  |
| |
|
Visiting nurses vie for funds January 28, 2004 Visiting nurses are hoping for an improvement of working conditions - after their profession received a nod in Gov. Pataki's state-of-the-state address, and as state officials negotiate a budget proposing big changes in health care financing. Pataki proposed comprehensive reforms in the state's long-term care system, saying "These efforts will provide the services that help the elderly stay in their own homes,where they've lived their lives, raised their children and built their memories." Already, however, the executive budget plan contradicts the ambitious policy. The governor has proposed that home health care agencies and hospitals pay a $35 million "sick tax" on revenue (a surcharge on providers). New York State United Teachers and other health care unions beat back a similar scheme last year. Unions are also reviewing the governor's Medicaid reform plan, briefly outlined in his executive budget. Cora Shillingford, a veteran visiting nurse in New York City, calls at-home medical care "nursing homes without walls" that allow people to stay in their own communities. "My biggest issue for my clients at home is to give them proper, quality care," said Shillingford, who chairs the Visiting Nurse Service of New York, a chapter of the United Federation of the United Federation of Teachers. "If we make jobs more respectful and less stressful, nurses would come back." In the executive budget, the governor's staff wrote, "The existing system is expensive, overly reliant on Medicaid and institutional care and it often difficult for consumers to access." The Visiting Nurse Service of New York has a recruitment and retention committee, facets that Gov. Pataki has said numerous times need to be improved. Among the issues that need to be addressed, Shillingford said, are:
"Our workload has gone up," Shillingford said. "Our float pool has dwindled because of the workload that is there when they get in." An assessment for a new client can take two to three hours, with 50 to 70 questions, she said. The initial visit requires education and administering medication. "When I first started, a new case required filling out three sheets of paper," she said, noting that visiting nurses now carry laptops. "In order to get a really good picture of a client, it takes time. You can't just sign like UPS." Visiting nurse agencies used to be reimbursed per visit; in recent years a Prospective Payment System has been in place, reimbursing per "episode of care" (e.g., post-op wound care, from start to finish, including supplies). Visiting Nurse Service of New York, which numbers more than 1,800, provides medical care to adult homes, assisted living homes, senior citizen housing, individuals and "naturally occurring" retirement communities - neighborhoods or housing projects where people have made their home for years. The service was founded 110 years ago by Lillian Wald, a nurse and union advocate. NYSUT also represents visiting nurses through its Capital District, Utica and Elmsford regional offices. - Liza Frenette |
|
| | |