US Army - Photo by Michelle Berrera,
US Army - Photo by Michelle Berrera,

Advocates say health care workers need better pay, not less training

It is a rare day at the Capitol when lawmakers override a veto by the governor, especially with help from members of the governor’s party.

That could potentially happen Wednesday when lawmakers again debate a bill dubbed the CNA Shortage Relief Act. But health care advocates say even if the bill passes over the governor’s objections, it won’t have nearly the impact on building up the workforce as would raising CNA pay.

The bill seeks to remedy a shortage of certified nursing assistants, or CNA’s, in nursing homes across the state by reducing the amount of required training to 75 hours, which is the federal standard. Currently, 120 hours of training is required by the state. This includes 32 hours of supervised, clinical experience. The amount of clinical hours also would be reduced by the change.

The bill passed the Assembly on a 66-31 vote in May. Democratic representatives Steve Doyle, D-Onalaska; Beth Meyers, D-Bayfield, and Don Vruwink, D-Milton, crossed party lines to vote alongside their Republican colleagues. 

A two-thirds majority is required to overturn a veto by the governor. All three Democrats would again need to vote with Republicans for that to happen. Attempts to reach the three Democrats were unsuccessful Tuesday. 

The bill passed the Senate on a voice vote. Gov. Tony Evers vetoed the bill in November. He cited safety concerns for patients, the need for lower staff turnout and higher job satisfaction when vetoing the bill. 

“Rather than continuing to pass the buck like the governor has in this matter, a successful veto override will help Wisconsin begin addressing the critical shortage of skilled certified nursing assistants who are responsible for providing care to seniors and other vulnerable citizens,” said Rep. Warren Petryk, R-Town of Washington, a bill co-sponsor, in a statement

The bill has support from organizations such as LeadingAge Wisconsin, Mayo Clinic Health System, Outagamie and Washington counties, Disability Service Provider Network, the conservative political group Americans For Prosperity, and Home Care Association. 

Opponents, including the AARP, argue the CNA shortage is due to low pay, not a drawn out training period.

“CNAs are some of the lowest paid health care professionals and are called on to do lifesaving work, caring for Wisconsin’s frail, elderly, and sick,” said Helen Marks Dicks, state advocacy director for AARP in a statement following the governor’s veto of the bill in November. “The fix to a shortage of CNAs is not reducing their hours of training. It’s by investing more value in their work by increasing their pay, benefits and working conditions. That’s how we solve the shortage.”

Emily Zellmer, 29, said she agonized over her decision two years ago to leave her career as a CNA. For eight years, she worked in various settings, including in-home healthcare,  nursing homes and hospitals. 

“I loved it. I loved being a CNA, and I feel like I was good at it,” said Zellmer, who lives in Baraboo and now works as an orthodontics assistant. “A big reason I left was pay.”

She said she finally had to face the fact that her hourly wage had hardly gone up after eight years in the profession. 

“It is a slap in the face,” she said. “The people making these laws are going to get old. At some point, they are going to be in a nursing home or a hospital. They need to ask themselves if they are going to need a bath, if they will want their back rubbed and if they are going to want to sit in soiled pants.”

Madeline Spangenberg, 23, graduated from UW-Madison in May with a degree in neurobiology. Following graduation, she had to decide whether she could afford to stay in Madison and keep her job as a CNA or if she would financially benefit by moving back in with her parents in Iron River while she applied to medical school and physician assistant programs. 

“The whole reason I left Madison was because I was not making enough as a CNA to pay rent,” said Spangenberg, who worked her senior year in college at SSMHealth. “I moved home to save money.”

She now works as a CNA in the intensive care unit at St. Luke’s Hospital in Duluth, MN. The hourly pay is nearly five dollars an hour less than what she earned in Madison. She says she “loves everything about her job in the ICU,” and can afford to gain the higher-acuity care experience because she is living with her folks. 

Working at a nursing home was never an option she considered, she said. 

“I did not apply to a nursing home because of the horror stories,” she said. “The patient load is too high. Some of my friends and family told me they would have 20 patients and would have to use ceiling lifts by themselves. To me, that sounds like an unsafe work environment.”

In contrast, she typically cared for eight patients at the hospital. 

She received her training at Wisconsin Indianhead Technical College. She said most of her coworkers were trained in Minnesota, which follows the 75-hour federal standard.

“I feel they know just as much as I do,” she said. “And I had 120 hours of training.”

Conor Smyth, a spokesman with the Wisconsin Technical College System, said that despite the fact the system provides classes to train nursing assistants, the system remained neutral on the bill. Smyth said the campuses throughout the system will teach to the standard that is agreed upon by lawmakers.