Bill Protects Nursing Home Residents, Providers

Published in the Pawtucket Times on June 1, 2020

This month, U.S. Senator Bob Casey (D-PA) and Senator Sheldon Whitehouse (D-RI) throw a bill in the legislative hopper to slow the spread of novel coronavirus (COVID-19) in nursing homes. It’s a common-sense legislative proposal and needed.

A recently released Kaiser Family Foundation study reported, “COVID-19 has had a disproportionate effect on people who reside or work in long-term care facilities, including the 1.3 million individuals in nursing homes; 800,000 in assisted living facilities; 75,000 in intermediate care facilities; and 3 million people who work in skilled nursing or residential care facilities.”

Combatting COVID-19 in Congregate Settings

With COVID-19 quickly spreading throughout the nation’s nursing homes and intermediate care facilities, Casey and Whitehouse’s legislative proposal, S. 3768, The Nursing Home COVID-19 Protection and Prevention Act, seeks to provide needed resources to facilities to protect frail residents and staff. Residents in these facilities are among the most vulnerable because of their age and underlying medical conditions. According to an analysis conducted by Gregg Girvan for the Foundation for Research on Equal Opportunity, as of May 22, in the 39 states that currently report such figures, 43 percent of all COVID-19 deaths have taken place in nursing homes and assisted living facilities

As more than 20,000 nursing homes residents and workers have died due to COVID-19, according to the latest reports, on May 19, 2020, Casey and Whitehouse introduced S.3768 to help states, nursing homes and intermediate care facilities put the brakes on the spreading of the deadly COVID-19. The legislative proposal, with 14 Democratic cosponsors (including Rhode Island Senator Jack Reed}, would help states implement strategies to reduce the spread of COVID-19 in congregate settings, including through the purchase of personal protective equipment (PPE) and testing and to support nursing home workers with premium pay, overtime and other essential benefits.

S. 3768 was referred to Senate Health, Education, Labor, and Pensions. As of March 30, 2020, a Congressional Budget Office cost estimate or this measure has not been received.

Days after the introduction of 25-page Senate legislative proposal, a House version (H.R. 6972) was introduced by Rep. Ana G. Eshoo (D-CA), cosponsored by Reps. Janice D. Schakowsky (D-IL), Donna E. Shalala (D-FL), Madeleine Dean (D-PA), Seth Moulton (D-MA) and David N. Cicilline (D-RI). The House bill was referred to House Energy and Commerce

“This virus spares no state, no county, no facility. The unprecedented crisis unfolding in our Nation’s nursing homes demands an immediate, extraordinary response. Reports indicate nursing home residents and workers account for roughly 1 in 4 deaths from COVID-19 in the United States,” said Casey, who serves as Ranking Member of the U.S Senate Special Committee on Aging, in a statement announcing the bill’s introduction. “The Nursing Home COVID-19 Protection and Prevention Act would provide $20 billion in emergency funding [for staffing, testing, Personal Protective Equipment, etc.] to devise a sorely needed national, coordinated response to stem the spread of this terrible virus in nursing homes and intermediate care facilities,” notes Casey.

According to Casey, the Senate bill would also require the U.S. Department of Health and Human Services (HHS) to develop guidance on cohorting best practices, including on how to safeguard resident rights. It would also instruct HHS to collect and publish data on COVID-19 cases and deaths in nursing homes and intermediate care facilities, and finally fund surge teams of nurses, aides, and other critical staff to fill in at facilities where multiple residents and staff members have been infected.

“COVID-19 poses an immediate threat to the more than 1.3 million Americans, including more than 7,000 Rhode Islanders, who live in nursing homes,” says Whitehouse, noting that frontline staff across the nation are “doing heroic work under very challenging circumstances.”

“We need to get vastly more personal protective equipment and tests to nursing homes, which care for the patients who are most vulnerable to the coronavirus. Our legislation would also help states fund surge teams, sending additional staff reinforcements to facilities where they are needed to care for patients and prevent infection,” adds Whitehouse.

