Author Archives for Herb Weiss

Fed’s Proposal to Confronting Nursing Shortage is Not Enough

Published in Pawtucket Times on April 1, 2002

Responding to the nation’s serious nurse staffing shortage, a new Federal proposal gives states flexibility to allow nursing facilities to use paid feeding assistants to supplement the services of certified nurse aides (CNAs). The specialty trained staff would help residents eat and drink.

With a growing number of frail elderly resident in the nation’s nursing facilities, today’s nursing staff must take care of residents who require a higher level of medical care. This leaves less time to ensure that residents eat their meals and drink enough fluids on a daily basis.

Oftentimes, both physical and psychological changes will interfere with a resident’s ability to eat and consumer a meal. Some residents may only need encouragement or minimal assistance with eating.

On the other hand, frail residents may require staff assistance with feeding .  Assistance would be needed for residents with cognitive impairment, impaired swallowing due to muscular weakness or paralysis, a tendency to aspirate or choke, poor teeth, ill-fitting dentures or partial plates, poor muscular or neurological control of their arms or hands, as with Parkinson’s disease.

Under the Centers for Medicare & Medicaid Services (CMS) proposal, trained feeding assistants are allowed to help residents eat and drink, especially at meal times.

The workers would be required to complete a state-approved course to quality to be hired for the new position.  Currently nursing facilities rely primarily on CNAs, registered or licensed practical nurses to assist residents with eating and drinking.  However, volunteers and family members also may assist with these tasks.

At this time, there is no provision in federal regulations for the employment of nursing facility workers to perform only a single task without competing 75 hours of nurse aide training.

The proposed rule change published in the March 29 issue of the Federal Register would allow facilities to hire workers to perform a single task with training on feeding techniques and some basic information that is currently part of CNA training requirements.

“Meal times can often be the busiest time in nursing facilities,” says CMS Administrator Tom Scully.

“Feeding residents is often a slow process and competes with m ore complex tasks, such as bathing, toileting and dressing changes, as well as urgent medical care,” he added.

“Trained feeding assistants will free nurses and nurse aides to focus on residents’ other health care needs. The result will be that residents will receive better nutrition and care,” Scully noted.

The American Health Care Association (AHCA), a Washington, D.C.-based trade group, that represents both profit and non-profit nursing facilities, gives the new federal rules a thumbs up.

‘Simple common-sense dictates that when our nation’s health care system is being undermined by a chronic nursing staffing shortage, and the greater needs of increasing sicker patients, we should do everything conceivable to better the lives of our patients,” stated Dr. Charles H. Roadman II, president and CEO of AHCA. “The rule will also help the overextended nurses and nursing aides already on the job cope with competing important tasks.”

Hugh Hall, executive director of the Johnston-based Cherry Hall Manor Nursing and Rehabilitation Center, supports the federal government’s approval of the single task workers who feeds nursing facility residents.

“The prior regulation was not logical or practical when prohibiting other nursing home workers other than registered nurses, licensed practical nurses and CNAs from feeding, but allowing volunteers and families to participate in the feeding process with little training,” he said.

Hall, the former president of the Rhode Island chapter of AHCA, said the health care community would prefer that the federal government develop long-term care programs to recruit fully trained certified nursing assistants and to financially support those initiatives.

Roberta Hawkins, who serves as the state’s nursing facility ombudsman and executive director of the Alliance for Better Long-Term Care agrees.

“The federal proposal is only a Band-Aid fix.” Hawkins says, calling on the federal government to put more funds into the nursing facility reimbursement system to enable facilities to pay better wages to hire permanent full-time staff and to create career ladders.

“Even though you may teach an aide to just feed residents, they are not trained to spot medical changes in the resident, Hawkins told Everything About Seniors.  More important, she said, “they will not be familiar with the specific needs of the residents.”

Hawkins believes that the Bush administration’s proposal can become an obstacle in providing continuity of care in nursing facilities.

A state commission, chaired by Human Services Director Jane Haywood, is currently looking at Rhode Island’s staffing shortage and how the existing Medicaid reimbursement system can be improved.

Recommendations for a new and improved system coming from Haywood’s group might just fix a long-time systemic problem, enabling nursing facilities to better recruit and retain CNAs.

Hopefully, Haywood’s long-awaited proposals will be seriously considered by the administration and General Assembly and won’t end up on a dusty shelf or a circular file.

While allowing the use of single-tax workers, proposed by the Bush administration, it is a step in the right direction. Gov. Lincoln Almond, state lawmakers and state policymakers must not lose sight of the real issue – inadequate Medicaid payments- which fuels an ongoing CNA shortage in many of the state’s nursing facilities.

