Report: Minnesota health care workers leaving at 'crisis rates'

Health care workers prepare to administer COVID shots.
Health care workers are leaving the profession at overwhelming rates. Eighty-five percent of workers are women, and 35 percent people of color.
Derek Montgomery for MPR News

In 2022 Minnesota nursing homes reported staffing shortages that were worse than anywhere else in the country. The ability to find direct care workers for these institutions and others has become a crisis. That’s according to a new report from the University of Minnesota. 

“The crisis of low-wage healthcare workers is a crisis for all those that require care,” report authors wrote. 

While direct care work can be incredibly dangerous, it is not paid well. According to the report, over 40 percent of direct care workers in Minnesota earn below 200 percent of the federal poverty line and nearly half use Medicaid or Medicare for insurance.

That’s for frontline work that involved exposure to COVID-19 before vaccines were developed, and produces injury rates that are higher than those experienced by firefighters. 

“The workers experienced a lot of loss in the early months of the pandemic where 15 percent of the individuals who were hospitalized were getting COVID before the vaccines,” said Jamie Gulley, President of SEIU Healthcare Minnesota. 

Now that vaccines are available, however, and the pandemic is waning, health care work in Minnesota has become much more difficult due to staff shortages. 

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“While the pandemic was difficult in its own way, most of our respondents were saying that the work actually became much more difficult as we recovered from the pandemic because of worker shortages,” said report author Jeanette Dill. 

The people doing direct care work in Minnesota are overwhelmingly women — 85 percent — and 36 percent are people of color. It’s a legacy Dill said stems from America’s history of slavery and domestic labor. 

“We have a history of depending on Black women in particular and other women of color, including immigrant women, to provide that kind of domestic care and domestic service. That’s part of our historic legacy here in the United States … women of color have had less access to education opportunities and so are more confined to these low wage care work occupations,” Dill said.  

To address critical and growing shortages, the report recommends a redistribution of Medicaid and Medicare spending. Current Medicaid and Medicare reimbursement policies and practices, “often promote dramatic wage inequality within and across health care occupations,” according to the report, and favor services concentrated around male-dominated work involving surgery and technology. 

Other recommendations include support for unionizing workers. Close to half of homecare workers in Minnesota are unionized as well as 32 percent of nursing home workers. 

“The low wages effect has a huge amount of cost to the system,” Gulley said. “The number one thing that we need to see is higher pay. Yes, union workers make a little bit more than non-union workers, as you might expect. But we also stay longer. There’s a lot more retention, you see a lot more continuity of care.”

Both Republican and Democratic lawmakers in Minnesota have expressed support for addressing Minnesota’s direct care issues. 

“It is a big deal. It’s gone from kind of a challenge to a problem, to a big problem to a crisis to I don’t know what the next level is, but the system’s on the verge of collapse,” said Sen. Jim Abeler (R-Anoka). 

Sen. John Hoffman (DFL-Champlin), who serves on the Aging and Long-Term Care policy committee with Abeler agrees, and hopes to help put forward a bill addressing direct care issues in the upcoming session. 

“The people that need (these) services, they’re dying, they’re filling up our hospitals,” Hoffman said. “Caregiving is a system. Like Jim says, the infrastructure’s falling apart. 53,000 job vacancies and nobody is having a serious conversation about paying people what they need to be paid.”