Gov. Blagojevich signs new laws to reduce nursing shortages and improve quality of health care

CHICAGO - Delivering on a promise made during his State of the State address last February, Governor Rod R. Blagojevich today signed into law six bills that will help reduce the nursing shortage in Illinois and mean better access to health care across the state. Today's announcement comes on the heels of several administrative actions by the Blagojevich administration to help reduce the nursing shortage, including streamlining the licensing process for nurses, adding funding to the Nurses Education Scholarship Program, and increasing funding for training nurses and other health care professionals.

 

At Chicago's Mercy Hospital, the Governor signed Senate Bill 1842, which establishes a groundbreaking nursing externship pilot program for Puerto Rican nurses; Senate Bill 2064, which eliminates the pre-test exam for foreign nurses; and Senate Bill 201, which will increase patient safety and reduce the risk of errors by eliminating mandatory overtime for nurses.

 

The Governor also traveled to Herrin Hospital in Southern Illinois to sign Senate Bill 1626, which allows advanced practice nurses to perform school health exams; House Bill 876, which makes important changes to the advance practice nurse license encouraging advanced practice nurses in Illinois to increase their skills; and House Bill 399, which will allow for a pilot program to protect nurses, other hospital staff and patients from violence in state facilities.

 

"Nurses are the backbone of health care in this country. They perform exams. They study lab results. They work with doctors on treatment plans. As a patient, you know that the nurse is there to help," said Gov. Blagojevich. "But we have a problem in Illinois - we don't have enough nurses. We have to do everything we can to increase their numbers. That's why I'm signing legislation today that will help us recruit and retain these highly skilled professionals. Health care is a right, not a privilege. And being able to attract and keep the best nurses will make a difference in the long term picture of health care in Illinois."

 

According to region-by-region numbers put together by the Illinois Department of Commerce and Economic Opportunity (DCEO), the state currently has a nursing shortage of 7 percent (vacancies vs. jobs filled) and that shortage is projected to grow to almost 8,000 registered nurses and 1,200 licensed practical nurses (per year, projected through 2010).  Further, the number of potential caregivers, including nurses, is projected to decrease 4.2 percent, and the number of those who need care is projected to increase by 31 percent between 2000 and 2020.

 

"Because of Gov. Blagojevich's leadership and the overwhelming support of legislators, this was an incredibly successful year for nursing.  INA is pleased that Illinois government officials recognize the value of nurses in the delivery of health care services in Illinois," said Kathy Perry, PhD., RN, President, Illinois Nurses Association.  

 

SB 1842 establishes a first-in-the-nation externship program for registered nurses licensed under the laws of another state or territory of the United States who wish to practice in Illinois and are preparing to take the National Council Licensure Examination (NCLEX).  The law will allow these nurses, primarily from Puerto Rico, to work under the direct supervision of a registered professional nurse licensed in Illinois while they are enrolled in a course which prepares them for the state exam and acclimates them to nursing and health care delivery in our state. In conjunction with SB 2064, it will increase diversity within the nursing profession and prepare nurses educated in a U.S. territory for practice in Illinois.  The law, which becomes effective immediately, was sponsored by State Representative Cynthia Soto (D-Chicago) and State Senator Miguel del Valle (D-Chicago).

 

"Creating opportunities for nurses trained in U.S. territories will increase access to quality health care in communities across the state. Through the use of externships, we not only have more nurses working in Illinois, we can be sure they are well trained and fully qualified," said Rep. Soto.

 

"There is a critical need for health care providers sensitive to the needs of minority and immigrant communities in Illinois. By offering hands-on training at some of our State's finest institutions, we'll be able to offer new opportunities to nurses trained in U.S. territories and other states," said Sen. Del Valle.

 

SB 2064 will make Illinois more competitive in attracting new nurses.  It clears the way for nurses trained outside of the U.S. to enter the work force faster. Under prior law, these nurses had to pass not only the standard national nurse licensure exam (NCLEX) but also sit for a special test (CGFNS) to become licensed in Illinois.  With the CGFNS test only offered four times a year, it was virtually impossible for hospitals in Illinois to successfully recruit foreign trained nurses. The new law will maintain nursing quality because foreign nurses will still have to pass the national exam but will speed up their entry into the workforce. The act sponsored by State Senator Susan Garrett (D-Lake Forest) and State Representative Susana A. Mendoza (D-Chicago) becomes effective immediately.

 

"The elimination of the Commission on Graduate of Foreign Nursing Schools (CGFNS) examination is long overdue. This predictor exam has been a barrier to entry into nursing practice for the foreign-educated nurses. This law will help foreign-educated nurses experience a seamless entry into professional nursing practice in the state of Illinois," said Jean Lytle, Chicago Bilingual Nurse Consortium.

