Just how bad is the state’s nursing shortage?
So bad that the Los Angeles County Board of Supervisors, in an effort to attract more nurse anesthetists to county hospitals, voted this month to hike the amount paid to the registries that supply them $130 an hour for the night shift, a jump of up to 37 percent.
Registries provide nurses who work on a casual basis to fill in for permanent staff. The nurses typically get two-thirds of the billing charge, with the cost of a full-time equivalent nurse-anesthetist at $270,400 per year.
The board’s move drew squawks from the Service Employees International Union, which has been seeking a new contract for the county’s permanent nurse work force. Union officials say that a generous contract would attract permanent nurses at a lower cost, but county officials say that with or without a contract, they would still need higher-cost registry nurses.
Jan Emerson, a spokeswoman for the California Healthcare Association, the state’s hospital trade group, said the supervisors’ action typifies the problems all hospital administrators face as they try to deal with an acute nursing shortage.
“The hospitals would love to hire those nurses but they can’t find them,” said Emerson. “We don’t have enough nurses in the state.”
The nursing shortage was the key reason cited by Gov. Arnold Schwarzenegger in relaxing California’s landmark nurse staffing law that sets minimum nurse-to-patient ratios.
Hospitals administrators complain that the shortage makes it impossible for most facilities to comply with the law. The governor took action on specific trouble spots for the industry: requiring fill-ins for nurses on short breaks and requiring compliance even when emergency rooms are hit with a flood of patients. The governor also delayed a further tightening of the law that was set to go into effect this January.
The state’s Office of Administrative Law upheld the emergency action on Nov. 12 for the next 120 days, but now the state must consider public comment on the matter.
The California Nurses Association, which sponsored the law and contends it has helped attract nurses to California, is planning a Dec. 1 rally at the state Capitol. It’s also considering legal action.
“We clearly hold the governor and the hospital industry responsible for putting patient safety at risk,” said CNA spokesman Charles Idelson. “There are consequences for these actions.”
The Southern California Biomedical Council is out with its list of award winners from the National Institutes of Health, and L.A. County-based institutions grabbed 11 of the top 20 spots in Southern California, capturing $751 million in grants out of $810 million awarded countywide.
But San Diego, with its growing commercial biotech industry, was awarded more money in total $1.14 billion. (Two out of every three dollars awarded by the NIH in California came to Southern California.)
Leading the list for Los Angeles County was UCLA, which was awarded $347 million, placing it third of all recipients in the state, behind the University of California at San Francisco and Science Applications International Corp., a San Diego firm.
Other L.A. institutions in the top 20 include USC, Caltech, Rand Corp., Childrens’ Hospital Los Angeles and Cedars-Sinai Medical Center.
Ahmed Enany, executive director of the Southern California Biomedical Council, said the study shows how San Diego’s thriving biotech sector also supports fundamental research. “The more you engage in commercial research the more doors it opens,” he said.
Mid-size employers seeking relief from the relentless rise in health insurance premiums have another option from Word & Brown Insurance Administrators Inc., the administrator of the popular CaliforniaChoice defined contribution plan for small employers.
CaliforniaChoice, which had only been offered to businesses with up to 50 employees, is now being expanded to employers with 51 to 199 employees.
The program allows companies to pay a monthly fee to offer a variety of benefit plans from three separate insurers. Employees can choose between packages with varying contribution requirements, including bare-bones plans with no contribution.
Critics say defined contribution plans are inferior to traditional insurance arrangements, but supporters say they provide an opportunity for smaller business to provide at least some health benefits when many do not.
“For employers this means a better way to control costs and be able to continue to offer affordable healthcare coverage to their workforce,” said Ross Goldberg, a spokesman for Orange-based Word & Brown, which has 150,000 covered lives for its California Choice product.
Specialty Laboratories Inc. took another step in its recovery with an agreement to be one of three reference laboratories to provide services to Premier Inc., one of the nation’s largest group purchasing organizations, with 1,500 hospitals and other participants. Management of the Santa Monica-based laboratory, which focuses on providing sophisticated testing services, said the two-year agreement that starts Jan. 1 “signals Specialty’s renewed position as a major national provider of specialized reference testing.” Specialty’s stock and earnings went into a nose dive in 2002 after it lost a major customer and ran into quality control problems with state and federal regulators.
Staff reporter Laurence Darmiento can be reached at (323) 549-5225, ext. 237, or at