AARP’s new COVID-19 Dashboard for national/local Nursing Home Data

Published in RINewsToday.com on October 26, 2020

While public health experts are predicting a second spike of the COVID-19 virus, expecting it to hit the nation as early as – now – and reaching its peak in December, AARP releases its Nursing Home COVID-19 Dashboard created to provide four-week snapshots detailing the infiltration of the virus into the nation’s nursing homes and its impact on residents and staff.  AARP’s latest Public Policy Institute analysis is the result of the Washington, DC-based aging advocacy group’s successful efforts to push for the public reporting of nursing home COVID-19 cases and deaths.

Using data collected by the Centers for Medicare & Medicaid Services—which is self-reported by nursing homes—the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the AARP Nursing Home COVID-19 Dashboard to provide four-week snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff. The first release of the dashboard on October 14 reveals that nursing homes in every state reported shortages of PPE, ranging from 8 percent of facilities in the best-performing states, to 60 percent in the lowest-performing state. The dashboard also compared state and national data on COVID-19 cases and deaths, staff cases and staffing shortages.

Key Findings of AARP’s First Dashboard

The AARP Public Policy Institute will analyze data and report on key findings as the dashboard is updated over time.  Here are some observations about AARP’s first Dashboard (using data from August 24 to September 20, in which 95 percent of the nation’s 15,366 nursing homes submitted data for this time period):

According to the database, in every state, nursing homes indicated a shortage of PPE (defined as not having a one-week supply of N95 masks, surgical masks, gowns, gloves and eye protection during the previous four weeks). Nationally, about one quarter (25.5 percent) of nursing homes had a PPE shortage during the Aug. 24 to Sept. 20 reporting period. In the highest performing state, 8 percent of nursing homes had a PPE shortage; in the lowest-performing state, 60 percent did not have a one-week supply.

The researchers note that while considerable attention has been paid to infections among nursing home residents, it is also critically important to consider direct-care staff. In the four weeks ending Sept. 20, one-quarter (24 percent) of nursing homes had at least one confirmed COVID-19 case among residents, and twice as many (50 percent) had at least one confirmed staff case. Per 100 nursing home residents, there were 2.6 COVID-19 resident cases and 2.5 staff cases, corresponding to a total of about 55,000 cases nationally.

Finally, there is considerable variation across states. COVID-19 deaths in the four weeks ending Sept. 20 averaged 0.5 per 100 residents across the nation (about 1 out of every 200 residents). At the state level, the death rate was as high as 1.2 per 100 residents (about 1 out of 80), and several states reported no resident deaths in the past month.

Looking at Rhode Island, AARP’s first dashboard detailed the following: 

·         2.2 COVID cases per 100 residents

·         0.2 COVID deaths per 100 residents

·         1.7 staff cases per 100 residents

·         19.7 percent of nursing homes without a 1-week supply of PPE

·         28.9 percent of nursing homes with staffing shortages

AARP’s dashboard will be updated every four weeks to track trends over time and will evolve to include more categories to follow other measures of interest.

As Others See It – in Rhode Island

“We have been very clear in our messaging: No state has done a good enough job to protect nursing home residents and staff,” said AARP Rhode Island State Director Kathleen Connell. “That said, it is good to see that in the first round of data postings on the AARP Nursing Home COVID Dashboard shows Rhode Island in better-than average shape compared to other states. But to our point, anyone in Rhode Island with a loved one in a nursing home expects – hopes and prays – for more than ‘better than average.”

“As we see daily reports of increased cases and deaths, safety concerns for nursing home residents and staff should be increasing as well. The pandemic is far from over and among many complicated aspects of dealing with it is transparency. The COVD Dashboard provides the public with a benchmark and tracks monthly changes; people need to pay attention and demand action at all levels to make nursing homes safer. These aren’t just numbers. These are lives,” says Connell.

