{"id":7285,"date":"2023-05-08T07:16:59","date_gmt":"2023-05-08T11:16:59","guid":{"rendered":"https:\/\/www.silvercentury.org\/?p=7285"},"modified":"2023-05-08T07:16:59","modified_gmt":"2023-05-08T11:16:59","slug":"a-possible-solution-for-the-staffing-crisis-in-long-term-care","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2023\/05\/a-possible-solution-for-the-staffing-crisis-in-long-term-care\/","title":{"rendered":"A Possible Solution for the Staffing Crisis in Long Term Care"},"content":{"rendered":"

The nation\u2019s older population is growing, along with the need for long term care, but at the same time, nursing homes are turning away residents because they\u2019re so short of staff. Writing for <\/span><\/i>Kaiser Health News<\/a> (KHN),<\/span> journalist Michelle Andrews describes what\u2019s happening and talks to experts who believe new immigrants could help a lot. Her article ran on <\/span><\/i>KHN <\/span>on February 3, 2023,<\/span><\/i> and also on the <\/span><\/i>Tampa Bay Times<\/span><\/a>.<\/span><\/i><\/p>\n

When Margarette Nerette arrived in the United States from Haiti, she sought safety and a new start.<\/span><\/p>\n

The former human rights activist feared for her life in the political turmoil following the military coup that overthrew President Jean-Bertrand Aristide in 1991. Leaving her two small children with her sister in Port-au-Prince, Nerette, then 29, came to Miami a few years later on a three-month visa and never went back. In time, she was granted political asylum.<\/span><\/p>\n

She eventually studied to become a nursing assistant, passed her certification exam and got a job in a nursing home. The work was hard and didn\u2019t pay a lot, she said, but \u201cas an immigrant, those are the jobs that are open to you.\u201d<\/span><\/p>\n

A few years later, her family joined her, but her children didn\u2019t want to follow her career path. When she was a teenager, Nerette\u2019s daughter, now 25, would ask, \u201cMom, why are you doing that?\u201d Nerette said. Her daughter considered the work underpaid and too physical.<\/span><\/p>\n

After many years, Nerette, now 57, left nursing-home work for a job with the Florida local of the labor union <\/span>SEIU1199<\/a>,<\/span> which represents more than 25,000 health workers. As the local\u2019s vice president for long term care, she is keenly aware of the staffing challenges that have plagued the industry for decades and will worsen as aging baby boomers stretch the limits of long term care services.<\/span><\/p>\n

The United States is facing a growing crisis of unfilled job openings and high staff turnover that puts the safety of older, frail residents at risk. In a tight labor market where job options are plentiful, long term care jobs that are poorly paid and physically demanding are a tough sell. Experts say opening pathways for care workers to immigrate would help, but policymakers haven\u2019t moved.<\/span><\/p>\n

Already, about one in four direct care workers are foreign-born. <\/b><\/p><\/blockquote>\n

In the decade leading up to 2031, employment in health care support jobs is expected to expand by <\/span>1.3 million<\/a>,<\/span> a nearly 18 percent growth rate that outpaces that of every other major occupational group, according to the federal Bureau of Labor Statistics. These <\/span>direct care workers<\/span><\/a>  include nurses of various types, home health aides, and physical therapy and occupational therapy assistants, among others.<\/span><\/p>\n

Certified nursing assistants, who help people with everyday tasks like bathing, dressing and eating, make up the largest proportion of workers in nursing homes. In the decade leading up to 2029, nearly 562,000 nursing assistant jobs will need to be filled in the United States, according to a far-reaching report on nursing home quality published last year by the National Academies of Sciences, Engineering, and Medicine.<\/span><\/p>\n

But as the US population ages, fewer workers will be available to fill those job openings in nursing homes, assisted living facilities and private homes. While the number of adults 65 and older will nearly double to 94.7 million between 2016 and 2060, the number of working-age adults will grow just 15 percent, according to an analysis of census data by PHI, a research and advocacy organization for older and disabled people that conducts workforce research.<\/span><\/p>\n

Immigrants can play a crucial role in filling those gaps, experts say. Already, about one in four direct care workers are foreign-born, according to a <\/span>2018 PHI analysis<\/a>.<\/span> <\/span><\/p>\n

\u201cWe do think that immigrants are critical to this workforce and the future of the long term care industry,\u201d said Robert Espinoza, executive vice president of policy at PHI. \u201cWe think the industry would probably collapse without them.\u201d<\/span><\/p>\n

Nursing homes and other long term care facilities have long struggled to maintain adequate staff. The problem worsened dramatically during the pandemic, when those facilities became hotbeds for COVID-19 infections and deaths. <\/span>More than 200,000<\/span><\/a> residents and staff members died during the first two years of the pandemic, representing about a quarter of all COVID deaths during that time.<\/span><\/p>\n

Unlike some other countries, the United States generally hasn\u2019t made it a priority to attract direct care workers from abroad.<\/b><\/p><\/blockquote>\n

