"Gov.-elect Schwarzenegger has not really said much of anything about health care," said Joanne Spetz, Ph.D., assistant professor at the UCSF Center for the Health Professions. "It's a wild card, really."

Members of Schwarzenegger's media team referred questions about health care and nursing to the governor-elect's Web site, www.joinarnold.com, but the site contains little information about health care and nothing about nursing. Transition team representatives said they could not provide further information because they did not yet have people in place who could answer specific questions.

Although nurses and health care policy experts said it was too early to tell how the change in leadership from Democratic Gov. Gray Davis will affect nurses and health care, they speculated on what the new governor might do based on his campaign statements, his previous political activity and his choice of members for his transition team. They agreed his priority would be the state budget, but how that might affect health care and nursing, they did not know.

"If he's not willing to raise taxes, there will be absolutely more cuts" in all state programs, Spetz said. "We'd be seeing that even if it were still Gov. Davis." But with Davis, she said, people had some idea which programs might be cut first. "With Schwarzenegger, we have no idea where he's going to go first."

Several nurses said Schwarzenegger's campaign speeches emphasizing his concern for children gave them hope he will preserve money for school nurses and programs such as Healthy Families, the state's insurance program for low-income children.

"I'm very optimistic," said Tricia Hunter, MN, RN, executive director of American Nurses Association\ California and president of the Government Relations Group, a lobbying organization. ANA\ C remained neutral on the recall election and did not support any candidate.

But Hunter said she personally supported Schwarzenegger and was impressed with his work on an initiative to set up after-school programs for children. She got to know him through that campaign, which ANA\ C supported, she said. "He has given a large amount of money and time to many charities that have to do with children and health care," Hunter said.

Although she had no inside track on what the new governor might do, Hunter said she believed he would do everything he could to preserve the Healthy Families program. "I can't imagine that cutting programs that impact kids is going to be anywhere on his radar screen," she said.

Roberta Williams, RN, PHN, a school nurse at Lawrence Elementary School in Lodi, did not support Schwarzenegger and voted against recalling Davis. But she said she hoped the governor-elect meant his statements about children and that his concern would show in his budget policies.

"The thing I heard him say loud and clear was that children are a priority," she said. "Obviously, the best thing [for school nurses] is a school nurse in every school. But I'm hoping to maintain what we've got."

Like Williams, Sacramento psychiatric nurse Dale Cohen, MSN, CS, RN, said she worried about possible budget cuts for programs already severely underfunded.

"I hope the new administration rallies to the cause of the seriously mentally ill, a very large group who may end up in our criminal justice system without needed support and services," said Cohen, past president of the California chapter of the American Psychiatric Nurses Association.

Other nurses said they would like Schwarzenegger to find some way to secure health care coverage for all Californians.

Many nurses expressed concern that Schwarzenegger's transition team appears to include no health care professionals. The biographies of the transition team listed on his Web site do not mention any members having direct experience in health care.

One transition team member, Charlene Zettel-listed in her biography as the public interest director of a San Francisco bank and two-term member of the California State Assembly-is also a dental hygienist, Hunter said. Hunter said she thought the team also would be getting input from health care experts in making policy decisions. She said she has received phone calls from at least five people on the transition team.

"There's not even a well-respected physician or someone from an academic medical center or the CEO of a major hospital or any of the people you might expect to be appointed by a Republican leader," said Beth Capell, Ph.D., a health care lobbyist for the SEIU.

Nurses are eager to see whether Schwarzenegger will continue to fund programs for nurse training and education.

Nurse educators also are concerned about the effect of budget cuts on the California Board of Registered Nursing's ability to oversee education programs, especially pre-licensure programs, said Mary Jo Clark, Ph.D., RN, associate dean of the Hahn School of Nursing and Health Science at the University of San Diego.

Several nurses talked about the importance of continuing support for science classes and other prerequisites in addition to nursing programs.

Contact Cathryn Domrose at kaguilar@well.com

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