Betsy Ryan is president and CEO of the New Jersey Hospital Association. Her blog, Healthcare Matters, examines the many issues confronting New Jersey's hospitals and their patients. Readers are encouraged to join the discussion, because healthcare matters - to all of us.

ACA Onlookers Hold Their Breath for Another Supreme Court Ruling

Two years ago, we all waited anxiously to see if the U.S. Supreme Court would uphold the constitutionality of the Affordable Care Act. The Supremes (as I like to call them) did uphold the law – but here we are again in 2015, waiting for another Court decision that could be historic in determining the law’s fate.

In King v. Burwell, the challenge involves one section of the 1,000-plus-page law dealing with the IRS, and it will determine if states that chose to use the federal government’s Web site to enroll people can offer those enrollees a federal subsidy to help pay for the insurance. New Jersey was among 37 states that chose not to establish their own exchange and instead rely on the “federal exchange.”

Most people agree that this was a drafting error in the law, but the Supreme Court will issue a decision within the next month that could determine if 203,473 New Jerseyans (out of 254,316 total enrolled on may continue to receive federal funding to offset the cost of the premium. This represents 83 percent of those enrolled in New Jersey. The Supreme Court decision could have a monumental impact on the ability of these individuals to afford health insurance.

The ACA evokes strong feelings in many, but no one can deny it has reduced the number of uninsured Americans in our country by about 11 million. It would be a shame to take a step backward and see that number creep back up.  I remain optimistic that the Supreme Court will view the law in its totality, listen to those that worked on the legislation and rule that the subsidies may continue to flow regardless of what type of exchange an individual used to enroll. Why should a New Yorker receive a subsidy but a New Jerseyan be denied, simply because of a technicality in where their exchange was rooted? It just doesn’t make sense.

Time will tell – about 30 days’ time to be precise, with the Court’s current session slated to wrap up at the end of June.

Written by Betsy Ryan at 00:00

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Nurses Week 2015: Ethical Practice, Quality Care

A number of recent reports have lauded New Jersey hospitals for the high-quality care they deliver. In the most recent example, our hospitals ranked fifth in the nation on The Leapfrog Group’s Hospital Safety Score.

New Jersey is also among the national leaders in the number of hospitals that have achieved the prestigious Magnet award for nursing excellence from the American Nurses Credentialing Center.

Coincidence? I think not. Nurses play an essential role in the quality improvement efforts under way in hospitals across our state.

Nurses are the eyes and ears on our patient units, and they hold invaluable insight into what works, and what doesn’t, when it comes to optimal patient care. Here at NJHA, our statewide quality improvement efforts are led by a nurse – Dr. Aline Holmes, RN, who recently earned her doctorate in nursing practice – along with several other nurses with various specialties. I am impressed every day by their knowledge not just of patient care, but of processes and policies that can make the healthcare system better. I’m so thankful to have them on our team. Working collaboratively with our member hospitals and post-acute facilities, they have helped New Jersey hospitals improve patient outcomes and reduce complications like infections and pressure ulcers. Empowered nurses deliver real results!

As we observe National Nurses Week, I can’t think of a better time to recognize New Jersey nurses for the vital role they play throughout our healthcare facilities – not just in hands-on patient care but in areas like quality and patient safety, ethics, patient education, community engagement and in executive leadership.

The theme for the 2015 observance of National Nurses Week is “Ethical practice, quality care.” It’s a short but very precise statement of the value that nurses bring to our healthcare system.

Written by Betsy Ryan at 00:00

Human Services Commissioner Jen Velez: A Passion for Public Service

The State of New Jersey is saying farewell to a wonderful public servant, with Department of Human Services Commissioner Jennifer Velez announcing today that she will step down from the post she has held for eight years. Human Services oversees the state’s Medicaid program and many other important health and social service programs. I’ve had the pleasure of working with Jen on many important issues, and I know she will be long respected for her hard work and commitment to the Department and – more importantly – to the disadvantaged residents of our state.

Too often people outside of state government throw stones at those in public positions, without fully understanding the constraints of state rules and regulations. I know, having served in state government myself. But Jen Velez is truly one of the most dedicated public servants I have ever met. I think her position is one of the toughest jobs in Trenton, and she has done it with integrity and with a true passion for service. Even though her home is far from Trenton, she put in many late nights trying to manage one of the largest departments in state government.  She “gets it” from every level.  She understands the impediments to making things happen and has always gone the extra mile to help the people who rely on DHS. She truly cared about every aspect of her job and her department, and all of the people out there served by DHS.  She will certainly be missed in Trenton, but I am very much looking forward to continue working with Jen in her new role at Barnabas Health.

