WOCN Northeast Region

Legislative Report- New York

October 12, 2007

Submitted by Jody Scardillo, MS, RN, CWOCN

NYS Dept of Health initiative “War on the Sore” started December 2006, based on state nursing home pressure ulcer prevalence data compared to other states.  See NYSDOH website for detail. 

Legislation

A1898/S6342   Mandatory Overtime-   This bill would prevent facilities from requiring RN’s and LPN’s to remain on duty longer than their usual shift.  Calls for zero tolerance unless there is an emergency. Passed Assembly, on Senate calendar

A6119/S1551           Safe Staffing would establish minimum nurse to patient ratios.

Currently in health committee Senate & Assembly.

A2480/S294     Education Advancement would require RN’s to attain a BSN within ten years of their initial licensure in order to re-register to practice in NY.

In higher ed committee both Senate & Assembly

A3873/S1865   Adds nursing to the list of physically taxing jobs in NYC providing NYC nurses the same benefits as other city employees.

NYC City Council did not enact a message rule to advance this bill.

A6186/S3441 Workplace violence adds attacks on RN’s or LPN’s to same as attacks on police, firefighters or EMT’s.  Passed Senate, in Assembly Codes Committee.

Budget

Nursing Faculty Support $4 million to students through the Patricia McGee Scholarship Loan Forgiveness Program.  Provides assistance to RN’s who are earning advanced degrees in order to teach nursing.  This is an increase from $1 million.

Support for Nursing Programs $1 million in new money to assist independent colleges to expand and improve their nursing programs.  Assistance provided on a per student basis. 

The Commission on Health Care Facilities in the 21^st Century report was submitted on Dec 1, 2006.  This group, also known as the “Hospital Closing Commission” or the Berger Commission recommended closing many hospitals through out the state and merging others. These recommendations became law on January 1, 2007. Several hospitals and unions (UUP, PEF, CSEA) have filed suit to fight these recommendations.   The commission recommended closing 9 hospitals, 7 nursing homes and merging other hospitals for a decrease in 4000 beds by June of 2008.  The state is offering up to $550 million in financial assistance to facilities to help implement the mandates.

Respectfully submitted,

Jody Scardillo, MS, RN, CWOCN

Legislative Report- PA

October 12, 2007

Submitted by Cheryl Bealer

Pennsylvania:

HB1019- Loan Forgiveness. Referred to education committee 4/3/2007

SB968-Mcare Act- decrease and prevent health care associated infections. Governor signed 7/20/2007

HB1581- Nursing Scholarship- Referred to education committee. 6/20/2007

SB 246- Smoke-Free Environment Act. Referred to Rules and Executive Nominations Committee 7/16/2007

HB720- Clean Indoor Air Act- Referred to Health and Human Services Committee 3/9/2007

HB539- 211 dialing code- Referred to Health and Human Services Committee 7/8/2007

Act 48- Signed by Governor Rendell 7/20/2007. Requires CRNPs to have malpractice insurance of 1mil per occasion/3mil aggregate

ACT 49- Signed by Governor Rendell 7/20/2007- Official Recognition of CNS. State Board to determine licensure.

Mandatory CEUs- Still undetermined as to reporting system by the State Board of Nursing.

Federal Issues:

Hand-out on Inpatient Prospective Payment System

CMS October 1, 20007:

New rule mandating that hospitals must inspect and document skin assessment on admission.

1.      All pressure ulcers will be under the jurisdiction of CMS under this new rule

2.      Hospitals must document pressure ulcers and track them closely.

3.      Have until the end of the second hospital day to identify a community-acquired pressure ulcer.

4.      This will change hospitals ability to add hospital-acquired pressure ulcers as a secondary DRG for continued hospitalization and pay at a higher rate.

5.      Pressure ulcer rates will be published and become part  of the public domain.

6.      Will probably not effect billing until October 2008.

DRG’s are changing. There will now be 2 types of DRG’s

1.      Basic: paid at lower rate.

2.      MSDRG: will reimburse hospitals more fairly

Federal Register announced the CARE tool, a combination tool for Home Care and LTAC. It encompasses the needs of both groups that are currently found in the Oasis tool and the MSDS tool. Changes are under the auspices of CDC. The Committee requested an acute care person be added to the committee, as the new changes will affect inpatients as well as patients in an LTAC or home setting. Ben Peirce and Lee Ann Krapfl are involved. It was approved by Congress and will be initiated upon discharge from acute care facility when making a home care referral of on transfer to an LTAC.

WOCN Public Policy Committee:

Cheryl Bealer is now a member of this National Committee

White Paper Available on-line re: Clean vs. Sterile Intermittent Catheterization.

NIWI  March 9-11, 2008- Some scholarships will be available from National Office and The Nursing Alliance also offers scholarships

NPUAP and WOCNS feel codes by which CDC/CMS ruling have utilized for use in categorizing pressure ulcers do not do a fair job of capturing what is going on with pressure-related skin breakdown. Both are considering working on a joint statement to encourage the CDC to tweak the codes. CMS had posted their rule for public comment WOCN did respond with a letter and all issues were addressed. The issue of unavoidable pressure ulcers is to be visited. The ICD-9 codes do not address severity level. Currently coding of pressure ulcers is based on MD documentation, not nursing. More reimbursement for Stage III, IV and Unstageable pressure ulcers. CMS felt that “DTI” was too new of a “phenomenon” to be included. They feel there is not enough research of data to support including this in coding of pressure ulcers.

Respectfully Submitted,

Cheryl Bealer