Long-Standing Health Care Measures Bite Dust, Advocates Ready to Try Again

Lilo H. Stainton | January 15, 2020 | Health Care
Legislation on staffing ratios in nursing homes, elective angioplasty — and others that once seemed destined for the governor’s desk — didn’t make it
Credit: valeoparde/Pixabay
Advocates made a last-minute push for several measures designed to address long-standing issues in health care.

The battle over vaccine exemptions may have absorbed much of the public — and political —focus in the waning days of the just-ended legislative session, but the bill to encourage more immunizations was not the only health care issue that failed to make it over the finish line.

The vaccine legislation was pulled from lawmakers’ agendas late on Monday, the last voting day, when it became clear the bill didn’t have enough support. Although plans to address several other long-standing issues did gain momentum in Trenton over the past year, none got as close to the finish line as the vaccine bill.

Hundreds of bills are introduced each year in Trenton, many with little fanfare and some never get any attention. But advocates made a last-minute public push for several measures designed to address long-standing issues that have significant impact on patients, local taxpayers, workers and hospital systems statewide.

They may not have made it to the governor’s desk for him to sign into law, but one thing is sure: Advocates already have pledged to keep these issues in play in the next legislative session, which began at noon on Tuesday.

Among these issues are:

S1612/A382: Dating back five years, this bill would establish minimum staffing ratios in nursing homes for certified nursing aides. Labor groups, like health care union 1199SEIU, argue that these direct-care workers are caring for greater numbers of patients than ever — with more challenging medical conditions  — a situation that endangers patient care and safety and puts workers at risk. (Nurses are also seeking staffing ratios in hospitals, which has also proved difficult.)

Last-minute press conference

The measure passed the Senate in 2018 and cleared an Assembly committee in June, albeit with amendments which labor said weakened the bill. The 1199SEIU organized a press conference last week featuring several CNAs to urge the Assembly to act and send the bill to Gov. Phil Murphy to sign into law. Union leaders said they had a pledge from Assembly Speaker Craig Coughlin (D-Middlesex) to post the bill, but he informed them recently it would not happen. Coughlin declined to discuss his decision.

“In our country, New Jersey starts 2020 with some of the worst staffing levels of primary caregivers in nursing homes. This status quo is unacceptable and morally irresponsible,” said Cheryl Roberts, a certified nursing aide and 1199SEIU leader. “We call on the Assembly leadership to reflect on the real human consequences of continued inaction for the seniors and people with disabilities who rely on 24/7 nursing care.”

S2427/ A3769: While the bill was only introduced in 2018, the concept dates back nearly a decade: changing how the state licenses hospitals that perform elective angioplasty, a lifesaving and lucrative procedure that currently is permitted by the state at 29 facilities in New Jersey. At least two dozen others also want permission to perform this process. (Angioplasty involves inserting a tiny tube into a patient’s artery to diagnose, and possibly treat, a blockage in order to reduce the risk of stroke or other complications.)

The bill would charge the state Department of Health with reforming the process and would require it to grant licenses to hospitals that demonstrate they have the training, equipment and capacity to do the procedure safely. The measure passed the Assembly with near unanimous support in May 2019, but was not brought up for a full vote in the Senate, despite last-minute advocacy by some hospital leaders eager to expand their work.

These leaders, aligned as the New Jersey Coalition of Community Hospitals, have argued that expanding access to the procedure would save lives, especially in underserved areas, both rural and urban. “This important legislation will enable more providers to provide lifesaving treatment at more locations assuring timely access for more New Jerseyans,” said Al Maghazehe, president and CEO of Capital Health, which currently can perform the procedure on a limited basis only. “It simply makes no sense to force patients to wait and travel to receive an elective procedure when they can get it done safely closer to home.”

Conflict with municipalities

S2642/A4013: These bills are among those that did not advance beyond introduction last session, even though the issue they seek to address has consumed local and hospital leaders in some communities for more than a decade. The measures sought to address how hospitals compensate municipal governments for the infrastructure and services they provide, with a schedule for contributions based on the facility’s number of beds, and a panel to study the issue long-term.

The concern became a statewide issue in 2015, when a tax court ruled Morristown Memorial Hospital had developed so many for-profit entities that it no longer qualified as a nonprofit that didn’t have to pay property tax. Since then, more than 40 nonprofit hospitals have faced legal challenges from local governments seeking to force them to pay property taxes, a situation that hospital officials said fails to recognize the economic benefit these facilities provide.

While lawmakers developed a similar solution in the years that followed, former Gov. Chris Christie vetoed the bills in 2016 and called for a commission to study it instead; he never appointed a commission. Hospital leaders have continued to push for a resolution under Murphy — including a last-minute effort last week — but they have yet to gain traction for it.

“Our hospitals and towns are expending resources on legal fees instead of using those resources to improve the care of our patients and promote better health in our communities,” said New Jersey Hospital Association vice-president Neil Eicher. “We are grateful for leadership in both the Assembly and Senate for taking up this issue and are looking forward to swift action in the new legislative session.”