Written by Betsy Ryan at 00:00

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Hire a Veteran and Your Workplace Will Benefit

I’ve worked in a number of different places and have even been the boss at a few of them. And I can tell you that few things have brought more “feel-good” spirit to a workplace than NJHA’s hiring of 25 U.S. veterans last year.

These smart and dedicated men and women have served our country at home and abroad. And today, they’re on a new mission as “Certified Application Counselors.” Their job is to help uninsured New Jerseyans navigate the healthcare marketplace and sign up for health insurance under the Affordable Care Act.

It is a job they have taken on with energy, commitment, good humor and a great esprit de corps. They really care about this mission, but most importantly, they really care about the people they are helping. One of our CACs helped a woman who was ready to halt her cancer treatments because she had lost her health insurance; he quickly guided her through the online Health Insurance Marketplace and helped her find coverage under another plan. Several of our CACs were on the ground in Atlantic City to assist the thousands of casino workers who lost their jobs.

All told, our CACs have reached nearly 60,000 New Jerseyans in the past year with information on their health insurance options. They’re now gearing up for Nov. 15 – the start of the ACA’s next open enrollment period.

For the rest of us working at NJHA, this program has made us feel good, plain and simple. We’ve helped people access healthcare. We’ve supported our veterans. And we’ve welcomed some wonderful new co-workers like: 

  • Norm Glover of East Windsor, who served in Vietnam and who remains active with the Military Order of the Purple Heart
  • Piertus Esperience of North Brunswick, who not only served two tours in Iraq with the Marines but also served a tour in Afghanistan with the Army. He and his wife recently welcomed their second child.
  • Hilda DeMello of Edison, a Navy veteran who now serves as one of our CAC team leaders.
  • John Rodriguez of Bayonne, an Army veteran who served in Operation Iraqi Freedom.
  • And Fred Kariuki of Phillipsburg, who grew up in Kenya and later became a U.S. citizen and joined the Air Force. He continues to serve in critical missions as a member of the Air Force Reserves.

I would love to list each one of our CACs but suffice to say that every one of our veterans has a legacy of service.

NJHA is fortunate to have these dedicated individuals on our side, not just on Veterans Day but every day. So to them and to all the veterans out there, thank you for your service.

Written by Betsy Ryan at 00:00

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Here’s How We’re Preparing for Ebola

Let me take an opportunity to share some thoughts on Ebola. It’s on all of our minds – and certainly has been at the top of every newscast. The nation is worried.

But I would urge everyone to take a deep breath and keep some perspective. The flu kills more than 20,000 people in the United States in an average year – about four times more than the number of Ebola deaths in this outbreak. I’m only noting those numbers to make the case that worrying about Ebola is understandable, but panicking about it is not.

NJHA and New Jersey’s hospitals have been gearing up for weeks as they have watched Ebola spread in West Africa. Fortunately, New Jersey has no known cases of Ebola at this time.

Ebola is not an airborne disease. It can only be spread through direct contact with the bodily fluids of an infected individual. And an individual with Ebola isn’t contagious unless that person is showing symptoms. But Ebola, especially in its advanced stages, can be very contagious in direct contact situations. That’s why isolation precautions and personal protection for healthcare workers is so important.

Our hospitals are on high alert to watch for a potential Ebola case that could come to their facilities and to take immediate action to isolate that individual and implement full precautions to protect their staffs and their communities.

To that end, our hospitals have reviewed all appropriate policies and protocols; identified areas in the hospital that would be used for patient isolation; inventoried supplies including personal protective equipment for employees; and provided training and best practices to staff on patient identification, isolation, infection prevention and use of protective suits.

In addition, NJHA has joined with the state Department of Health in strongly encouraging all New Jersey hospitals to conduct Ebola drills in their emergency departments by Oct. 17. We have been in near-constant contact with the state’s public health officials since Ebola arrived in our country, and we appreciate that access and collaboration. In an emergency response, it’s important that we’re all working from the same playbook in protecting our patients, our healthcare workers and our broader communities.

And speaking of healthcare workers, I want to send a most heartfelt thank you to the nurses, physicians, laboratory workers, EMS personnel and others who have chosen a career of caring for others – even if that care could place them in harm’s way. Not only in this situation, but every day, they put their well-being at risk for all of us.

This Ebola situation is changing every day, every hour in fact. But each new development helps our healthcare system improve its preparedness. Public health officials have learned a great deal from the situation in Dallas, and lessons learned from that initial experience will be used to make our response better – and safer – for both our patients and our staff.  Every acute care hospital in the state has the responsibility to be prepared to care for an individual with this virus – and that’s a role we take very seriously.

Written by Betsy Ryan at 00:00

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