SPEAKER: Homecare Workforce Shortage.
DAMON: Hi. My name is Damon Leivestad. I’m a white male with a beard, dressed in a gray shirt and a Minnesota Gophers knit cap. I’m a 49-year-old mechanical engineer from Plymouth, where I live with my parents, David and Diana. I was born with a neurological disorder called spinal muscular atrophy, and I’ve been in a wheelchair since I was 10 years old. I’ve been using PCA homecare services since 1992.
The shortage of homecare workers is growing at a staggering rate, which has had a tremendous impact on those of us who rely on homecare services. The time, energy, and difficulty of finding workers for those people with disabilities feeling very vulnerable, burdensome, and, at times, without hope.
This, in turn, inhibits our ability to have the security and stability in our lives that most people take for granted. Due to our inability to hire and retain quality homecare workers, our health, safety, and dignity needs have not been met. Without our basic needs being met, it’s impossible to know what the future will look like. Planning for an appointment, time with family and friends, or getting involved in our communities has been set aside because survival has become our primary task.
Recently–less than two weeks ago, actually–I lost a long-time homecare worker [indistinct]. One of the reasons she stayed as long as she did was because she had two young children at home.
Her husband would work from home two days a week and watch the kids while she was here, and she would be with the kids the other days. That allowed them to save close to $12,000 a year in daycare, which made up for the low wages she made working for me. Her kids, however, are in school full time this fall, so she found a better-paying job with retirement benefits, so she could start planning for her future.
Due to this and the overall difficulty of finding homecare workers, I began to rely more and more on my parents to provide for my cares. This solution, however, is not sustainable, as my parents are now in their late 70s and have much less ability to help me than they once did.
Many of my cares that are easily done by one homecare worker, require both my parents working together to accomplish. This has left me increasingly concerned about their and my safety as well as what the future has in store for me. Today, I’m fine, but what about tomorrow, next week, or next year, when my parents are no longer able to care for me? Will I finally have help to continue to live at home and to work, or will I need to arrange for a living facility? I’m not alone in this concern.
There’s thousands of other disabled Minnesotans are in similar situations. As a result, I’ve become increasingly active in advocating for changes in the homecare services that I feel are needed to address in the homecare crisis. Together, I hope we find a solution to make homecare work a desirable career opportunity with sustainable wages and benefits to attract quality, reliable home care workers. Thank you.
HOPE: Thank you, Damon, for your powerful statement. Damon sends thanks to everyone for being here today. He was not able to join us live.
Hello. I’m Hope Johnson, council member of Minnesota Council on Disability. I’m a white woman with brown hair, wearing a dark green blouse and a black sweater. I have a blurred background of my workplace office in Waseca.
This segment’s topic is homecare workforce shortage. The disability community has been in a homecare workforce shortage crisis for several years. Today, we are having a conversation, based on Damon’s story, with David Dively, Senator Carla Nelson, and myself.
I am a social work professional who manages county waiver programs, and have seen this shortage take its toll on not only people with disabilities, but also for the personal care workers themselves.
Thank you, Senator Nelson, for joining us today and discussing this critical issue around the homecare workforce shortage. Damon is a strong advocate, as many citizens are, especially for PCA and homecare services and disability support professionals whose work allows Minnesotans with disabilities to live, play, and work independently in the communities of their choice.
Apologies, it looks like David’s having some issues with his microphone, so David is going to discuss, if we can get that working, some ideas to increase the workforce in this area. We still can’t hear you, David. In the meantime, I’ll try to carry on.
So, some advocates such as Damon shared some ideas to increase the workforce. This includes allowing homecare workers to buy into MinnesotaCare so they have health insurance benefits, as well as grants for tuition to support people going into these caring professions.
Another idea is loan forgiveness programs for PCAs, creating seniority tiers that allow pay increases to increase with expertise, as well as allowing increased rates for RNs, LPNs, and others with additional credentials and licenses to encourage homecare workers to pursue more training and education.
Senator Nelson, as a member of the Senate Human Services Committee already, you have heard these issues and concerns brought up. What path do you see forward in the legislature to address these issues?
CARLA: Thank you so much for having me, Hope. First, can you hear me okay?
HOPE: Yes, I can.
