Tag Archives for nursing facilities

Chair Casey leaves mark on national aging policy. Leadership changes in DC and RI 

Published in RINewsToday on December 16, 2024

Last week, U.S. Sen. Bob Casey (D-PA), Chairman of the U.S. Senate Special Committee on Aging, held his last hearing, entitled “Empowering People with Disabilities to Live, Work, Learn, and Thrive, in SD 106.  This hearing was his swan song as Chairman of the Senate Aging Committee. 

The 3-term Democratic Senator, first elected in 2006, lost his reelection bid for a fourth term to Republican Dave McCormick, a West Point graduate, combat veteran and Bronze star recipient, and a national security expert, and former hedge fund manager.  A recount of votes confirmed that Casey lost by 16,000 votes (3,398,628 to 3,382,423) and he conceded the race on Nov. 21st.

With the dust settling after the Nov. 5th presidential election, Republicans will take control of the legislative agenda of the upper chamber, with a 53-47 majority, and control the house.

According to a Senate Aging Committee, during the upcoming 119th Congress Sen. Tim Scott (R-SC), a former Ranking Member, is expected to replace Casey as chairman on Jan. 3rd, 2025. Former Ranking Member Mike Braun (R-Ind) will leave the Senate after becoming Governor-elect of Indiana. 

An advocate for America’s seniors

During the 118th, the Senate Aging Committee under the helm of Casey held 18 full hearings, five field hearings, and one joint full hearing.  His final hearing, lasting one hour and 46 minutes, highlighted his long record as a champion for people with disabilities, and laid out his vision for how Congress must continue to work to empower them. 

“From the beginning of my time in the Senate, I heard a constant refrain from disability advocates that their needs were not being met—they faced barriers to save for their future, they were being paid well below a living wage, and they could not afford or access the care they needed,” says Casey in his opening statement. “Those refrains, including from some of the people we heard from at today’s hearing, are what inspired me to make people with disabilities a focus of my Senate career and time as Aging Committee Chairman,” he said.

During his 18 years in the Senate, Casey has been one of the foremost champions in Washington for people with disabilities. He created the Stephen Beck Jr. Achieving a Better Life Experience Act (ABLE) program, which has helped hundreds of thousands of families save for long-term care for their disabled loved ones with a tax-advantage savings account. The Associated Press hailed this legislation as “the most important new law for [those with disabilities] in 25 years.  He also made federal websites more accessible for people with disabilities, and propelled the fight for access to home care to the forefront of the national conversation. 

In addition, the Pennsylvania Senator led efforts to improve care in nursing homes by expanding and strengthening oversight over poor-performing facilities while ensuring that nursing homes and long-term care facilities have the resources they need to provide high-quality care to residents. His work has led the Centers for Medicare and Medicaid Services (CMS) to publicly release information about nursing facilities with a documented pattern of poor care, ensuring older adults and their families have the information they 

At the Dec. 12th hearing, Chairman Casey also released a series of issue briefs documenting his record chairing the Aging Committee on making government technology accessible, expanding access to home care, improving nursing homes, lowering prescription drug costs, and ensuring economic security for older adults:

“We have made a lot of progress, from creating the ABLE program to making government technology more accessible,” Casey continued. “But as we heard today, there is still a lot more to do—from expanding access to home care to finally phasing out the subminimum wage,” he added.

Kudos to Casey’s advocacy for America’s disabled Seniors

At the hearing, witnesses from Pennsylvania and national organizations testified about the impact of Casey’s work impacting the disability community in the Commonwealth and around the country.

I want to thank Senator Casey for your leadership. None of the successes I outlined would have been possible without your steadfast championship, advocacy and partnership. It is daunting to think about facing the challenges ahead, particularly the threats to Medicaid, without you at the helm, but we have been emboldened to reimagine what is possible because of your leadership,” says Witness Ai-Jen Poo, President of the National Domestic Workers Alliance and Executive Director of Caring Across Generations.

Witness Neil McDevitt, Mayor of North Wales, Pennsylvania, noted: “Senator Casey, you have been a steadfast ally of North Wales Borough, the Commonwealth of Pennsylvania, and millions of disabled and Deaf Americans. We owe you a debt that can never be repaid.”

“Things are actually changing. We are not yet where we need to be when it comes to disability access and acceptance, but we are getting there. It brings me great joy when I hear of disabled people in my community getting good paying jobs and not being relegated to sheltered workshops for less than minimum wage,” adds Erin Willman, CEO of White Cane Coffee in Warren, Pennsylvania. 

