Do something about healthcare worker misclassification

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Paying health care workers on a gig economy scale is a losing proposition for medicine and the people treated by its professionals, U.S. Rep. Alma Adams argues.

National Certified Nursing Assistants Week is June 15-21, and the best way we can celebrate the essential lifesaving work nursing assistants do every day is by making sure they get the benefits and protections they deserve.

Unfortunately, thousands of nursing assistants and other healthcare professionals don’t receive fair treatment and compensation because they’re misclassified as independent contractors.

While independent contractor classification makes sense for some professions and circumstances, healthcare is one of the most highly regulated industries in the country. Nurses often have little to no control over when, where, and how they work. CNAs and other healthcare workers follow a schedule dictated by a facility, with pre-determined shift start and end times. They perform their duties according to industry regulations and procedures, using resources and tools provided by the facility they work at. These conditions aren’t just crucial to running a safe, efficient healthcare facility, but also make it evident nurses should be classified as W-2 employees.

The issue of misclassification in healthcare is growing. To help ease the ongoing national nurse shortage, digital healthcare staffing platforms have emerged to match nurses with open shifts at facilities in need. These platforms are a helpful tool for addressing the nursing shortage, but some of these companies misclassify their nurses as independent contractors, arguing that because their nurses work part-time, they don’t need the full benefits of W-2 employment.
This couldn’t be further from the truth.

A recent survey of over 500 nurses working for Gale Healthcare Solutions – a digital staffing platform that classifies their clinicians as W-2 employees – found 65% of respondents exclusively work per diem shifts and nearly half work the equivalent of a full-time schedule. This data proves gig-style work isn’t just a secondary source of income for healthcare workers; it’s a primary job and a way to keep nurses in the industry despite staffing challenges.

The U.S. Department of Labor is paying attention to this issue. A new proposal from the Biden Administration on track to go into effect this year will create clearer guidelines for worker classification. The proposal will make it more difficult for companies to unfairly classify workers as independent contractors. I completely support the proposed rule, and I urge the Dept. of Labor to crack down on misclassification and fully enforce the penalties for violating this rule.

North Carolina is home to more than 100,000 nurses who work each day to keep members of our community healthy. My sister struggled with sickle cell anemia, and I saw firsthand how much love our nurses pour into their professions and their patients. Similarly, since the height of the coronavirus pandemic, America has seen our nurses and the health workforce fight tirelessly to combat the health crisis.

A nurse working every day to provide patients with the highest quality of care possible shouldn’t have to worry about receiving a fair wage and overtime pay, deducting their own payroll taxes or having to take unpaid days off when they’re sick. While these all seem like obvious benefits nurses need to perform their jobs well, when a nurse works as an independent contractor, they often don’t receive these vital protections.

This issue doesn’t just impact nurses. As many as 30% of employers are misclassifying their employees. Healthcare facilities relying on 1099 staffing platforms risk being held responsible for penalties like unpaid overtime and taxes. Because 1099 nurses are not subject to employer-mandated education and training requirements, patients may receive lower quality care.

Misclassification also harms our economy, both here in North Carolina and nationally, by depriving the government of billions in tax dollars to bolster programs like Medicare and Social Security.
 
If there’s anything the pandemic taught us, it’s that nurses are heroes. In honor of National CNA Week, let’s show our appreciation by fighting for fair classification and treatment of nurses.

Alma Adams represents Charlotte in the U.S. House of Representatives

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