In response to COVID, NJ moves to pay long-term care workers more

By Lilo H. Stainton for NJ Spotlight

This story was written and produced by NJ Spotlight. It is being republished under a special NJ News Commons content-sharing agreement related to COVID-19 coverage. To read more, visit njspotlight.com.

Facilities that care for and house New Jerseyans with disabilities did not experience the same level of COVID-19 outbreaks witnessed at some nursing homes. Now advocates for the disabled community fear this will keep the state from including their workforce in its plan to increase wages for certain frontline health care workers.

“Where is the recognition for this group?” said Valerie Sellers, chair of the New Jersey Coalition for a DSP Living Wage, which advocates for the direct support professionals who work with individuals with intellectual and developmental disabilities. “We’ve got to rectify years of underfunding.”

Gov. Phil Murphy committed $155 million last week to assist New Jersey nursing homes, which have the highest coronavirus case rate per facility in the nation and account for half of the lab-confirmed COVID-19 deaths in the state. Of this funding, a mix of state and federal dollars — $78 million — is allocated to hike pay for certified nursing assistants, the frontline caregivers who bathe, dress, feed and help residents with other daily activities.

Legislation to allocate $62.3 million in state dollars for this wage increase is among the eight bills scheduled for a vote Friday in a joint Assembly and Senate hearing. Other measures would expand sick leave to cover per-diem nursing home workers, establish a long-term care emergency operations system within state government and create a task force to oversee the industry.

Staff-to-patient ratios

Lawmakers also plan to consider a bill — now being finalized — that would set in statute nursing home staff-to-patient ratios, a long-debated proposal that facility operators contend is costly and unworkable. Currently, staffing levels are governed by state requirements, standards not set by law, that facilities provide a certain amount of daily care for each resident.

When it comes to wages, Sen. Joe Vitale (D-Middlesex), who is spearheading the Senate’s nursing home response, said Thursday he understands that other providers are also looking for funding to boost pay for frontline staff. “But it’s not going to happen. The money is just not there,” he told NJ Spotlight.

Vitale said his goal has been to recognize the sacrifices made by nursing home aides, who put their lives on the line to care for residents during the pandemic. The wage bill and others were developed based on a report from consultants at Manatt Health, which the Murphy administration hired in May to develop a short- and longer-term strategy to improve the coronavirus response at the state’s 371 nursing homes.

“We’re taking a big step that we can afford right now,” Vitale said. “It’s a first step. And we will move on to the next step,” he added. “But we can’t cut up the (funding) pie anymore.”

$3 more per hour

Frontline nursing home caregivers earn $15 hourly on average; officials estimate they would receive roughly $3 more with the funding allocated by Murphy and codified in the wage benefit bill, which requires the entire increase to go to workers. Additional money is set aside to help facilities pay for testing, cleaning and other coronavirus-related costs, but with a claw-back provision allowing the state to reclaim money if they don’t meet strict guidelines. “There’s an incentive for them to do the right thing,” Vitale said.

Sellers said direct support professionals earn closer to $12 or $13 hourly, although some have received temporary hazard pay, which will soon end. And while state officials approved higher Medicaid rates for home care services last year — boosting the reimbursement to $18 an hour — a portion goes to administrative costs and taxes, so personal care assistants, or PCAs, take home closer to $12 an hour, according to industry representatives. (PCAs are home care workers who care for the elderly in private residences, while DSPs work with individuals with disabilities in various settings.) New Jersey’s hourly minimum wage now stands at $11 and is set to increase to $15 by 2024 under a law Murphy signed last summer.

Under Murphy’s plan, the additional funding for nursing home wages would be distributed through a temporary increase of roughly 10% in the state’s Medicaid reimbursement rate for these facilities; the public insurance program pays for seven out of 10 nursing home residents. But the increase is only slated to last through June 2021, raising concern for industry and labor advocates seeking a sustainable solution.

The wage bill was part of the legislative reform package that was the focus of a spirited joint hearing last week before the Assembly Aging and Senior Services Committee and the Senate Health, Human Services and Senior Citizens Committee, which Vitale chairs. The hearing featured powerful testimony from nursing home residents, frontline workers and industry leaders. Lawmakers also heard from advocates for disabled individuals and representatives from the home care industry, which dispatches caregivers to help homebound seniors in their private residences.

“If there’s anything you can do, please do not forget about all the home care workers out there,” said Nancy Fitterer, president and CEO of the Home Care and Hospice Association of New Jersey, which represents private nursing and home care providers. Like nursing homes, she told lawmakers, these entities have also struggled with staff and resource shortages, including a lack of gowns, masks and other protective gear.

Assemblywoman Valerie Vainieri Huttle (D-Bergen), who is leading the reform charge in the Assembly, underscored that DSPs and home health workers are “valued members of our communities” who provide critical services and said she is “committed to addressing their concerns.”

More legislation ahead

“However, the legislative package in question is intended to focus on reforming our state’s long-term care system,” Vainieri Huttle continued. “Nonetheless, as we continue to examine the potential reforms in the wake of COVID-19, it is my intention to work with the home health and DSP communities and collaborate on additional legislation.”

That could be good news for the Coalition for a DSP Living Wage. Sellers said the group has proposed legislation that would tie worker pay to the cost of living, so that it would keep pace with inflation. “We’ve been nickel-and-diming to raise DSP wages for years. We need to do this once and for all,” she said.

While she supports the state’s goals of investing more in nursing homes, Sellers stressed that DSPs should not be overlooked. She said these workers provide much of the same kind of daily care as nursing home aides, including administering some medications, but they also help individuals communicate, assist with therapeutic activities and behavior modification, and provide mental and emotional support.

“This is not a minimum wage job,” Sellers said. Like advocates for nursing home aides, “all we’ve been asking is that you put us above minimum wage,” she said.

Nursing home employees and residents account for some 37,800 of the more than 188,500 cases of COVID-19 diagnosed statewide since March; more than 7,000 fatalities, out of more than 14,100 overall, are connected to these facilities. State figures show New Jersey’s COVID-19 case count also includes roughly 1,900 positive diagnoses among disabled individuals and their caregivers at state-run institutions and group homes, or private residences, of which 186 have died.