Category Archives for Congress

World issues pushed nursing home reform to the side in State of the Union. But it’s there

Published on March 7, 2022 in Rhode Island News Today

More than a week ago, President Joe Biden, with Vice President Kamala Harris and House Speaker Nancy Pelosi, sitting behind him in the House Chamber in the United States Capitol, delivered his first State of the Union Address. Harris and Pelosi made history marking the first time two women have been on the dais during a presidential address before the joint session and the American people

According to C-SPAN, Biden’s speech was the fourth-longest of the seven most recent presidents’ speeches, beating out Presidents George H.W. Bush, George H. Bush and Ronald Reagan. Amid frequent applause breaks, chanting from both sides of the aisle and heckling, Biden’s prepared remarks delivered Tuesday, March 1, 2022, totaled around 7,762 words, lasting over one hour and two minutes.

Biden spoke mostly on-script with his prepared remarks on a wide range of topics before lawmakers, Supreme Court Justices, guests, many waving small blue and yellow Ukraine flags or wearing the country’s colors to show solidarity with the people of Ukraine. While the first half touched on the Russian invasion of Ukraine and the need for a global coalition to respond, the second half addressed inflation, COVID-19 and the “new normal,” increasing domestic manufacturing, health care, prescription drugs, energy and taxes, voting rights legislation, and the nomination of Judge Ketanji Brown Jackson to the Supreme Court. 

Biden concluded his speech by proposing a “Unity agenda” calling for a fight against the opioid epidemic, pushing Congress to pass a mental health package, supporting Veterans returning from the battlegrounds of Iraq and Afghanistan and finding a cure for cancer.

The State of the Union and nursing homes

While Biden’s speech briefly touched on the quality of care in the nation’s nursing homes, his Administration is clearly making this a major domestic issue.  During the address, Biden expressed strong concerns about Wall Street firms that were taking over many nations’ nursing homes. “Quality in those homes has gone down and costs have gone up. That ends on my watch,” he told the packed chamber. “Medicare is going to set higher standards for nursing homes and make sure your loved ones get the care they deserve and expect and [they’ll be] looked at closely,” he said.

A day before the State of the Union address, the White house released a detailed document, entitled, “Fact Sheet: Protecting Seniors and People with Disabilities by Improving Safety and Quality of Care in the Nation’s Nursing Homes,” outlining dozens of proposed changes on how U.S. nursing homes are regulated and operate, including a vow to adopt federal minimum staffing requirements for facilities, step up enforcement of regulations and to eliminate overcrowded patient rooms.

Amid the ongoing COVID-19 pandemic that continues to wreak havoc on the nation’s nursing homes, where 200,000 residents and workers have died from COVID-19, nearly a quarter of all COVID-19 deaths in the United States, the Biden Administration says that staffing shortages are getting worse, reducing the quality of care provided to residents

Poorly performing facilities will be held accountable for improper and unsafe care and must immediately improve their services or will be cut off from tax payor dollars. Biden calls for better information to be provided to the public to assist them in better understanding the conditions they will find in each facility and to assist them in choosing the best care options available.  

Centers for Medicare & Medicaid Services (CMS) will begin to explore ways to reduce resident room crowding in nursing homes by phasing out rooms with three or more residents and promoting private, single occupancy rooms. Multi-occupancy rooms increase the risk of the spread of infectious diseases, including COVID-19.  The agency will also establish a minimum nursing home staffing requirement, the adequacy of staffing is closely linked to quality of care provided.

Meanwhile, CMS also plans to strengthen the Medicare Skilled Nursing Facility Value-Based Purchasing Program and base payment on staffing adequacy (including over weekends) and retention and the resident experience.  Although the nation has seen a dramatic decrease in the use of antipsychotic drugs in nursing homes in recent years, CMS will continue its efforts to identify problematic diagnoses and bring down “inappropriate use” of such drugs.

Enhancing accountability and oversight

The Biden Administration calls for the enhancing and accountability and oversight of the nation’s nursing homes by adequately funding inspection activities, beefing up scrutiny on more of the poorest facility performers, expanding financial penalties and other enforcement sanctions, and increasing the accountability for chain owners whose facilities provide substandard care. CMS will work with nursing homes to improve care by providing technical assistance.

To enhance transparency, CMS will create a new database that will track and identify owners and operators across states to highlight previous problems with promoting resident health and safety.  The agency will also collect and publicly report data on corporate nursing home ownership and will enhance the Nursing Home Care website. Finally, CMS will examine the role that private equity investors play in the nursing home sector.

