What a winter. It’s March and there’s barely any snow on the ground. I don’t think I’ve had to wear my heavy winter coat (or—for those of you who know me, my heavy winter poncho) more than once or twice this season. Traditionally, though, March is the snowiest month so keep your fingers crossed whichever way you want this to go. March offers no guarantees.
I’ve been hearing from people who can’t find caregivers and from agencies as well all about the shortage of home care workers throughout Minnesota. On February 28, Star Tribune reporter Chris Serres wrote an article concerning this issue and the extremes that some families must go to in order to care for their loved ones. I wonder if the state recognizes the desperate measures people are taking to provide support for their own family members. Do legislators and the Department of Human Services realize that our homecare programs are struggling and not working as intended? Certainly some of what’s going on would not meet the requirements of the state’s new Olmstead plan for the disability community.Serres wrote about a young child who was terminated as a client by his agency because the agency couldn’t recruit enough staff. And on short notice—only 10 days according to the Minnesota homecare patients’ bill of rights—the child’s mother could not get staffing before the termination deadline. The mother had to put her child in the hospital, which is not the “least restrictive environment” called for by the state Olmstead plan. After 21 days in the hospital, the discharge papers for the child stated the official reason for admission was “home care failure.”
Without correctly trained in-home direct support professionals, all of the state and federally funded accessibility opportunities are unusable to the elderly and people with disabilities. If they don’t have help getting out of bed and out of the house, accessible public transportation, equal opportunity jobs, curb cuts, modified buildings and special parking spaces are of no help to people with disabilities and senior citizens. These problems in the health care workforce will require more than just raising wages by 5 percent. The wage increase should be more like 25 percent or, more appropriately, a starting wage of at least $15 an hour for direct support staff or personal care attendants. Additional protective incentives, like 401(k) or other retirement savings, health insurance, time off for sick leave, maternity leave and holiday pay are needed in order to recruit qualified, trustworthy and dedicated people to home care jobs. We have to show our commitment to this workforce in order to get the numbers of devoted and loyal employees needed.
Many of these jobs in the near future will also require skilled nursing. If talented, accomplished and qualified RNs, MSNs or PHNs can make a more livable income and get benefits in the hospital or in nursing homes, that’s where they will go. The Minnesota Department that regulates home-care estimates that 60,000 home care support positions will be needed by 2020 with the shifting of care away from nursing facilities and into supportive community living. But unfortunately, it seems like the government funding continues to go to the facilities, following a medical model of providing services.
Pennsylvania’s Keystone Research Center (KRC) was created in 1996 to broaden strategies to achieve a more prosperous and equitable Pennsylvania. Rather than simply outlining the home care problems in that state, the KRC is using research and collaboration to propose workable policy alternatives. On April 14, 2015, a report from KRC stated that nursing homes have proved to be a very profitable industry, but they are taking advantage of the government’s by paying low wage rates for caregivers, forcing many full-time workers to rely on public assistance. The report also found that low wages lead to higher turnover rate in the staff, which in turn interrupted quality of care and wasted money in recruiting and training new employees.
All of this is happening in the health care industry when often there’s excessive compensation at the top; when CEO salaries are hundreds of times the average of the nursing assistant. And the majority of the income in home care is generated from revenue from public government resources. Why should Minnesotans allow this and not demand funding changes for community-based living? And why isn’t the general public doing the same? Talk to your friends and neighbors, and join them yourself in demanding the elimination of the very profitable institutional care centers that are detrimental to our population and economy. Replace them with flexible models for in-home care that can keep the elderly and disabled healthy and productive.
Enough of my ranting here. I’d like to thank Carrie Salberg for filling in as a guest columnist last month. Let’s set our sights on getting involved with this year’s legislative session and informing the public of the staffing shortages and wastes.