Tag Archives for Medicaid

Tackling surge of COVID-19 in Nursing Homes

Published ion RINewToday on December 15, 2020

Over the months, while public health officials watch the uptick in new COVID-19 cases, Congress releases two reports, one taking a snapshot of nursing home performance and resident deaths throughout the first eight months of the pandemic, and the other one sounding the alarm about the impact of COVID-19 on the nation’s nursing homes and warning it is now getting worse.  

About three months ago, Senate Finance Committee Chairman Chuck Grassley (R-Iowa) announced the release of a 67-page report on care provided in nursing homes and other long-term care facilities throughout the nation during the ongoing COVID-19 pandemic. The comprehensive report, titled “COVID-19 and Nursing Homes: What Went Wrong and Next Steps,” reviewed U.S. nursing home performance during the early fall and summer months of the pandemic. According to the report, more than two out of five deaths due to COVID-19 in the United States are linked to nursing homes and other long-term care facilities.

Stopping the Spread of COVID-19 in Nursing Homes

“Partisan finger pointing, rather than meaningful analysis, cannot serve as a useful guide for policymakers in crafting the necessary bipartisan reforms in response to the unprecedented challenges facing this entire sector and its employees working on the frontlines during this pandemic,” says the Senate Finance committee report, released on Sept. 23. It stressed that suggestions that coronavirus-related deaths in nursing facilities “are attributable solely, or even primarily, to acts or omissions by the current administration falls well short of addressing the multi-faceted problems in this sector.”

The report added, “Such a one-dimensional approach necessarily overlooks several factors that fueled the outbreak of COVID-19 in nursing homes across the United States, and around the world. Minimizing, or devoting scant attention to such factors, makes it enormously difficult for members of Congress to come together in support of long-overdue reforms and bipartisan solutions to the complex problems facing nursing homes today.” 


The report, produced by the majority staff of the Senate Finance Committee, examined what steps might have prevented these fatalities by minimizing the spread of COVID-19 in the facilities and discussed what actions could be taken now to slow the surge of deaths in nursing homes during this and future pandemics.  

While new coronavirus cases have surged to nursing homes throughout the nation and despite federal and state efforts to stall the spreading of the virus, the Senate Finance Committee report noted that facilities have already received significant relief assistance from Congress and the Trump administration totaling approximately $21 billion in addition to technical assistance, guidance and training.

The report’s findings noted that for years preceding the COVID-19 outbreak in March, private nursing homes have had widespread deficiencies in infection control and prevention.  The majority staff also found that state governments and health officials in some of the hard-hit states fell short of their responsibility to ensure quality care, and in multiple states, staffing and supply shortages persisted for years prior to the pandemic. 

Nursing homes around the world have struggled with many of the same issues as the United States during the pandemic, including Europe, the United Kingdom and Canada, noted the report.

State governments in some cases also failed to enforce federal guidelines for these care facilities as required through their participation in Medicare and Medicaid, particularly guidance provided to minimize coronavirus transmission in their facilities, noted the report. In addition, the majority staff found that nursing home staff who work in multiple facilities unknowingly played a key role in spread of COVID-19 in nursing homes. 


Finally, the Senate Finance Committee report also noted that several governors pressured nursing facilities to accept COVID-19 patients when personal protective equipment (PPE) was still in short supply and some did so even after the federal government made temporary hospitals available in their jurisdictions. 
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The Senate Finance Committee report provided, to members of the Senate Finance Committee with detailed background information on the many challenges that nursing homes continue to face during this year’s public health crisis. It provides Congressional lawmakers with specific recommendations, based on best practices that some facilities and public officials adopted during the ongoing pandemic to protect their residents and staff.  It also includes additional suggestions to better protect the nation’s older Americans from elder abuse, neglect and exploitation.

 
Updating the Grim Toll of COVID-19 Deaths in Nursing Homes 

Last week, U.S. Senators Bob Casey (D-PA), Ranking Member of the Special Committee on Aging, and Ron Wyden (D-OR), Ranking Member of the Finance Committee, released their report that warned that the already dire situation in nursing homes is worsening.

“It’s with great sadness that we are once again giving a grim update on the toll that COVID-19 is continuing to take on nursing homes. It’s abundantly clear that inaction has contributed to the loss of more than 104,000 mothers, fathers, grandparents, friends and neighbors who lived and worked in nursing homes and long-term care facilities across the country,” said Senators Casey and Wyden, in a statement announcing the report released on Dec. 10. “Experts are predicting that we are heading into the most severe months of the COVID-19 pandemic, marred by climbing caseloads and increasing stress on our Nation’s health care system,” they say, calling on the Senate colleagues to hammer out and pass a comprehensive COVID-19 relief bill. 

