Gov. Ned Lamont is offering up an additional $150 million in Medicaid funding to the nursing home industry, an increase of 4.5 percent for wage increases for workers in each of the next two years, in hopes of quelling the impending strike of thousands of employees Friday morning.
“We’re trying to do anything we can to avoid a strike,” Lamont said late Monday afternoon, asked at his coronavirus briefing where strike negotiations stood.
Earlier in the day, his administration put forth “an aggressive proposal,” he said, which, in addition to the $150 million increase, would temporarily boost Medicaid reimbursement by 10 percent for a total of $86 million, and add $32 million in hazard pay and retirement enhancements.
“There’s nothing more important than taking care of our seniors,” Lamont said, “and I hope to God the nurses are there to do it.”
The Lamont administration is not a direct party in negotiations between the union and nursing home operators over a new contract. But as the major payer through the state-federal Medicaid system, the administration is in talks with both sides to avert a strike.
Word of the enhancements came as 600 more SEIU District 1199 workers at six additional nursing homes voted to authorize a walkout on May 28 — bringing the strike threat to 4,000 total workers.
“We are negotiating our union contracts to finally rise out of poverty,” Rob Baril, president of District 1199, said in a written statement Monday evening. “But we’re also fighting to make sure that residents can regularly count on having enough staff to meet their needs.”
It was not clear late Monday whether the total Lamont made available would be enough to avert a strike, as both labor and management have said they need significantly more funding.
Baril said the union continues to negotiate with nursing home operators and members of the Lamont administration. Acknowledging receipt of the Lamont administration’s offer, Baril said workers still plan to strike pending further negotiations.
“We are hopeful that ongoing discussions with the administration will be productive,” he said.
A report released Monday by the Yale Law Clinic outlined poor working conditions, including understaffing and low wages, at Connecticut nursing homes during the pandemic.
Starting at 6 a.m. Friday, about 3,400 workers at 33 nursing homes in Connecticut are planning to walk off the job. They work at facilities operated by Genesis, iCare, RegalCare and Autumn Lake, with Genesis and iCare operating most of the facilities. Monday’s additional strike notices bring the total number of nursing homes under a formal strke threat to 39.
In addition to the nursing home employees, about 2,000 group home workers, also from District 1199, voted Friday to authorize a strike effective May 21 — with many of the same issues as the nursing home workers.
The nursing home talks were all the more tense Monday as facilities prepared to relocate residents at homes that would be hit with by the Friday strike — some, perhaps, to facilities outside the state.
“We understand that there’s an urgency,” said Paul Mounds, the governor’s chief of staff.
Any nursing home that receives a strike notice is required by law to submit contingency plans, including any discharge plans and how patients would be cared for, to the state Department of Public Health no later than five days before the possible strike.
The department is currently reviewing the plans submitted by impacted nursing homes. If the plans are deemed insufficient, the state could move to relocate residents to other facilities inside or outside the state.
It was unclear Monday afternoon how many nursing home residents would need to be relocated and how many would be cared for by replacement workers or managers. Mounds said close to 1,000 residents would be affected by Friday’s strike.
Lamont is hoping the $280 million proposal will be enough to convince the union and nursing home operators to reach a deal. The proposal would mostly be paid for through the state’s Medicaid program, which is matched by federal money, as the Lamont administration seeks to tap into hundreds of millions of dollars in unspent Medicaid funds.
Of the total, $25.5 million in federal stimulus relief recently adopted American Rescue Plan would be spent on hazard pay enhancements and workforce development and training.
That stimulus money would be allowed because the industry is experiencing financial instability due to the pandemic.
The governor’s budget director Melissa McCaw and Dr. Deidre Gifford, commissioner of the Department of Social Services, presented the proposal in letters Monday to union and industry representatives, saying increases for workers have averaged 1.1 percent over the last 14 years.
“This proposal is four times the average rate increase over that period and would be unprecedented,” they said.
Lamont acknowledged that the state would be propping up an industry “undergoing real tranistion.”
A report on nursing home demand released before the pandemic found the number of nursing home beds in Connecticut is expected to be reduced by nearly 6,000 by 2040. And the most recent annual census of nursing home residents, found that on Sept. 30, 2020, there were 18,402 people residing in Connecticut nursing facilities, 3,795 fewer residents than a year prior.
That decline reflect the 3,875 Connecticut nursing home residents who died in COVOD-related cases.
“There was a lot of vacancy in the nursing homes before Covid,” Lamont said. “There’s a lot more vacancy now after Covid.”
The 10 percent boost to Medicaid reimbursement would last for nine months, from July 1 through March 31, 2022. At that point, Lamont said, “Let’s see what the norm looks like.”
“Maybe more people are going to be doing home health care in the future but we’re going to make sure we have an industry that reflects that,” the governor said.
The state is attaching several stipulations to the money, including requiring nursing homes to reduce three- and four-bed rooms to single and double rooms, and ensuring they have full-time infection prevention staff.
Matt Barrett, president and CEO of Connecticut Association of Health Care Facilities, an association of one hundred and fifty skilled nursing facilities and assisted living communities, said in a written statement earlier Monday that the industry needs hundreds of millions of dollars per year in additional help.
The pandemic led to a “15 percent decline in occupancy” at nursing homes, which was “accompanied by a commensurate increase in operating costs, and new pressures to recognize the critically important work of nursing home employees with wage and benefit increases,” Barrett said.
He added that it’s “simply unreasonable and unrealistic to expect nursing home operators to enter into costly multi-year increased funding commitments to address collective bargaining issues without the resources needed to pay for those increased costs.”
Any large-scale strike would further add to those costs.
Barrett said the strike contingency plans submitted by nursing homes include entering into non-refundable replacement worker contracts to secure staffing if employees don’t show up to work. Nursing homes are also responsible for transportation and lodging of replacement workers and other costs such as increased security.
“These increased costs would be paid for by state taxpayers under Connecticut’s Medicaid program,” he said.
Citing the effect on nursing home residents, Barrett said the abrupt change to their care could bring added stress and trauma on top of an already difficult year due to the pandemic.
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