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Upstate NY hospitals facing some of worst financial, workforce challenges ever

Upstate New York hospitals are experiencing some of the worst financial and workforce challenges they’ve ever faced. The Iroquois Healthcare Alliance (IHA), a regional healthcare trade organization representing over 50 hospitals and health systems, is urging policymakers to invest in and adopt key policies to support these hospitals.


IHA has been meeting with policymakers for months to convey the needs of Upstate and rural hospitals as negotiations enter the next phase. Last year’s budget included a great deal of hospital supportive funding, including the Upstate Directed Payment Template (DPT) Program/Enhanced Safety Net Program, which has been a useful program for IHA members. IHA is calling on policymakers to increase available funding for this program and ensure that a fair share of that supportive funding be specifically designated for Upstate Hospitals and Health Systems.

Additionally, IHA is urging the investment in and adoption of key policies to address staffing challenges and safety net hospital support. The staffing crisis in Upstate has continued unabated, with vacancies continuing at rates 2.5 times higher than pre-pandemic years. The average number of vacant positions in CY 2022 was 11,188, and the average vacancy rate among all reported positions was 15.2% compared to 6% at the end of CY 2019. The average vacancy rate for registered nurses was 19.5% in CY 2022. IHA commends the Governor for including measures in the budget to increase transparency of staffing agency practices with the goal of remedying dependence on their services.


In terms of safety net hospital support, IHA is calling for any discussion of fundamental changes to funding streams for safety net hospitals to not exclude Critical Access Hospitals (CAHs) or Sole Community Hospitals (SCHs). Excluding them from any safety net proposals would be bad policy, according to Gary Fitzgerald, President and CEO of IHA.

Finally, IHA is advocating for the state to invest in a permanent Upstate Healthcare workforce recruitment and retention fund. This fund would support education and pipeline programs to supply the next generation of health care professionals. IHA believes that investment into health care is investment into economic development, and that supporting the functionality of hospitals is critical to ensure the vitality of new economic opportunities.

The fall-out of the pandemic is deep-rooted and unremitting, and hospitals need financial, program, and capital support in this year’s budget to continue operating at the level demanded by their communities. IHA urges the Legislature and the Governor to provide Upstate and rural hospitals with the critically important support they need.