Indiana elder care providers tap lawmakers for hiring help

Indiana elder care providers are tapping state legislators to pass measures that will help them recruit and retain workers as the coronavirus pandemic continues to exacerbate strains on nursing facility staffs.

The number of Indiana residents living in nursing facilities or receiving in-home care services dipped during the early months of coronavirus pandemic, according to data collected by Indiana’s Family and Social Services Administration.

Enrollment numbers in nursing homes and assisted living facilities have stabilized since the rollout of COVID-19 vaccines, but Zach Cattell, president of the Indiana Health Care Association, which represents the state’s nursing home operators, said maintaining a workforce is now “the No. 1 issue” facing the state’s nursing facilities.

“The labor participation rate is still very low, compared to where we were pre-pandemic, and we need workers, as do home health agencies, hospitals and hospice,” Cattell said. “It’s really from the ground up that we need help. It’s all a very intense competition for a scarce resource, which we’re very worried may not come back for everybody.”

About 40% of the health care association’s members are using contracted agency staff, Cattell said, a costly alternative to in-house health care workers, which facilities typically turn to “only in the most dire situations.”

Without the agency employees, however, Cattell said health care facilities might have to limit admissions or consolidate existing patient wings—putting additional responsibility on already stressed staff.

The number of Indiana residents turning to home-based care has increased since the onset of the coronavirus, but staffing shortages in that sector, too, have limited how many receive services, said Evan Reinhardt, executive director for the Indiana Association for Home and Hospice Care.

The group is asking lawmakers to ease regulatory requirements for training, which Reinhardt noted could include expanding the duties of unlicensed personnel like licensed practical nurses and registered nurses to boost the number of home health aides across the state.

“No one has a magic bullet for staff, and we are losing out more and more to hospitals and nursing homes that can afford to pay big bonuses and higher wages that we can’t compete with,” Reinhardt said. “The demands are at an all-time high … more overtime, more workers needed and work to be done, but fewer workers to do it.”

To increase the number of qualified health care workers in the state, AARP, the state’s largest advocacy group for older adults, is also urging lawmakers to ease limits on nurses.

Ambre Marr, legislative director for AARP Indiana, said that includes expanding the scope of practice for advanced practice registered nurses who are currently restricted under state law from performing certain duties, such as prescribing medications, unless they work under a doctor’s supervision.

Republican State Sen. Ed Charbonneau has said the coronavirus pandemic has highlighted provider shortages and the need for new health care options, though it’s still unclear what proposals lawmakers will weigh during their upcoming legislative session, which begins Jan. 4.

As part of Indiana’s response to COVID-19, Gov. Eric Holcomb has continued to renew his executive order first issued in March 2020, easing some licensing requirements for health care professionals.

The temporary orders have helped, Cattell said, but nursing facilities are still seeking help from legislators to train more licensed nurses, certified nurse aides, therapists, speech language pathologists and home health aides.