CARLA: Oh, wonderful. Well, it’s a joy to be with you today. Thank you for your great work. And yes, it is very clear. I think everyone in the legislature, I think, many, many Minnesotans realize the challenges that our home health care settings are enduring. Of course, that includes our assisted living homes, our nursing homes, our group homes, home care, DTN&H, palliative care, hospice. All of those settings for people that are so near and dear to us and who need that support. And the problem is there just aren’t enough workers. There’s a number of issues, but one of them is certainly not getting the number of workers needed to provide the care that we expect and that Minnesotans deserve.
And so some of the things that were passed last year out of the Senate, I think, could be very helpful moving forward with that workforce shortage in our group homes, our disability homes, our long term care nursing homes, and such. And in 2022, the Senate passed–the Senate Republicans introduced a bill for $1.322 billion that would be a budget priority to address those long-term care workforce needs. And again, I mentioned, those areas where it was so important that we get the workers–often it’s a time of life or death. We need to have those trained workers. And I think this need was only exacerbated by the COVID-19 and, of course, its after-effects. So I was glad to support that proposal.
What it did is, it was about a billion dollars to raise the wages of workers in our long term care, personal care, disability waiver, and rate service industries. Specifically, that provided a $1,000 retention bonus for those employees. It also provided hiring bonuses of $1,500 for up to 20,000 new nursing home assisted living, group homes, home care, DT&H, palliative care, and hospice employees. That would have been very helpful. That was about a $30 million cost. The retention bonuses was about a $206 million cost.
And then also, training funds. Provided $30 million for training funds, $1,500 for 20,000 new studies, background studies, training uniforms, to help get those needed workers into these settings. And then another issue that we heard so much about was also included, which–I anticipate these things will move forward. That’s what I’m pushing for. This significant investment in the workforce needed. And then also, one of the other items that you might recall–certainly, I heard from many of you about it–was moving up the advance disability waiver rate setting change. We need to move that up to April 1.
And, as you know, this timing shift will be incredibly important, especially at this time of massive inflation, to help our disability service providers with their cash flow. And it would then ensure the delivery of services to vulnerable Minnesotans. And that was a cost of about $55 million. And let me just say, that’s $55 million that our disability providers need now, and so it’s very important that we do that, of course. And then we also passed an emergency staffing pool. That was a temporary continuation of the emergency staffing pool used for training programs to help expand qualified workers.
And just a couple other things that I would mention. Again, one would be the temporary permitting and licensing changes, which would allow previously licensed nurses to temporarily practice in nursing homes and assisted living facility, and it created an expedited pathway to allow unlicensed employees in an assisted living facility to be more quickly trained and then provide direct care. I’ve seen that in Rochester work very well. And then, of course, timing is critical, as these changes are so much needed.
And then the last one I’ll mention today is the PACE program, streamlining that so that Programs of All-inclusive Care for the Elderly–PACE–can model the care for elderly residents of Minnesota, particularly those that are eligible for both Medicare and Medicaid benefits. And this would make the program work together more effectively. It would save taxpayers money, and most importantly, it would help patients more efficiently access the services.
So those are all items that have been well received in the Minnesota Senate, were passed. Great bipartisan support, you just heard from Senator John Hoffman. He was on the Health and Human Services Reform and Policy committees, where I was serving, as well.
And now he’s going to be chair, and he’s been a great champion, and I’m hoping that we will continue with these very much-needed, bipartisan measures to support the care, the direct care, the training, and the employees that are so needed. And of course moving up that reimbursement date calculation will be helpful, too. So these are all things that I think will be incredibly helpful. Because they were supported with such a bipartisan support in the Senate– In fact, I do not believe–at that time it was a Republican-controlled Senate–well, it still is until January 3, but what I would say–
HOPE: Sorry to interrupt, Senator Nelson. We are at time, and I appreciate everything you had to say. You said it so nicely, all the wonderful provisions of work that we can move forward in our session. So thank you for your time, Senator Nelson. I appreciate it.
SEN. NELSON: Hope, I just want–what I just want to close with is that we definitely, I believe, have good–should feel good that these things will continue on, as they were so well bipartisan-ly supported. They’d be a good model to continue with.
DAVID: That’s great to hear.
HOPE: Thank you.