Health Care Access

All across the country, health care costs are sky-rocketing and services are quickly being priced out of the reach of many.  Each year, Americans are seeing double-digit increases in the cost of health care.  More than 46 million are uninsured and increasing numbers of working families are losing their employee-sponsored health care coverage.

Will you support federal legislation that provides accessible, affordable, quality health care for all citizens?  Yes___X__No_______

Comments: I supported and applauded the passage of health insurance reform last month that expanded quality, affordable care for 30 million Americans. While not perfect, the bill will make major improvements in our health care system by slowing the skyrocketing health care costs that are crippling middle-class Ohio families, extending coverage to 30 million uninsured Americans, and providing strong consumer protections that hold insurance companies accountable for bad practices.

Will you support federal legislation enabling states to enact comprehensive health care reform? Yes_____X_______No__________ Comments While I supported the federal health insurance reform legislation that was passed in March 2010, I also realize that it was imperfect. States should be allowed to enact legislation that would make the measures in the federal legislation even stronger, which could include, for example, the public option.

According to the Institute of Medicine studies and other studies, disparities based upon a variety of factors, exist nationally in the delivery of health care services.   A series of articles in the  Cleveland Plain Dealer explored this issue in Ohio.

What strategies would you pursue to eliminate health care disparities that exist in our diverse population? The passage of federal health insurance legislation last month, which I supported, took major steps to begin eliminating health care disparities. For example, the legislation included tax credits for small businesses that provided health care coverage, created a high risk pool for those who are uninsured and unable to get coverage due to a pre-existing condition and expanded the Medicaid program for those who cannot afford health insurance.

The Nursing Shortage

A fundamental shift has occurred in the nursing workforce over the last two decades.  As occupational opportunities for young women and men have expanded, and working conditions have deteriorated, the number of young people entering nursing has declined.

The lack of young people in nursing has resulted in a steady and dramatic increase in the average age of the US nurse.  For instance, the average age of the working RN is over 43 years.  By 2010, approximately 1/3 of nurses are expected to retire and the total number of nurses in American and in Ohio will begin a steep decline.

At the same time, the need for nursing services is expected to increase.  The demand for nursing care is expected to balloon over the next 20 years, due to the aging population, advances in technology and various economic and policy factors.  This demand, coupled with imminent retirement of today’s aging nurse, will create severe stresses on the health care system.

Due to the critical problems of understaffing and the use of mandatory overtime in many hospitals, a staggering number of nurses are leaving for other less stressful jobs or retiring early.  This has created a nursing crisis in our nation’s and state’s hospitals and other health care facilities.  The Institute of Medicine has issued a number of reports highlighting the almost 100,000 deaths, in our nation, each year from accidental errors and the importance of working conditions, including adequate staffing, in ensuring patient safety.  There is also clear evidence that as levels of nurse staffing rise, the quality of care improves and the number of medical errors decreases.

Would you co-sponsor legislation to help increase the capacity in schools of nursing?  Yes___X_____ No___________________ Comments__________

What strategies would you pursue to eliminate unfavorable working conditions such as mandatory overtime and work related injuries? Comments Mandatory overtime is one of the main problems arising from a shortage of nurses in the workforce.  Improving staffing standards is closely tied to this issue and we need to increase capacity at our academic institutions, and provide incentive programs to recruit new nurses.  Unless we bring new nurses into the workforce, as our mature nursing workforce begins to retire, the problem of mandatory overtime and the resulted work-related injuries will only get worse.

What strategies would you pursue to improve safe nursing staffing levels in health care institutions? Comments As we know, the nurse staffing shortage is increasing and expected to peak in the next ten years. The shortage has an undeniable negative impact on patient care. I believe that in order to improve safe nurse staffing levels that protect both the patients and the nurses, we must increase funding for incentive programs like the Nursing Scholarship Program and increase funding for the Nurse Education Loan Repayment Program.  Additionally, I believe we must increase capacity and funding for nursing education programs.  One of the biggest problems for nurse staffing is the fact that we have an aging nurse population and a lack of capacity in our educational institutions to train the next generation of nurses. Nursing programs need additional capacity, which means more faculty, more physical capacity, and more funding.

Will you support and co-sponsor legislation that will help establish nursing home staffing standards and improve the quality of care in nursing homes? Yes____X_____No___________

Comments With approximately 25% of licensed practical  nurses working in nursing home settings, ensuring a safe environment for nurses, and their patients, is critical.  I would support legislation that will improve staffing in nursing homes in order to alleviate unfair employment practices and ensure that the workplace is safe and providing quality care to patients.

Services of APRNs

Advanced practice registered nurses (APRNs) are registered nurses (RNs) who have attained advanced practice expertise in the management of health problems.  An APRN holds a graduate degree with advanced academic and clinical preparation beyond that of a registered nurse.  Most APRNs have extensive practice experience as RNs prior to entering graduate school.  APRNs provide health care for individuals across the life span.  Practice areas include, but are not limited to anesthesia, family, gerontology, pediatrics, midwifery, women’s health, neonatology, adult health, and mental health.  Their practice locations include but are not limited to, hospitals, clinics, long term care facilities, public health facilities, educational settings, and occupational health settings.  Federal and state laws, and policies of various third party payors frequently limit reimbursement for APRN services.

If elected, would you support requiring insurers to cover all services that APRNs are legally authorized to perform?  Yes__X____ No_______

Comments_________

What opportunities have you had in working with nurses on issues or legislation impacting nurses and/or health care?

Comments: In 2007, I was proud to join Governor Strickland in announcing that the state minimum wage increase from $5.15 per hour to $6.85 per hour applied to home healthcare workers. In addition, I supported Governor Strickland’s decision to sign an executive order that gave home child and health care workers the right to organize in July 2007.

I also supported President Obama’s proposed budget for FY 2011, which includes $169 million in funding to place doctors, nurse practitioners, and dentists in medically underserved areas to improve access to needed health care services. In June 2009, I wrote a letter to the chairs of the Senate committees that had jurisdiction over health insurance reform to urge, among other things, that they include scholarship and placement programs for nurses and doctors in underserved rural and urban communities in order to ensure that all Americans receive the care they deserve.