On the other hand, the Rhode Island Department of Health questions the accuracy of AARP Nursing Home COVID-19 Dashboard as it relates to its Rhode Island findings. “The data don’t accurately reflect the Rhode Island reality in part because of how the questions are phrased,” says Joseph Wendelken, RIDOH’s Public Information Officer, specifically related to PPE data. “The question asks about PPE in the nursing homes. Nursing homes receive a weekly supply of PPE from their corporate warehouses. The question asks about one point in time. On occasion, reporting happens shortly before facilities receive their re-supply,” he says.

“RIDOH has taken several steps to protect nursing home residents, says Wendelken, noting that his department has built Congregate Setting Support Teams to conduct targeted to facilities regarding infection control, PPE, testing, and staffing. 

“We have weekly contact with facilities. We’ve worked with facilities to develop creative plans for reopening. We have implemented regular testing of staff every 10 to 14 days. We will take the lessons and experience we’ve gained from these past seven months and apply them to the increase in cases we see today,” adds Wendelken. 

According to Scott Fraser, President/CEO, of the Rhode Island Health Care Association (RIHCA), the AARP analysis shows what his organization has been saying in the last few weeks and months—that COVID-19 cases in nursing homes continue to drop. “Rhode Island is below the national average in all categories measured for this dashboard,” he says, stressing that the number of cases in nursing homes is dropping as is the number of deaths,” notes Fraser.  

The successful efforts to protect nursing home residents and staff can be directly linked to the measures the facilities have taken since the pandemic first hit, notes Fraser. “We are stocking up on PPE. We initially suspended visitation.  We are testing staff regularly and residents when necessary.  We are carefully monitoring visitors and vendors who come into our homes.  We isolate and quarantine anyone who tests positive or any new resident who moves into our facilities,” he says. 

Fraser says that RIHCA continues to advocate for regular testing of vendors who come into the state’s nursing homes, including ambulance drivers, lab technicians, and hospice workers.  RIHCA continues to call on RIDOH to renew the policy of having two negative tests before a hospital patient can be released to a nursing home and to allow those certified nursing assistants who received temporary emergency certifications to obtain their permanent licenses.

A Call to Action

More than 84,000 residents and staff of nursing homes and other long-term care facilities have died from COVID-19, representing 40 percent of all coronavirus fatalities in the U.S., according to Kaiser Family Foundation’s most recent analysis released on Oct. 8. Yet in its statement announcing the release of its Dashboard, AARP charges that federal policymakers have been slow to respond to this crisis, and no state has done a good enough job to stem the loss of life. 

According to AARP, policymakers have taken some action, such as requiring nursing homes to self-report COVID-19 casers and deaths at the federal level, ordering testing, and providing limited PPE and other resources to nursing homes. But more must be done, says the nation’s largest aging advocacy group in its statement urging elected officials “to acknowledge and take action to resolve this national tragedy — and to ensure that public funds provided to nursing homes and other long-term care facilities are used for testing, PPE, staffing, virtual visits and for the health and safety of residents.”

COVID-19 cases across the U.S. are again on the rise, and nursing homes remain a hotbed for the virus, says AARP promising to “continue to shine a light on what’s happening in nursing homes so that families have the information they need to make decisions, and lawmakers can be held accountable.”

AARP has called for the enactment of the following five-point plan to protect nursing home and long-term care facility residents — and save lives — at the federal and state levels:

·         Prioritize regular and ongoing testing and adequate personal protective equipment (PPE) for residents and staff — as well as inspectors and any visitors.

·         Improve transparency focused on daily, public reporting of cases and deaths in facilities; communication with families about discharges and transfers; and accountability for state and federal funding that goes to facilities.

·         Require access to facilitated virtual visitation, and establish timelines, milestones and accountability for facilities to provide in-person visitation.

·         Ensure quality care for residents through adequate staffing, oversight and access to in-person formal advocates, called long-term care ombudsmen.

·         Reject immunity for long-term care facilities related to COVID-19.

To see AARP Nursing Home COVID 19 Dashboard, go to:

www.aarp.org/content/dam/aarp/ppi/pdf/2020/10/rhodeisland-nursing-home-dashboard-october-2020-aarp.pdf

Social Security ’21 Cola Increase Anemic

Published in RINewsToday.com on on October 19, 2020

With the Social Security Administration’s (SSA) announcement of next year’s Social Security and Supplemental Security Income’s (SSI) meager cost-of-living adjustment (COLA), over 70 million beneficiaries will only see an increase of 1.3 percent in their monthly checks in 2021.  Last year’s COLA increase was 2.8 percent, the largest in seven years.

