In the next decade, Maine will need an additional 1,602 registered nurses, 475 nurse practitioners and physician assistants, and 2,474 direct care workers — those who provide long-term, hands-on care to seniors and people with disabilities.

For a small, aging state, that’s a lot of people. Indeed, nurses and direct care workers are among the fastest growing positions in the state. They are also mostly filled by women, so boosting wages and conditions for these positions could also help improve the livelihoods of many of the state’s women and their families.

There are three main bills currently being considered by the Maine Legislature that would directly affect nurses, physician assistants and nurse practitioners, and direct care workers in the state.

LD 1466 — Sponsored by Sen. Troy Jackson, a Democrat from Allagash, this bill would increase the amount the state pays nursing homes, residential facilities and home care agencies by 10 percent over the next two years through MaineCare, the state’s version of Medicaid. These long-term care institutions are then expected to pass on the raise to the direct care workers they employ. The real wages of direct care workers, who include certified nursing assistants, personal care aides and home health aides, have declined significantly over the past decade.

The bill would also set up a commission to study long-term care workforce issues and recommend solutions to improve the quality of long-term care jobs and attract more people to them.

There are other smaller bills, like LD 643, that would result in a wage increase for segments of the direct care workforce — in the case of LD 643, home health care workers. But LD 1466 would have the greatest impact on the most workers.

LD 1410 — Sponsored by Republican Sen. Amy Volk of Cumberland, LD 1410 would allow nurses from other states to work in Maine, and vice versa, into the future.

Although the switching is already possible, it won’t be for long if Maine does not pass LD 1410. That’s because the so-called nurse licensure compact that allows nursing licenses to be valid across state borders is being updated, and Maine must pass a bill to join the new compact, according to Lisa Harvey-McPherson, who chairs the government affairs committee for OMNE, a Maine nursing association.

If the bill is not passed, nurses wanting to come work in Maine would have to get fully licensed in Maine, instead of being able to automatically transfer their license from their home state.

“This is crucially important because we have a workforce challenge today, and it’s only getting worse,” said Harvey-McPherson.

LD 1134 — Sponsored by Republican Rep. Harold Stewart of Presque Isle, LD 1134 would allow nurse practitioners and physician assistants to perform routine tasks in nursing homes that are currently done only by physicians.

If this bill is passed, nurse practitioners and physician assistants would be able to perform the initial comprehensive visit with nursing home residents, for example, as well as routine visits.

Under federal law, nurse practitioners and physician assistants can already perform such visits. Maine law, however, is more restrictive, requiring that only doctors perform these visits.

Advocates of the bill say that Maine nursing homes — especially those in rural areas — are having an increasingly difficult time finding doctors who are available to see their residents and that this bill would help with that challenge.

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