According to the eight-page report, entitled, “The Cost of Inaction: 19 Deaths an Hour and Rising,” last month, more than 15 nursing home residents died from COVID-19 per hour, with 19 residents dying each hour during the week of November 22, 2020, the most recent week reported.

The Senate Aging Committee report noted that the number of weekly COVID-19 deaths among nursing home residents has increased 133 percent since Labor Day, and 96 percent among nursing home workers during the same period. Workforce shortages have also increased since Labor Day: In November, one in six nursing homes nationwide reported that they do not have a sufficient workforce, says the report.

The Democratic Senators warned that COVID-19 cases will surge in nursing homes if Congress does not come together to hammer out bipartisan legislation to stop the spread of the pandemic.

These new report findings serve as a warning as to what will come if Congress does not come together to alleviate the COVID-19 crisis in nursing homes, says Casey and Wyden. It calls for a national strategy to save lives in nursing homes, including providing facilities with a sufficient supply of PPE, ample access to testing, resources for vaccine distribution, funding for strike teams and adequate workforce supports, and accountability measures to uphold resident rights and permit safe visits with family.

Finally, in the Ocean State…

Just days ago,the latest update of the AARP Nursing Home COVID-19 Dashboard, released by AARP’s Public Policy Institute, unveiled a new report in a series on improving the care of care provided in the nation’s nursing homes. “Rhode Island’s nursing homes continue to face alarming trends,” says the AARP report.

Using data released 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 dashboard will continue to be updated every four weeks.

In the four weeks analyzed, from October 19 to November 15, AARP’s dashboard reports that Rhode Island nursing homes had a dramatic increase in resident and staff cases, and a higher percentage of facilities reporting they are without a 1-week supply of PPE.

“With coronavirus surging across the country, nursing home residents and staff remain in grave danger as the virus reenters nursing homes and other facilities at an alarming pace,” said AARP State Director Kathleen Connell.  “Facilities continue to have shortages of the staff and PPE needed to keep residents and workers safe and stop the spread. Our state leaders must act now to save lives,” she said.

Connell added, “AARP will continue fighting to protect nursing home residents now and offering solutions to improve our long-term care system for the decades to come.”

For copies of Senate reports go to: https://www.aging.senate.gov/imo/media/doc/The%20Cost%20of%20Inaction.%2019%20Deaths%20and%20Hour%20and%20Rising.pdf; 

https://www.finance.senate.gov/imo/media/doc/SFCNursingHomesCOVIDMajorityStaffSFCReport23Sep2020FINAL.pdf.

The complete dashboard is available at aarp.org/nursinghomedashboard.

Democrats Will Have to Compromise if They Lose Georgia Senate Run-Off

Published in the Pawtucket Times on December 7, 2020

With Democratic presidential candidate Joe Biden taking the White House, the Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) called on Congressional lawmakers to address the needs of older Americans during lame-duck session ending Jan. 3 and throughout President Biden’s first 100 days in office.  Can Congressional lawmakers put aside political differences to pass a last-ditch Stimulus package compromise, a defense bill, and consider aging legislation piling up in just 27 days when the lame-duck session ends?  Will there be political grid lock after President Biden takes office on Jan. 20 if the GOP maintains control of the Senate block Congress from taking up legislation impacting older Americans?

Legislation Piling Up in Lame-Duck Session

“Though this is normally a time when expectations for Congressional action are low, the National Committee expects our elected representatives to act on behalf of seniors and other struggling Americans hit hard by the pandemic,” says NCPSSM president and CEO Max Richtman, in correspondence sent to Congress on Dec. 3.

Across the nation seniors are the hardest hit age group by the ongoing coronavirus pandemic.  “Eight out of 10 deaths from COVID in the U.S. have been in adults 65 years old and older. Whether as part of an omnibus funding bill, continuing resolution or COVID relief package, The National Committee is urging lawmakers to pass urgently needed measures for seniors,” says Richtman.

Richtman calls on Congress to address the Social Security “Notch” issue. He warns that if Congress doesn’t take action, workers born in 1960 and 1961, will see lower Social Security retirement benefits in the future. According to the Chief Actuary of Social Security, this will sharply reduce benefits for those born in 1960 compared to the benefits received by people born just one year earlier, creating an effect known as a “notch,” notes NCPSSM’s correspondence.

