Thanks to the bipartisan leadership of the Pennsylvania General Assembly and Gov. Tom Wolf in the last state budget, Pennsylvania took a good first step in support of Pennsylvania’s long-term care industry. In total, Pennsylvania’s 2022-23 budget invests more than $600 million in state and federal funds so that it can help care for one of the nation’s largest senior populations.
So often we hear how government leaders won’t work together or how they place politics above good public policy. This is not one of those stories. Rather, it’s an example of how government, industry and labor can come together to improve care for older adults.
It’s important to understand what brought us to this point. For far too long, nursing homes struggled to keep dedicated workers, in part because Medicaid funding remained flat for years, making it impossible to keep up with even basic inflationary costs. The pandemic only made this worse. Pennsylvania has lost nearly 1,000 skilled beds over the last four years (source: CMS.gov), and a LeadingAge PA member survey showed the number of nursing beds pulled offline grew fourfold from 2019 to 2021. In addition, 14 nursing homes have closed entirely since 2020
The human toll is much worse than the statistics. With closures and loss of beds, where have these older residents been receiving their care? Unfortunately, some families have been forced to find care in an unfamiliar location, farther away from home. This undoubtedly led to social isolation for residents and feelings of depression and helplessness by their loved ones. As a speech pathologist and post-acute care clinician, I know too well the impact that has on one’s mental state and overall health.
That’s why this tremendous effort by government, industry and labor comes at such a critical time.
This $600-million infusion will begin to allow aging services providers to compete with other industries for skilled employees. It also helps to create some breathing room as long-term care communities continue to deal with the pandemic. The crisis is not over for aging services. Providers continue to bear the financial and operational burden of adhering to extensive infection prevention protocols, managing the cost of personal protective equipment and supplies, maintaining onerous and duplicative reporting, and continuously right-sizing staff and other resources based on the latest influx of cases. Now that the virus is becoming a part of everyday life and the threat has lessened, it’s time to rethink and reverse the rules and regulations that are no longer necessary and inhibit residents’ quality of life.
This new funding is a good start in the right direction, but there’s much more that needs to be done legislatively to help address ongoing challenges.
Early in the pandemic, the government provided a pathway to ease staffing burdens by creating the temporary nurse aide (TNA) program; however, this program ended in June following the termination of the federal waiver. Congress should pass legislation (H.R. 7744) to reinstate and extend the TNA waiver. In the interim, the state should apply for a federal waiver to extend the Oct. 6 testing deadline in light of testing capacity issues, which are making it difficult for these caregivers to become certified nursing assistants (CNAs).
We also need to make sure our current CNAs are given opportunities to advance, and that providers can remain competitive with other industries. Lawmakers can help communities by providing greater flexibility for CNAs to move up the career ladder, including allowing qualified nurse aides to train to become medical administration technicians. In addition, transparency and oversight of temporary staffing agencies and pricing protection are needed to ensure that older Pennsylvanians have access to needed care.
Pennsylvanians should be proud of the work accomplished in the state budget on behalf of long-term care. It will help improve the lives of countless older adults and their loved ones. But let’s not stop now. Too much important work remains in ensuring Pennsylvanians have access to these critical supports.
As we just saw, by working together – anything is possible.