That long-term care may, thanks to vaccinations, may finally be emerging from the worst of COVID-19 does not lessen the terrible loss of human life the virus has inflicted, nor the suffering of those infected by, but surviving, the virus. Federal visitation restrictions remain for our most vulnerable, contributing to depression and feelings of isolation, and now each college or university outbreak raises community prevalence — the metric by which facilities must operate — to a level that precludes restoration of any semblance of normalcy.
Keene State students might ponder whether the consequences of a party are worth making it impossible for elderly spouses to visit one another in a nursing home. Because that is what has been happening in Cheshire County. I long ago gave up hope that this pandemic would bring out the best in us. Though it has in some cases, with over 500,000 U.S. dead — and so many of those deaths preventable just through mask-wearing and social distancing — it has largely brought out our worst.
There has been a notable exception: Those working in long-term care facilities. Not only have so many staff in assisted living facilities and nursing homes stayed on their jobs through outbreaks and unimaginable adversity, but there are also new staff members who, heroically, came “rushing to the fire” during the pandemic. Still, all those working with the state’s Medicaid clients are plagued by New England’s worst gap between Medicaid care costs and payments, which depresses their wages. It is why a national study found in December that 30.8 percent of New Hampshire nursing homes reported a shortage of licensed nursing assistants, compared to a nurse aide shortage of only 2 percent in Massachusetts. Each day a net exodus of thousands of New Hampshire health care workers crosses the border for better wages. Who can blame them?
And what do long-term care workers have to look forward to in the ongoing legislative session in Concord? Myriad tax cut proposals will further diminish the resources available for their wages. Saving 5 cents on a $10 lunch from a proposed Meals and Rooms Tax reduction does not do you much good if you are not making a living wage, nor are you likely invested in the stock market to enjoy the proposed elimination of the 98-year-old Interest and Dividends Tax. And I doubt the Walton family, worth $247 billion as of the last measure I saw, will pass along their share of the proposed Business Enterprise Tax cut to Walmart customers.
That we have shortchanged paying Medicaid costs, primarily wages, for so long is a lasting shame, but to resume doing so — after the last budget brought a reversal with modest Medicaid increases — could not come at a worse time given the financial repercussions of this pandemic. Further, when $19 million in state funding is backed out of long-term care in the proposed two-year budget, compared to the current budget, it is your local property taxes that will have to make up the slack. That just makes housing even more unaffordable at a time when many of our workers cannot afford to live near the facilities in which they work (on the Seacoast, for example).
These considerations must guide the budget work being done in Concord. And let us pray that a federal stimulus bill brings additional resources to help our state shore up a long-term care system on the brink of collapse.