Congress can correct this notch in Social Security benefits by passing Rep. John Larson’s (D-CT) H.R. 7499, the “Social Security COVID Correction and Equity Act,” says Richtman.  The legislative proposal would increase benefits for those born in 1960 and 1961 without impact the benefits for any other beneficiary. 

In October, the Social Security Administration announced that approximately 70 million Americans would see a meager 1.3 percent increase Social Security benefits and Supplemental Security Income. “More than half of seniors receive over one-half of their income from Social Security, and it provides at least 90 percent of income for more than one-in-five seniors.  These seniors are dependent on a reasonable COLAs to maintain even a modest standard of living in retirement,” said Richtman.

With retirees experiencing financial difficulties during the pandemic, a $20 increase in their monthly check might not help them to pay for spiraling health care and drug costs, along with the expenses of purchasing personal protective equipment and cleaning supplies to keep them safe. 

Richtman’s correspondence also pushes for passage of Rep. Peter DeFazio’s H.R. 8598, “Emergency Social Security COLA for 2021 Act,” to provide Social Security beneficiaries with a 3 percent increase (or a $250 per month flat increase) which would reduce the impact of the small 2021 COLA increase. 

Protecting the Fiscal Viability of Social Security

Last August, NCPSSM and aging advocacy groups opposed President Trump’s signed executive order that would allow employers to defer workers’ payroll tax contributions for the rest of the year.  Between Jan. 1, 2021 and April 30, 2021, these employees will be required to pay back their deferred payroll taxes, doubling their FICA taxes for the first four months of 2021.  The National Committee has supported efforts to ease the burden for those affected by this hardship. 

NCPSSM correspondence also called on Congress to extend a protection to lower-income Medicare and Medicaid beneficiaries, including ‘Money Follows the Person’ (which provides funding for states to help skilled nursing care patients to remain in their homes) and impoverishment protections for the spouses of Medicaid recipients receiving long-term care.

Finally, Richtman requested extending the funding for Medicare Low-Income and Enrollment Assistance, which provides funding for State Health Insurance Assistance Programs and Area Agencies on Aging to assist low-income seniors access programs such as the Medicare Prescription Drug Program Part D Low-Income Subsidy.

NCPSSM’s “wish list”, detailed in Richtman’s correspondence, could easily be rolled into a continuing resolution that Congress must pass by Dec. 11 to get the federal government operational. But, any of the legislative proposals pushed by The National Committee would be bottled up in the Senate, by GOP Senate Majority Leader Mitch McConnell, referred to as the “grim reaper,” he Republicans maintain control of the Senate during the 117th Congress.

GOP ‘Grim Reaper’ Keeps Democratic Bills from Consideration

Last February, on Fox News Friday, anchor Bret Baier asked McConnell to confirm Democratic charges that House passed and Senate proposed legislation would never see the light of day on the Senate Floor.  At the time of this interview, the GOP Senator, controlling his chamber’s legislative agenda, confirmed that 395 bills sitting in his chamber would not be passed.

“It is true,” admitted McConnell during the Fox News interview.  “They’ve been on full left-wing parade over there, trotting out all of their left-wing solutions that are going to be issues in the fall campaign. They’re right. We’re not going to pass those.,” he said, recognizing the politics of a divided government. 

McConnell’s ‘Legislative Graveyard’ created by his blocking debate, markup and refusing to allow a vote on Democratic proposed legislation is well documented in the press and by a report released last September by Common Cause, a watch dog advocacy group with chapters in 35 states. “In fact, the Senate’s inaction has the 116th Congress on track to be the least productive in history, with just one percent of the bills becoming law [between] January 3, 2019 to September 16, 2020],” said Aaron Scherb, Common Cause’s director of legislation and author of the 2020 Democracy Scor

During an interview published on Sept. 16, 2020 in Newsweek, Scherb said, “There have been hundreds [of bills] that have been passed by the House at this point.  There have only been 158 enacted laws by this 116th Congress to this point.  Yet there are hundreds of bills that have passed the House but continue to sit in Senate Majority Leader McConnell’s desk, or his ‘legislative graveyard’ as it’s been called.”

