North Dakota is looking at ways to stabilize its child-care workforce as parents struggle to find openings. Part of that involves a new initiative that offers incentives to staff at licensed centers in hopes of reducing turnover.

A recent report found that the average child-care worker in North Dakota is paid roughly $11 an hour - barely above poverty level for a family of three in a full-time scenario. The authors say that makes it harder for centers to stay open.

Kay Larson, director of the North Dakota Department of Human Services Early Childhood Division, said to counteract the problem, they're offering additional stipends to eligible workers.

"We know," said Larson, "that making consistent, stable care available for young children and families is so essential."

Stipends range from $150 to $600 per quarter. Incentives max out at $3,600 per person or when they reach 18 months of participation.

Last year, the Legislature allocated $17 million in federal COVID relief money to bolster child-care services, but some advocates said the state didn't go far enough. They argued that smaller investments will keep parents out of the workforce.

This year, the governor and other state leaders have had talks with providers on how to approach the issue during the 2023 legislation session.

Meanwhile, Larson reminded parents having trouble affording care to take advantage of recent changes to eligibility for aid.

"Right now," said Larson, "the North Dakota child-care assistance has waived the co-pays for families and increased eligibility to 85% of the state median income."

That means a family of three with a household income of just under $6,200 a month can now qualify. The previous threshold was just under $4,400.

As for the incentives program, Larson said they'll evaluate its impact on turnover, with the hopes of receiving more funding down the road.

Nevada groups concerned about affordability, clean air and health care are speaking out against the "One Big Beautiful Bill Act" recently signed by President Donald Trump.

The new law extends tax cuts from 2017, funded partially by huge cuts to Medicaid and SNAP food benefits.

Dr. Joanne Leovy, steering committee chair for the Nevada Clinicians for Climate Action, noted it also ends the tax credit for electric vehicles on Sept. 30, which drives up the price of an EV by $7,500 while promoting the sales of gas-powered vehicles.

"This bill will dump an extra 2.1 billion tons of climate pollution into the atmosphere over the next decade," Leovy pointed out. "Increasing greenhouse gas emissions by about 7% over prior projections; the equivalent of adding more than 400,000 cars to the road."

The new law also cuts tax credits for rooftop solar and energy efficient home upgrades. Backers said the savings were necessary to fund other administration priorities, such as increased funding for immigration enforcement.

Yolanda Kemp, a member of the American Federation of State, County and Municipal Employees Local 4041, said she worries about job losses in the public sector.

"When states, cities, towns, and schools lose essential federal funding, they will be forced to make cuts to their budgets as well, putting all public services and jobs at risk of being cut," Kemp stressed. "And let me tell you, the 'Big, Beautiful Bill' that is supposed to help hardworking Americans is nothing more than another billionaire giveaway paid for by us."

The change to Medicaid and SNAP are not immediate but will be phased in mostly in 2027 and 2028.


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More than 1,100 caregivers at Portland's Providence St. Vincent Medical Center have voted to unionize, joining the Service Employees International Union Local 49.

Hospital staffers, including certified nursing assistants, cooks, lab assistants, pharmacy techs, environmental workers and patient representatives, will soon begin collective bargaining with management over a new work contract.

Finn McCool, senior food service attendant at Providence St. Vincent Medical Center in Portland, said changes to working conditions in the hospital were a major driver to organize.

"There's a lot that makes St. Vincent a great place to work, but we've also seen just tons of changes over the years around staffing and benefits," McCool explained. "My fellow caregivers really knew that jobs were only going to get harder."

The St. Vincent caregivers will join thousands of other unionized workers at Providence hospitals in Oregon, Washington state and other parts of the country. Providence officials released a statement, recognizing the union and saying they were prepared to work with it toward a new contract.

McCool noted the company made several changes to staffing and work policies without feedback from its employees, with changes to the employees' health care benefits causing a major upheaval.

"It's been a recent change to our health care plan with Aetna switching over, and that was probably a very large reason why a lot of us decided to vote yes," McCool pointed out. "We had our own internal health care system. We changed to a different thing. Co-pays changed. Things were definitely a lot harder with increased deductibles."

McCool stressed political uncertainty, particularly in the government's health care policies, was also a significant concern.

"We're seeing a lot of changes going on with the government with cuts, especially right now," McCool observed. "What threatens us is cuts to Medicare and Medicaid. Our CEO said, 'These cuts are threatening the hospital.'"

The multistate Providence Health System announced it will close the maternity center at one of its Montana hospitals in October.

Opponents are hoping the corporation will reverse its decision at negotiations starting next week. The Family Maternity Center at Missoula's Providence St. Patrick Hospital has delivered about 450 babies each year over the last several, and serves many people from the surrounding small towns.

Robin Haux, labor program director for the Montana Nurses Association, said the layoff notification came as a big surprise and will affect moms and babies, nurses and Missoula's other hospital.

"Not only were the nurses provided just a four-month turnaround, so was the community, so was Community Medical Center," Haux explained. "This has triggered a pretty large scrambling of trying to get prepared."

The cut comes as U.S. lawmakers close in on the "One Big Beautiful Bill Act," the Republican budget megabill proposing cuts to Medicaid which could close rural hospitals. Providence said the closure is due to "declining birth volumes" and "workforce shortages."

Megan Carey, labor and delivery nurse in the Family Maternity Center at Providence St. Patrick Hospital, said no one from the Family Maternity Center was included in the decision.

"We were told there was a discernment team as well as external stakeholders," Carey pointed out. "It's just really disappointing that administration could not look inward to better go about this process."

Carey added Providence sent what she calls an "unsettling" message informing nurses they could apply to work in other departments at St. Patrick Hospital but there would not be enough jobs for them all.


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