Dear Neighbor,
Last weekend, I sent a newsletter with some very sad information about the situation in our nursing homes, where 58% of the state's COVID-19 deaths have occurred. At that point, I was very disappointed in the response of the administration.
However, on Monday, they announced major new efforts to help nursing homes. These efforts are late, but dramatic and well-thought-out. Meanwhile, we are working to make sure people have adequate information about what's going on.
What's Needed - and what's in the new package
Directors of nursing homes, workers, and family members have told me that people in nursing homes immediately need help with staffing, personal protective equipment, money and information.
Money
 On Monday, Health and Human Services Secretary, Mary Lou Sudders, who heads the state's Command Center for COVID-19, announced that they will dedicate $130 million in new funds for nursing homes during the next two months. The administration already invested $130 million in 10% rate increases for all nursing homes, and 25% for dedicated COVID-19 units/wings/facilities.
The money comes with significant accountability:
To get the money, all facilities must test all staff and residents. The money can only be spent on staffing, infection control, PPE, and staff support such as providing housing. All facilities will be audited for infection control, and the results will determine future funding. The audit will include infection control, supply and use of PPE, staff, clinical care, and communication with families. At the end of two months, the state will post performance measures, testing, cases, mortality and funding use.
The accountability will concern some nursing homes, but it's important that the money be spent for the intended purposes. Most nursing homes report losing money and many have gone out of business. I've been confused by the fact that, at the same time, out-of-state for-profit companies have bought up many homes. One of my bills would require audits to ensure that a minimum percentage of their budgets is spent on patient care instead of high salaries, profit and inflated contracts with related companies, as the Globe reported four years ago.
Staffing
The funding can be used flexibly for the described purposes. The facility could increase wages, provide incentives or bonuses, or use staffing agencies to recruit and retain staff. For example, they might pay higher wages for staff who will agree not to work anywhere else, in order to reduce infection being brought in.
Clinical rapid response teams, 10 teams of 12 nurses and CNAs each, will provide urgent short-term staffing for facilities in need. This is very important, becaue nursing homes across the state have a 40% staff vacancy rate, as caregivers have gotten sick or quit. This has led to delays and difficulties in feeding, changing, toileting, and caring for patients.
 The National Guard is being deployed to assist with feeding, hydration, and other support. Again, this will provide much needed staffing. This has been a request from nursing home leaders and legislators for at least two weeks.
The administration will also contract with staffing agencies to provide added temporary staff. They will also encourage furloughed staff from hospitals and organizations like Atrius to come to nursing homes.
The state launched a site to recruit staff for nursing homes. Just recently, they began to allow nursing homes to use less-skilled support staff to provide care, such as feeding, carrying meals, moving, and help with walking or toileting. The qualifications and duties for these jobs are available on that site. This was a key request from several nursing home directors I talked to.
The state also has a list of and link to companies that are currently hiring during the crisis.
Personal Protective Equipment
 The nursing homes can use their new funds for needed PPE. There is a state portal for requesting, donating, or selling PPE. If you have some to donate, please use this portal, or contact a home, hospital, or your elder services provider. In Somerville and Cambridge, that's Somerville Cambridge Elder Services at 617-628-2601. In Medford it's Mystic Valley Elder Services (781) 324-7705, and in Winchester it's Minuteman Senior Services (781) 272-7177. Home care workers have also experienced shortages, and need to be prioritized for PPE.
Information
The state provides a daily report on COVID-19 cases. At that site, you can download a dashboard with lots of information on communities, hospitals and state-wide. Unfortunately, the information on individual nursing homes and assisted living residences is far from adequate. The number of cases is given as a range; one nursing home with well over a hundred positive cases is listed as having >30. There is no report of deaths.
The Elder Affairs Committee held a hearing and reported out a bill to require more detailed reporting, both publicly and to families of residents of nursing homes, assisted living residences, and senior buildings. We are currently working hard in the Senate on this bill, and I'm talking to leaders in the Department of Public Health and the Command Center, hoping they will just improve reporting of information they already have.
(For the first time in the legislature, our committee made all the written testimony available online. This is one of many innovations made during the crisis that may continue afterwards, this one in the interest of transparency.)
After the Crisis: Valuing and Paying Direct Care Workers
We are learning many lessons during this crisis. We already knew that there was a dangerous shortage of workers in nursing homes and home care, . Nursing homes were reporting a 17% vacancy rate. We knew that the extremely low pay was the cause. Chas Walker wrote in the Globe last week that "the low wages that prevail in the industry create staff recruitment and retention challenges, and high turnover and short staffing undermine infection control training and practice." Increasing pay for direct care workers is crucial. It will require higher rates to pay for caregivers across the continuum, as well as accountability to make sure the money gets to the workers.
AND: update on Pandemic Unemployment Assistance
In the first week of PUA, the unemployment program for gig workers and self-employed people, 130,000 applications were approved. There are real problems; if you had more than $5100 in W2 income in 2019, you have to use regular UI and aren't eligible for PUA. If you have problems with the system, be sure to contact our office at patricia.jehlen@masenate.gov
I hope you find these newsletters useful. If so, please share them with others. You can find the archive on my website.
Stay safe, and stay in touch,
|
|
|
|