With McConnell winning his reelection, the senator from Kentucky can only maintain control of the Senate’s legislative agenda if he can keep two GOP Senate seats up for grabs in next month’s Senate runoff in Georgia.  A Democratic win will give the party a majority 50 Senate seats, with Vice President Kamala Harris breaking a tie.

In order to pick up the two GOP Senate seats, held by incumbent Senators David Perdue and Kelly Loeffler, Democrats must successfully mobilize voters and adequately fund the campaigns of Democrat Jon Ossoff and Raphael Warnoc. At press time, millions of campaign dollars are pouring into Georgia’s Senate runoff elections, with the two GOP Senators bringing in more campaign donations because of Republican super-PACs giving them the spending edge. The Democrats are receiving their political contributions through small donors.

Even with the Democrats controlling the White House and House of Representatives, if McConnell maintains control of the Senate, legislative gridlock in the upper chamber will most certainly continue.  This will make it more difficult for the NCPSSM and other Washington, DC-based aging advocacy groups to successfully push for passage of legislation to ensure the financial security and health of seniors

Cicilline Hopes Dems Take Senate

Published in Pawtucket Times on November 9, 2020

On Saturday, November 7, at 11:45 a.m. (eastern Standard Time), as the Trump campaign called for legal challenges looming over ballot counting, CNBC projected Joe Biden to win the U.S. Election, making him president-elect.  As the dust settles over this very divisive election, Pennsylvania’s 20 electoral votes propelled Biden over the 273 electoral votes needed to win.

With the Democrats now taking control of the White House and maintaining control of the House, even with a loss of seats, the battle for control of the Senate now turns to Georgia with one regular and one special election scheduled to fill a vacancy take place on January 5.  

With garnering less than 50 percent of the vote, in accordance with Georgia law, GOP Sen. David Perdue and Democratic challenger Jon Ossoff meet again at a January 5 runoff election.  Rev. Raphael Warnock, the democratic challenger, and governor-appointed Republican Sen. Kelly Loeffler, who replaced Sen. Johnny Isakson when he retired last year, battle in the Peach State for a Senate seat in special-election runoff.

Democrats now have a long-shot of taking control of the Senate with Kamala Harris being elected vice president and if they win the two Senate races in Georgia’s upcoming election. By winning the Senate, both parties will each have 50 seats, Harris tipping the balance of power to the Democrats. 

McConnell, Oversees “Least Productive” Congress in its History

Rep. David Cicilline (D-RI) says that the Democratic-controlled House has had one of the most productive Congresses in the institution’s history. “We’ve passed more than 600 bills in the House, but there are more than 375 of them stuck on Mitch McConnell’s desk, many of them bipartisan,” notes Cicilline, who serves as Co-Chair of the House Democratic Policy and Communications Committee.

“Obviously, both Georgia senate races are hanging in balance and it’s important we win them.  A Democratic majority in the Senate will allow for the passage of the “For the People” agenda which creates jobs, raises wages, lowers health care costs and increases access to affordable prescription drugs.  These bills are good for Rhode Islanders and all Americans,” states Cicilline.

“I look foward to working with the Biden Administration to put together a robust agenda for the first 100 days and get to work passing bills that will help Rhode Island’s economy, workers and seniors,” adds Cicilline.

With the release of its 2020 Democracy Scorecard in September, Aaron Sherb, director of legislative affairs for the Washington, DC based Common Cause, documents how a Republican-controlled Senate has resulted in legislative gridlock.  “What the 2020 Democracy Scorecard makes plain is the blatant disregard for democracy reforms in the Senate. “The House of Representatives passed nearly 10 democracy reform bills, often with bipartisan support, this session, but Majority Leader Mitch McConnell (R-KY) blocked debate and mark-ups on all of these bills and refused to allow a vote,” he said.

In fact, the Senate’s inaction has the 116th Congress on tract to be the least productive in history, with just one percent of the bills becoming law,” charges Sherb. author of the 2020 Democracy Scorecard,

The National Committee to Preserve Social Security and Medicare (NCPSSM) strongly agrees with Sherb’s assessment of McConnell’s successful efforts to block Democratic and bipartisan-sponsored common-sense legislation critical to protecting the health and well-being of Americans.  Seniors will not be better off with a GOP-controlled Senate, warns NCPSSM, calling for the Democrats to win the Georgia Senate special elections to take over the control of the Senate.

