Proposal Presented for the Master Plan for Aging (#38)
Disclaimer
Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.
Summary
Establish financial investment in workforce recruitment and provide education about training provided at the nursing home. This proposal includes recommendations to decrease educational barriers, review safety, efficacy and requirements of technicians and assistants, and promote flexible career ladder opportunities.
Justification
As a result of the current and historic staffing shortages that have afflicted the Long Term Services and Supports (LTSS) field, workforce training needs to be modified to a more functional, effective, and efficient approach. This should be reflected through a focus on career ladders with flexible opportunities and doing away with the Administrator-in-Training (AIT) requirements that obstruct talented individuals from joining the nursing home administration field. Established training centers within nursing homes with accredited educational institutions will not only enhance the quality of the labor pool but will support recruitment efforts for bolstering the workforce.
Full Proposal
The paradigm shift away from a task-oriented model for labor requires financial investment in the workforce for recruitment, and to provide education about training provided at the nursing home.
- Establish training centers within nursing homes, with accredited educational institutions, by incentivizing providers and universities, which not only enhances, but supports the labor pool.
- Remove the AIT requirement and increase the flexibility of educational requirements and qualifying field experience to encourage new entrants into the licensed nursing home administrator field.
- Continue to consider the safety and efficacy of the use of medication techs/assistants to support clinical care. This can be done by looking at information from other states that have implemented the use of this level of staff. Explore a program to be implemented in nursing homes for use of medication techs/assistants and a study of their use, including evaluation of resident satisfaction, staff satisfaction, and quality outcomes.
- Revisit regulatory requirements for training to make it easier for nursing homes to utilize feeding assistants.
- Promote more flexibility, career ladder opportunities and integrated use of direct care staff, including the use of residential care assistants (RCA) that can become Certified Nursing Assistants (CNA) in facilities with approved training programs. Much work remains regarding the implementation and impact of current New York State required staffing ratios in nursing homes, especially as it relates to the pending implementation of federal rules from the Centers for Medicare and Medicaid Services (CMS).
MPA Council Commentary
This proposal is categorized as long-term. Governor Hochul’s FY23 to FY26 Executive Budgets included a proposal to allow certified medication technicians to provide care in New York nursing homes, but the proposal has not yet been included in the Enacted Budget. The Department of Health (DOH) and the State Education Department (SED) are engaged in discussions regarding direct care worker training and credentialing to improve the accessibility of caregiving employment.