Tag Archives for Senior Agenda of RI

Shortage of direct care professionals a local and national concern

Published in RINewsTdoay on April 22, 2024

Last week, at  the Senate Dirksen Building, Room SD-562,  Chairman Bob Casey, of the U.S. Special Committee on Aging, (D-PA), showcased S. 4120, legislation that he introduced with U.S. Senators Tim Kaine (D-VA), and Tammy Baldwin (D-WI). The Long-Term Care Workforce Support Act, introduced during the 118thCongress, would ensure that direct care professionals have a sustainable, lifelong career by providing substantial new funding to support these workers in every part of the long-term care industry, from nursing homes to home care, to assisted living facilities.

The Senate Aging Committee details a number of statistical findings showing the need for Congress to address the nation’s severe ongoing direct care professional workforce shortage. “A recent survey revealed 92% of nursing facility respondents and nearly 70% of assisted living facilities reported significant or severe workforce shortages.

In 2022, a survey of nursing facilities showed more than 50% of the facilities were limiting the number of new admissions due to staffing vacancies or shortages.  Another recent survey of Home and Community Based Service providers showed that all 50 states were experiencing home care worker shortages, and 43 states reported that some HCBS provider groups have closed due to worker shortages,” says the fact sheet.

Addressing the cause

By improving compensation, benefits, and support systems, S.4120  would ensure the United States has a “strong, qualified pipeline of workers to provide desperately needed care for older adults and people with disabilities.” notes a statement announcing the introduction of Casey’s legislative proposal.  

Specifically, S. 4120 would increase the number of direct care professionals, especially in rural communities.  It also would provide pathways to enter and be supported in the workforce for women, people of color, and people with disabilities.

S. 4120 would also improve wage compensation for direct care professionals to reduce vacancies and turnover.  It ensures that direct care professionals are treated with respect, provided with a safe working environment, protected from exploitation, and provided fair compensation.

The legislative proposal also documents the need for long-term care, identify effective recruitment and training strategies, and promote practices that help retain direct care professionals. It also would strengthen the direct care professional workforce in order to support the 53,000,000 unpaid family caregivers who are providing complex services to their loved ones in the home and across long-term care settings.

At press time, S. 4120 is endorsed by 50 organizations, including Domestic Workers Alliance, SEIU, AFSCME, Caring Across Generations, National Coalition on Aging (NCOA), Justice in Aging, National Partnership for Women & Families, National Council on Independent Living (NCIL), and the National Disability Rights Network (NDRN).

And a companion legislative proposal was introduced in the House by Congresswoman Debbie Dingell (D-MI).

Senate Aging Committee puts spotlight on Direct Care Staffing Shortage 

The April 16th hearing entitled, “The Long-Term Care Workforce: Addressing Shortages and Improving the Profession,” examined the challenges currently facing long-term care workers who are often underpaid and overworked, leading to widespread worker shortages that threaten the availability of care for those who need it.  

“It’s a crisis that stems largely from a lack of support for and investment in our caregiving workforce,” warns Casey in his opening statement. “Between 50 to over 90 percent of long-term care settings and providers report significant staffing shortages, affecting their ability to provide services, accept new clients, or even to remain open,” he says.

Casey noted that many direct care professionals have to work multiple jobs or overtime just to be able to support themselves and their families.  In 2022, their medium wage was just above $15 dollars an hour, well below what is paid for warehouse and convenience store jobs, per Casey.

“The direct care workforce, the majority of whom are women of color, are more likely to live in poverty compared to the general public,” notes Casey.

“Cumbersome federal regulations, requirements, and protections” and a “one-size fits all approach” won’t fix the direct care staffing shortage, responds Ranking Member Mike Braun (R-IN).

“To grow the long-term care workforce, the federal government should make it easier for people to enter by removing barriers,” says Braun, in his opening statement, calling for “productive approaches to build and grow the care professions.”

