Summary

A persistent and growing shortage of certified nursing assistants (CNAs), home health aides (HHAs), and licensed and registered nurses, and teachers in nursing schools poses a substantial challenge to the ability of health care providers to meet the health care needs of our communities.  This shortage impacts disproportionately on the provision of services for the frail elderly and in rural and inner-city communities and undercuts efforts to encourage home- and community-based service provision as an alternative to institutional care.

Conference Position

The Conference supports the development of a variety of mechanisms to ameliorate labor shortages in the health workforce:

• Cooperative programs which maximize the resources and expertise of government, business, labor and health care providers to identify and recruit available labor, such as job/worker matching and job training grants through the Department of Labor and the Empire State Development Corporation, and the development of curricula through the Department of Education to promote career choices in health
• Grants to assist recruitment, retention and training efforts and to expand benefits such as child care, transportation, tuition scholarships and/or loan forgiveness programs, including equitable and efficient use of HCRA and other funds
• Adequate payments to providers for services, which allows levels of revenues necessary to procure and maintain a well-trained and stable workforce

Rationale

Many factors contribute to the shortage of labor for the health care workforce:  low pay, insufficient benefits, inadequate training, absence of a career “ladder” with discernible stages of advancement, and competition from other sectors of the economy for workers.  A declining revenue base from managed care and reduced government payments, and the growing need for health care services as the population ages, compound the problem.

As a result, health care providers experience high staff turnover, and remaining staff experience overwork and stress, which further maintain the cycle of staff shortages.  Continuing shortages lead to reduced availability of health care services, most particularly home health and nursing services in rural and inner city areas.  In addition, staffing shortages pose challenges to the maintenance of quality of care in all health care settings.