Before S. 3768 was officially introduced, in early March, Washington, DC-based AARP announced its support for the Senate proposal. “AARP supports the draft of the Nursing Home COVID-19 Protection and Prevention Act that would help protect the health and save the lives of people in nursing homes and other facilities by supporting testing, personal protective equipment, staffing and more,” said Megan O’Reilly, Vice President of Government Affairs for AARP. “The proposal would also improve public transparency and help protect the rights of residents and their families, adds O’Reilly, calling on Congress “to act immediately to stem the loss of life and slow the spread of the virus.”

In the House Chamber, Rhode Island’s Cicilline, a member of the House Democratic Leadership as Chair of the Democratic Policy and Communications Committee, has also pushed for Congressional funding to stop the spread of COVID-19 in nursing homes. The fifth term Congressman has called for additional funding for the Public Health and Social Services Emergency Fund in the next package for congregate care facilities, including nursing homes. He also signed a letter to HHS Secretary Azar and Administrator Verma, of the Centers for Medicare and Medicaid Services (CMS), urging that HHS and the CMS to ensure that a significant portion of the newly allocated $25 billion for testing in the recently passed CARES Act be utilized for testing in nursing homes and other congregate living facilities.

State-wide Efforts to Combat COVID-19 in Nursing Homes

With Governor Gina Raimondo declaring a state of emergency on March 9, 2020, with the COVID-19 arriving in Rhode Island, the deadly pandemic virus spread quickly throughout the state’s nursing homes. At press time, it has been reported that 75 percent of all related COVID-19 deaths are in nursing homes.

According to Joseph Wendelken, Public Information’s Officer for the Rhode Island Department of Health (RIDOH), the state moved quickly to stop the spread of the COVID-19 virus in the community and in nursing homes. He stated: “We curtailed and then prohibited visiting early on, and we have been doing extensive testing in every assisted living facility in the state. We are doing cyclical testing, meaning that we are continually testing all residents in all homes on a rotating basis. We are giving tailored infection control guidance to specific homes, and we are helping them procure additional PPE.”

Adds Wendelken, RIDOH has established two COVID-19 Specialty Nursing Homes [at Oak Hill Center in Pawtucket and Oakland Grove Health Care Center in Woonsocket] to be a COVID-19 Specialty Nursing Home. “These are centralized facilities to accept patients who are being discharged from the hospital and who are COVID-19 positive but no longer require acute-level care. This strategy allows COVID-19 positive patients leaving the hospital to receive specialized rehabilitation and step-down, post-acute care while reserving hospital beds for patients who need acute-level care,” he said.

On Smith Hill, the Rhode Island House Republican Caucus has recently called for members of the House Committee on Oversight to meet to address the increasing COVID-19 death rate in the state’s nursing and assisted living facilities.

Putting Politics Aside…

With less than 156 days until the upcoming 2020 Presidential election, will S. 3768 reach the Senate floor for a vote. Since the beginning of 2019, more than 350 House-passed bills—including hundreds that have bipartisan support—have been buried by Senate Majority Leader Mitch McConnell (R-Kentucky) in his legislative graveyard. With no Republican Senators supporting Casey and Whitehouse’s COVID-19 bill, will it even reach the Senate floor for a vote?

It’s time for McConnell, who has called himself the “grim reaper” of Democratic legislation, to lay down his deadly scythe, making the safety of millions of residents who reside in the nation’s 15,583 skilled nursing facilities a legislative priority. The GOP Senator from Kentucky, who is in a close Senate race with Democratic opponent Amy McGrath, might consider putting politics aside during a raging COVID-19 pandemic sweeping across the nation to work with Senate Democrats to protect frail residents and nursing home staff. Kentucky voters might view protecting residents against COVID a bipartisan issue.

Social Security – the Third Rail in Politics

Published in RINewsToday.com on May 17, 2020

As Congress begins to hammer out the fifth coronavirus stimulus package to continue its efforts to jump start the nation’s economy, President Donald Trump warns he will not sign any bill that does not include a payroll tax cut.

