New York health workers stand ready to work with the state Legislature to address the health care staffing shortage, but said Tuesday the state Health Department's inaction in enforcing a safe staffing law passed in 2021 is one of the main factors driving staff from the workforce.

It's been nearly a year since the state law setting minimum staff-to-patient ratios in health facilities took effect, which require New York hospitals to establish staffing plans and improve patient care. The law directs health workers to file complaints to the state Health Department about facilities in violation of their staffing plan. The department is supposed to impose fines or consequences on facilities that fail to make corrective actions, but has not done so to date.

Michelle Crentsil, political director of the New York State Nurses Association, says the organization's 40,000 members from across the state have filed many violations to the state Health Department, and unsafe staffing conditions have gone unchanged. 

"The Department of Health is still sort of going through those violations and trying to ascertain which ones can be sustained," Crentsil said Tuesday. "But our members are working every day. They're working short. They're telling us this, they're filing the violations, they're filing the complaint with the state and they need the state to support them."

Recent reports show the department has received thousands of complaints.

Health Department officials Tuesday said the department has contacted facilities at the source of the complaints, and hospitals are required to submit a corrective action plan to be in compliance with state health law.

"As this may be the subject of an ongoing investigation, we cannot comment further at this time," DOH spokeswoman Danielle DeSouza said in a statement Tuesday.

The department did not answer questions about the number of facilities are under investigation, how long facilities have to submit the corrective action plan, or how many have submitted a plan. 

New York has roughly 394,000 licensed registered nurses — an 11% increase from last year — but the uptick has done little to ease the statewide health staffing crisis with just under half of registered RNs working in patient care. 

Health care workers at an Assembly hearing in New York City on Tuesday told lawmakers health staff will continue to leave if the issue is not addressed.

Crentsil said the Health Department's failure to implement the law hurts the industry's recruitment and retention of staff — forcing them to serve patients in a way that is medically unsafe.

"Some folks call it moral injury when you go to do your job and your job is to provide the best quality care that you can for this patient, and you know that that day, you couldn't because you were understaffed," she said.

Kerry Larkin, a registered nurse and member of CWA Local 1104, testified to lawmakers Tuesday health workers in the state are often forced to choose between leaving patients soiled in their beds, or holding a tube in place to save another patient's life.

They said patients have started taking notice.

"They're now speaking to it and telling us, which feels awful, but also [it]s almost like we are on the same team. We apologize to them and they're now noticing," Larkin said, adding they tell her: "'It's not your fault. You can't, you're doing the best you can.'"

Workers say being forced to make a difficult moral choice when they were trained to maintain a higher standard of patient care often forces them to leave the field.

Assembly Health Committee chair Amy Paulin asked many panelists for their stance on New York joining the multi-state nurse licensing and medical licensure compacts that most other U.S. states participate in to aid in the national health staffing crisis. But opponents, like NYSNA, are concerned allowing health professionals licensed in other states to practice in New York will reduce the state's standards of care and place additional burdens on existing staff.

As the demand for health care in New York increases, state officials are looking for ways to be creative to recruit, retain staff and meet the need.

Panelists during the hearing also said the Legislature must reduce costly regulatory practices, like repealing the COVID-19 sick leave statute, and make nursing programs more affordable.

Others like Health Care Association of New York State President Bea Grause pushed for more funding for facilities, as many health care providers across New York remain in perilous financial condition.

"Health care is people taking care of people, but it also requires sustained investments in infrastructure, technology, drugs and much more," Grause said. "As I have often said, nobody wants yesterday's health care, even today's health care. We want to build the health care system for tomorrow."

The fight to increase Medicaid reimbursement rates and a proposal to largely push out private insurers from the program is expected to be one of the tensest battles in the next state budget.

"Medicaid pays just 70 cents for each dollar of care provided and for nursing homes, Medicaid payments average, 76 cents for each dollar in 2019, and rates have fallen farther behind since then," Grause said. 

She urged the Legislature to make a multi-year commitment to close the Medicaid funding gap for hospitals and nursing homes.

"Adequate reimbursement from all payers is essential to retaining our workforce, sustaining the services our patients rely on and investing in the modern facilities and technologies we need to address current and future health challenges," Grause said.