Since March 2020, the long term care industry has lost more than <\/span>300,000 jobs<\/a>,<\/span> bringing employment to a 13-year low of just over 3 million, according to an analysis of BLS payroll data by the American Health Care Association and the National Center for Assisted Living.<\/span><\/p>\n

Immigration policies that aim to identify potential workers from overseas to fill long term care job slots could help ease the strain. But unlike other countries that face similar long term care challenges, the United States generally hasn\u2019t made attracting direct care workers from abroad a priority.<\/span><\/p>\n

\u201cImmigration policy is long term care policy,\u201d said David Grabowski, a professor of health care policy at Harvard Medical School, whose research focuses on the economics of aging and long term care. \u201cIf we really want to encourage a strong workforce, we need to make immigration more accessible for individuals.\u201d<\/span><\/p>\n

Most of the roughly <\/span>one million immigrants<\/span><\/a> to the United States annually are family members of citizens, though some come in on employment visas, often for highly skilled jobs.<\/span><\/p>\n

On his first day in office, President Joe Biden proposed comprehensive immigration reform that would have created a pathway to citizenship for undocumented workers and revised the rules for employment-based visas, among other things, but it went nowhere.<\/span><\/p>\n

\u201cThere hasn\u2019t been a lot of interest or political will behind opening up more immigration opportunities for mid- to lower-level care aides such as home health aides, personal health aides and certified nursing assistants,\u201d said Kristie De Pe\u00f1a, vice president for policy and director of immigration policy at the <\/span>Niskanen Center<\/a>,<\/span> a think tank.<\/span><\/p>\n

The United States is competing with other countries, who also want to attract immigrant workers. <\/b><\/p><\/blockquote>\n

The Biden administration didn\u2019t respond to requests for comment.<\/span><\/p>\n

Some local and regional organizations are working to connect immigrants with health care jobs.<\/span><\/p>\n

Ascentria Care Alliance <\/span><\/a>provides social services, refugee resettlement and long term care services in five New England states. With state and private philanthropic funding, the organization is beginning to help refugees from Ukraine, Haiti, Venezuela and Afghanistan get the supportive services they need\u2014language, housing, child care \u2014 to enable them to take health care jobs at Ascentria\u2019s long term care facilities and those of health care partners.<\/span><\/p>\n

The group has long helped refugees resettle and find jobs in traditional settings like warehouses or retailers, said Angela Bovill, president and CEO of Ascentria, which is based in Worcester, MA. \u201cNow we\u2019re looking at what it would take to move them into health care jobs,\u201d she said.<\/span><\/p>\n

The alliance is applying to the Department of Labor for a grant to scale up the program. \u201cIf we get it right, we\u2019ll build a pathway and a pipeline to move at the fastest rate from immigrant to effective health care worker,\u201d Bovill said.<\/span><\/p>\n

Some long term care experts say the United States can\u2019t afford to drag its feet on putting policies in place to appeal to immigrants.<\/span><\/p>\n

\u201cWe\u2019re competing with the rest of the world, other countries that also want these workers,\u201d said Howard Gleckman, a senior fellow at the Urban Institute.<\/span><\/p>\n

Staffing shortages are forcing nursing homes to turn away new residents.<\/b><\/p><\/blockquote>\n

Canada, for instance, is <\/span>going all in<\/span><\/a> on immigration. In 2022, it welcomed more than 430,000 new permanent residents<\/span>,<\/span> the most in its history. Immigration accounts for almost 100 percent of Canada\u2019s labor force growth, and by 2036 immigrants are expected to make up 30 percent of the population, the government said.<\/span><\/p>\n

In the United States, immigrants account for about <\/span>14 percent of the population<\/a>,<\/span> according to an analysis of census data by the Migration Policy Institute.<\/span><\/p>\n

Canada\u2019s <\/span>Economic Mobility Pathways Pilot<\/span><\/a> aims to identify and recruit refugees who have skills Canadian employers need. In January, after visiting a refugee camp in Kenya, recruiters offered jobs in Nova Scotia to <\/span>65 continuing care assistants<\/a>.<\/span> <\/span><\/p>\n

In a December survey of 500 US nursing homes, more than half said staffing shortages have forced them to turn away new residents.<\/span><\/p>\n

These staffing challenges, said industry representatives, are likely to become an even heavier lift, with more closed facilities, units or wings, after the Biden administration announced last year that it would establish <\/span>minimum nursing home staffing requirements<\/a>.<\/span> <\/span><\/p>\n

A government mandate alone won\u2019t solve long-standing problems with inadequate training, pay, benefits or career advancement, experts said.<\/span><\/p>\n

\u201cYoung people aren\u2019t going to clean 10 to 15 patients for $15 an hour,\u201d Nerette said. \u201cThey\u2019ll go to McDonald\u2019s. We need to face that reality and come up with a plan.\u201d<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

When Margarette Nerette arrived in the United States from Haiti, she sought safety and a new start.<\/span><\/p>\n

Read more A Possible Solution for the Staffing Crisis in Long Term Care<\/span> ›<\/span><\/a><\/div>\n

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