“We’re not doing anything without a payroll tax cut,” President Trump said at a two-hour “virtual town hall” event hosted by Fox News, at the Lincoln Memorial in Washington, D.C. According to Nielson Media Research, nearly 4 million viewers tuned into this the town hall, titled “America Together: Returning to Work,” on May 3rd, that focused on COVID-19 and the reopening of the nation’s economy.

Aging advocates and Democratic lawmakers charge that President Trump is using the virus pandemic as an excuse to slash payroll contributions, Social Security’s dedicated funding. Cutting the Social Security payroll taxes would reduce the amount of money withheld from employee paychecks, increasing their take-home pay. Republican lawmakers see it as a much-needed relief for hurting Americans. And so it goes…

Payroll Tax Cuts: Reducing Social Security’s Financial Stability

The Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) quickly released a statement warning that removing the payroll tax by a provision in the next COVID-19 stimulus package will ensure the fiscal insolvency of Social Security. 64 million Americans depend on Social Security benefits in their retirement years.

“President Trump set off alarm bells for America’s seniors and their advocates by insisting once again on eliminating Social Security payroll taxes – both employer and worker contributions. The President even threatened to hold hostage the next phase of badly needed Coronavirus relief legislation unless he gets his reckless payroll tax cuts. Make no mistake: by pushing to cut off the program’s funding stream, President Trump is taking the first step toward dismantling Social

“While we agree that providing tax relief to middle class Americans is an important consideration as we respond to the coronavirus pandemic, we do not believe that cutting, eliminating or deferring the Social Security payroll tax is an appropriate way to accomplish this goal, says Richtman, reminding the president in a letter that Social Security is an earned benefit fully funded by the contributions of workers throughout their working lives.

He pointed out that a payroll tax cut is an assault on that fundamental idea, equally true even if the funds are replaced by general revenues from the Treasury.

In his correspondence, Richtman suggests that a payroll tax cut should not be viewed as an economic stimulus because it leaves out large segments of the population. “Large numbers of federal, state and local government workers do not pay into Social Security, and therefore would not benefit from the payroll tax cut. Ironically, the senior population, those who are directly affected by taking their money from the trust fund, will not see a single dime of relief since most of them are not working,” he notes.

Richtman identified alternatives to the payroll tax cut that he believes would be more targeted and effective to fire up an economy slowed by the spread of the coronavirus. “Another one-time payment by the federal government can put money in the hands of taxpayers quickly, and the Making Work Pay Tax Credit can be passed by Congress rapidly as can an expansion of the Earned Income Tax Credit. Spending in other programs that directly help those who lose employment as a result of the virus can be the most targeted relief of all,” he suggests.

“In light of the recent Social Security Trustees report, it is clear that Social Security needs more revenue – not less,” observes Richtman, who served as a former staff director of the Senate Special Aging Committee.

While Democratic lawmakers push for strengthening and expanding the Social Security Program, GOP lawmakers are signaling their opposition to risking political capital on supporting the effort to cut the payroll tax. Sen. Chuck Grassley (R-Iowa), the Senate Finance Committee chair, responded, when asked by Politico, if he supports the tax cut, “Right now, not much.”

“I’m going to give it due consideration, if I can see a strong group of people who think it’s the right thing to do,” added Grassley, whose Senate committee oversees federal tax policy.

Although Senate Majority Leader Mitch McConnell (R-Kentucky) is not ruling out payroll tax cuts, he is focusing his efforts to put liability protections provisions in the next major stimulus package to protect businesses against virus-related lawsuits from workers, stockholders, and consumers.

Political insiders consider Social Security to be the “third rail of a nations politics.” Wikipedia states that this metaphor comes from the high-voltage third rail in some electric railway systems. Stepping on it usually results in electrocution and the use of the term in the political arena refers to “political death.”

Can President Trump politically survive, keeping his loyal voter base, if he steps on the “third rail” by continuing his efforts to cut payroll taxes, some say seen as pushing the Social Security program toward fiscal insolvency? When the dust settles after the upcoming November 2020 elections, we’ll see if the older voters consider Social Security an untouchable program.

