Tag Archives for Roberta Hawkins

Retiring Senior Advocate Played Key Role in Shaping Long-Term are Policy Debates  

Published in Pawtucket Times on November 18, 2002

Sheila Cabral Sousa, a long-time and well-respected senior advocate, leaves her post as executive director of the Rhode Island Association of Facilities and Services for the Aging to become a broker with statewide Residential properties.

Sousa has played a key role in shaping the Ocean State’s long-term care policy during her 12-year tenure representing nonprofit providers who operate nursing facilities, assisted living facilities and senior housing sites.

Sousa’s professional life experience would help her to successfully lead a major statewide nonprofit provider group, providing a continuum of  long-term care services to Rhode Island’s vulnerable elderly.

As a teenager, Sousa dreamed of becoming a lawyer. Once she received her bachelor of education degree from Rhode Island College, the young woman entered the Suffolk University School of Law in Boston.

Ultimately, she would complete a four-year night program, receiving a J.D. in 1971. Eight years in private practice would sharpen her legal skills, skills that would become valuable in helping her to lobby and shape public policy.

In 1979, a job offers given to her husband brought the young couple to Washington, D.C. Briefly, Sousa owned an operated an antique and collectible store in Alexandria, Va., until she found employment in the federal government.

While working for the Veterans Administration, her experience working on the Board of Veterans Appeals gave her a working knowledge of medical issues.

After the couple divorced, Sousa came back home to Rhode Island in 1986, where she would become the field manager for the Richard Licht campaign.  Her efforts helped him to become Lieutenant governor. From there, she became executive director of the Rhode Island Mental Health Association, a position that would give her an understanding of mental health issues in Rhode Island and a familiarity with the state legislature.

In 1989, Sousa would take the helm of the Rhode Island Association of Facilities and Services for the Aging (RIAFSA)

For 13 years, she would give credibility and recognition to the views of the nonprofit provider group to lawmakers, state policy makers and to the general public.  As executive director, Sousa would not represent one segment of the long-term care continuum, but the full spectrum, from nursing facilities, assisted-living facilities to senior housing.

Sousa leaves her position with many admirers.

“Enormously intelligent,” “quick-witted” and “a very committed advocate for social justice, women’s issues and the elderly” are traits used to describe Sousa, as quoted by Maureen Maigret, director of public policy for Lt. Gov. Charles Fogarty.

“Sousa was not afraid to push people to really examine all the policy issues. She really forced one to take a look at all the angles of an issue to make sure the best results happened,” said Maigret, whose personal and professional friendship with Sousa spans back to the 1970s.

According to Maigret, Sousa has a strong interest in elderly housing issues and has called for the need of supportive housing services to be offered to the residents.

“Through Sousa’s efforts, the Rhode Island Housing Resources Commission wrote a report looking at the need for supportive housing for the elderly and those with disabilities,” Maigret stated, adding that this report will be released in the near future.

Adds Susan Sweet, a consultant to nonprofit agencies and an elder rights advocate who is also a longtime friend of Sousa, “She can pierce the babble of irrationality with her quick and sharp wit and is never afraid to do so. She is fearless and funny, smart and compassionate. Quite a combination, adds Sweet.

“Wherever she spends her time, she will bring her considerable strengths to it and it will do well and do good things,” added Sweet.

Steve Horowitz, CEO of East Greenwich-based St. Elizabeth Community and RIAFSA’s past president told All About Seniors that Sousa is “a dynamic person” and a “visionary,’ and that she was the nonprofits first and only executive director.

“She was instrumental in bringing RIAFSA to the table when the state discussed policy issues,” he said.

“She didn’t look at an issue as to how it would affect us today, but how it would impact RIAFSA down the road,” said Horowitz.

Furthermore, Sousa had a tough job because she worked with only a part-time assistant.

“If you see her accomplishments over the years, you would think we had a staff of five people-based on all the work that was done,” noted Horowitz.

Roberta Hawkins, executive director of the Alliance for Better Long-Term Care and the state ombudsman, called Sousa a tireless woman who worked extremely hard on behalf of her nonprofit providers without ever losing sight of the elderly clients that they served.

“I will miss her tenacious nature and wonderful sense of humor. Her sense of humor brought levity to intense policy decisions, observes Hawkins.

While Sousa worked hard, she also enjoyed life, too. She is a great cook and has a love for Irish country dancing and music and playing poker, her colleagues say. She is also quite an interior decorator, with an eye for color, too.

Sousa, 60, is not  turning her attention toward her new challenging mountains to climb.

“It’s tie to try new career options,” she said.

Some people say that everyone is replacement.” But in Sousa’s case, and to those who have come to love and admire her, the person who takes the helm of RIAFSA will have big shoes to fill.

A farewell party for Sousa will be held on Thursday, Nov 21, 2002, from 4 to 6 pm, ag Green Tea, 5600 Post Road, East Greenwich. For more information, call Steve Horowitz at 471-6069.