Biden’s nursing home reforms will ensure that every nursing home has a sufficient number of adequately trained staff to provide care to the 1.4 million residents residing in over 15,500 Medicare and Medicaid facilities across the nation.  Nursing home staff turnover can be reduced by creating pathways to good-paying jobs along with ensuring staff to join a union.  CMS calls for lowering financial barriers to Nurse Assistant Training, adequate compensation and access to a realistic career ladder. The agency launches a National Nursing Career Pathways Campaign with partners including the Department of Labor.

Finally, Biden puts together his strategy to ensure emergency preparedness in nursing homes during the ongoing pandemic.  He calls for continued COVID-19 testing in nursing homes and continued COVID-19 vaccinations and boosters to be provided to residents and staff. CMS will strengthen requirements for on-site infection prevention, and make changes to its emergency preparedness requirements,   Finally, the agency will take what it has learned during the pandemic and integrate new lessons on standards of care into nursing home requirements around fire safety, infection control, and other areas, using an equity lens.

Point/Counter Point

In a released statement after Biden’s State of the Union address, AARP CEO Jo Ann Jenkins stated: “We were also encouraged to hear the President describe new actions to ensure that residents in nursing homes will receive the safe, high-quality care they deserve. For years, AARP and AARP Foundation have sounded the alarm about problems in America’s nursing homes. The COVID-19 pandemic exposed the chronic, ongoing issues with our long-term care system and emphasized the need for reform. It is a national disgrace that more than 200,000 residents and staff in nursing homes and other long-term care facilities died. AARP urges the federal government to act swiftly to ensure minimum staffing standards, increase transparency, and hold nursing homes accountable when they do not provide quality care.”

On the other hand, the nursing home industry had its views as to Biden’s call for nursing home reforms.  “The nursing home profession has always been committed to improving the quality of care our residents receive, and we appreciate the Biden Administration joining us in this ongoing effort. Over the last decade and prior to the pandemic, the sector made dramatic improvements. Fewer people were returning to the hospital, staff were providing more one-on-one care than ever before, and the unnecessary use of antipsychotic medications significantly declined,” said Mark Parkinson president and CEO of AHCA, in a released statement.

“Those who continue to criticize the nursing home sector are the same people who refuse to prioritize our residents and staff for resources that will help save and improve lives,” noted Parkinson, whose Washington, DC-based nonprofit organization represents more than 14,000 nursing homes and long-term care facilities across the nation. “Additional oversight without corresponding assistance will not improve resident care. To make real improvements, we need policymakers to prioritize investing in this chronically underfunded health care sector and support providers’ improvement on the metrics that matter for residents,” he said.

“It’s time to stop blaming nursing homes for a once-in-a-century pandemic that uniquely targeted our residents and vilifying the heroic caregivers who did everything they could to protect the residents they have come to know as family,” said Parkinson. ““Long term care was already dealing with a workforce shortage prior to COVID, and the pandemic exacerbated the crisis. We would love to hire more nurses and nurse aides to support the increasing needs of our residents. However, we cannot meet additional staffing requirements when we can’t find people to fill the open positions nor when we don’t have the resources to compete against other employers,” he said.  

To read the White House Fact Sheet to improving the quality of care in the nation’s nursing homes, go to:

https://www.whitehouse.gov/briefing-room/statements-releases/2022/02/28/fact-sheet-protecting-seniors-and-people-with-disabilities-by-improving-safety-and-quality-of-care-in-the-nations-nursing-homes/

On Monday, March 7th at 9am, AARP Rhode Island and US Senators Reed and Whitehouse will speak on the need for lower prescription drug prices in a virtual press conference.

AARP Rhode Island State Director Catherine Taylor, Volunteer State President Marcus Mitchell and Volunteer Lead Federal Liaison Dr. Phil Zarlengo will join Rhode Island US Senators Jack Reed and Sheldon Whitehouse for a virtual news conference highlighting the need for Congress to lower prescription drug prices. AARP Rhode Island will present the Senators with a petition signed by more than16,000 Rhode Islanders calling for Congress to act now and stop unfair drug prices.

You can listen in via ZOOM at:  

https://aarp-org.zoom.us/j/98668832992?pwd=bktuTjJBMUZhUDRaVDkvN2dCSXZqUT09

Passcode: 618357

Participants will respond to on-topic media questions posted in chat.

More information about AARP’s Fair Drug Prices campaign can be found at aarp.org/rx.

End Filibuster and Use Federal Government to Secure Elections

Published in RINewsToday.com on October 4, 2021

The clock is ticking… It’s 399 days before the upcoming midterm elections.

Following the Democrats winning the White House and taking control of both the House and Senate chambers, Republican-controlled state houses across the nation moved quickly to pass restrictive legislation to block access to vote. The Republican lawmakers see this legislative strategy as a way to protect election integrity. On the other hand, Democrats say the Republican legislative efforts are in large part motivated by false voter fraud claims coming out of the 2020 elections that continue to this day.

