mail letters to providers regarding the reopening 2. Contact women who are eligible and have complete applications (no information missing) 3. Contact the women with incomplete applications to get additional information 4. Contact women who called after Dec 12th and were placed on a waiting list.
Your collective hard work and advocacy ensured this important program was preserved. However, we must continue to call the House and encourage them to pass the supplemental appropriation to ensure Healthy Start has the funds needed to continue. The court order does allow the Governor to close the program if the legislature does not provide funding in a timely manner.
Please call your representative and ask him/her to support an additional $2 million for the Healthy Start program. (If you do not know who he/she is, you can either call 1-800-426-VOTE [8683] or visit http://www.state.ma.us/legis/citytown.htm)
In addition, we must spread the news far and wide that Healthy Start is "open for business". In order to enroll women in Healthy Start, please call the Department of Public Health at 1-800-531-2229. Please share this email with colleagues, friends and neighbors.
Thank you again for all of your hard work. Please call me if you have any questions.
Allison
Allison Staton
Manager, State Wide Division
Health Care For All
30 Winter Street, 10th Floor
Boston, MA 02108
Phone: 617.275.2927
Email: staton@hcfama.org
Hudson may go without paramedics
<http://www.metrowestdailynews.com/news/local_regional/hudparamedics01232002.htm>
Nicole Simmons, MetroWest Daily News, January 23, 2002
MARLBOROUGH - With the March shutdown of Marlborough Hospital's paramedic ambulance service, local communities are scurrying to find replacements, with Hudson considering not replacing it at all. Scott Kasper, director of Emergency Medical Services at Marlborough Hospital's parent company, UMass Memorial Health Care Inc. in Worcester, said Marlborough Hospital will no longer provide advanced life support, or ALS, paramedic service to its nine member communities: Marlborough, Hudson, Northborough, Westborough, Southborough, Berlin, Bolton, Stow and Sudbury. Those communities won't be left without ambulance service, Kasper said. They all have basic life support, or BLS, service that uses emergency medical technicians, or EMTs. EMTs, however, cannot perform as many life-saving techniques as paramedics. ...
Doctors dropping 2,400 seniors
<http://ledger.southofboston.com/display/inn_news/news02.txt>
Julie Jette, The Patriot Ledger, January 23, 2002
A group of 19 doctors affiliated with South Shore Hospital will stop accepting members of Tufts Health Plan's Medicare HMO by the end of March. The decision forces 2,400 South Shore seniors to find a new health plan or new doctors. The health insurer was unable to reach an agreement on payments with the doctors of South Shore Physician Hospital Group, said Patty Blake, vice president of Secure Horizons, the Tufts HMO. The physicians work at the hospital in South Weymouth, in offices in several South Shore communities and at the South Shore Medical Center in Norwell. Group administrators could not be reached for comment. "Doctors are pulling out because they don't like the rates that Secure Horizons is paying. Medicare is already the toughest payer on the block, and it's not clear what HMOs can add to that," said Michael Miller, policy director for the advocacy group Health Care for All. ...
Paul Levy's task
<http://www.boston.com/dailyglobe2/022/editorials/Paul_Levy_s_task+.shtml>
A Boston Globe Editorial, January 22, 2002
THE APPOINTMENT of Paul Levy as chief executive for Beth Israel Deaconess Medical Center signals that the hospital is serious about restoring itself to fiscal soundness. Levy will be adept at bringing the resources of the Harvard medical area to bear, but ultimately the staff of the hospital will be the ones to determine whether it will survive, be sold to a nonprofit chain, or close. The hospital is incurring operating losses of about $100 million a year. A report by management consultants The Hunter Group says that BI-Deaconess only has enough unrestricted endowment money to survive another 2 1/2 years. The prospect of extinction ought to calm the turf struggles that followed the merger of the Beth Israel and Deaconess hospitals in 1996. It also ought to provide clarity of mission to an institution that over the last five years has lost its way. ... The Hunter Group proposed Draconian cuts - 150 nurses, 268 physicians - to put the hospital in the black. Levy foresees significant layoffs, but wants nursing staff levels to be kept high. ...
Doctors who treat only the hospitalized win high marks
<http://www.boston.com/dailyglobe2/023/nation/Doctors_who_treat_only_the_hospitalized_win_high_marks+.shtml>
Anne Barnard, Boston Globe, January 23, 2002
When Dr. Joseph Li pinned his young career to a controversial new medical concept - doctors who treat patients only while they are hospitalized - he had a hard time explaining his job to patients. ''I'll be your hospitalist,'' he would tell them as they checked into Beth Israel Deaconess Medical Center. And they would look at him strangely, thinking he was talking about hospice care: ''You mean you help people die?'' Patients still don't know the name of Li's field - these days he just tells them he is ''a hospital doctor'' - but five years after doctors like him were dubbed ''hospitalists'' by an article in a leading medical journal, the new breed of physicians represents one of the fastest-growing trends in medicine. ...
