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SPONSOR: |
Bailey |
DATE TYPED: |
2/5/02 |
HB |
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SHORT TITLE: |
Address Nursing Shortage |
SB |
SJM 39 |
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ANALYST: |
Dunbar |
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APPROPRIATION
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Appropriation
Contained |
Estimated
Additional Impact |
Recurring or Non-Rec |
Fund Affected |
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FY02 |
FY03 |
FY02 |
FY03 |
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$0.1 |
See Narrative |
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(Parenthesis
( ) Indicate Expenditure Decreases)
Duplicates
HJM 33
Relates
to HB0042; HB0074; SB0052 and SB0099
Department of Health (DOH)
Health Policy Commission (HPC)
Board of Nursing (BN)
SUMMARY
Synopsis
of Bill
Senate Joint Memorial 39 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.
CONFLICT/DUPLICATION/COMPANIONSHIP/RELATIONSHIP
SJM
39 is a duplicate of HJM 33.
This
SJM 39 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
SJM
39 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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