Monica Christiansen walks into Consultants for Children in Aurora, Colorado on a Thursday afternoon with a big smile.
“It’s the highlight of my day,” she said as she opened the door to the business, an autism center that serves the greater Denver area.
Christiansen is on her way to pick up her daughter, 10-year-old Chloe: something she’s been doing three days a week for several years, but it’s still something that excites her despite the amount of work it takes.
“I have to put on (Chloe’s) shoes, prepare her lunch, everything. For most people, when their child is 10 years old, they can do most of this on their own – they are quite independent. But for Chloe, I have to do everything for her,” Christiansen said.
Christiansen is Chloe’s primary caretaker, but since last year that mother and caretaker role has included the title of certified practical nurse. Christiansen is paid by the State of Colorado to do something she has done full time for 10 years: taking care of her daughter.
Nationwide, Medicaid pays for home health care in one form or another in all 50 states, but in some states Medicaid will pay loved ones, like Christiansen, to care for loved ones if that care includes care qualified nurses who cannot be administered by a qualified nurse’s aide. That means Christiansen now gets 35 hours of paid work per week after earning his certification last year.
“It’s awesome. I mean, I have CNA next to my name. It’s my job. It’s not just the hard work of being a mom,” Christiansen said with a laugh. “I am proud.”
“It’s becoming very impossible to be a working parent and have a child with high needs, so this program is a lifeline for that,” added Jason Schlosky, an employee of Personal Assistance Services of Colorado (PASCO ), the group that helped make Colorado the first state to implement this model of paid family care in 1999.
Since then, PASCO has helped expand the program to other states like Indiana, New Hampshire and Missouri. It is currently working to expand the program even further to places like Texas and Florida, according to Schlosky, as the number of certified practical nurses in the country declines.
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Shortage of licensed practical nurses
According to the Bureau of Labor Statistics’ latest employment report released earlier this month, about 220,200 openings for nursing assistants and patient service associates are expected each year, on average, over the decade.
“I think we’re going to see a groundswell in this area just with what we’re facing in health care shortages,” Schlosky said. “There just aren’t enough CNAs to take care of these people, so for us it makes perfect sense to let loved ones, neighbors, uncles, aunts take care of someone. and get paid for it.”
In January, the Urban Institute called the shortage of CNAs in the United States a crisis. According to its report, “CNAs are the backbone of out-of-home elder care, but they are not well paid (in 2021, their median wage was $14.56 per hour). The profession itself- itself is difficult and dangerous and has limited advancement opportunities, leading to chronic turnover and staff shortages.”
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According to Schlosky, the paid family care model solves two problems: the issue of income for families like Christiansen’s, who often have to give up work to care for their loved one, while providing more comprehensive care.
A study published in the Journal of Pediatrics in February showed that paid family caregivers in Colorado were more likely to care for the same person for at least three years than non-family CNAs (82% vs. 9%), although ‘they make less money per hour for the same work. The study also showed that the number of hospitalizations was nearly the same, indicating that there is no decrease in level of care between paid family certified practical nurses and third-party certified practical nurses.
“I, her mother, who loves her the most, is there to take care of her, and she’s worth fighting for, you know,” Christiansen said. “Chloe is non-verbal. She can’t hold her own, and so it’s my job as a mother, as a CNA, to fight for her, and it’s worth it.”
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