An aging population in Connecticut is straining the elder care system in multiple ways. Will legislation pass this session to help?
WSHU’s Ebong Udoma spoke with CT Mirror’s Jenna Carlesso to discuss her article, “CT’s aging population is growing. There are not enough people and facilities to take care of them,” as part of the collaborative podcast Long Story Short.
WSHU: In your article, you write that Connecticut's elder care system, which has long been the final destination for many of the state's elderly residents, is at a precipice. Why so?
JC: So right now nursing homes are seeing increased oversight from the state, they are experiencing a rise in complaints against them to the state Long-Term Care Ombudsman, they are seeing a rise in immediate jeopardy violations, and increased pressure to right-size the industry.
This means with fewer people going into nursing homes, the nursing home sector has to condense to some extent to reflect that. And at the same time, on the home care side, we're seeing roadblocks left and right in the state's lofty goals to help more people stay in their homes. And that might look like the workforce not being there, that might look like difficulty navigating the system, and things like that.
WSHU: Now with nursing homes, they didn't fare too well during the pandemic. They lost a lot of staff and many were cited for violations. have they recovered?
JC: So nursing homes were at about 88% occupancy across the board in Connecticut before the pandemic. So they had a lot more people living there. At the height of COVID back in 2020, we saw a very large drop, down to the low 70s in occupancy percentages. And they have recovered somewhat back up to the low 80s. But haven't recovered fully since the start of the pandemic. And they have lost a lot of workers in that sector.
WSHU: But in the meantime, Connecticut ranks fourth in the share of the population 85 and older. So how do we deal with this? Where do we have a shrinking workforce? Does the state have any strategies to retain the workforce?
JC: It's certainly a topic of debate right now. Pay is an issue that is creating a revolving door in both the nursing home and the home care workforce. Benefits in some cases are another issue. And so there's discussion around, how we make it more attractive for folks to work in this industry, as well as perhaps some type of career ladder. So if you go into work in a nursing home as a certified nursing aide, for example, and you want to become a registered nurse, or advanced to some other position, might there be a pipeline there for folks to build up?
WSHU: You say that the trend generally is shifting into home health care. What has been done to improve that? You know, for the first time since 2018, the state spent more on home health care than they did for nursing home care. So what's being done as far as home health care is concerned?
JC: Yeah, home care is considered much more desirable to many folks. There are studies that show more people prefer to age at home than to go into a nursing home or some other type of institutional setting. And at the same time, the state actually can spend less money funding somebody on home care than paying for somebody in a nursing home. And the state has launched an extensive network of programs, like Medicaid waiver programs, to help people stay home.
WSHU: Well, you're talking about an extensive network, how easy is it to navigate this network? You mention the case of Alan Coker, a 65-year-old who's having a hard time getting through the system.
JC: Yes, a lot of people have reported having difficulty navigating the system, whether it's understanding all the steps that they need to take or having somebody to bounce questions off of, whether that's trying to hire a couple of aides to work for you at home to help you with meals, bathing, dressing, running errands, all of those things.
Sometimes folks are having to call dozens of people trying to secure an aide who can help them because they're either not taking new clients or they live far away from this person. There are a lot of challenges with people we're trying to connect with the aids.
WSHU: What about pay? That's been an issue, and there's been a massive turnover in the workforce. And as a matter of fact, you write that the union, SEIU 1199 has said that they cannot make a living wage doing this.
JC: Yes, until recently, the personal care aides in that union made an average salary of about $16.25 an hour, which would equal about $33,800 annually. They did reach a new agreement with the state recently, that rate paid $17.75 an hour last year, and then up to $18.25. But indeed, they have said that, in Connecticut, that's not a living wage.
WSHU: You also mentioned the fact that even those that do get the work, getting paid, is an issue. There's a person that you mentioned here, Ebony Ross-Peel, who had a hard time getting paid for the work that she had done.
JC: Yes, several workers have reported to the union problems with payment, maybe it's late payment, or maybe they didn't get paid at all, for a certain amount of time. And the union is working through sorting out many of those complaints. The state is now searching and I believe has agreed to bring on a new payroll agent through an RFP process that is in negotiations right now. So the payroll agent that it currently employs will be phased out. But for the time being, there are still problems with payment being reported.
WSHU: So with all these problems, how do we retain and keep the workforce that is needed to take care of the aging population in Connecticut? What are the legislative proposals to fix the problems?
JC: So there are a series of legislative proposals right now that deal with elder care. One of them concerns mandatory hours in nursing homes of direct care. So right now we're at three mandatory hours. And some folks want to bring that up to over four hours of mandatory direct care per person per day. That would mean an increase in staff or an increase in overtime.
There are proposals to make sure air conditioning is put into nursing homes. There are all sorts of proposals, but I think the workforce piece is something that's still being widely debated. How do we increase pay? How do we make that field look more attractive to people? Because the nation's 85 and older population is set to more than double over the next 20 years. And it's very critical to have that workforce in place.
WSHU: Any chance that we'll see legislation passed this year?
JC: There was a wide-ranging bill in a committee that I believe is coming up to the committee deadline. And in a different committee, we also saw some bills that were passed out of committee. So it's certainly been a very key topic this year in a number of committees, and we'll see where these proposals go.
