Medication aides could help states remedy health care worker shortages

The population of older adults is growing, but it seems the number of health workers in the U.S. able to care for them is shrinking. 

A survey last year of 524 nursing home providers, for instance, found that nearly 100% of respondents said they struggled to hire additional staff, and 84% of providers said they grappled with moderate to severe staffing shortages. And with the baby boomer population projected to double by 2050, states are scrambling to improve long-term care in their communities where health care worker gaps still prevail. 

“Nursing homes, specifically, have had to endure the worst workforce loss as a result of the pandemic. While other health care sectors have completely recovered their workforce, nursing homes are still down nearly 150,000 workers,” the American Health Care Association/National Center for Assisted Living, or AHCA/NCAL, said in an email to Route Fifty. “More workers in long term care are vital in order to meet [the aging baby boomer generation’s] care needs.”

One way states are trying to ease the squeeze of an aging population and nursing home staffing shortages is through medication aide programs. Medication aides are individuals with prior medical experience, such as nursing assistants, who are further certified to administer certain medications and treatments to patients.

“The benefits of medication aides are widely seen across the long term care sector,” the AHCA/NCAL said, adding that direct incentives can help states develop instructors and training programs for medication aides that will help support today’s workforce and prepare for the future.

Florida Gov. Ron DeSantis signed a bill in June authorizing nursing homes to allow registered nurses to delegate medication administration to qualified medication aides, or QMAs. These individuals can “administer routine medications as ordered, conduct blood glucose levels checks, make sure oxygen flow meters and CPAP machines [that help patients breathe when they sleep] are working properly, and maintain medication records,” Kristen Knapp, senior director of strategy and communications at the Florida Health Care Association, an organization that represents the state’s nursing homes, said in a statement to Route Fifty.

In Florida, QMAs must complete 40 hours of training after working as a certified nursing assistant for at least one year and must be vetted by a nurse. 

“The use of QMAs also helps get nurses back to the bedside so they can concentrate their efforts on supporting residents’ health outcomes, by having more time to use their specialized skills of conducting nursing assessments and interpretations and managing clinical care needs of residents,” Knapp said. Plus, “helping nurses get back to nursing helps increase their job satisfaction and further supports care centers’ retention efforts.”

QMAs can also help improve patient safety. “[N]urses can be pulled away from administering medication for several reasons including tending to other resident needs, communicating with physicians, interacting with family members, supervising staff and more,” according to the Health Care Association of Michigan. “Experience in other states shows [medication administration] errors decrease with the use of medication aides.” 

Currently, more than 30 states already authorize medication aides to operate in health care facilities, and more are looking to leverage the benefits QMAs could offer. 

Two recent bills in Michigan, HB 4885 and HB 4923, establish a medication aide training and certification framework to be managed by the Department of Licensing and Regulatory Affairs. The legislation requires medication aides to practice as a nurse aide for at least 2,000 hours in two years at a nursing home or nursing facility before they are certified. It also determines that the medication aide certification program will be funded through the state treasury. The two-bill package was signed by Gov. Gretchen Whitmer last month.

Texas is also looking to improve the certification process for medication aides. In a July letter to health care providers, the state’s Health and Human Services Commission announced the state’s licensure and credentialing services for medication aide candidates would move to an online portal. The enhanced system will make the approval process “more efficient and convenient” for health care workers and providers to submit and renew applications, send and receive application documents, make electronic payments and track documents’ statuses, among other features. 

Elsewhere, Pennsylvania’s state Senate passed a bill in November allowing medication aides to work in long-term care nursing facilities like nursing homes. If enacted, it would require medication aides to first work as nurse aides at a single facility for at least one year. They must also complete a training program and pass an exam that tests their knowledge of medication names, their uses, potential side effects or adverse reactions and any additional steps to administering the medication such as checking the patient’s pulse rate. 

New York lawmakers introduced a bill in November that, if passed, would allow certified medication aides to administer some medications at residential health care facilities under the supervision of a registered nurse. They would not be allowed to administer medicine by injection, catheters or sterile procedures, except for diabetes-related injections and overdose reversal drugs, among others.

“Additional helping hands are a saving grace during our sector’s historic workforce crisis, and medication aides are a valued part of the nursing home workforce,” the AHCA/NCAL said.