Gov. Tony Evers vetoed a bipartisan plan Wednesday that would have reduced the number of required training hours to become a certified nursing assistant in Wisconsin.
Wisconsin requires 120 hours of training to become a CNA, including 32 hours of clinical training. The bill would have reduced that to the federally required minimum of 75 hours of training, including 16 hours of clinical experience.
Evers said he objected to providing less training for those caring for the state's most vulnerable.
“Research has shown that higher training standards result in better outcomes for patients, lower staff turnover and higher job satisfaction," Evers said in his veto message. "There are better ways to address the shortage of nurse aides than reducing the quality of training programs.”
Evers noted that he directed the Governor’s Task Force on Caregivers to develop strategies to attract and retain a strong direct care workforce.
Bill author Sen. Rob Cowles, R-Green Bay, said he doesn't believe that reducing training hours to the federal minimum would diminish quality.
"The governor disagrees with that, so we move on," he said in an interview Thursday. "That's the way it is."
He said he believes the nursing homes that told him the federally required minimum would be sufficient and help recruit more young people into the field.
"Having been in numerous homes, I believe the people around those facilities have credibility and they have passion and they're not trying to skirt anything," Cowles said. "They care about elderly, frail people."
Cowles also said that a bigger issue in addressing the workforce shortage is pay, noting that Republican lawmakers pushed for higher Medicaid rate increases that were included in the current budget.
"Hopefully that's enough to stem the loss and generate more people in the field," Cowles said.
A coalition of long-term care providers said in a statement that the state is facing a critical caregiver workforce shortage.
"This policy would have helped facilities have the staff to maintain and advance care quality," they said in a statement.
Mindy Meehean, director of nursing at Wausau Manor, said the bill would have made the CNA profession "more financially available for potential applicants."
"The current CNA hourly training requirement creates a financial obstacle that leads many interested candidates to look for jobs elsewhere," Meehean said in a statement. "It is disappointing that this bill was vetoed, as it was a needed change to help providers maintain quality care for our residents."
LeadingAge Wisconsin CEO John Sauer said having a higher required amount of training "stings a bit" for nursing homes along the Minnesota, Iowa and Michigan borders. Those states are at the federal minimum, making recruitment efforts more difficult for Wisconsin facilities, he said.
"We're facing unprecedented times in competing for workforce," Sauer said. "What we were hoping is that if we went to the national standard for training, that we might be able to attract and compete with other non-healthcare employers."
The bill faced opposition from advocates for seniors and those with disabilities, who warned it could hurt the quality of care.
"We think that a reduction in hours leads to a reduction in quality of care," said Helen Marks Dicks, state issues advocacy director for AARP Wisconsin. "This is not a solution to the problem of the workforce crisis."
She said that the Governor's Task Force on Caregiving is charged with addressing the workforce crisis and will probably discuss training.
Disability Rights Wisconsin warned the bill could have led to “unintended long-term consequences" that would diminish quality care.
The task force may recommend a reduction in training requirements, but at that point “it will be part of a carefully considered comprehensive plan to address the larger issue," the statement noted.
While the task force could take up the training requirements, pay is the number one thing, Cowles said.
"I think this whole field is going to be going through a lot of trauma in the years ahead," Cowles said. "There's going to be more closures, there's going to be more pain and more difficulty for families trying to figure out where grandma and grandpa are going to go. And that's something we have to pay attention to."
Sauer said the task force should consider innovative ways to address the caregiver shortage, including allowing people with prior experience as a caregiver count some of their hours served toward the required training.
"We need a lot of innovation," he said. "This is going to be a multi-faceted solution."
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