Testimony of Health Professionals and Allied Employees

Senate Budget and Appropriations Committee

Assembly Budget Committee

March 13 and 14, 2007

 

Good afternoon and thank you for the opportunity to address the Committee.  My name is Jeanne Otersen and I am the Public Policy Director for the Health Professionals and Allied Employees which represents 12,000 nursing and healthcare workers in hospitals, long-term care, research, home health and blood bank facilities across New Jersey.

 

Front-line caregivers witness first hand the multiple crises facing our healthcare system: inadequate reimbursements and charity care funding for our hospitals; rising numbers of uninsured; insufficient funding to the NJDHSS to fulfill its current oversight and surveillance responsibilities; the healthcare workforce shortage and its root causes in unsafe staffing and working conditions; and  the failure of our regulatory agencies,  due to either lack of authority or resources, to step in, monitor and save failing hospitals on behalf of our communities. 

 

I will focus brief comments on four areas of concern for our union, and attach more detailed comments for your review on two areas: the saving of our hospitals, and the healthcare workforce shortages due to unsafe working conditions.  These comments are in the context of an urgent need to address the growing number of uninsured and underinsured in our state through more comprehensive programs, rather than piece-meal and short-term fixes. . 

 

1)      The NJDHSS current mission.  Existing mandates require the NJDHSS to oversee implementation of programs as diverse as use of safety needle systems in our hospitals; quality of care inspections; and development of programs to meet new challenges, such as infection control due to emerging ‘superbugs’.   We encourage this Committee to examine additional funding for the NJDHSS to fulfill existing surveillance and enforcement mandates such as-blood bank inspections; implementation of the DHSS’ strategic plan to address “superbugs” such as antibiotic resistant staph infections; and implementation of the surveillance requirements under NJ’s Needle Safety law enacted 7 years ago. 

 

2)       NJDHSS initiatives on disparities in health care.  The NJDHSS has announced a serious new initiative addressing disparities in care for at-risk and urban and minority populations.  This mission includes a range of programs, from increasing breast cancer screening for underserved women to the development of a culturally competent workforceAll of these initiatives require funding.  Successful workforce initiatives would need to include new recruitment methods in urban areas; linkages between secondary educational institutions, community colleges and healthcare institutions; and funding to support recruitment, education and training.  We encourage this committee to develop funding for these programs or this program will not succeed.

 

3)      The fiscal crises facing NJ hospitals.  From the recent number of hospital bankruptcies, near bankruptcies, bond defaults, mergers or closures, it is apparent that our state agencies lack the authority to intervene before it is too late.  Most recently, Hackensack Hospital has just asked the NJDHSS for $60 million to help purchase Pascack Valley Hospital, which is in danger of bond default due to its high debt ratio.  We urge this committee to set aside funding for cases where state support can preserve and improve community health care, such as the Hackensack-PVH deal, or in the case of Bayonne Medical Center.  We also urge our state legislature and Governor’s office to establish transparency and accountability for its support, through the work of the Governor’s Commission on the Rationalization of Healthcare.    Attached is an HPAE paper on approaches for supporting and saving our hospitals while requiring transparency and accountability for public funding.

 

4)      Healthcare workforce shortages and hospital working conditions.  Studies continue to predict serious shortages in the coming years of nurses and other health professionals.  At the root of these shortages are the physical stresses and dangers of the work, combined with an aging workforce. 

 

  • Nursing and health care workers are among the top ten occupations for work-related musculoskeletal injuries, in most cases related to patient lifts and transfers.
  • Health care leads all other sectors in the incidence of nonfatal workplace assaults.


These hazards threaten the safety and health of patients as well as caregivers, undermine our efforts to recruit and retain qualified staff, and add millions of dollars in unnecessary healthcare expenditures. 

 

Programs to reduce healthcare worker injuries related to unsafe patient lifting and transfers and workplace violence  actually have minimal impact for our budget in the next three years, but do provide long-term significant savings to our health care system.  For example, one estimate concludes that a 400-bed hospital would spend $500,000 for a comprehensive safe lift program with all necessary equipment.  On the other hand, one preliminary review of the costs of patient handling injuries at a university hospital in Connecticut estimates $20,000 per injury of direct workers’ compensation costs and additional indirect costs at five times the direct costs, for an average of $120,000 per injury.[1] Another estimate puts the cost of back injuries to a 200-bed hospital at $300-600,000 a year. 

 

We would request that the Committee review with legislative services the anticipated costs to state institutions and developmental centers, which are covered by the safe patient handling legislation (S1758/A3028) and violence prevention legislation (S1761/A3027) currently pending.  

 

Thank you for your attention to these issues. 

 

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[1] Morse TM et al “Doing the Heavy Lifting; Health Care Workers Take Back their Backs” (manuscript)