According to NCPSSM, a Washington, DC-based advocacy group with a mission to protect Social Security and Medicare, “Since 2019, the Democratic-controlled House has served as a firewall against Trump’s efforts to defund, cut and privatize Security and Medicare.  But as long as Republicans control the Senate, legislation to protect and expand seniors’ earned benefits will remain in limbo. Under a Democratic majority, though, seniors would likely see real progress where their financial and health security are concerned.”

NCPSSM charges Senate majority leader McConnell, who gave himself the nickname, the “Grim Reaper,” has buried hundreds of House-passed bills during the 116th Congress that would have benefitted America’s seniors.  He even refused to take up last May’s House-passed COVID-passed relief bill, and the lower chambers recently passed COVID-19 legislation, as the nation’s public health officials battled the spread and spiking of the deadly virus. 

McConnell also blocked consideration of H.R. 3, the Lower Drug Costs Now Act, which the House passed almost a year ago, says NCPSSM. 

H.R. 3 would allow Medicare to negotiate prescription prices with Big Pharma, which would save the government and seniors nearly $350 billion in drug costs. The bill would also expand traditional Medicare by adding dental, vision, and hearing benefits.

NCPSSM says that the GOP Senate Leader will not even allow a bipartisan crafted bill, the S 2543, the “Prescription Drug Pricing Reduction Act, introduced by Senators Chuck Grassley (R-Iowa), and Ron Wyden (D-OR), to be considered on the Senate floor.  According to the Congressional Budget Office, this legislation would save taxpayers $95 billion, reduce out-of-pocket spending by $72 billion and finally reduce premiums by $1 billion.

The eyes are now on the Supreme Court, where three Trump-appointed Justices will rule on legal issues coming before the nation’s highest court. “If the Supreme Court strikes down the Affordable Care Act, which strengthens Medicare’s finances and included enhanced benefits for seniors (not to mention protecting older patients with pre-existing conditions), a Democratic House and Senate could replace or revise it,” notes NCPSSM. 

House Democrats are considering HR 860, The Social Security 2100 Act, to strengthen and expand Social Security.  The landmark legislation, introduced by Rep. John Larson (D-CT), referred to the Subcommittee on Social Security would keep the program financially healthy through the end of the century, while boosting benefits for all retirees. NCPSSM notes that president-elect Joe Biden has incorporated many of the proposals in this bill into his own plan. 

NCPSSM adds that a Democratic-controlled House and Senate could reduce the financial impact on COVID-19 on current and future retirees’ Social Security benefits.  Under Democratic Senate leadership, notes the Washington, DC-based advocacy group, the upper chamber could work with the House to increase the tiny 1.3 percent cost-of-living adjustment (COLA) to 3 percent for 2021.  which would be welcome news for older Americans who were laid off during the COVID-19 pandemic that sweep the nation, forcing many into early retirement

Finally, NCPSSM says that a Democratic-controlled House and Senate could prevent aging Baby Boomers born in 1960 (and possibly 1961, as well) from suffering a lifetime reduction in their future benefits caused by a COVID-related drop in average wages.

A Final Note:  Let’s Bring Back House Aging Committee

During the last two Congresses, Cicilline introduced a resolution three times to re-establish a House Permanent Select Committee on Aging. Two of the times a GOP-controlled Congress blocked consideration.  Democrat House efforts to impeach President Donald Trump and a continual battle over policy issues with the Trump Administration and the Republican-controlled Senate put Cicilline’s resolution on hold the third time.  

The previous House Aging Committee was active from 1974 to 1993 (until it was disbanded because of budgetary issues) put the spot light on an array of senior issues including elder abuse, helped increase home care benefits for older adults and helped establish research and care centers for Alzheimer’s disease.  

After introducing his resolution this Congress, Cicilline says that a reestablished House Aging Committee could initiate comprehensive studies on aging policy issues, funding priorities, and trends.  Like its predecessor, its efforts would not be limited by narrow jurisdictional boundaries of the standing committee but broadly at targeted aging policy issues, he notes.

According to Cicilline, the House can easily create an ad hoc (temporary) select committee by approving a simple resolution that contains language establishing the committee—giving a purpose, defining membership, and detailing other aspects.  Funding would be up to the Appropriations Committee. Salaries and expenses of standing committees, special and select, are authorized through the Legislative Branch Appropriations bill.

During the 117th Congress, as the House begins its debates on Social Security, Medicare and Medicaid, the Older Americans Act, and other issues of importance to older adults, it will be important to have a House Aging Committee that once again puts the spotlight and attention on America’s aging issues.