The Hamas terror attacks on Israel have shocked the United States and the entire world. Michael Balboni, GNYHCFA’s Executive Director, joined Newsmax National Report to examine pivotal questions: What’s next? What else might have intelligence communities missed?
By Michael Balboni
Unwinding the pandemic will take years of planning
The pandemic has challenged the way many of us look at life.
Updated February 7, 2022 6:00 AM
We should start thinking about how we unwind the pandemic. Like a bad traffic accident that takes minutes to close a road but hours to reopen, the pandemic hit quickly but it will take years to bring back our economy, health care, and society.
The pandemic has challenged the way many of us look at life. We should not rush back to pre-pandemic expectations around things like job performance, academic evaluations, and social interactions. The reality is that some individuals will never feel comfortable without a mask. Some of our neighbors will never believe recommendations that come from the Centers for Disease Control and Prevention because they have lost faith in our public health institutions. Others will never accept a five-day workweek.
Part of the pandemic’s devastation is its randomness in affecting different people differently. Over the years, I have worked with governments and companies to design tabletop exercises to model the impact of a pandemic. I would ask certain leaders to step out and let the decision-making process proceed with the unexpected absence of someone in the chain of command. The goal was to build organizational resiliency through dealing with the unknown impacts of widespread disease. The solution was to deal with a response plan that suddenly had holes in it and to adjust to unexpected complications.
The pandemic has impacted different communities disproportionately. How can society assure them they will not suffer the same fate from the next global disease?
Michael Balboni is a former New York State senator and deputy secretary for public safety.
Many of the impacts are generational because they affected children. In the short term, children will have to reintegrate into society after being shut in and not being in school. Long term, children will need to recover from the loss of a parent, guardian, or caregiver.
Our workforce has changed as well. From the “Great Resignation” and the federal stimulus program that allowed workers to stay home, to telecommuting and the hybrid workweek, the office of 2022 will look nothing like it did in 2019.
These changes should be studied, anticipated, and recognized for what they are. We should not assume that all of us will be ready to get back to normal because the definition of normal is changing. The next steps should be to re-examine how health care is provided in our country, including concerns ranging from underserved communities to the impact of long-haul COVID to issues with the expansion of medical technologies.
We need to recognize some early estimates that as much as half of our workforce will remain remote. What will this do to small businesses, mass transportation systems, and sales tax receipts? Can we adjust our tax structure to recognize this new reality and institutionalize the need for worker flexibility? What to do with all of the commercial properties that will feel the brunt of the worker-less real estate economy? One idea might be to convert commercial properties to residential properties. Government should explore easing the conversion process to facilitate this transition, without leaving out housing the homeless and individuals with mental health needs.
As we move into this post-pandemic world, we must recognize that for some people, mask mandates provide a sense of security, for others a frustrating restriction. While the revocation of such mandates will likely reintroduce some level of fear, we should consider whether fear alone is sufficient to dictate our future but acknowledge it in planning for the new reality.
Op-ed: We must rebuild the long-term-care workforce
Michael Balboni
When the Covid-19 pandemic ripped through our state, it deepened a crisis that was already facing New York’s nursing homes. Prior to the pandemic, the state stopped investing in long-term care. This ill-advised decision made it harder for facilities to pay competitive wages, which in turn led to a hemorrhaging workforce. To make matters worse, under Gov. Andrew Cuomo, New York actually cut Medicaid funding right at the beginning of the pandemic. These short-sighted policies have created a catastrophic storm for nursing homes in the last two years.
If Gov. Kathy Hochul has her way, this is all about to change. The governor’s executive budget reinvests in our health care workforce at levels not seen in decades: $10 billion in health care spending, the largest in the state’s history. It could be just the shot in the arm that long-term-care facilities need to rebuild and develop in a post-Covid era.
And just in time too. The state is facing its greatest shortage of health care workers in history, all while our population continues to age. New York nursing homes have a turnover rate of 94%, with most staff opting to work in retail in positions that have traditionally paid far less. Meanwhile, facilities across the state are holding their collective breath each week, praying they’ll have enough staff to provide care. This is particularly the case on the weekends, when ensuring adequate staffing has become next to impossible.
But the real solution goes beyond dollars and cents. Getting talented people to join this workforce will require convincing them that this is incredibly important work that can lead to a fulfilling future beyond the entry-level job. That’s why I’m encouraged to see additional initiatives proposed by Hochul that will support educational opportunities that lead to career advancement. It’s not enough to get new workers in the door; we have to keep them and develop a workforce with the experience to support New York’s growing ranks of seniors.
