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Landmark Win for Safe Staffing Act Advocates

ALBANY, N.Y.—After more than 20 years of pressure from health-care workers, the state Legislature on May 4 overwhelmingly passed a pair of bills intended to ensure adequate staffing in hospitals and nursing homes.

“For the first time in New York State, there will be a process for setting and enforcing safe staffing standards at every hospital and nursing home — regardless of whether the facility is public or private, not-for-profit or for-profit, union or nonunion,” the New York State Nurses Association said in a statement. NYSNA President Judy Sheridan-Gonzalez called the bills “a major step forward for every patient’s right to safe, quality health care.”

Posting on Twitter, 1199SEIU praised the package as “historic staffing legislation that protects nursing-home residents and workers, and forces employers to invest in quality care.”

One of the two measures in the Safe Staffing Act package will require all nursing homes to have enough staff by Jan. 1 to give each resident 3.5 hours of care per day, including at least 1.1 hours of care by registered nurses and licensed practical nurses. The other would require hospitals to establish committees that would set staff-to-patient ratios for each unit, with at least half the members nurses and others providing direct patient care. 

Those ratios would have to “meet or exceed those set in existing union contracts,” NYSNA said, and would be enforceable by the state Department of Health, “effectively making NYSNA-negotiated staffing ratios state law.”

The bill, sponsored by Assemblymember Aileen Gunther (D-Sullivan) and state Senator Gustavo Rivera (D-Bronx), also instructs the Department of Health to establish new minimum staffing standards for intensive-care and other critical-care units that would require at least 12 hours of care by a registered nurse per day. 

The ideal minimum for ICUs is one nurse for every two patients, a NYSNA spokesman told LaborPress, but ICU nurses in many hospitals, particularly in poorer areas, are often responsible for three or four patients at a time. Correcting that “fundamental inequality” will be a NYSNA priority for the rest of the year, he said.

The hospital-staffing bill passed by 144-5 in the Assembly and 63-0 in the Senate. The nursing-home bill drew more opposition, with the votes 126-24 in the Assembly and 54-9 in the Senate. The nine senators voting no comprised eight Republicans, primarily from Western New York and Long Island, and Democrat Simcha Felder of Brooklyn.

“For decades, nurses, patients and their families, and legislators have fought for passage of a safe-staffing law,” Assembly Health Committee Chair Richard Gottfried (D-Manhattan), who introduced the first bill on the issue in 1996, said in a statement. “COVID-19 has made this longstanding need even more clear and compelling.”

Gottfried cited a report released in January by state Attorney General Leticia James, “Nursing Home Response to COVID-19 Pandemic,” which noted that more than half of the state’s 619 nursing homes entered the pandemic with the federal Centers for Medicare and Medicaid Services rating their staffing levels at only one or two out of five stars. That included 280 of the 401 privately operated, for-profit facilities.

Many for-profit homes, the report said, have a business model of keeping staffing at a minimum to cut labor costs, and that had already “created conditions of systemic causes of resident neglect and abuse at a number of facilities.” When the pandemic hit, that low-staffing model “simply snapped under the stress” in many cases.

At one for-profit nursing home in New York City with a CMS two-star staffing rating, 33 residents died of COVID in one week in early April 2020, 15% of the patients in the facility, the report said. At a two-star for-profit facility upstate, one certified nursing assistant told investigators that after 14 staff members tested positive for COVID-19, it was common to have only one or two CNAs per unit, leaving them so overloaded that residents were lucky to “get toileted and cleaned up once a shift.” 

According to the report, the 333 nursing homes that had a CMS staffing rating of one or two stars as of June 1, 55.4% of the state’s total, accounted for 66.2% of the COVID deaths in nursing homes between March 1 and November 16, 4,401 out of 6,645.

“The benefits of safe staffing are clear — it means better care and outcomes for all New Yorkers,” Communications Workers of America District 1 Vice President Dennis Trainor said in a statement. “Frontline health-care workers have known this for years and have long advocated for these measures. If we have learned anything from the COVID-19 pandemic, it’s that our health-care heroes can’t wait anymore for improved staffing levels.”

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