Wage hikes deepen nurse short­age

As boomers age, new home health care work­ers needed

The Washington Times Daily - - NATION - BY ANNA GRONEWOLD

WEST CHAZY, N.Y. | Only 17 snowy miles from the Cana­dian bor­der, Katie Bushey’s most ba­sic needs are met by trav­el­ing health aides who come into her home to change her di­a­pers, track her seizures, spoon-feed her fet­tuc­cine Al­fredo and load her wheel­chair into the shower.

But that’s only if some­one shows up.

Ms. Bushey, 32, who lost her vo­cal and mo­tor skills shortly after birth, is one of more than 180,000 Med­i­caid pa­tients in New York who are au­tho­rized to re­ceive long-term in-home care, the most in the state’s his­tory. But there are in­creas­ingly too few aides to go around, es­pe­cially in re­mote, ru­ral ar­eas.

When there aren’t enough aides for Ms. Bushey — over a re­cent two-day stretch there were work­ers for only four of the 26 hours of care for which she is au­tho­rized — her mother must stay home from her job at an el­e­men­tary school, for­go­ing a day’s wages and scrap­ing her sav­ings to pay the bills.

It’s a na­tional prob­lem ad­vo­cates say could get worse in New York be­cause of a phased-in, $15-an-hour min­i­mum wage that will be statewide by 2021, push­ing no­to­ri­ously poorly paid health aides into other jobs, in re­tail or fast food, that don’t in­volve hours of train­ing and the pres­sure of keep­ing some­one else alive.

“These should not be low-wage jobs,” said Bruce Dar­ling, ex­ec­u­tive di­rec­tor at the Cen­ter for Dis­abil­ity Rights. “We’re pay­ing some­one who gives you a burger the same as the per­son who op­er­ates your rel­a­tive’s ventilator or feed­ing tubes.”

There are 2.2 mil­lion home health aides and per­sonal care aides in the U.S., with an­other 630,000 needed by 2024 as the baby boomer gen­er­a­tion ages, ac­cord­ing to the non­profit re­search and con­sult­ing group PHI. New York state em­ploys about 326,000 home health work­ers but is pre­dicted to need an­other 125,000 by 2024.

For now, home health aides in New York state earn an av­er­age of about $11 an hour, though wages are lower in up­state re­gions. Ad­vo­cates say the sys­tem needs an over­haul that fo­cuses on higher pay, worker re­ten­tion and find­ing meth­ods of com­pen­sa­tion beyond what is pro­vided through Med­i­caid.

Demo­cratic Gov. An­drew Cuomo has com­mit­ted nearly $6 bil­lion in fund­ing for home health care re­im­burse­ments in com­ing years as the agen­cies tran­si­tion to the $15 min­i­mum wage. The state’s health de­part­ment has said it is de­vel­op­ing an ini­tia­tive to at­tract, re­cruit and re­tain home health work­ers.

New York law­mak­ers have held hear­ings on the is­sue, and both the Se­nate and As­sem­bly so far have in­cluded lan­guage in their bud­gets that would re­view and re­struc­ture how the state trans­fers Med­i­caid dol­lars to the providers, agen­cies and work­ers with the aim of pro­vid­ing work­ers and hours where they are needed most.

Other states are grap­pling with how to ad­dress the dwin­dling work­force as their min­i­mum wages climb.


Stephanie Bushey (right) must of­ten stay home from her job in or­der to care for her daugh­ter, Katie, as there are few in­home health care aids in their ru­ral up­state New York area.

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