MSCA President Tara Gregorio, earlier this month presented testimony to the Legislature on Senate 379 and House 648, Acts to Improve Quality and Oversight of Long Term Care. The proposed omnibus nursing facility reform bill is designed to address workforce, resident care, and suitability issues identified by the 2020 Nursing Facility Task Force. The bill includes vital workforce investments, among other items, that establish career ladder grants, create a tuition reimbursement program, and fund living wages for front line employees.
Mass Senior Care strongly supports efforts to ensure quality resident care and solutions to the workforce crisis. As such, Gregorio’s testimony offered support for many of the initiatives contained in this omnibus bill while also proposing important modifications or additions we believe would further advance quality care and reduce the sector’s 23% caregiver vacancy rate. Gregorio explained to lawmakers that, “Today we face enormous challenges in addressing the workforce crisis. There are approximately 7,000 vacant nursing positions in Massachusetts nursing facilities. In order to meet the care needs of current residents, the vast majority of directly employed staff are working overtime and, as the Health Policy Commission (HPC) recently documented, the use of temporary registered nursing staff has quintupled from 4% in 2019 to 19% in 2022. Not only does temporary nursing agency use decimate the employed staff morale, it also is disruptive to continuity of resident care and the charges are exorbitant and unsustainable based on current Medicaid funding.”
Gregorio’s oral testimony emphasized support for four sections of the omnibus bill including Section 1: establishing separate grant programs for supervisory training and career advancement; Section 2: establishing a paid Certified Nursing Assistant training program for individuals completing their nurse aide training at an approved certified nursing assistant program; Section 10: requiring MassHealth to recognize in the nursing home rate a living wage for direct care staff, and; Section 12: requiring the HPC to conduct an analysis of nursing personnel and staffing requirements in long-term care facilities to meet resident nursing care needs based on acuity, resident assessments, care plans, census and other relevant factors.
To build upon these important sections of the proposed legislation, Gregorio respectfully requested that the Committee include in its bill the following 3 key items:
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Language that consistent with the Nursing Facility Task Force Report and as proposed in Senate Bill 739, fully recognizes the actual cost of quality resident care and funding for competitive living wages;
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Language establishing a Certified Medication Aide Position as part of the clinical care team in nursing facilities. This position is allowed in over 30 other states and even in rest homes and group homes in Massachusetts. Under Senate Bill 1468, Certified Nurse Aides (CNAs) after extensive training and competency testing would be permitted to dispense non-narcotic medications to residents.
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Language that reigns in temporary nursing agency fees, and establishes greater accountability, and transparency measures on these firms as proposed in House Bill 1174, Senate Bill 810, and House Bill 1166 and Senate Bill 780.
Gregorio closed her remarks by offering her thanks for the opportunity to testify and stating that MSCA looks forward to continuing to work with the Committee to ensure that we have a strong, transparent, accountable, well-staffed and equitable long term care system.