My Turn: State must address health care workforce shortage

For the Monitor
Published: 5/7/2019 12:10:19 AM

With the closing of Laconia State School in 1991, New Hampshire became the first state in the country to close its institution for individuals with intellectual and developmental disabilities and to develop a totally community-based system of supports and services.

New Hampshire is rightly proud of this accomplishment but, unfortunately, this proud tradition of inclusion and integration is in jeopardy due to the severe health care workforce shortage in the state.

Agencies that provide supports and services for individuals with intellectual and developmental disabilities have not seen a Medicaid reimbursement rate increase in more than 10 years and the ability to recruit and hire qualified direct support professionals (DSPs) to provide these services has been severely compromised by the inability to pay them a living wage.

New Hampshire has many wonderful, dedicated staff who are finding that in order to survive and feed their families, it is necessary to leave the work they love. Instead, they take jobs in other areas that pay more and do not require the level of training and responsibility that a DSP job requires. As a result of low Medicaid reimbursement rates and subsequent low budgets, direct support organizations are not able to pay a sufficient wage to attract qualified candidates from an ever-shrinking workforce in New Hampshire. As a result, some of New Hampshire’s most vulnerable residents do not have access to the care they need.

The New Hampshire Legislature has worked hard to fund the developmental disabilities waitlist each year, but without an appropriate workforce, it is all for naught. A lack of a workforce to provide services for the developmentally disabled means that individuals receive funding but still cannot receive services, and they sit at home rather than getting out to work, volunteer and participate as active, vital members of their communities.

Provider agencies are unable to accept new referrals, as they do not have the workforce to safely support individuals in the community, and families are forced to adapt their schedules to ensure their family member is safe while they wait at home for services. Other individuals with physical disabilities are left without caregivers and may end up in more expensive, residential or facility-based options in order to simply be able get out of bed and function on a daily basis.

There are currently more than 2,000 vacant health care positions across New Hampshire, including in hospitals, nursing homes, community health centers, mental health agencies and developmental disability service agencies, among others. We are all struggling to attract and retain qualified workers, creating a health care crisis in New Hampshire as a whole.

How can we keep New Hampshire residents healthy if we do not have the health care workers to provide the much-needed care?

Something needs to be done about our health care workforce shortage. Our solution should include, but not be limited to, Medicaid rate increases, investing in the state loan repayment program, implementing an online background check system for new employees and reforming the Medicaid “spend down” system. It is time for lawmakers to invest in our health care workforce and fund a budget that allows our state to be healthy and thrive economically in these challenging times.

(Michelle Donovan is the New Hampshire state director of Living Innovations.)




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