Higher wages and increased state funding are necessary to prioritize New Hampshire’s direct care workforce, according to industry advocates and experts.
The New Hampshire Commission on Aging recently heard testimony about the state’s long-term care workforce challenges.
The Granite State has just over 15,000 direct care workers in assisted living communities, nursing homes and home care settings. In the next decade, it is anticipated that the state will have more than 24,000 job openings as workers leave the field due to low pay and lack of career advancement, according to the state Commission on Aging’s annual report, released earlier this month.
The commission is taking on workforce challenges and looking at initiatives used in other states to rethink funding for training and advancement opportunities for workers.
In its annual report, the body provided three overarching recommendations: strengthen the state’s long-term services and supports system, increase the direct care workforce and advance age-friendly policies, systems and environments.
Within those recommendations the commission suggested adjusting rates for services where a provider gap exists, including better supporting the state’s Choices for Independence Medicaid waiver program in assisted living to keep individuals in a lower level of care for a longer period of time. As it now stands, CFI pays for services provided in assisted living but does not cover room and board.
The commission also advocated for supporting the direct care workforce. Investments supporting workers, they said, could decrease public assistance expenses, stimulate consumer spending and job growth, reduce turnover and save healthcare costs.
Lisa Henderson, executive director of LeadingAge Maine and New Hampshire, told McKnight’s Senior Living that the annual report is a comprehensive strategy document that illustrates that the state has a lot of work to do to make critical investments in its long-term care infrastructure, including the direct care workforce.
Citing a statistic form the National Low Income Housing Coalition, Henderson said that workers need an hourly wage of $26.29 to afford a two-bedroom apartment in New Hampshire. But she added that Medicaid reimbursement rates aren’t likely to ever translate to such a wage for frontline workers.
“In the meantime, providers are doing all they can to increase wages and provide career growth opportunities so that caring staff will stay,” Henderson said. “But they need tangible commitments from the governor and the legislature to be their partner in meeting the needs of older adults. This report offers excellent suggestions on how to do that.”
Amy Robins, PHI director of advocacy, testified before the commission on a report released earlier this year showing that New Hampshire will lose more direct care workers than it needs in the next decade. Data from the New Hampshire Department of Employment Security showed an overall decrease of 10% in the long-term care workforce from 2015 to 2021.
“Care infrastructure, for which direct care workers are the backbone, is critical for the economic welling of this state,” the report reads. “Growing the direct care workforce is one of the most critical tasks facing our state.”
The Commission on Aging was established in 2019 to advise lawmakers on policy and planning related to aging. The commission completed a strategic planning process in 2020, developing a three-year plan outlining for strategic priorities for investigation: develop strategies to improve the ability to age in communities of choice, become an age-friendly state, advocate for the emerging needs of older adults during the pandemic and develop an infrastructure to support operational success.