Advocates seek $300 million to address health care workforce shortage
Feb. 1 – CONCORD – A coalition of providers on Wednesday accepted a senator’s proposal to spend up to $300 million in state and federal grants to expand the healthcare workforce in New Hampshire.
The Health Care Workforce Development Act 2023 (SB 86) would give the Department of Health and Human Services the money to grant rate increases to health care providers based on need.
The legislation would also professionalize a class of existing health workers and support proposed rural health training and residency programs.
Democratic Senate Vice Chair Cindy Rosenwald of Nashua, the bill’s lead sponsor, said COVID-19 and a chronic labor shortage had brought the system to the brink of collapse.
“When COVID happened, all of our vendors were suddenly incredibly tight. The cracks have gotten so wide and so deep that I think we can truly say that our entire system is clearly in crisis,” Rosenwald told the Senate Health Care Committee.
Her pitch was the first of many made as lawmakers prepared to write the next state budget for the biennial cycle, which begins July 1.
In the last state budget, the Legislature approved blanket price increases for all Medicaid providers of 3.1% for two consecutive years.
Rosenwald said that helped, but prices remained well below what providers in most states receive for reimbursement.
“It’s difficult to get a hospital bed in New Hampshire when you need it. It’s difficult to get patients into a nursing home because they can’t staff their full capacity,” said Rosenwald, who serves on the Senate Treasury Committee.
Since COVID, hospitals have lost 6% of their staff and nursing homes 9%, she said.
“Some of our frail elderly literally die before they can be served and even examined,” Rosenwald said.
Legislation for the next biennial budget would provide:
– $145 million for carrier rate increases;
—$9.65 million for regional health education centers;
—US$2 million for an advanced rural health education program;
—$1 million for a rural residency program.
The federal government matches state spending on its standard Medicaid program, which would total approximately $300 million in grants for Rosenwald over the next two years.
Medicaid spending for the current two-year cycle is approximately $2.5 billion.
The Granite State Advantage program, which has expanded coverage for low-income adults, offers the state 90% of the state grant. Lawmakers must decide this year whether to continue offering this coverage.
Henry Lipman, the state’s Medicaid director, said that this level of higher spending, if applied broadly, would mean an approximately 11% increase in rates.
Senate President Jeb Bradley, R-Wolfeboro and Rosenwald made history when they jointly sponsored the nationwide walk, the first in at least 14 years.
The Department of Health and Human Services has traditionally preferred to be able to differentiate how much providers should receive.
The state clearly faces greater challenges in some areas of healthcare than others, Lipman said.
The legislation would create certification of community health workers who perform non-clinical work. This would result in higher pay for those workers and relieve clinical staff, Rosenwald said.
Ken Gordon, CEO of Coos County Family Health Services, said his program has already received a federal grant to develop a medical residency program in the North Country.
“The idea of developing our own doctors, rather than relying on out-of-state recruitment, is an attractive opportunity that has been successful in other states,” Gordon said.
The New Hampshire Health Care Association, which represents private nursing homes, cited AARP research that concluded New Hampshire has the second-biggest staffing shortage in the country, said Alex Koutroubas, a lobbyist representing the group.
Joe Bohunicky, manager of Mount Carmel Rehabilitation and Care Center in Manchester, said he has 30 nursing positions open and has spent $1.2 million on outside agency staff to work at his facility over the past nine months.
“Hospitals are getting angry at us because of the restrictions we have put on them. We need help,” he testified.