 

"With the signing of this critical measure, Illinois will be able to attract more nurses that we so desperately need," said Sen. Garrett.

 

"The opportunities for nurses in Illinois are almost limitless and I have confidence that this law will allow recent immigrants and other foreign-trained nurses to use their education and experience to care for those in need," said Rep. Mendoza.

 

SB 201 will also be critical in attracting more nurses to Illinois, and will greatly protect patient safety by reducing the risk for medical errors when staff has worked too many hours. The bill, which eliminates mandatory overtime for nurses, provides that hospitals may mandate a nurse to work overtime only in an unforeseen emergency circumstance. If they must do so, a nurse may not work more than 4 hours beyond her/his regularly scheduled work shift. In addition, a nurse may not be punished for refusing to work overtime, and if a nurse works 12 hours there must be an 8-hour rest period before working again.  The bill represents a compromise between the Illinois Nurses Association and the Illinois Hospital Association. State Representative Angelo Saviano (R-Elmwood Park) and State Senator Donne E. Trotter (D-Chicago) co-sponsored SB201.

 

"This law recognizes that mandatory overtime can put patient care at risk. It can also cause highly skilled nurses to opt out of working at hospitals where they are urgently needed," said Sen. Trotter.

 

"Too many nurses have faced the challenge of having to work unexpected overtime, often at the expense of family commitments or a much needed break from a stressful work environment. This law will ensure that the nurses on duty have their full attention to the job at hand and are not too tired to do their best work," said Rep. Saviano.

 

Among the bills signed by the Governor in Southern Illinois:

 

SB 1626 authorizes advanced practice nurses and physician assistants to, with proper supervision by a collaborating physician, perform health examinations for school employees and issue any certificates required for insurance and attendance purposes.  The law, sponsored by State Representative Susana A. Mendoza and State Senator Carol Ronen (D-Chicago), becomes effective immediately.

 

"As the primary care-giver in school-based settings, nurses are immediately qualified to authorize health certificates necessary for extended leaves of students and teachers. This new law gives them the authority to do so," said Sen. Ronen.

 

"This law recognizes and clarifies the responsibilities of school-based advanced practice nurses. As the health care professional with day-to-day contact with faculty and staff, it makes sense for nurses to have the authority to issue health certificates," said Rep. Mendoza.

 

HB 876 will encourage highly trained advanced practice nurses to stay in Illinois by making it easier for them to advance in their careers.  The law will enable advanced practice nurses to be licensed in more than one specialty without having multiple graduate degrees as long as they have the educational and clinical experience to be nationally certified.  This law, sponsored by State Representative Richard T. Bradley (D- Chicago), State Representative Angelo Saviano (R-Elmwood Park) and State Senator Carol Ronen (D-Chicago), is effective immediately.

 

"Illinois health care offers many opportunities for advanced practice nursing specialists. Now, nurses wanting to train in more than one specialty will be able to focus their studies on core curricula and clinical experience and will face fewer bureaucratic barriers to additional licenses," said Rep. Saviano.

 

"This law will encourage advanced practice nurses to learn new specialties by eliminating the need for some of the non-essential course work currently demanded in the licensing process. The need for advance practice nurses in a variety of specialties is urgent, and whenever we can speed up the process, we should do so," said Sen. Ronen.

 

HB 399, the Healthcare Workplace Violence Prevention Act, requires designated state facilities to create a 2-year pilot program to implement a violence protection plan and staff education program by July 1, 2006. After 2 years, a task force will evaluate the program. The measure, sponsored by State Representative Lou Lang (D-Skokie) and State Senator Debbie DeFrancesco Halvorson (D-Chicago Heights) becomes effective immediately.

 

"No health care professional should have to face violence at their workplace and this law establishes new programs designed to protect staff and patients from the potential of violence," said Rep. Lang.

 

"This law recognizes that violence in the workplace is not acceptable. Through the pilot programs at the designated facilities, we will be able to assess the best ways to ensure a nurse a safer working environment," said Sen. Halvorson.

 

The Governor has initiated several other steps to both retain nurses that are already practicing and bring more nurses to Illinois.

 

Critical Skills Shortage Initiative (CSSI) - In his State of the State speech, the Governor also made a commitment to address the shortage of health care workers through his Critical Skills Shortage Initiative (CSSI).  Eighteen million dollars is being invested statewide to ensure that every region of the state has a well-trained and equipped workforce in the health care industry.  Through an innovative approach that is currently being replicated by Indiana, Local Workforce Investment Boards, area employers, economic development professionals, educators and service providers are developing individualized strategies to address local employment needs and to get more health care professionals into the workforce. 

