In case you missed it … the Central Penn Business Journal recently published a joint op-ed written by Luke Bernstein and Nicole Stallings, the respective presidents and CEOs of the PA Chamber and the Hospital and Healthsystem Association of Pennsylvania (HAP), outlining the current shortage of health care workers and encouraging policymakers to prioritize workforce solutions over state-imposed mandates.
In the op-ed, Bernstein and Stallings criticized legislation that aims to establish mandatory nurse staffing ratios in Pennsylvania hospitals as “catastrophic” to patients, businesses, and communities, as its implementation could lead to higher costs, reduced access to care, and even hospital closures.
The full text of the op-ed is shown below:
As leaders from the Commonwealth’s business and health care communities, we are working collaboratively to address the workforce emergency that threatens Pennsylvania’s entire health care system.
Pennsylvania hospitals report that staff vacancy rates are in excess of 30 percent for registered nurses, support staff, and many other professionals who help care for patients. And this shortage of health professionals is projected to grow.
The resulting strain on Pennsylvania communities cannot be overstated. Now more than ever, we need lawmakers to prioritize long-term solutions to grow our health care workforce and attract more qualified candidates to the Commonwealth. Unfortunately, the approach outlined in House Bill 106 – which passed the House of Representatives in June – is simply not aligned with these goals.
Rather, the bill would remove experienced nurse leaders from decisions about appropriate patient care and impose mandatory nurse staffing ratios on every hospital in the state. It is surely the intent of the bill to enhance patient access to high-quality care. However, H.B. 106’s effect on patient care would be more than counterproductive; it would be catastrophic to Pennsylvania patients, businesses, and communities.
Mandates do not create nurses. It’s unreasonable to assume that a mandate would bring enough nurses to the bedside, in the exact specialties and communities where they’re needed.
Instead, our state’s hospitals would face an impossible dilemma: Dramatically reduce the number of beds and services available or break the law and risk losing their licenses.
As a result, communities across the Commonwealth would see diminished health care access and a greater strain on emergency services, as well as longer wait times both in the emergency room and to schedule necessary appointments and procedures. In the worst-case scenario, these new mandates could force some hospitals to permanently close their doors.
Health care deserts can quickly become economic deserts. Hospitals support nearly a fifth of the Commonwealth’s gross domestic product and one in 10 Pennsylvania jobs. Longer waits and farther travel for care can translate into more missed time from work, job losses, and increased costs to patients and their employers. Reduced access to care makes communities less livable, hindering growth.
While these devastating effects would be felt statewide, providers in rural communities—where access to care is already limited and hospitals are struggling to attract the staff needed to maintain their services—would be especially at risk. These concerns are far from hypothetical. The appropriations fiscal note for H.B. 106 estimates that the seven state-owned hospitals alone would need to hire 500 more nurses to comply with the bill’s strict ratio mandates.
When the new staffing mandates for Pennsylvania nursing homes took effect earlier this year, LeadingAge Pennsylvania polled nearly 150 skilled nursing professionals and found that over one-third of respondents have reduced available beds due to staff shortages.
Over half of respondents have been forced to turn away patients transferred from hospitals, which means patients must wait in the hospital longer, and 83 percent said they are currently relying on nurses from temporary staffing agencies.
This is simply unsustainable.
As Pennsylvania ages, health care professionals and educators are retiring while the need for care increases. The workforce shortage is also partly a symptom of two concurrent phenomena: the ‘brain-drain’ of graduates and skilled workers from Pennsylvania and difficulties obtaining the certifications and licenses needed to work.
In response, Pennsylvania hospitals have taken extraordinary measures to better recruit and retain their workers, including pay raises, bonuses, schedule flexibility, loan forgiveness, and countless other incentives. Hospitals are also innovating with team-based care, virtual nursing pilots, and telehealth to reduce strain on care teams.
Additionally, Gov. Josh Shapiro and his administration recently took laudable action to allow nurses with multistate licenses issued by 40 other states and territories to practice in Pennsylvania. But we must do more.
Growing our state’s health care workforce will require forward-thinking public policies and sustained investments in expanding access to (and interest in) careers in health care.
HAP is advocating for policies that support students through educational assistance and invest in health care schools, educators, and clinical preceptors. Both of our organizations support meaningful regulatory reforms so that bureaucratic backlogs don’t keep nurses from the bedside.
As lawmakers consider how best to support Pennsylvania’s health care teams and patients, we urge them to reject ineffective mandates and focus on solutions that will broaden the health care workforce, protect access to high-quality care, and strengthen Pennsylvania communities.
Luke Bernstein is president and CEO of the Pennsylvania Chamber of Business and Industry.
Nicole Stallings is president and CEO of the Hospital and Healthsystem Alliance of Pennsylvania.