PROCLAIMING April as Care Workers Recognition Month, President Biden unveiled a “fact sheet” and gave a speech, utterly ignoring the dedicated caregivers in long-term care facilities. He touted the $37 billion spent under the American Rescue Plan Act for home and community-based services — a laudable investment, to be sure — without noting his signature law spent nothing on nursing home care.
Far from supporting that care, President Biden has proposed an unfunded staffing mandate that could cost several billion dollars a year. Health and Human Services Secretary Xavier Becerra, with his eyes reportedly on becoming California’s next governor, has publicly touted the mandate as a boon for unions. And because licensed practical nurses (LPNs) are typically unrepresented by unions, the proposal would not count the nearly 178,000 LPNs working in nursing homes nationwide.
That is more than just a shameful omission; it’s an attack on the dignity of a vital nursing workforce, 89% of whom are women, providing bedside care.
I personally support unions, and professionally support ongoing efforts by my member facilities to hire more nursing staff. Nursing homes have led all health care sectors in wage increases since the COVID-19 pandemic began. Yet they are beset by the same hiring challenges all health care providers face, compounded by the fact that most nursing home residents are on Medicaid.
Medicaid underfunding is the primary reason a government report last month stated most nursing homes (51% in 2022) are operating at a loss.
A health care labor crisis is revealed by the fact that the state itself, despite offering attractive union wages and benefits, recently tripled the cost of its temporary staff contracts at the New Hampshire Hospital and Glencliff Home to $11,500,000. Of the 16 staffing agencies contracted with, only two are based in New Hampshire.
As if it would offset a new cost estimated at $6.8 billion annually, the Biden administration trumpets a one-time expenditure of $75 million toward “nursing home careers,” to be spread quite thinly across roughly 15,000 nursing homes nationwide. To put that one-time expenditure into perspective, it’s 1% of the $7.5 billion directed toward building electric vehicle charging stations. That $7.5 billion investment has only produced seven new stations nationwide in two years. In other words, Teslas (and those who can afford them) clearly matter more than nursing home caregivers. A hundred times more.
The Democratic governors of three states — Illinois, New York, and Rhode Island — have suspended their own nursing home staffing mandates because facilities simply cannot find licensed workers. And those states are nowhere near as rural as ours, nor do they have New Hampshire’s red-hot service economy that presents so many competing job opportunities to those who might consider becoming, say, a licensed nursing assistant.
It is in recognition of what makes New Hampshire different and unfitting for a one-size-fits-all mandate that Governor Chris Sununu, U.S. Sens. Maggie Hassan and Jeanne Shaheen, and U.S. Rep. Chris Pappas are among those opposing it. Fearing its repercussions on hospitals, which are already jammed up with discharge-ready patients unable to access nursing homes, the hospital sector has also registered opposition.
If even states with staffing mandates have recognized that you cannot hire licensed nursing workers that objectively do not exist, why would President Biden impose a care-destroying mandate nationally? Though he says his final mandate is just “weeks” away, it’s not too late for him to change his mind. He should.
Brendan Williams is the president and CEO of the New Hampshire Health Care Association. He lives in Manchester.
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