LCAO Calls for Fourth Stimulus Bill to Protect the Health and Well-Being of Seniors

Published in the Wooonsocket Call on April 19, 2020

As part of the Economic Impact Payment provision in the recently enacted $ 2.2 trillion stimulus bill, at press time about 80 million Americans have already received their $ 1,200 stimulus check ($2,400 for joint filers) through direct deposit. But for those 70 million Americans waiting for this payment by paper check, this Congressional handout may not be delivered to their mail box by early May, predict a Democratic Senator.

While the U.S. Treasury Department denies that embossing President Donald Trump’s signature on the “memo” section of the check will delay the delivery of paper checks, Senate Finance Committee Ranking Member Ron Wyden, (D-Ore.) disagrees.

A Break in Protocol

In an April 15 statement, Wyden stated: “Donald Trump is further delaying cash payments to millions of Americans struggling to pay the rent and put food on the table to feed his ego. Only this president would try to make a pandemic and economic catastrophe all about him.”

According to an article published in the Washington Post on April 14, “It will be the first time a president’s name appears on an IRS disbursement, whether a routine refund or one of the handful of checks the government has issued to taxpayers in recent decades either to stimulate a down economy or share the dividends of a strong one.”

The Washington Post article, penned by Reporter Lisa Rein, reported that Trump had initially approached Treasury Secretary Steven Mnuchin, who oversees the Internal Revenue Service, to be allowed to sign the checks. “But the president is not an authorized signer for legal disbursements by the U.S. Treasury. It is standard practice for a civil servant to sign checks issued by the Treasury Department to ensure that government payments are nonpartisan,” says the article.

Political insiders say that we can expect to see a fourth stimulus package hammered out between the Democratic-controlled House, the GOP-led Senate and Trump, to pump billions to jumpstart the nation’s sputtering economy. A second round of cash payments may well be part of this economic stimulus package, they say.

“We could very well do a second round,” said President Donald Trump at a White House news conference held over a week ago. “It is absolutely under serious consideration,” he said.

Last week’s commentary publicized Max Richtman, president and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare, call to Congress to protect seniors in a fourth stimulus package (go to https://herbweiss.blog/2020/04/12/congress-must-protect-seniors-in-phase-four-stimulus-package/).

The continuing political battle over crafting the fourth stimulus bill has been put on hold for now with Democratic and WRepublican congressional leaders extending recess. After conferring with public health experts, the House and Senate will not come back into session until, Monday, May 4th.

Calling on Congress to Protect Seniors During the COVID-19 Pandemic

In an April 8 letter, the Washington, DC-based Leadership Council on Aging Organizations (LCAO), representing 69 national nonprofit organizations, urged Congressional lawmakers to ensure that a fourth stimulus package will protect the health and wellbeing of seniors and their families. LCAO’s 19-page communication provides over 50 recommendations (in the areas of housing services, income security and health and community resources) that are key to helping and providing the needed support to assist seniors cope with the raging COVID-19 pandemic.

Specially, LCAO calls on Congress to put funding for affordable housing in a fourth stimulus bill, by funding $ 1.4 billion for federally assisted housing supports to make up for vacancies along with decreased rents from HUD-and USDA-assisted older adult residents, and for emergency housing assistance. Investing $1 billion for new Section 202 Homes would result in short-and long-term jobs as well as 3,800 affordable homes becoming available with service coordinators, says LCAO. Congress was also requested to allocate $450 million in emergency assistance for HUD-assisted senior housing communities, too.

LCAO opposes any attempts to weaken the nation’s Social Security and Medicare programs. The aging group strongly resists any efforts to include a provision in the stimulus bill that would eliminate the payroll contributions to these programs and pushes for the expansion of Social Security and Supplemental (SSI) benefits to enhance the income security of America’s retirees.

Over 10 million workers and retirees have earned benefits under multiemployer pension plans, says LCAO, urging Congress in their letter to allocate sufficient funds to protect the “hard-earned benefits” of these retirees.

With a growing number of the nation’s seniors relying on the support of caregivers, LCAO calls for support of older adult caregivers and children through the expansion of the refundable tax credit for “other dependents.”

Within the next five years, 25 percent of the workforce will be age 55 and over, says LCAO, noting that it becomes crucial to provide adequate funding to the Senior Community Service Employee Program for workforce training.

