Ashlee Beaulieu lives in Dartmouth, Massachusetts and has been a registered nurse for 18 years. She works at nursing homes, picking up a shift whenever a facility needs help and when it fits her family’s schedule.
“I'm scared to work. But I have a family, and I have to support my kids,” she said. “I don't want to put myself out there. But you know what? I have to.”
She has to keep working, but she doesn’t have to keep working in Massachusetts.
Beaulieu has discovered that she can make substantially more money in Rhode Island. She said she can make up to $20 more an hour in the Ocean State.
“I would rather work down the street at the facility I'm used to working at, that I always work at," she told WGBH News. "But for me having to go out there and put my life on the line and take into account my children and what's going on, I think: ‘Okay, well, let me go an hour down the road and work in Rhode Island versus working in Massachusetts because they are paying me more.' I just feel like it's a kick in the gut,” she said.
Beaulieu said she has no idea why this pay gap exists. But David Coppins knows.
Coppins runs an app called IntelyCare that serves like a temp agency, matching their pool of nurses with nursing homes that have shifts they need to fill.
“Massachusetts is the only state in the country that has a rate cap on how much companies like ours — those that are providing nurses and nurse assistants on a per diem basis — can charge,” Coppins explained.
Coppins said, in effect, the regulation means that nurses who work for temp agencies cannot get hazard pay or increased wages for working in nursing homes hit by the coronavirus.
This regulation affects nurses who come to nursing homes and hospitals through temporary nursing agencies ; it does not impact nurses who are employed through contracts directly with these facilities. It also does not affect temporary nurses at assisted living facilities.
He said IntelyCare is usually able to fill basically all the open shifts that nursing homes post on their app. But with the coronavirus outbreak, he said the company is able to fill less than half the posted shifts, leaving nursing homes understaffed.
He said that’s partly because about 15 percent of their nurses are at home, scared to work or in a high-risk category. And, along the state border, another 15 percent of their temporary nurses are heading to neighboring states to make more money.
IntelyCare is based in Quincy, Massachusetts, but it operates in 10 states. He said that through the app, he is seeing nurses in eastern Massachusetts pick up shifts in New Hampshire and Rhode Island, and in the western part of the state nurses are crossing the border to work in nursing homes in New York and Connecticut.
“We're effectively bleeding the supply and the talent outside of Massachusetts and we're not allowing our facilities that are in desperate need right now to be fully staffed,” said Coppins.
He believes the regulations were originally written to rein in what the state would have to pay for Medicaid, since that’s how many nursing home patients pay their bills.
Peter Leibowitz, who runs another temporary nursing agency based in Massachusetts called Worldwide Staffing, estimates he gets up to 10 calls a day — including on weekends — from some of the state’s nearly 400 nursing homes frantically trying to fill shifts.
“The demand is getting overwhelming,” Leibowitz said.
He points out that during the coronavirus outbreak many state licensing requirements have been waived, making it even easier for nurses to leave Massachusetts.
Leibowitz said he and other temporary nursing agencies have been asking state officials to temporarily lift the cap on wages during the coronavirus outbreak, but they do not appear to be making headway at the State House.
WGBH News reached out to state officials but did not get a response.
In the meantime, nurse Ashlee Beaulieu continues to make the hour-long drive from her home in Massachusetts to work at nursing homes in Rhode Island. And David Coppins warns that inaction at the state level could extend the crisis already facing Massachusetts.