Nursing assistants in demand but not paid well

Serving as a nursing assistant has become a career for hundreds of area residents, but the pay is so low that they’re still living in poverty.

Over the past four years, Schenectady County Community College has trained 1,300 people to be certified nursing assistants. Graduation rates have been high: 1,400 started classes, and only 100 didn’t graduate.

Of the 1,300 licensed graduates, about 1,000 found health care jobs, according to the college’s internal tracking system.

Their average pay ranges between $10.20 to $11 an hour, about the same as some fast food and retail jobs that don’t require the time and expense of attending college. About 30 to 35 percent of the graduates from SCCC’s CNA program eventually jump to one of these non-nursing jobs.

“If people can make a dollar an hour more in retail, they will,” said Tiziana Rota, who runs the SCCC program. “And there is a culture of disposability, similar to McDonald’s. And there is the fact that these are not living wages.”

However, many of the CNAs were unemployed, or making only minimum wage, when they started the program. On average, their wages went up $2.10 per hour when they got their first nursing job, Rota said.

“It’s still not a living wage,” she added. “The lack of good wages prevents people from staying for a long period of time.”

She wants students to eventually climb higher on the nursing ladder. They could become registered nurses, but that route is highly competitive. There are other jobs within easier reach that offer better pay than nursing assistants get.

They could take the “technology track” and study to become X-ray or ultrasound technicians, respiratory therapists and other technology-centered positions. They could become licensed practical nurses and go on to be surgical technicians or other specialists.

“LPNs for a while were not hired at hospitals, only as nursing facility supervisors,” Rota said. “Now with 18 months [of additional study], you can get a certificate as a technician — surgical technicians, hospitals need tons of those.”

But her students are not finding it easy to move up.

“It requires money and flexibility of employment,” Rota said. “If you have to pay for child care, you cannot afford it.”

Some have gone on to get an associate’s degree in business so they qualify for health care administration positions.

“It’s at the entry-level, but it’s a stepping stone,” she said. “We are trying to develop these bridges, so there is a pathway.”

The college’s five-year grant for the CNA program ends this September. In addition to applying for a renewal of the grant, officials also hope to get funding for a new class in community health workers.

living wage sought

The goal is get students to a job that pays at least $16 an hour, which Rota said she would consider to be a living wage for her typical students, many of whom are single parents.

One of the biggest employers of SCCC graduates is Glendale Home in Glenville, a county-owned nursing home. But openings for full-time work are few, because the home has an unusually low turnover rate. It loses about 10 percent of its full-time CNAs over the course of a year.

Some facilities report to the state that they have turnover rates as high as 100 percent.

“Working at Glendale offers some of the highest wages and benefits in the area,” said its administrator, Edmond Marchi.

Full-timers start at $12.97 per hour.

“In the scheme of things, that’s still a tough existence, if you have a family,” he said.

But they also get credit in the state retirement system, 13 paid holidays, 12 sick days, and a week of vacation time.

Marchi said they deserve every bit of it, and more. “It’s a very hard job,” he said. “The county chooses to recognize the enormous effort and difficult job our CNAs and LPNs do every day.”

The problem is that Medicaid does not, he added.

Medicaid won’t reimburse for the pension costs and the higher-than-average wage, he said.

Any deficits the nursing home incurs because of this would likely have to be absorbed by the county.

“It’s the exact reason that counties are closing their institutions,” he said. “Medicaid penalizes institutions that offer these benefits.”

The Medicaid reimbursement rules break each state into regions. Wages and benefits in each region are calculated and averaged to determine how much Medicaid will reimburse. That means institutions that offer more than the average will not have that cost fully reimbursed by Medicaid.

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