Maine’s direct care workers — those who provide hands-on, long-term care to the elderly and disabled — have long had demanding, underappreciated jobs. But their conditions have gotten even worse in recent years.
The 24,000 mostly female members of this workforce have seen their wages decline in real terms over the past decade, at the same time that the residents they care for have gotten sicker. You can now make more as an entry-level cashier at Target than as a certified nursing assistant, or CNA, at a nursing home.
While cashiers have their own challenges, the job of a nursing home CNA — one who dresses, feeds and bathes the elderly and disabled, among many other things — is by all measures more physically demanding and emotionally draining. They are caring for people’s lives.
The work is needed more than ever. The share of Mainers over age 65 is projected to grow from almost one-fifth to one-third of the state’s population between now and 2030. The state will require far more people to care for its burgeoning elderly population.
Indeed, direct care workers — an umbrella term encompassing the positions of CNA, personal care aide and home health aide — are among the fastest growing occupations in the state, according to the Maine Department of Labor. An additional 2,470 jobs are projected to be added to this sector between 2014 and 2024.
Yet today, long-term care providers can’t even fill existing positions, let alone additional ones. There are currently about 600 CNA vacancies at nursing homes statewide. There are more than 3,000 CNAs currently employed at nursing homes, according the Maine Health Care Association, a trade group representing nearly all of Maine’s 103 nursing homes.
“I’ve been here for 30 years, and it’s never been this difficult,” John Watson, the CFO of The Cedars, a non-profit nursing home in Portland, told the BDN’s Maine Focus team. About half of his facility’s 44 CNA positions are now unfilled most of the time, he said.
The solution is simple: Direct care providers like The Cedars must raise wages to remain competitive with other low-income jobs. But it’s also complicated, since employers are largely unable to boost pay without legislative action. That’s because some 70 percent of their funding comes from MaineCare, the state’s version of Medicaid.
And MaineCare reimbursements, which are set by Maine lawmakers, have been chronically low. In 2015, for example, there was a $20-million gap between what the state paid for MaineCare patients and the actual cost, according to the Maine Health Care Association.
There is at least a partial legislative solution already on the table — a bill before the Maine Legislature that would boost direct care workers’ pay. LR 1387, sponsored by Sen. Troy Jackson, a Democrat from Allagash, would raise wages for direct care staff in nursing homes, residential facilities, adult day care centers, and home care agencies by 10 percent in 2018 and another 10 percent in 2019. It would also set up a committee to study the long-term care workforce that would be tasked with building career ladders for these jobs and developing other strategies to improve long-term care work.
While the bill could go further — by setting a minimum wage for direct care jobs to ensure they remain competitive with positions that require similar education and work experience, for example — it is an important start.
“Those working in nursing home settings have one of the most demanding, heart-wrenching jobs. And what a slap in the face: You’re taking care of our loved ones, and we can’t even take care of you,” Traci Place, a business agent with Teamsters Local 340, a union that covers one nursing home in Eastport, said.
Maine’s lawmakers should pass LR 1387 as a first step in taking care of those who will, ultimately, take care of all of us in our last phase of life.
