The negative impact of New Hampshire’s workforce shortage is perhaps best illustrated by the plight of the Carpenter Home in Swanzey.
The Carpenter Home is a 16-bed, not-for-profit home owned and operated by the town of Swanzey. It has been providing services to the elderly residents of southwestern New Hampshire since the 1930s. However, about a month ago the town announced plans to close the home. The town selectmen said the principle reasons for the closure after several decades were the inability to hire and retain staff, and the inadequacy of Medicaid funding to sustain operations.
Across our state, residential care and assisted living homes see the implications of the health care workforce shortage each day. Like the Carpenter Home, the Gafney Home in Rochester, founded in 1904, is a not-for-profit home that has served the elderly citizens of Rochester for many decades. The Gafney Home closed May 1 because, as the president of their board of trustees put it, “Financially, it is not feasible for us to maintain our assisted-living program at this time.” Without a boost in Medicaid reimbursement rates many of the smaller homes across the state that provide the bulk of Medicaid-funded assisted-living services will share the fate of the Carpenter Home and the Gafney Home. For their sake, and for the sake of all our state’s elderly citizens, the Medicaid rate increases and other provisions in Senate Bill 308 need to be included in the state’s budget.
Virtually all of the 76 homes that are part of the N.H. Association of Residential Care Homes are having difficulty hiring and retaining staff, and for some, like The Carpenter Home and the Gafney Home, it is now a question of whether or not they can survive. This crisis directly affects the quality of life of residents. Their care can be compromised by not having enough staff, or staff that are burned out by repeatedly working overtime shifts. Our nursing homes are now accepting the responsibility of caring for thousands of older adults while simultaneously facing closure due to lack of staff.
In the case of residential care and assisted living, the longstanding underfunding of the Choices For Independence Medicaid waiver has also created a crisis in access to care for New Hampshire’s elderly and disabled adults. The demand for Medicaid-funded residential care beds far exceeds the number of beds available. This is because most providers cannot offer services at the rates offered, and those that do often find themselves in a financially precarious position.
The impacts of the health-care workforce shortage extend beyond our aging population as well. It is an established fact that all of the state’s health care providers are facing a workforce crisis, including staffing shortages in hospitals, community health centers and community mental health centers, where there are over 2,000 clinical vacancies.
New Hampshire’s hospitals provide lifesaving care to hundreds of your neighbors a day, including functioning as New Hampshire’s new “hubs” for substance misuse treatment. Community health centers give our most vulnerable residents, including young children, access to critical medical care. Community mental health centers see thousands of patients every year and are particularly necessary during our state’s mental health crisis. None of these organizations can function effectively without qualified medical professionals to staff them. It is not hard to envision a community without access to these medical facilities if we do not find ways to grow the health care workforce.
The good news is that, as we move forward, there are opportunities to support and grow our health care workforce. Increasing Medicaid reimbursement rates and decreasing administrative costs will play a part in supporting providers in their quest for talent. Both low Medicaid reimbursement rates and high administrative costs pose threats to health care providers in their attempts to provide both preventative and lifesaving health services.
Investing in recruiting new talent is a way to fill the hundreds of vacant positions that are preventing Granite Staters from getting appropriate health care. We need to create strong residency programs and a pipeline for new professionals to meet the increasing demands of the workforce. Young people entering the workforce today are doing so in a drastically different working world than in the past. Employers need support in attracting these young people to health care jobs and training them to work in this fast-paced industry effectively.
Our state lawmakers have a responsibility to support a budget that will promote the health of New Hampshire residents and help our state thrive economically. Health-care workforce development is one crucial way to do just that.