Witness Lydia Brown, Director of Policy, National Disability Institute, told the attending Senators:“Ten years ago, Sen. Casey’s leadership in introducing and passing The ABLE Act changed the game. People whose disabilities began before age 26 can now access a savings vehicle that can conserve up to $100,000 total without their savings counting against them in determining eligibility for SSI and Medicaid. Money in an ABLE account can be used for a wide range of qualified disability expenses, including otherwise unaffordable assistive technology and health care, as well as educational and employment related costs. For many disabled people on Medicaid, an ABLE account is also their only available means to save for retirement.”

A fond farewell 

“Bob Casey served honorably as the chair of the Senate Special Committee on Aging.  He held a wide range of hearings intended to develop a record that could be used to help shape future legislation,” says Max Richtman, President & CEO, National Committee to Preserve Social Security and Medicare who also is a  former staff director of the Senate Special Committee on Aging. Casey had held numerous hearings on issues facing older adults that helped build support for components of the Older Americans Act reauthorization – which just passed the Senate and may be included in the end-of-year package, noted Richtman. 

“Senator Casey also held hearings on disabled older adults, including one with former Social Security Commissioner Martin O’Malley to discuss what the Social Security Administration (SSA) is doing to make the application process easier,” added Richtman, noting that other hearings were held on scammers preying on the elderly – designed to help older adults and their families know what to look for — and protect against.  

“We can only hope that when Republicans assume control of the Senate in January, this committee will continue the serious work of looking after the interests of seniors, who have contributed so much to our society and yet are among our most vulnerable citizens,” says Richtman.

“Leadership Council of Aging Organizations (LCAO) thanks Senator Bob Casey for his leadership and dedication to improving the lives of older Americans through his work on the Senate Aging Committee,” said Debra Whitman, LCAO Chair. “We look forward to collaborating with incoming Chairman Rick Scott to continue addressing the needs and enhancing the well-being of our nation’s growing aging population,” she says.

“As Chairman of the Senate Special Committee on Aging, Senator Bob Casey was a critical champion for seniors. He fought to strengthen Social Security and Medicare, stop elder abuse, and improve conditions in nursing homes. Casey will be greatly missed in the Senate by everyone who cares about senior issues. We urge the next chairman of this invaluable committee to continue his legacy.” Says Nancy Altman, President of Social Security Works.

“It is wonderful to have a Senate Aging Committee and Senator Casey’s terrific advocacy but inexcusable for the House not to restore its counterpart, which Chairman Claude Pepper proved is indispensable,” said Robert Weiner, former Chief of Staff of the House Select Committee on Aging and later a senior White House spokesman.

Announcing job transitions and retirement – in Rhode Island

Two well-known aging advocates have announced their departures.

The Alliance for Better Long-Term Care announces the retirement of Kathleen “Kathy” Heren. She dedicated 26 years to serving Rhode Island’s seniors.  For the past 15 years, Heren has served as the Rhode Island State Long Term Care Ombudsman, tirelessly advocating for the rights and well-being of residents in long-term care facilities across the state. She is known for her “fierce dedication, wisdom, and compassion have made her an unwavering champion for those in need.”

After serving as Executive Director of LeadingAgeRI for over 16 years, James P. Nyberg is leaving the nonprofit to become Senior Advisor at the Boston-based Public Consulting Group.   He will provide his expertise to the company on home and community-based services.

During his tenure, he significantly advanced aging services by advocating for quality, affordable care and fostering partnerships with state and national stakeholders. His leadership has driven innovative initiatives addressing the needs of older Rhode Islanders while supporting workforce development and professional growth among member organizations.

Nyberg ably served as Chair of the state’s Advisory Commission on Aging for over six years.

Nursing facilities gear up for October vaccination deadline

Published in RI News Today on September 20, 2021

Over a month ago, the U.S. Centers for Disease Control and Prevention (Centers for Disease Control and Prevention) issued a Health Alert Network (HAN) Health Advisory to public health practitioners and clinicians about the urgent need to increase COVID-19 vaccination coverage across the United States to prevent surges in new infections that could increase COVID-19 related morbidity and mortality, overwhelm health care capacity, and widen existing COVID-19-related health disparities.

According to the July 27 Health Advisory, there is growing medical evidence that the Delta variant is at least twice as contagious as the original SARS-CoV-2 virus. It is reported that most cases of COVID-19 hospitalizations and death are in unvaccinated people; however, there are breakthrough infections in vaccinated people because of the surge of infections among the unvaccinated. This is a particular concern in nursing homes, where vaccinated residents are infected by unvaccinated staff.

The Biden Administration announced plans in August to require COVID-19 vaccinations for nursing home staff as a condition for those facilities to continue receiving federal Medicare and Medicaid funding. Rhode Island Governor Daniel J. McKee, along with other states’ leadership, took similar steps to protect nursing home residents by requiring all healthcare staff to be vaccinated and the new federal mandate will ensure consistent and equitable standards throughout the country. At a COVID-19 update held at the state capitol in early August, McKee called for the new vaccine mandate (as a term of employment) to take effect.