Overworked and not enough money

Nicholas Smith, a direct support professional at SPIN, a Pennsylvania-based organization that provides lifespan services for over 3,000 people with intellectual disabilities and autism, came to testify. “I work nearly 65-70 hours a week… due to my work, I have missed family events, nieces’ and nephews’ recitals, and school functions… a lot of people are leaving this field to make more money,” said the Philadelphia resident who has worked in the long-term care industry for over 25 years.

According to Smith, the national average for direct service professional wages is only $15.43 in long-term care. “We spend time training new hires only to lose them because they cannot make a living wage,” he says, noting that other industries are offering more money.

“While people want to stay in this field, they cannot make ends meet. Pennsylvania has a long waitlist for home and community-based services, and this is due to the workforce crisis,” he says.

In her testimony, Brooke Vogleman, a licensed Practical Nurse with Huntington, Indiana based TLC Management, stated:  “I’ve seen what happens when long-term care facilities lack workers, resources and government support, like during the pandemic. Many of my colleagues got burned out and left the profession, forcing facilities to rely on costly temporary staffing agencies.”

Vogleman called on federal policy makers, including members of the Senate Aging Committee, to address the challenge through “targeted investments, not blanket mandates.”  

For instance, she told the Senators that LPNs are integral to the facility’s interdisciplinary team. “Staffing mandates that do not include our contributions to patient care or recognize us as nurses are very concerning to me and will have unintended consequences on residents,” she says.

Staffing mandates will force facilities to depend more on expensive staffing agencies, warns Vogleman. “Personally, I’m concerned they will actually increase staff burnout, as current caregivers will be stretched thin and working longer hours in order to comply with these impossible standards,” she says.

Matthew Connell, Ed.D., of Ivy Tech Community College of Indiana, came to share the work and achievements of his community college in addressing the shortage of healthcare and long-term care workers in Indiana.

According to Connell, serving more than 190,000 students at 19 campuses and 26 satellite locations as well as on-line, graduates more associate level nurses in Indiana.  Nearly half of these students are pursuing college credit while in high school. Ivy Tech is the nation’s single largest provider of dual credit.

Ivy Tech’s programs are especially designed to help graduates enter the workforce quickly and provide critical services for the state’s long-term care population at a tuition rate that is the lowest in the state, he notes. “One in three Registered Nurses [in Indiana] is an alum. More than 90% of its nursing graduates choose to remain in Indiana, working in hospitals and care settings,” he adds.

The last witness, Jasmine L. Travers, assistant professor at New York University’s College of Nursing,  concisely summed up how to fix the nursing shortage.  She suggested: “To improve access to and quality of long-term are, we must ensure that all direct care workers receive a living wage, a safe, respectful work environment, opportunities for advancement, adequate training, and accessible benefits to maintain their health and well-being.  Only when we recognize that these workers are critically important, hardworking processionals, can we begin to improve equity and health outcomes for staff and patients alike.”

Putting the spotlight on Rhode Island’s Direct Care Staffing Shortage

According to John E. Gage, MBA, NHA, President & CEO, of the Rhode Island Health Care Association (RIHCA), the Covid-19 pandemic had a dramatic impact on the healthcare sector across the country and especially in Rhode Island, and a disproportionate impact on nursing facilities. On a national level, in February 2020 nursing facilities workforce totaled 1,587,000. Today, it is 1,462,800, down by 124,200 or 7.8%. In Rhode Island, it is more dramatic. Pre-pandemic RI nursing facility workforce was 9,797 (2/2020). Current BLS data shows the most recent number of workers in RI nursing facilities is 8,300 – down 1,497 workers or 15.3%.  This is just about double the rate of loss of workers post-pandemic in RI compared to the national statistics.

“There are some local efforts to attract workers back to RI nursing homes,” says Gage, noting that there is a need to be laser-focused on workforce development efforts. 

Gage calls for RI Medicaid to increase reimbursements to nursing facilities to cover today’s actual cost of care, not on facility costs from 2011 (13 years ago!) with minimal average inflationary increases in the 11 years since the price-based reimbursement methodology began in 2013.  According to Gage, RI nursing facilities need an adequate, sustainable reimbursement system to foster continued high-quality care and services and provide nursing home with rates that enable them to retain current workers and recruit more caregivers.

