December 21, 2023 — New York State’s health care sector is experiencing a staffing crisis. The Department of Health projects a shortage of 40,000 nurses by 2030. The state is also experiencing staffing vacancy rates between 30-40% and turnover rates exceeding 25%.
It’s a recipe for disaster and the reason why state lawmakers and concerned parties, like PEF, are seeking solutions.
During a legislative hearing held at Hunter College in Manhattan on Dec. 19, PEF Statewide Nurses Committee Chair Amy Lee Pacholk prescribed one fix.
“We need to invest more in front-loaded loan forgiveness programs that reward individuals for taking on this work and to help them earn the education they need to do it successfully,” said Pacholk, who works as a teaching nurse at SUNY Stony Brook. “PEF believes that these workers should be given immediate loan relief in exchange for meeting their work requirements.”
Pacholk’s testimony centered on the future of the industry. Retention is already difficult as wages and other benefits struggle to keep up with the private sector. Recruitment, however, is equally important.
“We need to fortify and invest in our SUNY teaching hospitals and expand their health care course offerings,” Pacholk told the panel of legislators. “We need to expand enrollment in these schools so that our health care professionals look more like the communities that they serve.”
PEF’s priorities to combat short staffing include increases and changes to compensation and a fix to the Tier 6 pension plan.
After decades of lobbying by PEF and other unions, New York ’s registered nurses received a salary reallocation in 2022. But Pacholk pointed out that while compensation is slowly catching up, pay for travel nurses is still almost three times the salary of other full-time nurses. She advocated for another increase and to include nurse practitioners this time.
“We should also end the lag payroll system,” Pacholk said. “It is antiquated and really hurts the state’s competitiveness for talent. In this labor market, trained, licensed health care workers considering state employment can’t fathom that they won’t receive a full check for their work for up to 14 weeks.”
Pacholk said that another helpful fix to alleviate short staffing is for legislators to address the culture of workplace bullying. Employees are more likely to enjoy their jobs and keep at them when they don’t work in a toxic environment. PEF has launched a “Toxic Tales” campaign to raise awareness about bullying and abusive conduct and will be pushing for the Senate to pass legislation next session that the Assembly already passed.
“New York state needs to define behaviors that constitute ‘bullying’ and ‘abusive conduct’ in statute as we have done for sexual abuse and to support specific protected classes,” Pacholk said. “We need to set a clear standard of conduct in the workplace so that individuals who bully their colleagues or who act abusively can be held accountable for this conduct. This will improve service delivery to New Yorkers.”
Legislators questioned Pacholk on these and other issues, like the Nurse Licensure Compact, which allows nurses to work in other states without the need to obtain additional licenses. While there is an argument that allowing nurses to travel to New York would increase the number of nurses in hospitals, PEF does not support this as a solution for New York.
“Many of the nurses who are part of the compact are travel nurses,” Pacholk said. “They get paid more than full-time nurses and often do not have the same level of skill or experience.”
Pacholk pointed out that there is a shortage of nurses across the country and the compact takes nurses from other states facing the same issue. It will not work as a long-term solution and it does not benefit PEF or public-sector employees, she said.
Many of the legislators agreed with Pacholk’s call for Tier 6 reform with some even calling for it to be completely abolished.
Legislators took interest in Pacholk’s focus on bolstering the workforce by adding more teachers to the system. In addition to forgiving loans for nurses and other health care professionals who stay within the SUNY or CUNY system for up to five years, Pacholk suggested helping those already in the system transition into teaching roles.
“We also need to try to reach high schoolers,” Pacholk said. “They should know what options are available to them, but we need to make sure the educators are in place.”
PEF delivered several other solutions in written testimony, including the adoption of scholarship programs, Preceptor Programs—like the mentoring program New York has for teachers—and called for the Nurse Practitioner Modernization Act to be made permanent. The act was introduced in 2014 and gave Nurse Practitioners the ability to work more independently of physicians when they surpassed 3600 hours of supervised care. The NPMA 2.0 introduced in 2022, had enhanced the NP autonomy and is set to expire on April 1, 2024.
For more information, click here to read PEF’s written testimony. Video of the hearing can be watched, here, with PEF’s testimony by Pacholk starting at around 1:19:25.