COVID Cases Rise in Rhode Island Nursing  Homes

Coronavirus continues to increase in nursing homes, warns AARP Rhode Island in a statement issued on September 17. According to the latest data from AARP’s Nursing Home COVID-19 Dashboard, in the four weeks ending August 22, resident cases increasing from 0.05 to 0.34 per 100 residents and staff cases increasing from 0.11 to 0.88 per 100 residents since the mid-July report.

Nationally, cases are concentrated among the unvaccinated, and those residents were three times as likely to contract COVID-19 last month compared to residents who are fully vaccinated.

The last eight months have shown vaccines to be the most effective tool in preventing COVID-19 related deaths, says AARP Rhode Island’s statement. There were modest increases in vaccination rates during this four-week period, with 92% of Rhode Island Nursing Home residents and 76% of staff fully vaccinated as of August 22.

“This month’s dashboard underscores why all staff and residents in long-term care facilities must be vaccinated as quickly as possible,” said AARP Rhode Island State Director, Catherine Taylor. “For unvaccinated nursing home residents, their risk of an infection is back up to the levels we saw a year ago. Too many people in Rhode Island who lived and worked in nursing facilities have died from COVID-19, and no one wants to see that tragedy repeated,” said Taylor.

The AARP Nursing Home COVID-19 Dashboard also found over a 300% increase in RI nursing homes reporting an urgent need for PPE in the period ending August 22, with almost 10% of facilities in Rhode Island reporting they did not have sufficient PPE.

Nursing Facilities Struggling to Maintain Adequate Staffing

While the Rhode Island Health Care Association supports Governor McKee’s decision to mandate COVID-19 vaccinations across the health care continuum, says John E. Gage, President and CEO of the Rhode Island Health Care Association, representing 64 of the 77 nursing facilities in the Ocean State, nursing homes are struggling to maintain their staffing levels to meet the state’s direct care requirements, but many are struggling to maintain that level, he says, noting that next month’s deadline requiring nursing facility staff will further strain the already “precarious staffing crisis in the state’s nursing facilities”.

Gage noted that the state’s Department of Health has surveyed facilities this week regarding the number of staff that will be unable to enter facilities in two weeks because they are unvaccinated. “It is reported that nursing facilities will lose 7% of their workforce – 706 staff of 10,137 in the workforce across all disciplines,” says Gage, noting that 495 out of the 706 are clinical staff members.

According to Gage, “Rhode Island nursing facilities are ranked the fourth best state for resident vaccinations and fifth best state for staff vaccination rates in the country. He notes, when taking a look at the Centers for Medicare and Medicaid Services data released last week, in Rhode Island 92.65% of residents are fully vaccinated compared to 84.1% nationwide. As to staff, 78.99% of Rhode Island’s nursing facility staff are fully vaccinated compared to 63.7% nationwide.

Gage says, “The vaccine mandate will further add to the challenge of staff retention and recruitment. We are facing the implementation of a minimum staffing mandate to take effect 1/1/22. There’s not adequate staff available to hire, and the legislature did not provide for adequate funding to achieve the upcoming mandate”. 

Finally, Gage notes that while visitation is currently open at Rhode Island nursing facilities there are many factors that make it difficult to stop the spread of COVID-19 from staff to residents. “Our staff are members of each and every community in Rhode Island  They interact with others outside of work who may or may not be vaccinated, and many have children under the age of 12 who are not eligible for vaccination. To further complicate matters, there are breakthrough cases among those who are fully vaccinated, especially now with the prevalence of the Delta variant,” says Gage.

“Rhode Island facilities will continue to take all steps necessary to mitigate the risks of COVID-19 infections,” says Gage, noting that vaccinations are the key to eradicating this pandemic, together with the proper use of personal protective equipment.  

The AARP Nursing Home COVID-19 Dashboard analyzes federally reported data in four-week periods going back to June 1, 2020. Using this data, the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the dashboard to provide snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff, with the goal of identifying specific areas of concern at the national and state levels in a timely manner.

The full Nursing Home COVID-19 Dashboard is available  www.AARP.org/nursinghomedashboard, and an AARP story about this month’s data is available here. For more information on how COVID is impacting nursing homes and AARP’s advocacy on this issue, visit www.aarp.org/nursinghomes.

State Lawmakers Ok Many Senior Initiatives  

Published in Pawtucket Times on July 7, 2003

 As this year’s legislative session came to an end, even the widely publicized tight state budget did not keep aging advocates from seeing some of their legislative proposals get passed by the House and Senate.

