Tiffany agrees to explore legislation addressing CNA pay, training requirements
Last Wednesday morning, Senator Tom Tiffany (R-Hazelhurst) stopped in for a visit with staff at Pine Crest Nursing Home, after being contacted by Director of Nursing Mindy Meehean regarding a shortage of Certified Nursing Assistants across the state.
Whether it’s a well known or little known fact, the position of Certified Nursing Assistant (CNA) is not only one of the lowest paid of health care support occupations nationwide, but in the state of Wisconsin as well.
According to the US Bureau of Labor Statistics, the current national median wage for CNAs is $25,090, translating to approximately $13.97/hr. In the state of Wisconsin, CNAs drop a couple thousand dollars below the median to right around $11.10/hr or $23,088 per year.
According to Meehean, the low pay for the position and other factors have contributed to a shortage of CNAs in facilities across the state.
Those other factors include a Wisconsin mandate requiring 120 hours of instruction, which is primarily completed via online coursework, to qualify for certification.
However, according to Meehean, the federal mandate is only 75 hours.
The difference comes into play when courting and interviewing candidates from other states who have the 75 hour minimum.
“I recently had an applicant from Colorado who was a great candidate,” Meehean explains. “But she only had the 75-hour federal requirement. In order to be employable in the state of Wisconsin, she would have had to go through the CNA course all over again. Most candidates just don’t want to do that.”
And for good reason, it seems.
The total cost to even become a CNA in Wisconsin is nearly $1,000. The course itself lasts between 3-4 months with average costs of approximately $800, which is not eligible for financial aid.
In addition, candidates then must pass a written exam at a cost of $115, with a re-test fee of $45. All requirements must be fulfilled within one year or the candidate must start the entire process over.
“The process to become a CNA is expensive,” Meehean adds. “Having to pay that amount of money out of pocket for a low paying job, there just isn’t much of an incentive for candidates to take an interest in becoming a CNA. I would like to change that.”
As Meehean further explains, the shortage of CNAs is considerable and could lead to a crisis if the present outlook doesn’t change soon.
“We have seen a steady decrease of CNA employment since 2012. As of this year, we are looking at a 14.65% decrease in the Wisconsin CNA registry. Here in Lincoln County, an estimated 35% of our population will be ages 65 and older by 2040. If something doesn’t change and change very soon, we will be looking at a serious crisis. We aren’t quite at that point now, but it’s definitely very possible.”
So rather than stand on the sidelines and watch the statistics continue to drop, Meehean decided to take action.
But the second-year administrator didn’t just rely on word of mouth and write a letter or two. She in fact sent several letters and e-mails to various legislators and anyone else who could possibly assist with her cause.
That is when Tiffany answered the call.
Tiffany arrived at Pine Crest Wednesday morning and met with eight staff members, including five CNAs and three nurses currently employed at the facility.
“We work long hours and the pay is low, but we come back every day because we love our jobs!” said Julie Johnas, a CNA in attendance on Wednesday. “We are on the front lines of providing care to our residents every day. We become their family. But when it comes to hiring more CNAs, there just isn’t a very large pool to choose from.”
In listening to Meehean, Johnas and other staff present, Tiffany took an immediate interest, citing a recent health care consortium with other legislators.
“Of course health care facilities can use more money and that is something we always face as legislators,” Tiffany said, “how to allocate what little funds we do have. I think half the equation is finding which of these regulatory impediments we can get out of your way, such as the higher state training mandate.”
“That would be a great start. I understand why the state has a higher training requirement. Raising the standard for training means raising the level of care and I completely get that. But most of the training is done online, and as any of my staff will tell you, this just isn’t a job you can learn by taking a course on a computer!” she added. “It requires far more hands-on training and I think that is something we can take on here at the facility. If we could go down to the 75-hour requirement, we would be more than happy to offer the rest of the training here in hands-on form.”
“Exactly!” agreed CNA Lori Emerling, citing an example of catering to individual resident needs. “No two residents with dementia are the same. You just can’t provide quality care to a resident with dementia by what you read in a book or on the computer. For example, if a resident had made a career of working the night shift and was always on the move. Even though the resident is now here with us, we just can’t expect the resident to forget all those years where they were up all night, working, walking around and checking on things or whatever the case may be. Part of providing quality care is catering to that. Instead, we would give the resident a flashlight and go on rounds or whatever makes them feel happy. That sort of activity makes them feel like they’re being productive. But you wouldn’t know that about that particular resident, from reading a book about dementia.”
Tiffany agreed on seeing room for improvement and suggested willingness to initiate a bill in the 2017 legislative session.
“I’d be willing to work with colleagues to see what we can do here. I would be interested in initiating a bill to reduce the state mandate for CNA training down to the 75-hour federal requirement and have the remaining hours completed in the form of hands-on training,” Tiffany explained. “But I will caution you, this type of bill will not come without challenges. There will be concerns of reducing quality of care, so I will need you and other facilities to advocate for this, to send the message we are not sacrificing quality of care here. But rather making it easier and more affordable to become a CNA and increase the employment pool.
“If we can hurdle some of these regulatory requirements and obstacles, maybe we can free up money for facilities to allocate as you deem fit.”
Other possible contributing factors discussed on Wednesday included thousands of dollars in monthly bed tax paid out from care facilities, minimal payments received from Medicaid and mandatory overtime requirements for care staff.
“Working as a CNA was once a very respectable profession,” Meehean stated following the meeting. “I want to bring that back!”
“Being a CNA has become more of a stepping stone for other careers in the health care field, but I would like to see a Certified Nursing Assistant once again become a desirable career. It’s a hard job but a very rewarding job. That’s why I am here advocating for higher wages and trying to make it more affordable to become a CNA.
“I would like to see wages improve to make it worthwhile to pursue this career and work those long weekends. Higher pay means better quality candidates and possibly even higher quality of care. I hope to change the face of what it means to be a CNA, and today was a big step in meeting with Senator Tiffany. We are so very appreciative for him taking the time to talk with us and hear our concerns!”
Due to the close of the 2016 legislative session being right around the corner, Senator Tiffany stated his intent to meet with other legislators with experience in health care related policy and possibly bring a bill forth during the 2017 session.
Tiffany agrees to explore legislation addressing CNA pay, training requirements