RIHCA, a non-profit trade association representing more than 80 percent of the nursing homes in the state, and its parent organization, the American Health Care Association (AHCA) support the legislative efforts of Senator Casey’s Long-Term Care Support Act. “We support all efforts to increase Medicaid rates to enable facilities to regain and grow their workforce – both direct care and ancillary staff, to enhance the quality of care and quality of life for our nation’s and RI’s most frail elder citizens today and for the years ahead,” he says. 

“It is heartening to see the Senate Committee on Aging and leading members of Congress addressing the care worker crisis in long term care including supporting our many thousands of unpaid caregivers who provide a significant portion of long term supports and services,” says Maureen Maigret, policy advisory of the Senior Agenda of RI (SACRI). Multifaceted solutions are needed, adds Maigret that include supporting training programs for nurses and paraprofessionals, career ladders and providing adequate Medicaid provider payments as Medicaid is the primary payer for long term care.

According to Maigret, in homecare alone, 75% of persons referred for subsidized home and community care through the state Medicaid or the Office of Healthy Aging Home Cost Share program are waiting two months, and often longer, to get services. “Our nursing homes are challenged to recruit the nursing staff needed to provide resident-centered quality care. Federal funding during the pandemic brought some funding in to support worker wages but that funding has ended,” she says.

“The state Healthcare Workforce Initiative led by the Executive Office of Health and Human Services and the Department of Labor has been looking at needs across the healthcare system and addressing some of the training and education issues,” says Maigret, noting that advocacy groups, such as the SACRI, support the Medicaid reimbursement rate increases as recommended by the Office of the Health Insurance Commissioner. “These rate increases are necessary to reduce service wait lists and provide livable wages for direct care staff many of whom are women and women of color,” she says. 

Over 23 years ago, in his weekly commentaries in the Pawtucket Times, this writer reported on the crisis of a direct care staffing shortage and inadequate reimbursement being paid to  nursing facilities to care for Rhode Island’s fail seniors. Isn’t it finally time for the Rhode Island General Assembly to come up with the necessary funds and strategy to fix these problem once and for all?

To watch the Senate Aging Committee hearing held on April 16, 2024, go to https://www.aging.senate.gov/hearings/the-long-term-care-workforce-addressing-shortages-and-improving-the-profession

Voters 50+ most powerful, election deciders; true for all Rhode Island cities, towns

Published in RINewsToday on October 24, 2022

Every political pundit knows that seniors are the most reliable voters. AARP Rhode Island’s latest analysis of voter records from the office of the Rhode Island Secretary of State clearly confirms this observation. Age 50 and over voters accounted for more than 70% of Rhode Island voters who turned up in the September 13th primary election, says Rhode Island’s largest aging advocacy group.

“This year’s 50+ numbers increased over the last midterm election in 2018, when Rhode Islanders aged 50 and over accounted for 67% of those who voted,” says AARP Rhode Island. 

“In this year’s primary, 72% of voters statewide were 50 years old or older. This held true in analysis of the Congressional District 2 voters, where 72% of CD2 primary voters also were 50 or older,” says AARP Rhode Island, noting that municipal percentages ranged from 59% (Providence), 69% (Pawtucket and Cranston), 74 % (Warwick), 79% (Bristol) to 87% (Narragansett).  

“Voters 50+ consistently show up at the polls in much greater numbers than their younger counterparts – and then some,” said AARP Rhode Island State Director Catherine Taylor in an Oct. 18 statement announcing the voting analysis.

“This extremely powerful voting bloc has made it clear that key issues such as protecting and strengthening Social Security and Medicare, improving nursing home safety, achieving retirement security, and providing means for people to live in their own homes with independence and dignity as long as possible are powerful motivators when they vote. It is undeniable that Rhode Island candidates who want to win must pay attention to issues that matter to 50+ voters,” says Taylor.

“The 50+ are our most powerful voters – and they will be the deciders in the 2022 elections,” Taylor added.