According to the New York-based Brennan Center for Justice (BCJ), “between   and July 14 2021, at least 18 states enacted laws that restrict access for the vote. These laws make mail voting and early voting more difficult, impose harsher voter ID requirements, and make faulty voter purges more likely among other things.More than 400 bills with provisions that restrict voting access have been introduced in 49 states in the 2021 legislative sessions.”

“There may be more new state voting laws still to come this year. Active regular legislative sessions continue in California, Massachusetts, Michigan, North Carolina, New Jersey, Ohio, Pennsylvania and Wisconsin. And Maine’s special legislative session is ongoing,” warns BCJ.

At the same time, more than 900 bills were dropped in the legislative hopper expanding voter access in 49 states during the 2021 legislative session, says BCJ, noting that at least, 25 states enacted 54 laws with provisions to expand voting access. These laws expanded access to early and mail voting, make voter registration easier, and restoring voting rights to Americans with past convictions.

Democratic lawmakers say Congress has the power to block Republican efforts at the state level to restrict access to voting.As of March 2021, the For the People Act passed by the House now awaits action in the Senate, and would reduce the impact of many state-level restrictions by creating new national standards for elections, while preventing common forms of voter suppression and easing access to voting. Democrats are also pushing for passage of the John Lewis Voting Rights Advancement Act to protect voters by preventing discriminatory election laws from being implemented.

Safeguarding Ballot Access for Seniors

The Washington, DC-based National Committee to Protect Social Security and Medicare (NCPSSM) along with 40 senior advocates and political influencers, call on Senators Krysten Sinema (D-AZ) and Joe Manchin (D-WV) to support changes to the filibuster to protect older Americans’ voting rights. So long as the moderate Senators oppose filibuster reform, Senate Democrats have no legislative path to enact S.1, For the People Act, legislative, passed by the House to ensure voting rights.  Under current Senate rules, Senate Republicans can block S.1 through a filibuster, a legislative procedure requiring a “supermajority” of 60 votes for passage.  Democrats need to pass filibuster reform to pass this legislation.

In a Sept. 21 letters to the two moderate Senators, NCPSSM President and CEO Max Richtman writes that adjusting the Senate filibuster is the only way to safeguard ballot access for seniors if enough Republican Senators won’t support new federal voting rights legislation.  Such legislation is necessary, says Richtman, because of restrictive, new state laws that infringe on seniors’ right to vote by mail.

“We urge you to support a narrow change to the filibuster rule to allow the Senate to approve new voting rights legislation by a simple majority vote. This crucial legislation will help to protect our democracy and the right to vote for all Americans, including older Arizonans who cast ballots by mail,” says Richtman. 

“Currently, seniors who are immobile, sick, or don’t want to risk being infected by the delta COVID variant can request mail ballots — along with those who cannot drive or lack access to mass transit,” says Richtman. “Voting by mail allows these older citizens to exercise their constitutional rights in a safe, convenient way. In 2020, the majority of voters over age 65 cast their ballots by mail.  Multiple studies have shown vote-by-mail to be consistently free of fraud,” he says.

Richtman urged Sinema and Minchin to support a narrow change to the filibuster rule to allow the Senate to approve S. 1, the For the People Act, by a simple majority vote. “This crucial legislation will help to protect our democracy and the right to vote for all Americans, including older Arizonans who depend on voting by mail,” he says.

According to Richtman, study findings note that vote-by-mail to be consistently free of fraud.  For instance, a Massachusetts Institute of Technology study results show that  only 0.00006% of 250 million votes by mailed ballots nationwide were fraudulent. Additionally, scholars at Stanford University analyzing 1996-2018 data in California, Utah and Washington found vote-by-mail did not advantage one political party over another, he said.

During the 2020 elections, many seniors chose to vote-by-mail to exercise their right to vote, more important to stay safe during the COVID-19 pandemic,” says Richtman, noting that 41% of voters age 50-64 and 55% of voters over age 65 voted by mail in the 2020 election. 

“The safety and convenience of this method of voting is likely to prove equally effective in future elections – unless state legislatures decide to obstruct voting by mail,” adds Richtman.

Richtman said, “Given the advantages and encouraging results of the nation’s vote-by-mail experience, and the paucity of evidence of voter fraud, we question why so many states are moving in the opposite direction – to discourage vote-by-mail.”

Ensuring Voter Access Once and For All

“The For the People Act would protect all Americans from new state voter suppression laws by setting national mail-in voting standards and guaranteeing no-excuse mail-in voting,” says Richtman, noting that  S. 1 requires states to give every voter the option to vote by mail, calls for prepaid postage for all election materials and state-provided drop boxes for federal races.

