By Mel Tanzman, Executive Director
On Wednesday March 19, 2014, members of Rochester ADAPT, a national disability rights group fighting for the rights of all people with disabilities to live in the community, initiated an occupation of the offices of the New York State Nurses Association in Albany NY. The reason for this action is because NYSNA opposes amending the NYS Nurse Practices Act to allow non-licensed attendants to perform health related tasks such as medication administration, ventilator care and assistance with catheter care, tube feedings, and administration of suppositories. The legislation the NYSNA is opposing would allow nurses to train and delegate tasks to advanced home health aides.
So what is really going on here? Why is ADAPT so committed to this legislation and why is the NYSNA opposing it? This is actually just the latest round in a struggle to remove institutional bias’ for long term care, and that would remove systemic barriers to people living independently in the community. Currently, the Nurse Practices Act requires health related tasks to be performed by a licensed nurse. The primary exemption to this requirement is for self-directed consumers or their surrogates receiving assistance under the Consumer Directed Personal Assistance Program. The problem is that this restrictive exemption does not allow the provision of these services by a non-nurse to people who are not self directed such as individuals with dementia or some forms of psychiatric and developmental disabilities. ADAPT has pointed out that this limit would still result in needless and unwanted institutionalizations. In addition, ADAPT points out that it prevents New York State from fully utilizing the new Community First Choice Medicaid Option to keep and return individuals to community settings, and can generate an additional $340 million per year in federal Medicaid dollars. One may ask: why is the Nurses Association opposed to this. Essentially, I believe that NYSNA and the nursing profession in general are trying to preserve their exclusive ability to perform these tasks, even though there are not enough nurses available in the community who can provide these services and the use of nurses is much more expensive. They claim to be interested in protecting the health and well-being of their patients. NYSNA issued a statement that included the following; “ NYSNA nurses believe that we can implement the CFC without gutting the Nurse Practice Act, which could endanger our patients in many settings where nursing care is delivered. We believe that we can address the concerns raised by ADAPT, and we are open to a fruitful discussion when we have completed our internal process”. Unfortunately, they seem to be asking the disability community to further delay the full implementation of CFC so they can symbolically preserve a Nurse Practices Act that frankly does not apply to today’s realties and the expectations of community living.
In my view, nothing should have a higher priority than independence, consumer choice, and the individual rights of people with disabilities to decide what are reasonable risks and how they will live their lives. People with disabilities are not being “protected” if they continue to languish in nursing homes where they develop bed sores, and opportunistic infections all under the supervision of licensed nurses. I respect and value the profession of nursing, however, no group should have the power to block the choices and free decisions of people with disabilities. No one should delay realization of civil rights promised by the Americans with Disabilities Act. If you agree, contact the NYSNA at Jill.Furillo@nysna.org and Assemblywoman Deborah Glick at Glickd@assembly.state.ny.us and ask that the Nurse Practices Act be amended to allow delegation of nurses duties. WDOMI supports ADAPTS in their efforts to “FREE OUR PEOPLE”.