The health care we need today - and tomorrow
<http://www.boston.com/dailyglobe2/023/oped/The_health_care_we_need_today_and_tomorrow+.shtml>
Ron Hollander, Boston Globe, January 23, 2002
NEARLY TWO years ago, then-Governor Paul Cellucci announced the formation of a state Health Care Task Force, stating: ''Massachusetts needs to protect its reputation as a health care leader ... Not only must we ensure our citizens continue to have access to the highest quality health care, we need to take steps to protect this very important sector of our economy, which employs thousands of Bay State residents.'' On Monday the task force will conclude its work, issuing a report on the state of health care in the Commonwealth and proposing policy options. Underlying those policy options and recommendations is the very human endeavor that is health care. ...
NURSES STRIKE NURSES STRIKE NURSES STRIKE NURSES STRIKE NURSES
St. Catherine of Siena Medical Center Strike
<http://www.nysna.org/NEWS/current/stcath.htm>
Negotiators talked from about 2:00 PM Monday until 4:30 AM Tuesday. No agreement has been reached, but the parties report continuing progress. Negotiations will resume today, Wednesday, January 23, 2:00 PM. ... For further updates as negotiations continue, keep checking here and the strike hotline at 800.724.NYRN, ext 287.
In their most ambitious effort to date, striking RNs from St. Catherine of Siena again traveled throughout the Smithtown community on Saturday, January 12, to inform the public about the serious patient care issues they are fighting to resolve. This follows a similar community outreach held January 5. Teams of nurses visited area shopping centers, distributing leaflets and talking to the public one-on-one about strike issues. They will also circulate a petition asking the administrations of Catholic Health Services and St. Catherine of Siena to resume negotiations. Leaflets are available here online (Adobe Acrobat Reader required; download a free Acrobat Reader.)
United We Stand: 9 N/S
<http://www.fairpay4nurses.org>
by Stephany Pelky, RN, BSN Doernbecher Children's Hospital
Tuesday, January 15, 2002, is a night that will be fondly remembered by 37 Registered Nurses from Doernbecher Children's Hospital. That night, we gathered at Janet's home. Many of us see each other on the pediatric floor where we work, but this night we were all united in our common bond. Each of the 37 nurses has been true to their beliefs, uncompromising in their resolve. None have sold themselves out to the "almighty buck", none have crossed the picket line.
Represented at this gathering was a total of 340 years at OHSU, most at Doernbecher, in patient care. Six of the nurses have been employed for one year of less, but have a strong understanding of their loyalties during the strike. With a mean length of employment at 9+ years, the range of longevity and dedication was evident. Pediatric nurses at OHSU are their own breed, able to juggle patient load, initiate family involvement/acceptance and educate future doctors and nurses. This is a difficult process for some of the newer hires, but after sharing this strike, these dedicated nurses will receive any help they require from their experienced co-workers.
The roar of private conversations, mixing and talking, regardless of shift, experience or other prejudice; the laughter and hugs exchanged; the sharing of knowledge and job leads, was only a part of the night. All were able to identify their own struggle and sacrifice suffered during the strike, and able to verbalize frustration and mistrust with those who have crossed, even with the co-workers they believed they knew so well.
This union of registered nurses has resulted in a stronger bond, stronger than any inservice or education day ever offered at OHSU. We are Doernbecher; our dedication, love for our patients and their families, and value of self-worth are strengthened in our struggle. We need to be thankful for this opportunity, as we have grown. The struggle is not pleasant, but the outcome refreshing.
Nurses rally in Paris
Several thousand French nurses demanding higher wages and better funding have taken to the streets of Paris in a second day of industrial action by the country's health workers. Police said that some 3,200 people took part in the demonstration, while organisers put the figure at 15,000. The participants were primarily self-employed nurses, who treat patients in their homes. They headed for the Labour Ministry on the capital's Left Bank, where their representatives were due to discuss their demands with Employment Minister Elisabeth Guigou. The unions want a package of 230m euros ($203m) to increase the fees and allowances of self-employed nurses, many of whom work up to 70 hours per week and travel long distances to tend to their patients. The demonstration came a day after hospital workers, including doctors, nurses and administrators, went on strike to protest against staff shortages caused by the introduction of the 35-hour working week. ...
Strike would be "civil emergency"
<http://onenews.nzoom.com/news_detail/0,1227,77900-1-6,00.html>
ONE News, January 23, 2002
The Mayor of Christchurch has described the threat of further strike action by nurses at the city's hospitals as tantamount to a civil defence emergency. More than 2,000 nurses and midwives have been attending stopwork meetings on Wednesday, but already there is a suggestion the votes that have already come in are enough for the union to reject the Canterbury District Health Board's latest offer. The union has issued further strike notice, virtually doubling next week's industrial action from eight days to 15. ...
