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SPONSOR: |
Vaughn |
DATE TYPED: |
02/08/02 |
HB |
HJM33/aHGUAC |
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SHORT TITLE: |
Address Nursing Shortage |
SB |
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ANALYST: |
Dunbar |
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APPROPRIATION
|
Appropriation
Contained |
Estimated
Additional Impact |
Recurring or Non-Rec |
Fund Affected |
||
|
FY02 |
FY03 |
FY02 |
FY03 |
|
|
|
|
|
$0.1 |
See
Narrative |
|
|
(Parenthesis
( ) Indicate Expenditure Decreases)
Duplicates
SJM 39
Relates
to HB0042; HB0074; SB0052 and SB0099
Department of Health (DOH)
Health Policy Commission (HPC)
Board of Nursing (BN)
SUMMARY
Synopsis
of HGUAC Amendment
The
House Government and Urban Affairs Committee amendment includes the NM Board of
Nursing, nursing associations and the schools of nursing with effort.
Synopsis
of Original Bill
House Joint Memorial 33 requests the Department of Health to conduct an in-depth study on specific issues related to the nursing shortage and provide findings and recommendations on the development of an integrated approach to address the nursing shortage. The findings and recommendations are to be presented to the Legislative Health Subcommittee or an appropriate interim committee by October 1, 2002.
Significant
Issues
There is an acute
nursing shortage in New Mexico, as well as nationwide, which affects employers
and recipients of health care, including the Department of Health.
The New Mexico Board
of Nursing has convened a task force to study the feasibility of regional
licensing across state lines. Though
regional licensure would not be a long-term solution to the shortage, it could
mean that agencies could hire nurses immediately.
Nursing pay has
increased across the State. Nurse sign-on
bonuses range between $1500 and $5000.
Average base salary for nurses begins at nearly $20 per hour. Many hospitals add on night and specialty
deferential that bring salaries closer to $30 an hour. Most other states are paying nurses 33% more
than New Mexico. In Texas, a graduate
nurse of a nursing program with no experience can receive $25 per hour, plus a
sign-on bonus.
FISCAL IMPLICATIONS
According
to DOH, the issue has impacted the entire nation and it is likely that the
Centers for Disease Control and Prevention (CDC) and the Health Resources and
Services Administration (HRSA) has federal grant money available to pay for
this type of study.
ADMINISTRATIVE IMPLICATIONS
Department of Health Staff or contracted services would be required to concentrate on the proposed, labor intensive study (approximately one person full time) until the October 1, 2002 report to LFC.
DUPLICATION/RELATIONSHIP
HJM
33 is a duplicate of SJM 39.
This
HJM 33 study would include assessment and recommendations on the creation of a
Center for Nursing Excellence, which is referred to in SB 0031. In addition, HB0042 HB0074, SB0052 and
SB0099 are bills that are attempting to address the nursing shortage.
TECHNICAL ISSUES
HJM
33 resolutions include a request to DOH to “Collect and Evaluate” data on the
nursing shortage. This request may
constitute a duplication of available services, as the New Mexico Health Policy
Commission and the New Mexico Board of Nursing currently collect statewide data
on the nursing work force by statutory mandate. The Health Policy Commission conducts analysis and evaluation on
the data to identify workforce shortage and underserved areas of the state
through the Geographic Access Data System (GADS), in compliance with the Health
Policy Commission statutory mandate.
The
sponsor of the bill may wish to consider a collaborative effort with other
state agencies that collect and analyze data on issues related to the nursing
work force including the NM Board of Nursing, the Health Policy Commission, UNM
and NMSU Schools of Nursing and DOL.
Moreover, the Board of Nursing notes that the
memorial will duplicate the work proposed in SB31 which appropriates t$150.0
from the tobacco settlement program fund to the Board of Nursing for expenditure
in FY02 and 03 on and or for a program for nursing excellence.
The program includes strategies for recruitment
and retention of professional nurses, career ladder education opportunities,
improved interaction with health facilities administrations, the medical profession
an institutions of higher learning.
Further, the Board of Nursing states the
memorial also duplicates SB 42 which appropriates $50.0 from the Board of
Nursing Fund for expenditure in FY 02 and 03 to contract for a statewide study
of the need for additional nurses and the types of education an training
necessary to meet NM health care need.
OTHER SUBSTANTIVE ISSUES
The national nursing shortage is severe.
The national average for nurse
vacancies is about 11%. The American
Association of Colleges of Nursing (AACN) considers an 8% vacancy rate a
"crisis." The New Mexico
vacancy rate averages between 18% and 25%.
New Mexico also has a nursing workforce that is older than the national
average (48 years vs. 46 years) which means that more people will be retiring
sooner, and leaving the workforce (average age of nurse retirement is 60 years
of age.) New Mexico's schools of nursing
are adding about 580 new RNs to the workforce each year. The average number of vacancies from four
studies completed last year was 785.
Thus, there is an ongoing shortfall, which exacerbates public
dissatisfaction with New Mexico's health care system.
It is expected that in 20 years (2020) the shortage will be
20% higher than it is today. In 15 years (2015), 50% of the nursing workforce
is expected to retire. Vacant positions take an average of 59-72 days to
fill. In 10 years (2010), increased
complexity of care will require that 66% of the workforce have a BSN; currently
27% have a BSN (National Advisory Council on Nurse Education and Practice,
1996). There has been an annual decrease of 5% in BSN enrollment each year over
the past 5 years.
DOH reports that if
action is not taken soon the nursing shortage is expected to only get worse and
the result will impact the health of people in New Mexico. As our population
ages, the demand for nursing care will increase and under the current
environment the skilled nursing workforce will not be available. This will serve to further drive up the cost
of health care, create concerns related to the quality of care as nurses are
overworked, and pull nurses away from primary care and prevention into those
specialty areas where salaries are higher.
Severe nursing shortages affect the health care industry and the state
economy. Strong educational and health
care systems are incentives for large businesses to move into the State.
HPC reports that
data concerning the nursing supply in New Mexico is incomplete. HPC states that
the National standards that define nursing shortage areas do not currently
exist, creating difficulty in quantifying the nursing shortage in New Mexico.
New Mexico may consider the development of nursing shortage standards and
definitions of underserved areas that are suited to the health care needs of
New Mexicans, and which can be used to analyze supply and demand and develop
initiatives that will effectively identify and address the nursing shortage in
New Mexico.
HSD
acknowledges that since nurses are an integral part of the provider population
in offices, schools and clinic settings,
an increase in the number of nurses in New Mexico would have a positive
impact on the Medicaid performance indicator of increasing the percentage of
children and adolescents receiving Early Periodic Screening and Diagnosis and
Treatment and well-care visits.
AMENDMENTS
HPC suggests redirecting the memorial to
the Health Policy Commission and/or the Board of Nursing. As mentioned in the technical issues section,
both agencies already have statutory requirements to collect and analyze
nursing work force data.
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