According to SSA, the 1.3 percent cost-of-living adjustment (COLA) will begin with benefits payable to more than 64 million Social Security beneficiaries in January 2021. Increased payments to more than 8 million Supplemental Security Income (SSI) beneficiaries start on December 31, 2020. 

SSA ties the annual COLA to the increase in the Consumer Price Index as determined by the Department of Labor’s Bureau of Labor Statistics. 

The maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase to $142,800 from $137,700, says SSA.

The earnings limit for workers who are younger than “full” retirement age will increase to $18,960. (SSA deducts $1 from benefits for each $2 earned over $18,960.)

The earnings limit for people reaching their “full” retirement age in 2021 will increase to $50,520. (SSA deducts $1 from benefits for each $3 earned over $50,520 until the month the worker turns “full” retirement age.)

There is no limit on earnings for workers who are “full” retirement age or older for the entire year. 

Next Year’s COLA Increase Not Enough 

Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM) calls the increase as inadequate especially for COVID-Ravaged Seniors and noted that it’s the lowest since 2017.  

“The timing could not be worse. The COVID pandemic has devastated many older Americans both physically and financially.  Seniors living on fixed incomes need a lifeboat; this COLA increase is more like an underinflated inner tube,” says Richtman.

The average Social Security beneficiary will see a paltry $20 month more in benefits in 2021, calculates Richtman. “This COLA is barely enough for one prescription co-pay or half a bag of groceries. Worse yet, seniors could lose almost half of their COLA increase to a rise in the Medicare Part B premium for 2021, the exact amount of which has not yet been announced,” he warns.  

“The current COLA formula – the CPI-W – is woefully inadequate for calculating the true impact of inflation on seniors’ pocketbooks. It especially under-represents the rising costs that retirees pay for expenses like health care, prescription drugs, food, and housing. We support the adoption of the CPI-E (Consumer Price Index for the Elderly), which properly weights the goods and services that seniors spend their money on,” says Richtman. 

Examining the Growth of SSA COLAs 

Social Security checks in 2020 are almost 20 percent lower than they otherwise would be, due to the long-term impact of extremely low annual inflation adjustments, according to a newly released analysis by The Senior Citizens League (TSCL).  The analysis comes as SSA announced that the 2021 COLA will be just 1.3 percent, making it one of the lowest ever paid. 

“People who have been receiving benefits for 12 years or longer have experienced an unprecedented series of extremely low cost-of-living adjustments (COLAs),” says TSCL’s Mary Johnson, a Social Security policy analyst for the Alexandria, Virginia nonpartisan senior advocacy group. “What’s more those inflation adjustments do not account for rapidly rising Medicare Part B premiums that are increasing several times faster than the COLA,” she says, noting that this causing those with the lower Social Security benefits to see little growth in their net Social Security income after deduction of the Part B premium.  

Johnson’s COLA analysis, released on Oct. 13, compared the growth of retiree benefits from 2009-through 2020 to determine how much more income retirees would receive if COLAs had grown by a more typical rate of 3 percent. TSCL’s analysis found that an “average” retiree benefit of $1,075 per month in 2009 has grown to $1,249 in 2020, but, if COLAs had just averaged 3 percent, that benefit would be $247 per month higher today (19.8 percent higher), and those individuals would have received $18,227.40 more in Social Security income over the 2 010 to 2020 period. 

During that period COLAs have averaged just 1.4 percent. In 2010, 2011, and 2016 there was no COLA payable at all and, in 2017, the COLA was 0.03 percent. “But COLAs have never remained so low, for such an extended period of time, in history of Social Security,” says Johnson, who has studied COLAs for more than 25 years.  Over the 20-year period covering 1990 to 2009, COLAs routinely averaged 3 percent annually, and were even higher before that period. 