CANADIAN CONTRADICTIONS CANADIAN CONTRADICTIONS CANADIAN
Now or Never on Medicare
<http://www.nursesunions.ca/na/index.shtml#2>
Canadian Federation of Nurses Unions
2002 will be a defining year for health care.
This year will see the filing of a number of key reports on the future of Medicare -- from Don Mazankowski (see adjacent article), Senator Michael Kirby, and from Commissioner Roy Romanow.
It also promises to see the greatest assaults ever on Medicare's founding principles in the Canada Health Act. The provinces of Alberta, Ontario and British Columbia will allow the establishment of more private and for-profit health care schemes.
The greatest challenge will be to the federal government and the Prime Minister in particular.
The PM will have to decide what to do with Canada's most cherished social program. The Romanow Commission, we believe, will give the PM good reasons to make Medicare whole once more. However, the PM may choose to ignore the advice of his Commissioner. The decision will not be based primarily on reason and evidence. It will be based on power politics. It will be based on what political costs and benefits are realized by the PM and his ruling party.
The PM might make his decision on this all-important issue and declare his retirement. Or he might decide to take a position and then declare an election - essentially using Medicare as the next election's political football.
One way or the other, Jean Chretien is more likely to make the right decision if he feels intense pressure to restore, improve and expand Medicare.
This is our job. Nurses must focus on ensuring that Mr. Romanow brings in a good report and that there are strong reasons for the PM to take his advice. But nurses' actions alone won't save Medicare.
So while the CFNU and our affiliates gear-up to appear before the Commission on the Future of Health Care, we must also reach out like never before to the rest of the labour movement. Medicare needs a truly national campaign - not the usual effort but an extraordinary one. Only with your help, can we hope to get it done.
Happy New Year.
Kathleen Connors, President
Manitoba nurses lured south during contract talks
<http://cbc.ca/cgi-bin/templates/view.cgi?category=Canada&story=/news/2002/01/19/nurses_020119>
CBC, January 19, 2002
WINNIPEG - U.S. recruiters have to come to Winnipeg for a weekend job fair directed at health care professionals. The latest recruiting drive comes at a difficult time for the province, which is trying to negotiate a new contract with its nurses. One of the recruiters was Margaret Eaton of the Methodist Health Care System of Houston, Texas, an organization overseeing five hospitals in the state. She said it was a comfortable 20 C when she left her country to come to the city, where temperatures hit -36 C with the windchill. "We've heard there are professionals up here looking for opportunities in a warmer climate, and that is something that we absolutely can offer them," she said. Eaton's group was just one of 20 American health care organizations who will have an exhibit at the job fair. One team of recruiters was offering $10,000 signing bonuses to try to tempt Manitoba nurses to go work for them. The prospect of losing more nurses and adding to a serious shortage prompted the Manitoba Nurses Union to buy radio ads, asking the government to take action. "Working conditions must be improved to alleviate never-ending overtime demands," one commercial said. ...
Doctors and nurses wanted
<http://www.canada.com/search/site/story.asp?id=C6904BAA-FA64-4F23-8392-CEA8A2864B3F>
Valerie McLaughlin, Pembroke Observer, January 23, 2002
Thousands of Ontarians want more doctors and nurses, shorter waiting lists and an increased emphasis on wellness in the province's health care system, according to a survey released on this week. Questionnaires asking Ontario residents for their opinions on health care were mailed out to four million Ontario households last July and August at a cost of about $3.8 million. Of those sent out, 400,000 were returned to the Ministry of Health. ...
Facing yet another job loss
<http://www.canada.com/search/site/story.asp?id=853FC9E9-D447-4AE0-B352-169FE78C4050>
Angie Clarke, Victoria Times Colonist, January 23, 2002
I am a registered nurse. I was recruited to work at the Royal Jubilee Hospital from England. I recently was interviewed for an article on returning to nurse in Canada, it was for a major recruitment drive to hire nurses back to Canada. I was one of the nurses that was laid off when Klein did his number in Alberta. I can certainly empathize with all the people that have recently been laid off. There were absolutely no jobs when it happened to me, so were did I go? The United States. Difficult decision, when you have to leave the place that educated you and has your family and friends. I moved away, but always hoped to return home. ...
NS urging national database of health-care workers
Canada needs a national database of doctors, nurses and health technologists, say Premier John Hamm and Health Minister Jamie Muir. They said they'll press their colleagues to establish one when they meet Thursday and Friday in Vancouver. Mr. Hamm said Tuesday that knowing the numbers of physicians, nurses, licensed practical nurses and technologists would help provinces know how many are needed for the future. That would allow the province to know how many training positions at universities it needs. The premier said it's important for all provinces to work together, rather than in isolation. ...