© Geriatric Times. All rights reserved.
Panel of Experts Looks at the Health Care Labor Crisis
| Geriatric Times |
 |
July/August 2001 |
|
Vol. II |
|
Issue 4 |
A blue-ribbon panel convened by the Nursing Institute at University of Illinois
at Chicago added its voice to the growing chorus of experts predicting a crisis
in the health care labor field. Chaired by former U.S. Secretary of Labor Lynn
Martin, the panel was charged with creating a diverse, interdisciplinary voice
to make recommendations that will help the United States meet the challenges
caused by the coming labor shortage. The final report, "Who Will Care For Each
of Us? America's Coming Health Care Labor Crisis," was released in May.
The report addressed four overall objectives: wage and benefits increases to
recruit and retain professional staff more successfully; creation of a more
professional environment for nursing care providers; adequate training and
education for nursing care staff; and data and research support for health care
labor issues. In addressing these objectives, the panel made a number of
recommendations to both the private and public sectors. Some recommendations
call for a private-public partnership.
Noting "No labor shortage has ever been solved without a market-based set of
economic incentives," the panel called for the private sector to make changes
that would enhance the professionalism, stature and respect for all nursing
care occupations. By doing this, the panel concluded recruitment and retention
of qualified staff will also be enhanced. The panel recommended that the
private sector focus on the first two overall objectives: to increase wages and
benefits and to create a professional work environment.
The report argued that wages for nursing care providers need to exceed
prevailing market wages in competitive service sectors. This could be done by
designing packages that reward occupational longevity. Such packages could
include bonuses, retirement plans, educational reimbursement for dependents and
subsidized loans for homes and cars.
In order to create a more desirable work environment, the panel urged the
private sector to design better models of shared governance between health care
management and labor. These models, the panel wrote, would minimize the amount
of administrative and bureaucratic duties given to direct care providers and
allow them to focus on providing nursing care. In addition, the report
emphasized, nursing care providers need ongoing training and continuing
education, with a focus on teamwork.
The public sector recommendations focused on the national level. The panel
called for the U.S. Departments of the Treasury, Labor, and Health and Human
Services (HHS) to establish a federal commission to investigate publicly funded
economic incentives targeting individuals in geriatric nursing occupations. The
possibilities and costs of incentives to both nursing care providers and their
employers would be identified. The panel also recommended that the secretaries
of labor and HHS, in collaboration with the American Association of Colleges of
Nursing, convene a national panel to examine education and training
requirements for the nursing professions.
Addressing the objective of adequate training and education for nursing care
providers, the panel recommended that Medicare rules and regulations be amended
to include geriatric training in all entry-level nursing education and training
programs. The report noted, "Currently there are minimal training requirements
for unlicensed nursing care providers if employers are to bill Medicare. One
way to enhance the respect, stature, and effectiveness of nursing care
occupations is to have significant training and education requirements."
Another step toward professionalizing the nursing care occupations is to
standardize entry requirements for training and education programs. The panel
recommended that appropriate federal agencies issue guidelines for states to
follow in developing standardized criteria.
Data and research support related to the health care labor force were
included in the report so that policies, programs and resource allocations can
be made using the most up-to-date information. The panel directed the U.S.
Bureau of Labor Statistics, Immigration and Naturalization Service, and HHS to
provide the most recent data on health care occupations and utilization and
directed them to make this information available to elected officials,
policy-makers, researchers, educators and health care executives.
The panel also recommended that the federal government and private
foundations form partnerships to research health care labor issues, especially
nursing care labor and the aging population. Suggested topics included
successful recruitment and retention strategies for geriatric nursing care
providers and informal (unpaid) caregiving and its economic consequences and
impact on work and family life.
While the panel acknowledged that part of the coming health care labor
shortage is due to a decline in the working population (people between the ages
of 18 and 64), it called for a concerted national effort to increase the number
of people in that age group who choose geriatric nursing care occupations. This
can be done by increasing wages and benefits, creating a professional and
desirable work environment, ensuring adequate training and education, and
providing relevant data and research support on health care labor issues.
Without these changes, according to the panel, "Chronic worker shortages and
inadequate care for the elderly will be the norm." The complete report can be
found online at
<www.uic.edu/nursing/nursinginstitute/policy/finalreports/
finalreport.pdf>-EAD