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.

CDC: Rhode Island Hit with Widespread Flu

Published in the Woonsocket Call on January 6, 2018

The U.S. Centers for Disease Control (CDC) says it’s a no brainer as to what issue I should cover this week. Being homebound for three or four days, with the flu, and my submittal deadline looming, I pen my commentary on widespread flu activity now being reported in Rhode Island.

CDC’s Influenza surveillance (ending Week 52) reported widespread influenza “flu” activity in 24 states including Rhode Island. This CDC warning recently triggered a requirement by the Rhode Island Department of Health (RIDOH} to require unvaccinated healthcare workers in a variety of health care settings to wear masks when entering a person’s room, serving food, or participating with patients in group activities.

The masking requirement helps protect healthcare workers from catching the flu, and helps protects patients who are often dealing with other serious health issues,” said Director of Health Nicole Alexander-Scott, MD, MPH., in a statement released on January 2. “For people who have not been vaccinated yet, it is not too late. Flu vaccine is the single best way to keep yourself and the people you love safe from the flu. Getting vaccinated today will provide you with months of protection,” she says.

According to the RIDOH, typical flu symptoms include having a fever, coughing, a sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people also may have vomiting and diarrhea. People may be infected with the flu, and have respiratory symptoms without a fever.

There are many types of illnesses or injuries even less severe cases of the flu do not require a visit to the emergency room, says RIDOH, noting that less severe cases of the flu will be treated more promptly by a primary care provider or in urgent care facilities. The department notes that going to an emergency room can oftentimes result in long waits because emergency room providers prioritize more serious injuries and medical conditions.

But, when do you seek out treatment for a nasty case of the flu? RIDOH says that difficulty in breathing or shortness in health, pain or pressure in the chest and having flu-like symptoms that improve and return with a fever and worse cough are clear warning signs to go immediately to an emergency room.

CDC expects that increased flu activity in the coming weeks, noting that the average duration of a flu season for the last five seasons has been 16 weeks, with a range of 11 weeks to 20 weeks. With significant flu still to come this season, CDC continues to recommend that anyone who has not yet gotten a flu vaccine this season should get vaccinated now. It takes approximately two weeks for the protection provided by vaccination to begin.

Although 480,000 Rhode Islanders were vaccinated last year, RIDOH, says that the flu sent 1,390 Rhode Islanders to the hospital and resulted in 60 deaths (compared to 1,216 hospitalizations and 33 deaths the previous year. The state saw more flu activity during the 2017-2018 flu season than during any flu season since the 2019-2010 season, when the state experienced the state experienced the H1N1 flu pandemic.

It’s Not too Late to Get Vaccination

In kicking off Rhode Island’s annual flu vaccination campaign last October, RIDOH Director Nicole Alexander-Scott, MD, MPH, said, “A flu shot is the single best way to protect yourself and the ones you love against the flu. When you get a flu shot you are not only protecting yourself, you are also protecting the people in your life by limiting the spread of the flu.”

So, if you have not been vaccinated, consider doing so. RIDOH recommends that children older than 6 months of age should be vaccinated against the flu. Others should, too., including health care workers, pregnant women, people over age 50, nursing facility residents and persons with chronic conditions (specifically heart, lung, or kidney disease, diabetes, asthma, anemia, blood disorders, or weakened immune systems).

It’s easily to quickly get a flu shot because of its availability at doctors’ offices and pharmacies throughout Rhode Island.

In addition to getting a flu shot, here are a few simple tips that can help prevent you from getting the flu.

Wash your hands thoroughly throughout the day, using warm water and soap. If you do not have soap and water, use an alcohol-based hand gel.

According to the CDC, the flu can spread to others up to about 6 feet away, by droplets made when a person cough, sneezes or talks. So, reduce spreading the flu, just by coughing or sneezing into your elbow or into a tissue.

Avoid touching your eyes, nose, or month because germs spread this way.

Get a good night’s sleep, be physically active and look for ways to manage your stress. Also, drink plenty of fluids, and eat nutritious food.

Keep surfaces wiped down, especially bedside tables, surfaces in the bathroom, and toys for children, by wiping them down with a household disinfectant.