According to Johnson, the suppressed growth in Social Security benefits not only creates ongoing benefit adequacy issues, but also Medicare budgetary programs when the COLA is not sufficient to cover rising Part B premiums for large number of beneficiaries. When the dollar amount of the annual Medicare Part B premium increase is greater than the dollar amount of an individual’s annual COLA, the Social Security benefits of about 70 percent of Medicare beneficiaries are protected by the hold-harmless provision in the Social Security Act.  The Medicare Part B premium of those individuals is reduced to prevent their net Social Security benefits from being lower than the year before, she says. 

However, Johnson notes that the people who are not covered by hold harmless include higher income beneficiaries, beneficiaries who have not started Social Security yet and who pay for Medicare by check and about 19 percent of beneficiaries whose incomes are so low that their state Medicaid programs pay their Medicare Part B premiums on their behalf. 

Johnson says, “that a provision of a recently enacted government spending bill restricts Part B premium increases in 2021. The bill caps the Part B premium increase for next year at the 2020 amount plus 25 percent of the differences between the 2020 amount and a preliminary amount for 2021.”

Don’t look for the “potential Part B spike” to go away, warns Johnson. “Unless Congress acts to boost Social Security benefits and finds a better way to adjust benefits for growing Medicare costs, this problem will continue occur with greater frequency in the future,” she says.

Fixing SSA’s COLA Problem Once and For All

During the COVID-19 pandemic seniors are relying more on their Social Security check but continue to face cost increases each year beyond the extra income provided by the COLA, says Social Security Subcommittee Chairman John B. Larson (D-Connecticut) in a statement following SSA’s announcement of its tiny 2021 COLA increase. “It’s time to fix that by enacting the Social Security 2100 Act.,” says the Connecticut Congressman calling for passage of his legislative proposal that would strengthen SSA benefits by basing the COLA on what seniors actually spend on items such as medical expenses, food, and housing. Under this new CPI-E index, a beneficiary would experience benefits that are 6 percent higher by the time they reach age 90. 

Meanwhile, Congressman Peter DeFazio (D-Oregon) sponsored and Larson, a co-sponsor, have proposed emergency legislation to increase next year’s COLA up to 3 percent. “Due to the COVID-19 pandemic, seniors are facing additional financial burdens in order to stay safe,” said DeFazio.  “This absolutely anemic COLA won’t even come close to helping them afford even their everyday expenses, let alone those exacerbated by COVID-19. Raising the COLA to 3 percent 2021 will provide seniors with an immediate, crucial lifeline during the ongoing coronavirus crisis,” says the Oregon Congressman. DeFazio’s legislative proposal, the Social Security Expansion Act, would also provide a permanent fix to the COLA formula, like Larson using a CPI-E index to factor in seniors’ actual, everyday expenses.

16 year olds and up: Be a Poll Worker – Shortages Threaten Elections

Published in RINews Today on October 6, 2020

With spikes in COVID-19 cases occurring across the nation, causing concerns about the safety or health risk to workers staffing polling sites, AARP announces a new initiative to recruit persons of all ages for the upcoming presidential election to work the polling sites.  AARP along with the Association of Young Americans (AYA), Power the Polls (POP), and New Leaders Council (NLC) are working to ensure that in-person voting is still an accessible and safe option at the polls.   

“There is an urgent need for more poll workers this election, including people 50-plus and younger voters. We need to ensure that in-person voting is still an accessible and safe option,” said Nancy LeaMond, AARP EVP and Chief Advocacy and Engagement Officer. “We will encourage all AARP members to communicate with their younger family and friends around the importance of voting and how to participate as a poll worker,” says LeaMond.

According to Pew Research Center analysis of government data, “Older People Account for Large Shares of Poll Workers and Voters in U.S. General Elections,” published on April 6, 2020, nearly six-in-ten (58%) poll workers were ages 61 and up in 2018 and 56% in 2016. Many communities faced poll worker shortages prior to the pandemic. The 2016 U.S. Election Assistance Commission found that two-thirds of jurisdictions already had a difficult time recruiting enough poll workers on Election Day.

