A fix in the works for health care jobs crisis

LILO H. STAINTON, HEALTH CARE WRITER | MAY 16, 2022

NJ Spotlight News

On April 17, 2020, a health worker arrives to take a nose swab sample as part of testing for COVID-19 at a nursing and rehabilitation facility.

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The COVID-19 pandemic significantly exacerbated the existing workforce shortages in New Jersey’s health care sector. Now these shortages impact hospital nurses, nursing assistants in long-term care, home-care providers and direct-service professionals who assist disabled people, among others.

New Jersey — where the minimum wage is now $13 and rising to $15 — has spent hundreds of millions in public money to boost wages for frontline health care workers during the crisis. The state plans to invest another $211 million over the coming year to enhance pay for a range of caregivers, including mental health and child-care workers.

Leaders in business and higher education have also joined forces to support a longer-term solution to advance workforce development for the health care sector and three other industries critical to New Jersey. The New Jersey Business and Industry Association has partnered with the state’s community colleges to develop a targeted training model that connects health care graduates with credentials and opportunities for career advancement.

“Over the years this has been an issue that never seems to go away. It’s always front and center,” said Chrissy Buteas, NJBIA’s chief government affairs officer, who has also worked in the state’s home-care sector. “This partnership is critical to try to get more people into the pipeline for these fields. Whether it be direct care, nursing, dental, you name it, we are seeing very severe workforce challenges.”

With nearly 500,000 workers, health care is the largest industry sector in New Jersey, according to NJBIA, and state forecasts indicate more than 78,000 new jobs will be added by 2026. While some are extremely well paid, many of these positions involve lower-wage jobs.

Nursing assistants, who provide 90% of the care in nursing homes, earn an average of $15 an hour in New Jersey, and at least one in 10 lack health insurance, studies show. There are nearly 16,000 certified nursing assistants, or CNAs, in New Jersey, according to a recent report, and close to 6,000 licensed practical nurses (LPNs), who also provide direct care. Another 5,000 active registered nurses, or RNs, administer medications, create care plans and assist at the bedside. Women comprise nine out of 10 members of this direct care workforce, it noted, while 84% are people of color, and half are immigrants.

Some facilities, like nursing homes, have long struggled with staffing challenges. COVID-19 amplified the problem, sickening many workers and forcing others to quarantine just in case. Last week alone, more than 2,800 nursing home workers and nearly 200 hospital staff tested positive, according to state data. Caregivers are now exhausted, struggling with anxiety and depression, and leaving the workforce in growing numbers.

Impact of shortage on nursing homes

Staffing shortages at New Jersey’s nursing homes hampered their response to the pandemic, and that contributed to high levels of viral spread and deaths, according to a June 2020 consultant’s report. Among other things, the report recommended better wages and benefits for nursing aides, plus paths for professional development. A new task force is now reviewing workforce issues and other nursing home concerns, officials said, and will report to the Legislature by year’s end.

“It’s a nationwide problem,” state health Commissioner Judy Persichilli, whose department regulates nursing homes, told the Assembly Budget Committee in late April, “and some of the same struggles and issues we have in New Jersey are definitely national problems. And workforce, infrastructure and staffing are probably the three main areas. We focus on that every day.”

Gov. Phil Murphy’s $49.5 billion budget proposal for fiscal year 2023, which lawmakers must approve before it starts in July, includes tens of millions for various workforce training initiatives in multiple industries, in addition to short-term funding to boost certain caregivers’ pay. There is also a new $1 million appropriation to fund a career-development program for direct support professionals. Another $1 million would be used to train more nurse-midwives under the plan and $500,000 would fund community health worker training.

NJ Pathways to Career Opportunities, the NJBIA partnership with county colleges, is slated to receive $6 million next year to finish building the program infrastructure, according to those involved. It received $8.5 million under the current fiscal year budget. While not all is dedicated to the health-industry collaboration, organizers said it would likely receive a large share of these funds, given the program’s size and need.

Aaron Fichtner, president of the New Jersey Council of County Colleges, said the primary health workforce collaboration is spearheaded by Camden County College, and six others will also participate. Three other county colleges are focused on health care technology and administration issues.

New Jersey’s 18 county and community colleges already train a large percentage of the state’s health care workforce, Fichtner said. In 2021, they awarded nearly 4,000 degrees and certificates for studies in health fields, he said, nearly one in five of all county college degrees granted that year.

Preparing for health care workforce

Academic leaders are now meeting with business representatives and health care providers to develop curricula to best prepare students for today’s dynamic workforce. The partnership also stands to bring the colleges closer, he said, as they will be able to share lessons and instructors.

“We’ve always had good employer relationships” at the county college level, Fichtner said, “but this really redoubles that effort to make sure that we in the educational world are listening intently to the needs and perspective of the employers and those employers are part of the solution.”

The pathways program is not just about academic preparation, Fichtner said, but will also be designed to help people move up the career ladder once they are employed — chances that many have said are lacking in the current system for direct care workers in lower-wage jobs. “I think there is a huge economic mobility opportunity,” he said. “That is at the heart of our pathways concept, to build these stackable pathways for progression at all levels.”

Creating the partnership program is not without hitches. There is also a shortage of health care educators in many fields, including nursing, which makes expanding classes a challenge. Buteas, at NJBIA, is also part of a coalition that recently convinced the health department to revisit the regulations around nursing aide instructors to make it easier for colleges to find teachers.

Another concern is the state licensing process, which Buteas and others said has been slowed under the pandemic, leaving trained individuals unable to get the paperwork they need to start working. Higher education officials, health care providers and business interests are urging the state to improve the process, she said.

Results will take time

The partnership program could have a noticeable, long-term impact on New Jersey’s health care staffing shortage, Fichtner and Buteas agreed, but it will take time to produce results. “If we only focus on the immediate, we lunge from one crisis to another and never really solve the bigger issue,” Fichtner said.

But Buteas would also like to see more immediate relief for the sector and called on state officials to invest a portion of New Jersey’s federal COVID-19 relief — some $3 billion remains unspent — on short-term solutions. Georgia committed $125 million in federal funds to hire hospital workers, Texas budgeted more than $7 billion to add nurses and other hospital workers, and New York plans to invest $20 billion in health care infrastructure, she said.

“The employers and their employees are struggling,” Buteas said. “Can we sit around the table and actually figure out what the best use for those funds would be to actually help the sector that was on the front lines?”

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published this page in News and Politics 2022-05-16 02:49:55 -0700