With the passage of companion legislative proposals (H 5841/ S 876), the state’s long-term care ombudsman law will be revised to reflect federal law, expanding the scope and authority of the state’s ombudsman program.

The new statute changes will require the state ombudsman to represent the interests of nursing facility residents or clients of service providers before governmental agencies.

The state ombudsman will also be charged with seeking administrative, legal and other remedies to protect the health, safety, welfare and rights of Ocean State seniors.

Another legislative proposal also got the thumbs-up from lawmakers. With the passing of companion proposals  H 5418/ S 506, new state funds totaling $ 300,000 will pay for nursing facility care of legal immigrant Rhode Island seniors who ae not eligible for Medicaid.

Meanwhile, the Rhode Island General Assembly provided that it sees the value in preventative medicine and how it can ultimately save health care dollars.

The Ocean State Adult Immunization Coalition requested $ 103,000 in new state funding to expand the coalition’s efforts to get the world out about the importance of seniors getting influenza and pneumococcal vaccinations.  While not receiving the whole loaf, lawmakers gave a half loaf instead – about $ 50,000.

With state dollars now allocated up front, large savings will be realized down the road. The cost of a flu shot is $ 15 and a pneumonia shot is $ 30.

If a senior is hospitalized, the average length of stay for an older person with influenza is five days, costing $ 12,000.  That’s a huge savings.

Lawmakers also passed legislation to make pharmaceutical drugs more affordable to Rhode Island seniors.

With the passing of companion proposals H 5237/S 374, persons eligible to participate in the Rhode Island Pharmaceutical Assistance to the Elderly Program (RIPAE) who also have prescription drug coverage through a health plan, will now be allowed to use RIPAE to pay for an individual prescription drug once they reach the maximum level of coverage for that drug.

Also, companion measures H 5239/ S378 passed, expanding RIPAE to allow persons age 55 to 61 on Social Security Disability Insurance to receive a 15 percent RIPAE co-payment in addition to their RIPAE drug discount rate.

As previously reported in All About Seniors, an 18-month study of .B.D.O. Seidman, a consulting firm hired by the state Department of Human Services, found that Rhode Island was underpaying its nursing facilities in excess of $ 30 million annually.

It seems that the General Assembly agreed with that report’s assessment and made a partial allocation of new Medicaid dollars to overhaul the state’s ailing Medicaid system.

With the passage of the state’s budget, nursing facilities will receive a total of $ 18.8 million in state and federal dollars – a three-year phase in will bring the total federal and state dollars to $30 million.

On the other hand, some aging agenda items went down in flames.

Aging advocates called on Gov. Don Carcieri and state lawmakers to allocate taxpayer dollars in the FY 2004 budget to allow more low-and moderate-income persons to choose Medicaid waiver-funded assisted living.

Although the federal government has already approved an additional 180 units in the state’s Medicaid assisted living waiver program, state funding of this initiative is required.

No funding in this year’s budget ensures that low-and- moderate income seniors will continue to be denied an option of choosing a less restrictive level of care, an option that higher income seniors have.

Additionally, lawmakers chose not to pass companion proposals (H 5478/ S 299) which would have allowed Rhode Island residents to buy prescription drugs from Canadian pharmacies, where they are routine cheaper.

Finally, in the aftermath of the tragic Station nightclub fire, the General Assembly and governor moved quickly to tighten regulations and to hire additional staffing at the Fire Marshal’s office to protect the patrons of bars and restaurants from fire.  However, beefing up the state Department of Health’s regulatory oversight of the Ocean State’s assisted living facilities, where 3,700 plus seniors reside, did not receive one dime in funding in the FY 2004 budget.

An assisted-living provider group, aging advocates, the Long-Term Coordinating Council, the state ombudsman and officials at the state Department of Health, have all called for new state dollars to fill one full-time surveyor position ( a nurse) to ensure that assisted living residences across Rhode Island are inspected on a timelier basis.

Last year, state lawmakers passed legislation to protect frail Rhode Island seniors who receive assisted-living services.

As this legislative session ends, the governor and General Assembly have failed to allocate the necessary funding in the FY 2004 state budget to fully implement state law that would result in the inspection of the state’s 72 assisted-living facilities and 155 assisted-living beds in nursing facilities in a timely manner.

According to the state’s Department of Health, another seven assisted-living projects are expected to be up and running over the next 18 months.

The ball now moves to Carcieri’s court to either use contingency funds in his office budget or to take administrative action to hire more assisted-living inspectors.

While it has been reported that the governor is amenable to using funds flushed out by his “fiscal fitness program” to pay for a new surveyor position, the time to act is now, rather than later.

Acting now to fix this policy glitch is sound public policy.  I am sure that Rhode Island seniors and taxpayers will agree.