Coronavirus-related hospitalizations have increased as the number of staff licensed to treat such patients has steadily declined, leaving a healthcare system to crumble under a growing wave of COVID-19.
New Hampshire hospitals are operating at 91% of capacity, Department of Health and Human Services Commissioner Lori Shibinette said at a tax committee meeting on Thursday. Even that number is misleading, she said, as the remaining 9% of beds could be in pediatric wings or maternity wards that only accept a specific patient demographic.
She said hospitals were transferring people out of state, all the way to Connecticut and New York City, to find them available care.
Concord Hospital, which has 186 medico-surgical beds, currently has only three open beds. All members of the Dartmouth-Hitchcock health care system have reported “marked increases” in active COVID-19 cases and are ready to cut back or delay non-essential procedures if the flare-up continues to worsen, wrote Wednesday a spokesperson.
Now the state is looking to spend around $ 90 million to help.
Governor Chris Sununu last week signed an executive order that mandates the Department of Health, the Board of Nursing and the Office of Professional Licensing to find strategies to deal with a health system in crisis. Here are the ways in which the agencies plan to help under this decree:
Most of the state’s large hospitals are operating at full capacity, she said.
“It’s very different now than it has been for the past year and a half,” said Shibinette. “It’s kind of the point we didn’t want to get to …”
Most of the funding to address the health care crisis will go to clearing a backlog of patients, who are staying in hospitals longer than necessary while waiting for a bed to be opened in a long-term care facility.
Nursing homes and assisted living facilities – just like hospitals – face a severe shortage of registered nurses, forcing many homes to close beds or take entire units offline.
Waitlists for a nursing home bed can have hundreds of names, often forcing hospitals to use their coveted beds for patients who may be referred to a lower level of care.
The department will create eight “strike teams,” which will be made up of nurses, licensed practical nurses, paramedics and out-of-state paramedics who will be dispatched to long-term care facilities in across the state.
The hope is that the teams will increase the capacity of long-term care facilities that have empty, unstaffed beds. Shibinette said a handful of long-term care facilities have already expressed interest in reopening units that have been closed due to understaffing. The state expects teams to authorize the reopening of two major nursing home units.
The department will also announce a plan to allocate strike time to hospitals next week, Shibinette said.
In addition, the state plans to provide financial incentives for long-term care facilities and rehabilitation centers to accept older patients from hospitals. Rehabilitation centers would be paid at their normal rates to accept patients waiting in hospital from a bed in a long-term care facility.
The funding, if approved, will also be used to pay providers who take patients while their Medicaid eligibility is pending approval, who would normally wait in the hospital until nursing homes know that. their care would be compensated.
Shibinette said the ultimate goal of these programs is to achieve less than 80% hospital capacity, which it was before the winter outbreak of COVID-19.
Funding for these programs, which comes mostly from federal aid money, was unanimously approved by the Joint Legislative Tax Committee on Thursday and will now be submitted to Executive Council for consideration.
“We realize that the point of crisis is really our staffing,” he said. “We have the physical beds, we have the capacity, we don’t have the staff in the hospitals to handle the type of volume that we are receiving right now.”
The Nursing Council met on Thursday to find ways to speed up the nursing licensing process and send much needed staff into the healthcare system. O’Hearn was sent to the meeting on behalf of hospitals across the state to convey the urgency of the situation.
“From an intensive care perspective, we are overcapacity in most, if not all, hospitals,” he said. “Every day I have participated in this call and I have seen the situation become more and more perilous… If I leave you with the idea that this is a perilous position that we find ourselves entering , so it’s unfortunately a success for tonight.
The board has voted to allow future nurses licenses to practice in New Hampshire while their background checks are being processed. Lindsey Courtney, executive director of the Office of Professional Licensing and Certification, said high demand for background checks has delayed the approval of many nursing licenses – potential nurses typically wait two to three weeks for their verification. antecedents be processed by the Ministry of Security. .
“The demand for health care has increased dramatically, so a two-week delay is no longer acceptable,” she said.
Courtney said that, according to a recent report, there are 829 files under the Board of Nursing that need to be completed. She said 89% of those apps did not go through an FBI criminal background check and could not be authorized under existing requirements.
Courtney said it’s hard to say how many nurses this change will free into the workforce. Data on the number of pending licenses is mixed with abandoned and duplicate requests.
“The database is like the Atari version of a gaming system,” she said. “It’s just awful. “
Courtney said her office is working to refine the data and assess other legislative solutions, including a bill that eliminates background checks from the licensing process. Courtney said the requirement is redundant because most healthcare companies do background checks before hiring a new employee anyway.
The OPLC and the Board of Nursing will submit legislative and regulatory reform proposals to the governor by December 23.
“We just need the body,” Courtney said. “We’re dealing with licensing, but we just need more people. “