Almond and the General Assembly are currently at odds over subsidized gambling in the Ocean State.

During this year’s budget debates, overshadowed by a projected $70 million plus budget deficit, let us not forget about Rhode Island’s 10,000 nursing facility residents or the growing elderly population who may ultimately require that level of care or community-based long-term care services.

If the General Assembly can easily find $ 15 million next year to keep the greyhound racing industry afloat, lawmakers might dedicate some time and a little energy and effort in finding state dollars to increase funding to Rhode Island’s long-term care delivery system.

For older constituents and the state’s aging baby boomers it is the right thing to do.

Supreme Court Jumps into Age Discrimination Debate

Published in Pawtucket Times on March 25, 2002

In 1983, my 70-year-old father expressed his concerns about job hunting in his senior years.

Like many at his age, he was not considering retirement but was seeking a new professional challenge. He began to put out feelers for new employment while still being employed by a Dallas, Texas-based retail chain after m ore than 40 years of service.

They won’t hire me if they find out my age,” my father staid, adding that he believed that job experience gleaned from years of employment is not valued by many in corporate America.

Sadly, my father’s fears of age discrimination expressed to me years ago is still documented today by the federal government.

Last year, more than 20 percent of the 80,840 discrimination complaints filed with the Equal Employment Opportunity Commission against private-sector employers were related to age discrimination.

Last week, the Supreme Court jumped into the age discrimination debate and will determine whether seniors have the same legal rights as other types of discrimination claim suits do.

Layoffs at the Florida Power Corporation during a series of reorganizations led to the termination of Wanda Adams and 116 older workers.

More than 70 precent of these persons were at least 40 years old or older. A lawsuit, Adams vs. Florida Power Corp. was filed, claiming the Florida-based corporation discriminated against older workers based on their age in violation of the Federal Age Discrimination in Employment Act.

Under the 1967 federal statute, older workers must not be treated differently than younger workers because of their age.

The 11th U.S. Circuit Court of Appeals in Atlanta affirmed the trial court’s decision that older workers could challenge their termination by proving that their employer’s action had a discriminatory motive or intent (disparate treatment) rather than a disproportionate impact (disparate impact) on older workers.  AARP believes that this court ruling would make age bias suits tougher to prove, giving employers a greater ability to trim their payrolls of older workers.

Now the U.S. Supreme Court is posed to consider a hot judicial issue, especially one that will impact millions of employed aging baby boomers.

AARP, a Washington, DC-based aging advocacy group that represents more than 35 million members, has filed a “friend of the court brief” showing that its support of disproportionate impact, for use in proving age discrimination suits.

The nonprofit group says that the U.S. Supreme Court has already ruled that these types of suits are allowed under the 1964 Civil Rights Act, to prove discrimination based on an employee’s gender, religion or race.

AARP official Laurie McCann states that if the U.S. Supreme Court supports AARP’s legal position, then older workers can win suits by not having to show employer’s intent to discriminate.

“Older employees will always find it hard to prove intent, because it’s difficult to get inside the employer’s head to get evidence as to what they are thinking.”

McCann says oral arguments were heard on March 20, and the justices ruling should be expected to the end of June.

“We will explore  the possibility of a legislative fix,” she adds, “to allow older workers to prove age bias if they’ll company’s practices and policies has a disproportionate impact on older workers.”

Adds AARP State Director Kathleen Connell, “Once unemployed older workers face sharply limited employment opportunities, re-employment after job loss declines dramatically at older ages.

“Older workers have a fundamental right to work in an environment free of age discrimination,” she says. “Age discrimination can be blatant or subtle and can include such practices as refusing to hire or promote older workers, encouraging their retirement, targeting them in reductions in force, curtailing their employee benefits on liming their training opportunities job responsibilities and duties.”

If the U.S. Supreme Court rules to make age bias suits tougher to prove, then aging baby boomers will continue to face the same concerns of my father’s generation – that age discrimination runs rampant throughout corporate America.

When reviewing the merits of the Adams case, it is hope that the justices will see the wisdom of giving older workers the same legal clout as women, minorities, gays and religious persons. Courts have allowed these groups to legally challenge racial, sexual or religious discrimination on the grounds that an employer’s actions had a disproportionate impact on them.

It’s time to protect older workers, too. It’s only fair.

Program Allows World War II Vets to Get High School Diplomas  

Published in the Pawtucket Times on March 18, 2002

Thousands of young students across the nation left their high school studies to join the armed forces during World War II.

Their high school education would instead be gleaned from life experience learned on the bloody battlefields rather than from school textbooks.

Former Pawtucket resident George Redman, a World War II veteran, along with others, will receive his long-awaited high school diploma in May, courtesy of a state initiative dubbed Operation Recognition.