In order to turn the staffing crisis around, the industry and the state need to partner together and get the message out about the importance of long-term care to our communities and the increased wages and career opportunities that come with this work. Failure to do so could result in a total collapse of the industry, leaving tens of thousands of health care workers without jobs and vulnerable seniors without adequate care. Let us use the impact of Covid-19 as a lesson in why investment in long-term care must remain a priority.
By promoting and supporting long-term care in New York, we can make a strong long-term plan for tomorrow’s workforce.
Michael Balboni is executive director of the Greater New York Health Care Facilities Association.
“Nursing homes set to fail”
Michael Balboni
The state of New York can mandate the COVID vaccination for any and all involved in health care. What it can’t do is mandate that new employees join this critical workforce.
The recent concerns about unvaccinated health care workers walking off the job en masse because of the governor’s mandate turned out to be unfounded. But this result could still become a ruinous reality when the new staffing ratios law for New York nursing homes takes effect in several months. The question now becomes: How will the nursing home industry meet these new requirements when it can barely attract sufficient numbers of staff now?
Without a comprehensive workforce development plan that has been established and supported by our leaders in Albany, New York nursing homes are being positioned to fail.
Although the pandemic exacerbated a staffing shortage, the struggle for nursing homes to find qualified employees began long before the COVID-19 pandemic. This is not just a New York problem either. Seventy-five percent of nursing homes in the United States have demonstrated they do not have enough staff to meet this recommendation. And that statistic was recorded in 2016 when the circumstances were far less dire.
Nearly every nursing home in the U.S. is struggling to find staffing today, with 99 percent facing a shortage according to a September poll conducted by the American Health Care Association. And as the pandemic has gone on, the staffing shortage has only intensified. According to an Associated Press review of federal data, 32 percent of nursing homes had worse staffing levels in June compared to the start of the pandemic, demonstrating that the exodus has gained momentum with time.
Simply put, recruiting and retaining nursing home staff is the urgent priority.
Look beneath the surface of the crisis and you will see that this situation has been developing for some time. Financially speaking, minimum wage levels make it difficult to justify working as a certified nurse assistant when it’s only a little more than one can make working in a service industry. Combine that with the pandemic’s devastating impact on nursing home residents and staff, which most Americans witnessed through months and months of harrowing images. Other impediments to recruiting staff include the challenges of in-person work, a heightened risk of COVID-19 exposure, and the mental and emotional toll of caring for those most vulnerable. As a result, there is little incentive to get tomorrow’s workers to see the long-term care industry as their future.
The problem is real and immediate. Without having sufficient staffing, 78 percent of nursing homes across the country are concerned that workforce shortages might force them to close. This has already started having implications on the next generation of nursing home residents, with 58 percent of long-term care facilities limiting new admissions due to staffing shortages.
In order to survive the challenges ahead, Albany must become a full partner with the state’s nursing home industry to develop and enact a comprehensive workforce development plan. As the Hochul administration seeks a clean slate on a broad range of issues, the governor should restore the financial resources that were eliminated under the Cuomo administration. At the peak of the pandemic — at a time when 23 other states and the District of Columbia all increased Medicaid funding to nursing homes — New York made the unconscionable decision to cut Medicaid funding by 1.5 percent.
Recognizing the slow motion crisis taking place before our eyes, the Hochul administration should work with the nursing home industry to create a compelling messaging campaign that inspires potential staffers to pursue meaningful careers in our long-term care facilities. As part of this campaign, the state and the industry should combine resources to offer incentives for those who are committed to entering the nursing field. Similar to the Peace Corps, those who are interested in nursing should be offered partial college tuition reimbursements in exchange for working in a long-term care facility.
COVID-19 has proved that a pandemic can dismantle our health care system if we are either incapable of identifying the threat or unable to respond quickly in confronting the crisis. It is imperative that we reimagine our health care system in a way that integrates the resources needed so that we are not caught unaware when the next pandemic arrives.
Which raises the most urgent question: What happens on January 1 when Albany’s staffing mandate is enforced? Will our leaders simply ignore the reality of fewer and fewer nursing home employees reporting for work? Or will we learn from lessons past and heed this critical warning while we still have time?
Michael Balboni, of East Williston, is a former state senator now executive director of the Greater New York Health Care Facilities Association, a trade association providing regulatory compliance and life-safety services to more than 80 nursing homes in the New York City metro area.
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