“Gray voting block” watching Congress

Published in Rhode Island News Today on September 14, 2021

With recess ending, budget reconciliation begins in the House and Senate as lawmakers come back to Capitol Hill to begin crafting a budget. Last month a $ 3.5 trillion budget resolution bill was passed which gave instructions in the Fiscal Year (FY) 2022 budget resolution to allow up to $1.75 trillion of the package to come from new borrowing. It also gave instructions to both the Senate Finance Committee and House Ways and Means to reduce deficits by at least $1 billion each. With lawmakers promising that the package be fully paid for, both Committees must come up with offsets for the full $1.74 trillion of borrowing in addition to any new spending and tax breaks proposed. 

The 11 Senate authorizing committees and 12 House authorizing committees are currently in the process of writing text for their respective portions of the reconciliation bill with a nonbinding completion deadline of Sept. 15. The reconciliation process allows for each chamber’s Budget Committee to combine each part into one reconciliation bill, to be given a floor vote in each chamber.   

The House also has on its legislative agenda a scheduled vote on a Senate-passed bipartisan infrastructure bill (H.R. 3684) on Sept. 27. With the 2021 fiscal year up at the end of September, Congressional leaders must vote on a short-term continuing resolution to keep the government running. 

Don’t Forget Support Service for Seniors

As Congress crafts and finalizes its budget, don’t forget to provide adequate support and services to America’s seniors, warns the LeadingAge, representing 5,000 nonprofit providers across the nation. The Washington, DC-based aging advocacy group announced the results of poll in June that shows an overwhelming majority of Democratic and Republican voters call on Congress to support programs and services to seniors – and they believe that this should happen now.

The findings from an online survey finding, gleaned from the responses of 800 U.S. adults ages 18 and over from June 15 to June 20, 2021, also revealed that Americans are very concerned about how seniors are treated and believe that elected officials have failed them.

“American families are in crisis. Millions of us are growing older without access to the affordable care and support we need, and demand is surging for critical services,” said Katie Smith Sloan, president and CEO of LeadingAge in a statement announcing the release of the polling results. “Americans agree that for too long our country has ignored and underfunded our aging services systems,” she says.

Sloan adds, “Americans will no longer accept that millions of older adults living at home can’t get the care and services they need, from help getting in and out of bed to bathing and eating meals,” Sloan added. 

According to Sloan, a large number of seniors can’t access the needed services to age in place in their homes. They are “stuck on affordable housing waiting lists for years, are living in places they cannot afford, are skipping meals and medicine to pay rent or are experiencing homelessness,” she says.

 “Millions of family members and friends are struggling to balance the demands of caring for loved ones—and are increasingly stressed, stretched and in unsustainable situations. It’s time for our elected officials to listen to Americans from both parties and act now to support older adults,” said Sloan.

Here’s a Sampling of Key Findings

LeadingAge’s poll findings revealed that 85 % of the respondents agree that now is the right time to think about building a better aging services system for seniors. This belief is bipartisan, with 91% of Democrats, 83% of Independents and 80% of Republicans, agreeing that now is the time to begin improving programs and services for seniors. This view is also consistent regardless of where people live, with 85% of urban Americans, 87% of suburban Americans and 82% of rural Americans agreeing.

The poll’s findings also call on Congress to make a greater investment in services for seniors, this view is overwhelmingly bipartisan. Eighty six percent say the government must make a bigger investment in services and care for seniors. This includes 92% of Democrats, 80% of Republicans and 84% Independents.

The poll’s respondent’s overwhelmingly support proposed investments for older adults that are currently being considered by Congress. Eighty-nine percent support public investment in affordable home care services to help older adults with essential needs like bathing and dressing, medication management, transportation, and basic daily chores. Eighty-six percent support public investment in housing and support for low-income older adults to address the shortage and waiting lists that lead to homelessness, instability and skipping meals and medicine to pay rent. Finally, 83% support public investment in broadband internet to ensure equitable access for older adults who need this basic utility for telehealth and other care services, and to fight social isolation.

According to the poll’s findings, Government plays a critical role to ensuring that appropriate care and services are available to seniors. Eighty five percent of respondents agree that every person has a right to receive a basic level of housing,  and essential support regardless of age. Regardless of political party affiliation support is robust: 92% of Democrats, 85% of Independents, and 75% of Republicans agree.

More than half of all respondents say that seniors are not treated well in the United States. Eighty-three percent says that elected officials have failed older adults and the people who care for them by ignoring and underfunding America’s aging services for decades. This belief is consisted across communities, with 85% of Americans in rural settings, 83% in urban settings and 83% in suburban areas agreeing.

It’s just 421 days before the midterm elections. LeadingAge’s poll findings should be a stark warning to lawmakers who underfund and ignore the needs of their older constituents. If things stay the same, the gray voting block may well just send a message of their discontent at the polls.

For poll survey details, go to https://bit.ly/393hBRs