The City of Pawtucket has joined other Rhode Island communities in conferring diplomas to aging war veterans in their 70s and 80s who were honorably discharged between Sept. 16, 1940 and Dec. 31, 1946. Diplomas can also be awarded posthumously. Additionally, those who have earned GEDs are also eligible to receive their diplomas.

For many like then 17-year-old Redman, high school took a back seat as the clouds of war swirled over Europe. Times were tough for the youngster’s family because the Great Depression was just ending. It became necessary for Redman to take a job to help his disabled war veteran father supplement the family’s coffers. It became a very easy decision for Redman, who was playing baseball Pawtucket Red Sox, to drop out of Pawtucket High School’s Class of 1939.

Initially, Redman had wanted to serve on an aerial bomber. Coming from a military family fueled this high school dropout’s desire to serve his country even more, says the longtime resident of North Attleboro. He claims that his uncle was the first Pawtucket resident to die in the Great War of 1917.

“Wait until they call you,” his mother urged. That is what the young Redman did, taking a night shift job at New England Pretzel Company, packing hundreds of boxes of salty pretzels each shift. Before he entered military service, the young man would ultimately become a drill press operator at H P& B American Machine Company.

When his draft notice arrived in 1942, 21-year-old Redman gave up his manufacturing job, traveling to Fort Devens in Avery, Mass., for training. Later he would travel to Oklahoma and Texas for field training before being sent overseas to fight in the bloody Italian Campaign. Two bullets from a German machine gun in 1944 ended Redman’s military career. Upon his discharge, he returned to the states with a Purple Heart, the Combat Infantryman’s Bade and the Bronze Star Medal.

Redman would later re-enroll at Pawtucket Hight School, but a bout with the flu forced him to withdraw from his studies. Not having hs high school diploma never negatively impacted his career selling office supplies and equipment. “You learned your trade on the road,” he quips.

More than 50 years after World War II, not graduating high school, however did come back to haunt him. The retired war vet called a local college to inquire taking paralegal courses. Not having is diploma effectively blocked his admission to take courses.

“Right there, I knew that I needed that high school diploma to further my education,” Redman says. “Any college course I wanted to take would require my diploma.”

Like Redman, Pawtucket resident Henry Fugere, 78, a World War II veteran who is a retired electrician from Rhode Island Hospital never graduated from high school. Helping to support his 15 sibling and a nation mobilizing for war ended his dream of  obtaining a high school diploma.

“Getting my high school diploma is now a matter of principle,” Fugere says, explaining why he filed out his application to participate. “I will feel a little bit prouder of myself for getting that diploma. I didn’t earn my diploma by sitting at a desk buy by the hard way, through serving my country and the many jobs I held.”

A chance conversation by Assistant General Manager Laureen Grebien, of Gregg’s Restaurant on North Main Street, Providence with Redman ultimately got Pawtucket City Councilor Donald Grebien involved in bringing  Operation Recognition to Pawtucket.

Grebien remembers his wife, Laureen, waking him up at 11:30 p.m. that night to tell him of her conversation with Redman and about the war vet’s desire to get his high school diploma.

After contacting local veterans groups, the Rhode Island Veterans Affairs Office, and checking the Internet for programs implemented by other states, Grebien said, “things just snowballed.”

With the blessing of the Pawtucket City Council President John Barry, Grebien created a Veterans Ad Hoc Committee that would later hammer out Pawtucket’s Operation Recognition program. Members include Grebien along with School Committee Chair Raymond Spooner. Santa Almeida, a veteran and president of AFSCME Local 1012, Ken McGill from the mayor’s office and representatives of the Pawtucket School Department.

Thirty-plus meetings held over the last year have created Pawtucket’s Operation Recognition Program, promoted it and have planned the upcoming graduation ceremony on May 31 at Veterans Amphitheater on Roosevelt Avenue, Grebien says.

“Promoting the program heavily in newspapers, on cable TV and to veterans groups is key to our success,” Grebien notes, because lack of records block the efforts to develop accurate listing of all those eligible to receive a high school diploma. High school yearbooks, with a listing of students from 1941 to 1946, were used to identify potential candidates.

“Approximately 10 veterans responded,” Grebien adds, noting that he hopes to identify other eligible former veterans, too.

Ad Hoc Veterans Committee member Ray Spooner, who chairs the Pawtucket School Committee stands strongly behind the program.

“Their education was sacrificed for our freedom,” he says. “After all these years we are giving seniors their just due for all their years of service to their country. For all the people that we can find who are eligible to participate, they deserve getting their diplomas.”

Applications to participate in Operation Recognition for War II Veterans are due on March 31.