AARP Rhode Island’s “Voters 50+: Our Voices Decide” campaign has provided tens of thousands of Rhode Islanders information on how, when and where to vote at www.aarp.org/RIVotes. Here they also can view videos of gubernatorial and CD2candidates answering questions that reflect older voters’ top concerns as determined by AARP’s most recent statewide Vital Voices Survey.  

AARP Rhode Island captured some 50,000 views of the eight Video Voter Guide videos posted on Facebook and on its Web page for the Primary and General Elections.

According to Maureen Maigret, Policy Advisor for the Senior Agenda Coalition of RI, the AARP data shows the continued importance older voters have in election outcomes. “This will surely carry over to the November 8th election. Older adults are motivated to vote  because they see it as a civic duty and understand how government decisions made by elected officials impact not just their lives, but that of their family members and their community,” says Maigret.

“After the election, protecting Social Security and Medicare must be a major focus of advocacy at the federal level. Seniors also care about strengthening programs to promote independent living in the community and caregiver supports which are both national and state issues,” adds Maigret.  “And they care that our children and grandchildren have access to quality educational opportunities as they represent the future of our state, country and the world,” she says.

Disabilities won’t keep older voters from voting

The second “State of Voters with Disabilities Survey”,  released by Easterseals in partnership with AARP, found that 92 percent of Americans with disabilities age 50+ plan to vote in the 2022 midterm election. The majority say they will use early voting methods and/or require specific accommodations to vote. 

“Tens of millions of Americans with disabilities plan to vote in the 2022 midterm election, but nearly half (43 percent) require specific accommodations to vote, and 62 percent are concerned that changes to voting laws could negatively impact their ability to cast a ballot,” said Kendra Davenport, Easterseals president and CEO in an Oct. 4, 2022, statement announcing the survey findings. “This bipartisan population is highly motivated to participate in the democratic process, but they are very concerned about the barriers in their way to fully exercise their right to vote,” she says.

According to Easterseals, the survey was conducted among a nationally representative sample of people with disabilities, and an oversample of adults with disabilities 50+, from August 23-29, 2022, by Pathfinder Opinion Research. Combined with Census estimates for this population, the survey results show there are an estimated 33 million registered voters with disabilities with nearly 30 million planning to vote in the 2022 U.S. midterm election.

“Recent changes in election laws are impacting voters’ ability to successfully cast their ballots this year. That’s why AARP is dedicated to providing all voters 50+ with trusted information on when, where and how to vote during this election cycle,” said AARP’s director of Advocacy Engagement and Inclusion, Lisa Simpson in a statement. “It’s more important now than ever for all voters 50+ to use their voice and power to vote,” she said.

Sixty one percent of American voters with disabilities 50+ rely on early voting methods to participate in the election by using absentee main-in voting, ballot box drop or early voting in person prior to Election Day. Only 39 % will vote in person.

Additionally, the researchers say that a significant number of voters with disabilities, 43%, require at least one accommodation in order to vote, such as transportation assistance to a voting location, in-person voting assistance from a voting official, a wheelchair at their voting site, and a braille ballot or sign-language interpreter.

“If people with disabilities voted at the same rate as other Americans, there would have been 1.75 million more voters in 2020,” said Lisa Schur, professor and co-director of the Rutgers Program for Disability Research. “Part of the disability gap is due to inaccessible voting systems, which not only make it physically difficult to vote but also send a psychological message that people with disabilities are not welcome in the political sphere,” she says.

Voters with disabilities demonstrate broad, bipartisan support for various policy reforms that would make it easier to vote.  Ninety percent support allowing voters who are older and/or have disabilities to receive assistance from people they trust to request, fill out and return their absentee ballots while 82 % support expanding the use of absentee ballot drop boxes. Finally, 70% support allowing any registered voter to vote by mail with an absentee ballot with no reason given (available in RI).

Be an educated voter

For updates on the upcoming 2022 midterm election, go to AARP.org/elections. Follow local events sponsored by AARP Rhode Island and its advocacy efforts, go to states.aarp.org/rhode-island. You can also text RIVOTES to 22777 to receive a one-time text message with a link to Rhode Island voter information. (Message and data rates may apply.)