Proposed regulatory board for nursing home workers sparks debate, clears labor committee

Travis Burth served in the military and now works at a nursing home in Minnesota.

Surely life as a solider was more difficult?

“I thought boot camp in the U.S. Army would be the worst experience of my life. Boot camp was not that bad compared to working in a nursing home that does not have enough staff,” he said.

According to Burth, workers in the industry are underpaid and overwhelmed. Every day some employees break down and cry. Quitting has reached endemic levels due to burnout. Coming out of the COVID-19 pandemic, he maintains working conditions need to be improved if the field will ever attract and retain a sufficient workforce.

Rep. Esther Agbaje (DFL-Mpls) believes she has the answer for what ails the industry. She sponsors HF908, which would establish a Nursing Home Workforce Standards Board.

The House Labor and Industry Finance and Policy Committee approved the bill, as amended, on a party-line 7-5 vote Tuesday, sending her proposal to the House Human Services Finance Committee.

Agbaje believes that creating this board would raise wages and improve working conditions, thereby addressing the main drivers of the staffing crisis in nursing homes across the state. She noted Gov. Tim Walz has proposed a similar board in his budgetary recommendations.

The board would “adopt rules establishing minimum nursing home employment standards that are reasonably necessary and appropriate to protect the health and welfare of nursing home workers.” This includes establishing initial standards for wages and working hours no later than Aug. 1, 2024.

The board would be comprised of nine members. The Human Services, Health, and Labor and Industry departments would each designate one member. Employers and employees would be given three seats each to represent their interests as well. The governor would have to make these initial appointments no later than Aug. 1, 2023. A simple majority vote would be needed for the board to take any binding action.

Prior to adopting minimum employment standards, the board would have to investigate industrywide market conditions to ensure standards meet or exceed existing conditions for a majority of workers. These standards would have to be reviewed at least once every two years.

Furthermore, the board would be empowered to certify worker organizations it deems qualified to provide training to nursing home workers and establish requirements for the curriculum used in these trainings. These training sessions would have to cover several topics, including the minimum working standards established by the board; antiretaliation protections granted by the bill; and information on how to report violations of workers’ rights to various regulatory entities. The board would have to review the adequacy of the curriculum at least annually.

Employers would have to ensure their employees attend a one-hour training session every six months and would have to compensate workers for these sessions.

The bill would provide the board and the department with several enforcement mechanisms, as well as affirming the right of nursing home workers to bring a civil action against an employer for alleged violations.

Per a fiscal note, the cost for the coming biennium would be just over $1 million.

Industry lobbyists expressed numerous concerns about the bill.

Toby Pearson, vice president of advocacy for Care Providers of Minnesota, agreed that the state’s nursing homes are overwhelmed and can’t meet the growing demand – over 11,000 Minnesotans were denied admission last fall due to lack of staff and resources in these facilities.

But he insisted the bill does nothing to increase funding for nursing homes. If nursing homes, which are funded in large part by the state government, received larger and more timely reimbursements, they would be able to hire more workers at higher wages. Pearson referenced HF733, a bipartisan bill which would explicitly raise reimbursement rates for nursing facilities, as a better solution to the current dilemma.

Rep. Isaac Schultz (R-Elmdale Township) is critical of the proposal as well. He questions if the board could accomplish its stated goals, while also fretting that it would take regulatory authority away from the elected officials in the Legislature.

“I appreciate your stated intent. … I just worry that this might be something that doesn’t get at your stated intent,” he said.