It’s important to protect seniors from confusing and unfair billing hospitals and payment scams. This can be accomplished by establishing standards for billing that will help seniors manage the aftermath of health care costs due to the pandemic.

Each year, Medicare loses $60 billion to fraud and abuse. LCAO also requests $20 million for the Senior Medicare Patrol to educate Medicare beneficiaries on combating fraud and abuse scams.

LCAO’s letter also asked Congress for adequate funding of mass testing for COVID-19, data collection and accelerate Medicare enrollment to provide seniors and people with disabilities with access to needed medical treatment, two populations with the highest risk for being afflicted by the devastating virus. Congress must also ensure access and affordability to prescription drugs, says the Washington, DC-based aging advocacy group.

LCAO urged Congress to give states sufficient Medicaid funding to keep hundreds of thousands of Medicaid recipients from losing health coverage, which would increase the risk of these individuals spreading the COVID-19 virus.

The need to social distancing may force day care centers to close. LCAO says that a fourth stimulus bill package might add language within the Medicare and Medicaid Home and Community Based Service funding to authorize states to apply retainer payments to adult day care centers for the purpose of providing services to seniors outside the physical center.

LCAO also made a recommendation to prevent the unnecessary transfers of seniors to hospitals and nursing homes and support those recovering from COVID-19 by increasing beneficiary access to home health care by eliminating Medicare’s requirement that they be home bound to quality for this benefit.

LCAO’s letter supported the expanded access to hospice care by allowing physician assistants to certify need and to create a federal fund to identify and set up alternative care sites to nursing homes that meet the same minimum federal standards of care.

LCAO pushed for an additional $50 million to fund the Medicare State Health Insurance Program, a program providing unbiased, free and personalized information to assist seniors to chooses Medicare products, to help seniors understand their specific health care coverage needs under this COVID emergency.

The fourth stimulus bill, says LCAO, must also include funding to ensure providers in health care facilities and at community-based programs, be given personal protective equipment. These providers should be provided free child care and sick leaved during this crisis, too.

Considered “a frontline resource in the battling the pandemic,” LCAO calls for the adequate funding to Geriatric Workforce Enhancement Program, administered by the Health Resources Administration.

LCAO, noting the importance of federal programs that assist seniors to stay at home (including the Older Americans Act that directly serve seniors and caregivers, and the Supplemental Nutrition Assistance Program, the largest federal nutrition program), asks Congress to increase funding, benefits and streamline the application process to these programs to address healthcare and food needs during this pandemic.

With the COVID-19 virus spreading throughout the nation’s nursing homes and assisted living facilities, LCAO calls for more funding to the nation’s long-term care ombudsman program for remote online training and education of nursing facility staff and volunteers, and to the National Ombudsman Resource Center for training materials.

With elder abuse and neglect cases in the community reaching 63,000 in 2018 and an expected surge in incidences due to the pandemic, LCAO calls for funding of $ 120 million for the nation’s state and local Adult Protective Services programs in the next stimulus bill. Also, allocating $4.1 billion for the Social Service Block Grant Program can provide critical services to vulnerable seniors through adult protective services, adult day care and in-home support services, congregate and home delivered meals, case management programs.

Finally, in a fourth economic response package, LCAO calls on lawmakers to include $15 million for the Retired Senior Volunteer Program and $10 million for the Senior Companion program to provide volunteer opportunities for seniors in their communities during the pandemic crisis. Congress might also consider “easing or suspending the current age requirements for participation,” to allow younger seniors to participate.

Remember Your Older Constituents

With the Trump Administration and GOP lawmakers pushing to put billions of dollars into the fourth stimulus bill to support the nation’s large corporations and small businesses, during the COVID-19 pandemic, it is important for Congress to not forget the needs of the nation’s seniors. If you run into your Congressman or Senator, make sure you urge them to seriously consider the needs of their older constituents.

To get a copy of LCAO’s letter to Congress, go to https://www.lcao.org/files/2020/04/LCAO-April-2020-Letter-for-COVID-19-Package-4-FINAL.docx.pdf .