A Call for Poll Workers 

“The poll worker shortage is an urgent issue, and we’re on the clock,” states Scott Duncombe, Power of Poll’s Co-Director. “This unprecedented shortage threatens our democracy, puts our older population at risk, and disproportionately affects low-income communities and communities of color. This is a historic moment for first-time poll workers to sign up to protect their communities, their neighbors, and their democracy. We will keep working until there are enough poll workers and volunteers to keep polling sites open, staffed, efficient, and functioning. We must do everything we can to ensure this upcoming election is safe, fair, and accessible,” he says.

Adds Ben Brown, AYA’s Founder, “Poll workers play a critical but often overlooked role in ensuring safe elections. The pandemic has hampered recruiting efforts for poll workers, who tend to be repeat workers, and fewer poll workers means longer lines, delays, and more confusion on Election Day,” said Ben Brown, Founder of Association of Young Americans. ““

Clare Bresnahan English, NLC’s President and CEO, notes “Poll workers are the essential workers of our democratic process. All voters should feel safe and welcome when they participate in the upcoming election.”  He observes that that this intergenerational collaboration with AARP and Power the Polls allows for the recruitment of young poll workers whose identities reflect the community in which they serve.”

The Power the Polls initiative is also working with local organizations and partners to help election officials provide the necessary PPE to keep poll workers and voters safe. For more information, reach out to your local officials through workelections.com  

In August, AARP launched “Protect Voters 50+,” a comprehensive voter engagement campaign to support and protect Americans 50-plus as they vote in the 2020 elections. The campaign will help Americans over 50 votes safely, whether at home or in person. The “Protect Voters 50+” campaign will provide people with the information they need about this year’s elections, including video voters’ guides, issue briefings, direct mail, text messaging, social media and paid media.

In the Trenches…at the Polling Sites

Last month, over 2,000 persons voted at Pawtucket’s 26 polling sites, over 4,000 chose to vote by mail ballots, says Ken McGill, the City’s Registrar for over 17 years.  He estimates that it was almost triple the number of votes cast at a primary. 

Looking back, McGill says it was a struggle to get enough workers to man Pawtucket’s polling sites during the September primary.” Many of our veteran poll workers, especially those with health issues, opted out because of the COVID-19 pandemic,” he said. 

But with Rhode Island allowing 16-year-olds to work at the polls, McGill plans to continue reaching out to youngsters to serve as election officials at the polls. 

According to McGill, like the primary Pawtucket polling officials continue to follow social distancing guidelines at the upcoming presidential election to be held on Tuesday, November 3, 2020.  Only a certain number of voters will be allowed into the polling site at the same time. Hand sanitizer are readily available for use by both poll workers and voters. All poll workers will be required to wear masks and voters are encouraged to also wear masks to stop the spread of COVID-19.  Also, at every poll, a person will be assigned to wipe down the booths after use and to clean and disinfect the site throughout the day and to ensure that voters are social distancing from one another.  

Nick Domings, a spokesperson for Secretary of State Nellie M. Gorbea, says that the Secretary has made it her top priority to make voting convenient, safe and secure for the upcoming presidential election. “During the pandemic, that means providing options for casting a ballot that ensure no voter must risk their health to exercise their constitutional right to vote. Rhode Islanders can choose to either vote from home with a mail ballot, vote early in-person at their city or town hall, or vote at a polling place on Election Day,” he says.  

Secretary Gorbea has sent registered voters a mail ballot application for the November 3 general election.  But for those voters who wish to cast their ballot in-person, either early at their city/town hall or at a polling place, know that facilities will be thoroughly sanitized, single-use pens will be utilized and poll workers will be wearing personal protective equipment, notes Domings. 

Domings recommends that Rhode Island voters check the location of their polling place on vote.ri.gov, as some may have changed due to the pandemic.

Becoming a Poll Worker

“Because our older citizens are most at risk for serious complications from COVID-19, there is a definite need for poll workers this year. This is a great opportunity for young people to see how our democracy works up close. If you or someone you know wants to be a poll worker, contact your local board of canvassers or call the Board of Elections at 401-222-2345,” suggests Domings.