Proposed changes to an existing law overseeing protections for older adults would delay hiring practices, create backlogs and become another unfunded mandate for Pennsylvania’s nursing homes and senior living providers, according to industry leaders in the commonwealth.
Representatives from the Pennsylvania Health Care Association and LeadingAge Pennsylvania testified before the state legislature’s Aging & Youth Committee recently on the potential negative effects of proposed changes to the state’s Older Adult Protective Services Act.
In a LinkedIn post, PHCA President and CEO Zach Shamberg said that the act had been deemed “unconstitutional” almost 10 years ago but has reemerged as a priority among state legislators. He warned, however, that assisted living communities, personal care homes and other long-term care providers would be negatively affected by the proposed changes if they were to go into effect, specifically when it comes to recruiting and retaining skilled workers.
In his testimony before the committee, PHCA Director of Government Relations Tim Ward said that providers want to hire more caregivers, but their ability to increase wages is limited due to insufficient Medicaid reimbursements.
“Providers can’t hire more caregivers, because the caregivers don’t exist,” Ward said, adding that nursing homes are particularly concerned because they are “struggling” to meet staffing requirements recently implemented by the state Department of Health.
Speaking to the proposed changes to the act, Ward said that applicants for all positions at long-term care facilities in Pennsylvania would be required to undergo both FBI and state police background checks — and providers would be on the hook for those costs, which he called “another funded mandate.” Each FBI background check costs $25.25, and state police criminal history records cost $22 each.
For nursing homes, the cost would be $1.1 million for FBI background checks alone, or $1.9 million for both types of background checks, or an average of $2,798 per nursing home, Ward said.
Garry Pezzano from LeadingAge PA testified that the proposed background check requirements would be in addition to other prerequisites already on the books for those looking to work in senior care, including relevant licensing and certification, tuberculosis testing and general onboarding, and that the requirements would lengthen the onboarding process.
“The hiring environment in aging services is already intensive and often causes candidates to abandon their onboarding in favor of jobs that can begin earning a paycheck in a timelier manner,” Pezzano said.
He also raised concerns that the proposal does not include any “guardrails” to ensure adequate access to background check processing sites. Ward and Pezzano suggested that provisions be included to allow 10 days for scheduling background check appointments and also for the waiving of background checks if securing those checks becomes a burden due to limited hours or locations.
Loss of immunity protections
Ward and Pezzano also raised concerns about the elimination of immunity protections for providers who make a “good faith” effort but hire or retain applicants with criminal histories. At the same time, they pointed out, language in the bill would give the state — which acts as a clearinghouse for all state and federal background checks, as well as initial employment determinations — full immunity from civil liability for their determinations of an applicant’s eligibility for employment in care settings.
“Pennsylvania’s long-term care providers are struggling with both workforce and financial challenges, and the administration’s proposal would further exacerbate both,” Ward testified.
The state has acknowledged through multiple reports over time the workforce challenges facing the long-term care industry, Pezzano said. Those acknowledgements, he added, include the 2019 “A Blueprint for Strengthening Pennsylvania’s Direct Care Workforce” report from the Department of Aging and Long-Term Care Council, and this year’s “Aging Our Way, PA” report creating a master plan on aging.
“Any reforms to OAPSA must balance the realities of our state’s current workforce shortages, providers’ ability to serve the growing older population’s needs, and effective protective services to older adults,” Pezzano testified. “Safeguarding seniors’ well-being includes ensuring they have access to quality care and a direct care workforce to deliver that care.”
This article originally appeared on McKnight’s Senior Living.
