New Hampshire’s long term care system is a condo waiting to collapse

When a condominium collapsed in Florida in June of this year, tragically killing 98 people, evidence of structural issues, reports of overdue repairs, and emails between owners, contractors, and city officials surfaced, all pointing fingers and demanding answers to the question “Could this have been prevented?” So many disasters, natural or manmade, are followed by reactionary tales of reform and bemoaning missed opportunities, whether intentionally or unintentionally ignored, to avoid the looming tragedy to begin with.

New Hampshire’s long-term care system, whether delivered by nursing home, home health, or community-based services for adults with developmental disabilities and acquired brain disorders, as well as our front-line direct care workers in healthcare organizations, is a condo waiting to collapse. We are slinging repairs against cracks in the foundation that are decades in the making, identified in reports, studies, data, white papers, ad nauseam – and yet here we are still sounding the alarm and waiting for the tragedy that will bring real sustainable reform.

I get it. The country is in a workforce crisis. I struggle to empathize with our local employers and truly key partners in other sectors who are facing reduced revenue due to curtailing hours or closing completely due to the lack of staff. Our Direct Care Workers work in organizations that cannot curtail hours and cannot reduce the census on the numbers we serve. If we don’t show up, people will die.

I hear the cries about the impact of the pandemic and unemployment benefits, however, I always politely disagree when it comes to our front-line workers, and remind my audiences that our perfect storm has been brewing long before any of us had heard of COVID-19. An aging state, young people leaving after high school and not returning, more demand on services with fewer people to serve was predicted. Exasperated by a pandemic? Sure. Precipitated by “too little too late” in the areas of workforce housing, affordable childcare, and a living wage built the momentum for this crisis long before the pandemic brought us a tsunami.

As long as we dare to compare the wages we are offering in healthcare-related businesses to the wages being advertised by the fast-food industry and major retailers, we are sending a clear message to not only the direct care workers but to the vulnerable citizens of New Hampshire that they support, that they are not worthy of a profession staffed with well-trained professionals, trusted with their daily care, earning a career inspiring wage. The provider reimbursement rates in New Hampshire require not incremental increases such as we saw in 2019 and 2020, after almost 15 years without any increases, but sweeping, significant sweeping reimbursement reform, bringing the entire wage scale out of its current state.

Yes, we need workforce housing, childcare, transportation, but most importantly, we need action on wages, and we need it now. Do not wait for the condo to collapse. Call your state legislators and demand better for New Hampshire’s Direct Care Workers before more nursing home beds close, before more home health agencies cannot meet demands and drive more people to our overflowing hospitals. Do it now before our thousands in New Hampshire with developmental and physical disabilities are left home in dangerous situations, possibly even to die. We have had our warning New Hampshire, now we must demand that the structural damage be addressed, and no one can tell us in hindsight that they wished they had known. We know. We must act.

Rebecca Bryant
President and CEO
Lakes Region Community Services