 

The Nursing Education Scholarship Program has increased its effectiveness with additional funding included in the reauthorization of the Nursing Practice Act, signed by Gov. Blagojevich in 2004.  The Act increased the percentage of license fees that are transferred into the scholarship program.  In 2006, there will be $1.2 million - an increase of $450,000 - to provide approximately 150 students with financial assistance to pursue an associate degree in nursing, an associate degree in applied sciences in nursing, a hospital-based diploma in nursing, a baccalaureate degree in nursing, a graduate degree in nursing, or a certificate in practical nursing. 

 

License Process Streamlining  - Through a coordinated effort by the Governor's Office, the Department of Financial and Professional Regulation (IDFPR) and the Illinois State Police (ISP), 800 nurse-licensing applications were reviewed and approved since the Governor's announcement in the State of the State address.  Since 2001, Illinois has required nursing professionals to submit to a background check as part of the application process.  A backlog of more than 1,800 applications had built up since the law was enacted.  Both IDFPR and ISP have developed comprehensive guidelines for dealing with licensed fingerprint vendors to ensure that backlogs do not recur in the future.

 

Today's announcement is part of Governor Blagojevich's long standing effort to make sure that more people get more health care and better benefits, protect coverage for those who have health care, and help hospitals, doctors and nurses provide better health care.  Specifically:

 

·                    Best in the nation for providing health care to the working poor:  Since Governor Blagojevich took office, 318,000 more men, women and children have received health care through the KidCare and FamilyCare programs - at a time when most states are not only not providing more coverage for the working poor, but also kicking people off of Medicaid or significantly reducing their benefits.  This year's budget included funding to add another 56,000 men, women and children.  The Kaiser Foundation has ranked Illinois the best state in the nation for providing health care to people who need it. 

 

·                    One of only a handful of states to protect Medicaid recipients: The budget signed by Governor Blagojevich a few weeks ago ensures - for the third consecutive year, despite facing budget deficits - that Medicaid recipients maintain their health care, unlike states ranging from Missouri to Tennessee to Texas to Washington who are either kicking people off of Medicaid or significantly reducing benefits. 

 

·                    First state to develop a statewide small business health insurance pool and program: Governor Blagojevich and the Chicagoland Chamber of Commerce are developing a small business health insurance program that will help small businesses reduce their costs by 10-15% and provide more health care for their employees.  Illinois will be the first state to create a pool where businesses of 50 employees or less can join, saving money on the negotiated rate, administrative costs and broker fees. 

 

·                    First state to make Rx drugs from foreign countries available: Under Governor Blagojevich, Illinois became the first state to allow its citizens to purchase prescription drugs from Europe, Canada, Australia and New Zealand.  More than 10,000 people have enrolled in the last few months alone to take advantage of lower prices (25-50% less) for over 120 name brand prescription drugs. 

 

·                    Most comprehensive state response to fill in gaps in the federal Rx drug benefit: This spring, the General Assembly passed the Governor's Leave No Senior Behind legislation, which is Illinois' response to the federal Medicare Rx drug benefit.  Because of the major holes in the federal program, the Governor's plan fills in the gaps, so Illinois seniors will not suffer the same fate as seniors in other states.

 

·                    First state to require pharmacists to dispense female contraceptives:  In April, Governor Blagojevich issued an emergency rule requiring pharmacists whose pharmacies sell contraception to dispense birth control to women with valid prescriptions.  The Governor's emergency rule will become permanent this summer.  In addition, the state has launched a new website to help women know which insurers now cover contraceptives, helping hundreds of thousands of women save an average of $400/ year on the cost of their contraceptives. Several of the leading prescription contraceptives are now also available through I-Save Rx with savings of up to 79%.

 

·                    Improving women's health programs: Governor Blagojevich created the Illinois Healthy Women program to provide health care to women who otherwise would go without.  To date, the program has served more than 90,000 women.  In addition, Illinois has dramatically increased the number of mammograms and cervical cancer screenings since Governor Blagojevich took office.

 

·                    Accessing nearly $2 billion in new federal health care money: Governor Blagojevich signed the hospital assessment legislation, which means nearly $2 billion in new federal funding for Illinois hospitals.  Last year, the Governor persuaded the U.S. Department of Health and Human Services to approve a plan that meant nearly $500 million in new federal funds for Illinois hospitals.  This plan, which requires federal approval but was constructed with their guidelines in mind, means more than three times that amount.

 

Medical Malpractice Reform: This summer, Governor Blagojevich will sign major medical malpractice reform legislation, which will reduce the cost of insurance premiums for doctors and stop doctors from leaving the state.  Governor Blagojevich helped pass the legislation despite his personal opposition to caps, because making sure that people have access to health care is probably the most important function government performs.