NEW YORK NURSE: February 2008
by Nancy Webber
When New York Gov. Eliot Spitzer announced his Executive Budget proposal on Jan. 22, he included $2 million in new money for nursing education programs at public institutions.
“While this is less than what is needed, it is a significant first step in a year the state is predicting a $4 billion deficit,” said Shaun Flynn, director of the NYSNA Governmental Affairs Department. “The governor recognizes the need to expand education programs to meet current and future demands for registered nurses.” The proposal includes $1 million for schools in the SUNY system and $1 million for CUNY schools.
The budget plan supports the recommendations of the governor’s Commission on Higher Education, which were announced in December. “Over the next five years, we must hire 2,000 new full-time faculty members for SUNY and CUNY,” Spitzer said. “We must invest in our community colleges, which train New Yorkers for high-skilled jobs and serve as the gateway to four-year colleges.”
As usual, the Executive Budget tries to reduce Medicaid costs, which account for nearly one third of state expenditures.
Spitzer proposed to do this, however, by changing the Medicaid reimbursement structure to favor primary care and preventive services. According to the governor, the current system does not adequately support those services and “over-reimburses” hospitals for inpatient care.
The proposal would reduce the “trend factor,” the increase built into hospital reimbursements for inpatient care, by 25%. It would then increase payments for ambulatory care based on the intensity of the services performed in hospital-based ambulatory care clinics, ambulatory surgery and emergency departments, community-based clinics, and office practices.
“This proposal seems to be taking away with one hand and giving with the other,” said Flynn. “We plan to monitor this carefully. While in the long term, it may reduce hospital admissions, in the short term it will mean hospitals will be receiving less money than they expected for inpatient care.”
Flynn said that, all too often, cuts in hospital funding result in staff cutbacks. “We will fight any cuts that endanger patient care,” he added.
In a move supported by NYSNA and other healthcare reform advocates, the governor proposes to expand Child Health Plus, the public health insurance program for children. The expansion would result in coverage for nearly all of the 400,000 uninsured children in the state. At the same time, the state plans to pursue a lawsuit against the Bush administration over the President’s veto of an extension of the federal State Children’s Health Insurance Program (SCHIP).
Beginning in April, private employers would have the option of offering Family Health Plus coverage to employees who are eligible for that program. The state would share in the premium costs for those employees, increasing access to care and reducing costs for employers.