Heard of Nursing Shortage Nightmares?
Stand up and be counted for safe staffing!

After eight years of hard, persistent work by health care workers' unions and community groups, the public is in a position to achieve safe nurse-to-patient ratios in California hospitals. AB 394, passed in 2000, directed the Department of Health Services (DHS) to determine the what the ratios should be. The next few months are crucial because DHS is developing the ratios, which must be implemented in January 2002. DHS is expected to release its first draft of these staffing regulations soon. For more specific information, check out the Web site of the California Nursing Association, or SEIU's Nurse Alliance site.

WHAT ABOUT THE NURSING SHORTAGE? A LESSON FROM DOWN UNDER

The current "nursing shortage" is a result of years of worsening working conditions forced on direct care nurses by the health care industry.

Over the last ten years, the degree of illness of patients has steadily increased, while restructuring and the replacement of nurses by unlicensed personnel have had a disastrous impact on keeping nurses and on the ability to provide patient care.

Many nurses have left hospitals and even the nursing profession because they refused to endanger their patients and their licenses under such conditions. Many of those remaining have had to cut back to the bare minimum of what they do for their patients. Now the industry is using the nursing shortage that it helped to create as an excuse to try to block this Safe Staffing Bill by saying the ratios can't be achieved because there simply aren't enough nurses available to hire.

Is this a reality we just can't change? Of course not. In August 2000, the Australian state of Victoria (pop. 4.6 million) enacted minimum nurse-to-patient ratios, which has had a dramatic impact on their nursing shortage. Nurses have taken re-entry courses and are returning to the hospitals in large numbers, now that working conditions are improving. The same thing can happen in California and the rest of the United States. When it does, families can once again, with confidence and pride, urge young people to go into the nursing profession as a fulfilling, rewarding life's work, as well as entice non-practicing nurses to return to direct care nursing.

County says "Fix it yourselves" to Medical Center trustees

Despite Vote Health's community and labor activists working hard behind the scenes to lobby each supervisor of the Alameda County Board for additional funding for the ACMC, the results were disappointing. Kay Eisenhower, a longtime Vote Health member and an officer of SEIU Local 616, headed four of the delegations. The health aide of one supervisor said, "This was the most impressive effort on Vote Health's part I've seen for years, and it was particularly important that representatives from each supervisor's district attended the meetings." Here's what was won and what didn't happen that we need to continue to work toward:

• The Health Care Services Administration (HCSA) was directed to provide $500,000 for medical services provided to Juvenile Hall inmates;
• HCSA must commit $200,000 from within Behavioral Health Care's existing budget, a nod to the fact that they have been taking out $115 in administrative fees from each $750 that the state pays per day per patient for care. Our position on this was that, if the money were fully passed through to the Medical Center, the resulting $4-5 million a year would significantly reduce the Medical Center's deficit.

Vote Health submitted two position papers to each supervisor (which will be available in their entirety on this Web site in August), requesting that:

• the Board of Supervisors pass a resolution committing the County to spending up to $3 million for FY 2001-2002 to keep the Neuro-Respiratory Unit (at Fairmont Hospital) open, making up for any funding shortfalls not covered by the State;
• the County allocate $2.5 million to increase staffing in the ACMC specialty clinics. We are asking that the County make a commitment to provide this funding if the Alameda Alliance for Health (the county Medi-Cal provider) fails to approve a request for this support now pending from ACMC.

FATE OF THE NEURO-RESPIRATORY UNIT STILL UNCLEAR
The budget decisions do not bode well for the 13 patients who remain in the neuro-respiratory unit at Fairmont Hospital. For many months now, they and their families have been dealing with the uncertainty of where they'll be cared for. The supervisors demanded that the Medical Center fund the NRU deficit out of money that the trustees had set aside for true emergencies. In years past the Medical Center was scolded for not having such reserves. Any institution with an operating budget its size should have millions set aside. The possibility is real that in the case of an epidemic or earthquake, it could be overwhelmed with demand for services from people without insurance.

Vote Health mailed over 200 postcards from concerned community members to the supervisors and the Trustees of the Medical Center opposing closure of the NRU. We will continue to work toward a commitment from the county to reinvest in the Fairmont campus by keeping this unit open and replacing the deteriorating buildings with modern facilities. Fairmont Hospital is an important part of the county's health care safety net for the under- and uninsured, and as a community we must insure that it remains open.

THE SPECIALTY CLINICS
Although no immediate financial commitment was made in the budget for the specialty clinics, a number of community clinic spokespersons tolds the supervisors that their clients need improved access to the speciality clinics. Board members agreed that they would work together with the Medical Center and the Alliance to identify alternative funding to meet these needs.

We will continue to seek a commitment from the Alliance to direct a regular percentage of the Medi-Cal dollars they collect, now proven to be well above their normal operating costs, to the Medical Center, which is suffering financially as a result of the state's experiment in managed care Medicaid. And we will continue to ask the Board to see the county as an ongoing partner with the Medical Center in financial and moral responsibility to serve the health needs of the uninsured, until we attain a single payer health care fund.