TOPEKA — Kansas health care entities hope a series of programs and funding opportunities will help home and community-based services rebound from a serious workforce shortage exacerbated by the pandemic.
A survey conducted monthly by the National Healthcare Safety Network showed shortages among nurses and aides in 25 to 30% of the responding long-term care sites. Sites reporting shortages rose steadily beginning in May, and although the number has leveled off, it remains higher than earlier this year.
In response, the Kansas Department for Aging and Disability Services wants to funnel $57.1 million in federal funds toward these workforce issues in home and community-based services, including $51 million for one-time retention bonuses.
“That would be a $2,000 bonus per HCBS worker to retain, keep them in the field, recognize the work that they had done and acknowledge what they’ve gone through during the pandemic to support and maintain long-term care,” said Scott Brunner, KDADS deputy secretary of hospitals and facilities.
Brunner and Janis DeBoer, KDADS executive director, were among health care agency representatives on hand to present before the Kansas Senior Care Task Force. The representatives highlighted funding, education and collaboration to frame where the state is falling short in workforce issues and ways to curb shortages.
In addition to the one-time bonuses, $5.1 million will go toward training and $1 million to study and design a career ladder so employees who start as an attendant care worker can move up through other positions in the industry.
The use of these funds for addressing workforce shortages has not yet been approved by the Center for Medicare and Medicaid Services, but the state could soon receive conditional approval to begin these projects, DeBoer said.
“We are in the same boat with 41 other states who received partial approval,” DeBoer said. “Then we’ll transition into conditional approval, which means we can start drawing on the projects that they don’t have questions about.”
One reason these shortages have risen to crisis levels is poor pay for low-level jobs in long-term care facilities, said Kevin Sparks, CEO of United Healthcare Kansas. He laid out a scenario in which a worker needs to care for an elderly Kansan who has advanced Alzheimer’s, along with severe diabetes, high blood pressure and more.
Under the Kansas Medicaid rate, an individual would be paid an hourly rate of just $11.84 to care for this individual, Sparks said. That is less than the starting hourly rate of $18 at Amazon and $15 at either McDonalds or Scooter’s Coffee.
“Some of the tasks and jobs that you have to do take a special person to do it,” Sparks said. “That person also has to be paid for what it is that they’re trying and being asked to do.”
United Healthcare convened a workgroup in 2019 to begin looking into how they could address pay problems. It has also encouraged the use of the Kansas Personal Care Directory, which helps to match those seeking care and those seeking employment.
Additional investigation into workforce shortages is being conducted by the Network Adequacy Task Force, an effort led by Aetna Better Health of Kansas. Jennifer Pruente, director of long-term services and supports for Aetna, said this panel meets weekly to review what areas of Kansas health care could be affected by workforce shortages.
“We’re looking at our administrative process for claims and billing, making sure that when providers are delivering services, that those payments are coming in and that process is efficient, and they’re not experiencing unnecessary administrative burden during a time when they need to have the resources pointed toward addressing workforce issues and staffing members,” Pruente said.
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