Prohibited Offenses and The Healthcare Worker Shortage

Having written about staffing shortages from several angles, I want to explore a forgotten group: those that have been or are currently in the legal system.

       Addressing the obvious concern of safety for our elders is of course most important, but if there was a vetting procedure and a way to closely track those wanting to enter or re-enter the healthcare field it might be a worthwhile exercise both to help fill the vast vacancies in staffing and to get these prior offenders back into society as a valuable citizen.

      Missouri has a successful program for offenders to study and receive their C.N.A certificate and assists them in employment placement. It would be much more difficult in Kansas unfortunately because our prohibited offenses list is quite lengthy and has at least a 6-year waiting time (which that clock does not start until the entire sentence has been satisfied, including, jail/prison, probation, parole, and all fines, court costs etc.). This is a catch-22 as it is near impossible to pay fines when there is no income or employment opportunities. If a person committed an offence and serves 5 years, then after that person is released they are on probation for another 5 years, this person has $5000 in fines to pay, this takes at least 6 or 7 years to pay back, and you can see how a 6 year ban on becoming even a C.N.A can actually turn into a minimum of 10 years from the offence to upwards of 15 or even more.

     Teaching entry level healthcare certification courses for over 22 years now, I have so many heart-wrenching stories that I could share. In the interest of time, I would like to share just 3 that have stayed in my thoughts.

(Names have been changed)

1.)    Annie grew up in a difficult home. When she was 17, she became pregnant and was kicked out of her home. She moved in with her boyfriend and when she was just barely 18 and very pregnant her boyfriend was driving her car, with her in it, and committed a robbery. Because she was in the car and the car was hers, and with no money for good representation, she was convicted with a felony. When she came to my school and took C.N.A she was in her early 20s, poised and her old boyfriend was long gone.  She was a star student passing with a high A. At clinicals she was offered a job on the spot because of her excellent care she gave to the residents. She worked for less than a week when she was called into the director of nursing office and was let go due to being “red lined” and banned from working in a LTC setting. She was devastated, she had wanted to be a nurse and I have no doubt she would have made a spectacular nurse. Now all those dreams were down the drain, because of a mistake she made when she was a very young vulnerable girl. Our team worked very hard, contacting all our friends in the healthcare community vouching for her and trying to find her employment. We did finally find a small private pay home plus that reluctantly hired her. She was thrilled but she also knew that even though she had the intelligence, drive and heart to become a nurse, she would never be able to move forward or climb the ladder for a better job in healthcare. We did our best to help her, but I still mourn for what not just she, but all of society lost in this situation.

2.)    DeMonte grew up in what he calls “the hood.” He joined a gang when he was just 15. He was shot by a rival gang member when he was 17. He was on a dangerous path until his nephew, who looked up to him, was shot and killed. DeMonte immediately changed his life; he did a full 180. When he came to our school to take C.N.A he was married with a small child. He volunteers working with at risk youth. He became a model for other young men to follow. He took the C.N.A and passed. The prohibited offences list is very long and convoluted, and difficult to understand. Neither us nor his caseworker thought his offence would be flagged, but it was. He wanted to continue his education and become a paramedic, but that could not be. He was crushed he felt that after all he had done to prove himself, he could never rise above it. He decided to stay at his construction job, which he hated. He wanted and felt deeply called to healthcare but was so discouraged he left that aspiration. Again, we all lost.

3.)    Lori had been an LPN for years, working at the same nursing home for years caring for her elders. Her husband was in a terrible motorcycle wreck and without decent insurance, medical bills stacked up. Her husband was in chronic pain, but they could not afford the medications needed. Lori make a huge mistake taking expired pain meds (not from residents but from the destroy pile) home to her husband. She was caught and lost her license. Five years later, even after probation, she still could not even work as a C.N.A in a LTC community. C.N.As do not handle medications and so the risk would be very low for the same situation.

Surely working together across the healthcare, education, and legal system we can find a path forward for these people.

 -Dianne Powell