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What We're Reading: Nursing Home Staff Shortages, Closures; State Guidance for New Mental Health Hotline; Doula Services for Medicaid


Staff shortages due to the COVID-19 pandemic could lead to closures for nursing homes; some states lack funding and guidance for the mental health hotline opening next month; 17 states are considering implementing policies to provide Medicaid reimbursement for services of doulas.

Nursing Homes Face Closures

Nearly 60% of nursing homes in the United States are operating at a financial loss, according to a survey by the American Health Care Association. The survey found that 60% of nursing homes have had worse staffing situations since the start of 2022. Nursing home representatives surveyed said that they had needed to hire temporary staff and limit new admissions to their facility in order to compensate for lack of staff, and 99% of nursing homes had asked employees to work overtime. Nearly three-quarters of nursing homes in the survey reported that they were concerned about having to close if these staffing shortages continued.

Mental Health Hotline Without Funding in Numerous States

A mental health hotline, reachable at the number 988 as soon as July 16, lacks set funding or legislative support on the state level. The legislation to enact the hotline, which passed in 2020, left financial support for staffing, phone lines, computer systems, and other infrastructure in the hands of the states. However, only 4 states (Colorado, Nevada, Virginia, and Washington) have passed comprehensive plans for the implementation of the hotline. A RAND Corporation report claimed that more than half of public health officials felt unprepared for the rollout of the new hotline in a month.

States to Extend Medicaid Money for Doulas

Several states have considered extending coverage of Medicaid to doula services, which may help combat the poor statistics on maternal mortality in the United States, according to Pew. A doula is a trained support person who can provide guidance—but not medical assistance—to a pregnant woman before, during, and after labor. There are 6 states that currently provide these services to women on Medicaid (Florida, Maryland, Minnesota, New Jersey, Oregon and Virginia) while 5 other states (California, Illinois, Indiana, Nevada, and Rhode Island) and the District of Columbia also plan to apply to CMS for this reimbursement.

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