This testimony from President Matthew Yarnell is originally from April 12, 2022, when President Yarnell and Tisheia Frazier, CNA spoke in front of the House Aging & Older Adult Services Committee on the healthcare “workforce crisis.”
Thank you for inviting me to speak here today.
My name is Matthew Yarnell and I’m the President of SEIU Healthcare Pennsylvania. Our union brings together tens of thousands of health care workers across the Commonwealth working in hospitals, nursing homes, state agencies and caring for seniors and people with disabilities in their home.
Among those members is approximately 4,000 thousand nursing home workers who, over the last two years, have – to be blunt – been through hell.
Over 20 years ago when I started working as an aide in a nursing home in Centre County, it didn’t take long to realize that my residents weren’t getting the care they needed and deserved, and workers weren’t respected or valued. I quickly became active in the union, because I wanted to fight for a better system. I wanted our seniors to receive the high quality care they need from workers who would choose and stay in this career because they were respected, protected, and paid a living wage for the essential work they do.
As I speak to you now, decades later, I am proud of the incredible work and advocacy our union caregivers have done to push nursing home care reform forward. But the root of the problems remain – Inhumane staffing levels, inadequate funding with no transparency, and poverty wages for this essential workforce. Together, these flaws resulted in Pennsylvania having one of highest nursing home COVID deaths in the country, and countless caregivers also fell ill and lost their lives.
Simply put, we failed our seniors and those who care for them.
Just last week a much-anticipated landmark study from the National Academies of Sciences, Engineering, and Medicine’s Committee on the Quality of Care in Nursing Homes was released. The report found that “The way in which the United States finances, delivers, and regulates care in nursing home settings is ineffective, inefficient, fragmented, and unsustainable” and that “immediate action” is needed.
The good news is that right now in Pennsylvania we are poised to make change.
Through the unrelenting advocacy and demands of workers and other senior care advocates, the Wolf Administration has already started the process for state nursing home regulation reform. The two proposals released so far tackle some of the core issues contributing to the crisis: Staffing standards and change of ownership.
When the Department of Health announced its proposal to increase staffing standards to 4.1 hours of care per day, per resident, we were overjoyed. This standard is cited by studies as the number needed to deliver the high level of care residents deserve, and will also ease the injury and burnout of caregivers, who are leaving the bedside in droves because of the physical, mental and emotional demands of caring for too many residents on one shift.
A question we’re often asked is: How will we meet such high staffing standards in the midst of a workforce crisis?
“Crisis” is the key word: We do not have a shortage of caregivers, we have a crisis of caregivers leaving the bedside. They are leaving caregiving for better paying, less demanding jobs that don’t jeopardize their health. They are leaving because the store down the street is paying much better. They are leaving because they are stretched too thin. They are leaving because they’re tired of going home every day knowing they can never do enough for their residents.
This workforce crisis exists because working conditions and wages in nursing homes are unacceptable.
To solve this crisis we need to bring thousands of new staff into the industry, and we need to raise standards and wages so that caregivers return to the bedside. That means increasing staffing so that caregivers can do their jobs, and raising wages so they’re not living in poverty.
This will involve a three-pronged approach:
- We need an immediate investment of $150 million in ARPA funds to address the current crisis and flow of experienced caregivers away from the bedside by raising wages and standards. Similar to the ARPA funds provided to hospital caregivers, this investment must go directly to essential caregivers.
- An additional investment of $25 million will create CNA training hubs across the state to train thousands of new CNAs, preparing them to be confident and successful at this work which is shown to help with retention.
- But one-time funding will not end this crisis. We will also need a permanent $175 million investment in Medicaid rates tied to strong accountability to ensure that money makes it to caregivers, so that we can finally end the poverty wages and 128% turnover rate that plagues our long term care system.
I want to emphasize that accountability for this funding is absolutely critical. Pennsylvania’s long-term care system has been underfunded for years. And while over 70% of funding for nursing homes comes from taxpayer dollars, there has been no accountability to make sure homes spend that money on bedside care. We cannot reform this system without that accountability.
Pennsylvania’s rapidly-aging population makes our nursing home crisis even more dire. Every person deserves to have patient-centered care in the setting of their choice. And we must ensure all of those settings are safe, reliable, and able to provide high quality care.
COVID exposed the failures of our nursing home system with deadly consequences. It’s now or never: The legislature must provide the accountable investment needed to protect nursing home residents and those who care for them.