Maryland lawmakers are grappling with how to increase wages for long-term health workers while also keeping nursing homes and similar facilities afloat.
A new bill would increase Medicaid payout rates to those businesses by 8% from 2026 to 2029, and require that at least 75% of that rate hike go to increasing pay for employees.
The move would add about $200 million a year to the state’s budget, but also provide a much needed incentive to an ailing workforce.
“We are not making much more than minimum wage,” said Carolyn Taylor-Chester, a long-term care worker who testified on the bill before Maryland lawmakers this week. “I can easily go to work for Wal-Mart or even Amazon, which pays more with less stress.”
Taylor-Chester said she stays in the job because she loves the work.
Maryland’s Commission to Study the Health Care Workforce Crisis released its report at the end of 2023.
The commission found Maryland is slower than other states in growing its healthcare workforce to the detriment of current employees being overworked.
“Maryland is not restoring its pre-pandemic healthcare workforce at the same rate as other states,” the commissioners wrote in the report. “While most states in the mid-Atlantic region have not fully returned to their 2019 level of employment in the healthcare sector, Maryland is tied with Pennsylvania as having the second-worst recovery rate post-pandemic at 4.3%.”
Baltimore has taken matters into its own hands. The city is using $2 million in American Rescue Act funds to give relief to healthcare workers in long-term care facilities.
“Nearly everyone recognizes that they do not make enough money,” said Meg LaPorte, executive director of the Maryland Direct Services Collaborative. “If you look at the MIT living wage calculator, they're either at or just below living wages.”
There are about 55,000 workers across Maryland who care directly for patients. The job is filled overwhelmingly by Black women, according to the Maryland Direct Services Collaborative.
About 84% of home care workers are women, as well as 85% of workers at assisted living facilities, and 95% of workers in nursing homes. A total of 68% of home care workers, 80% of workers at assisted living facilities and 76% of workers in nursing homes are Black.
Not everyone thinks the bill will solve the wage problem though.
Medicaid only pays for some of the patients in long-term care facilities, meaning the businesses will not get a rate increase from patients who pay using private insurance.
“The problem that we have is if we were 100% Medicaid, there would be no issue, but the issue that we're having is the fact that our pay our structure is not 100% Medicaid,” said Danna Kauffman, a public policy consultant for the Lifespan Network, a senior care provider network. “Under this bill, your expenses are increasing, and you have to increase your salaries for everybody because you can't just pick and choose which nurses are caring for Medicaid residents or patients.”
The Maryland Department of Health is also pushing back on the bill.
In a letter to House of Delegates Health and Government Operations Committee Chair Joseline Peña-Melnyk obtained by WYPR, MDH states it does not have any enforcement mechanism to ensure nursing homes fall in line with the spirit of the bill and use 75% of the funding for wage increases.