Morgan Health Center receives Prominent Award

Published in Pawtucket Times on July 1, 2002

Patient abuse, financial exploitation, Medicaid fraud, and poor nursing care.

In many cases, these activities are often picked up by the print and electronic media across the state.

The nursing facility industry will tell you that “bad news can sell a lot of newspapers.” In many cases, stories about good patient care, a loving staff and facilities that deliver high standards of care do not even reach the pages of a newspaper talk show or nighttime newscast.

Here’s a story that hopefully will be picked up and reported by Rhode Island’s print and electronic media.

The Joint Commission on Accreditation of Health Care Organizations (JCAHO) has awarded Johnston-based Morgan Health Center with Accreditation by Full Standards of Compliance for providing quality long-term care and subacute services.

Nearly  2,300 nursing facilities across the nation are JCAHO accredited every three years, notes JACHO spokesperson Charlene Hill.

Hill says that only five percent of these facilities receive the survey’s highest designation, that is, Accreditation with Full Standards Compliance.

In the Ocean State, 19 facilities out of 96, have been JCAO-accredited Only Morgan Health Center and The Clipper Home in Westerly, have obtained JCAHO’s highest designation.

What does JCAHO accreditation really mean to the consumer”

“JCAHO standards, in many cases, exceed federal nursing facility requirements,” Lois Richard, administrator of Morgan Health Center, tells All About Seniors,

Here’s an example of the difference between federal regulatory requirements and JCAHO. Federal law does not require a nursing facility to implement a process to accredit members of its medical staff, she says. However, JCAHO accreditation requires that facilities determine if physicians have hospital privileges, validate that they care malpractice insurance, actually have a medical license and practice within the scope of their license.

Ricard added JCAHO also requires that registered nurses, licensed practical nurses and certified nursing assistants also be credentialed in what they do. “Their skills and techniques are monitored annually or whenever necessary,” she said.

According to JCAHO, its accreditation process is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.

JCAHO uses standards to conduct a survey every three years that is evaluative, consultative, and educational. The primary goal of this survey is to assist a facility to identify and correct potential problems and improve the safety and quality of care and services provided.

During the survey, information, is collected through  observation, interviews with residents and staff and document reviews. The survey measures the organization’s against objective, state-of-the-art standards contained in the Comprehensive Accreditation Manual for Long-Term Care.

Richard said her facility now enters its third accreditation cycle. The 120-bed skilled nursing facility sought its initial accreditation in 1996.

For Roberta Hawkins, state ombudsman and executive director of the Alliance for Better Long-Term Care, it is no surprise that Morgan Health Center was awarded JCAHO’s highest designation. Lois Richard is “personally vested in the facility,” Hawkins said. “It is more than just a 9-to-5 job, that’s what makes the difference,” she says.

The next survey is scheduled for 2005. Richard said to get another perfect scored, “you have to be doing what is expected of you every day.”

“As a JCAHO accredited facility, you’re consistently looking at what you do to identify the problems in order to respond proactively before they occur,” says Richard.

“You can’t let things fall through the cracks. If you do , things will start slipping,” she notes.

For their successful effort of reaching the highest level of JCAHO accreditation, Morgan Health Center, and its staff must be commended for their efforts. Positive stories about nursing facility care might even reduce the fear that seniors experience when they have to consider nursing facility care for their loved ones or for themselves.

Editors and news directors might believe that a negative story about poor care in nursing facilities might shed light on an issue that needs to be addressed by public officials.

While this is true, it is now time to give as much weight to stories that recognize the hard efforts of nursing facility staff who strive against incredible odds (from inadequate Medicaid reimbursement  to chronic staffing shortages) to provide higher standards of care.

The way I look at it, allocating more print space or air tie to recognize facilities providing quality of care is only-balanced journalism.

Fed’s Proposal to Confronting Nursing Shortage is Not Enough

Published in Pawtucket Times on April 1, 2002

Responding to the nation’s serious nurse staffing shortage, a new Federal proposal gives states flexibility to allow nursing facilities to use paid feeding assistants to supplement the services of certified nurse aides (CNAs). The specialty trained staff would help residents eat and drink.

With a growing number of frail elderly resident in the nation’s nursing facilities, today’s nursing staff must take care of residents who require a higher level of medical care. This leaves less time to ensure that residents eat their meals and drink enough fluids on a daily basis.

Oftentimes, both physical and psychological changes will interfere with a resident’s ability to eat and consumer a meal. Some residents may only need encouragement or minimal assistance with eating.

On the other hand, frail residents may require staff assistance with feeding .  Assistance would be needed for residents with cognitive impairment, impaired swallowing due to muscular weakness or paralysis, a tendency to aspirate or choke, poor teeth, ill-fitting dentures or partial plates, poor muscular or neurological control of their arms or hands, as with Parkinson’s disease.

Under the Centers for Medicare & Medicaid Services (CMS) proposal, trained feeding assistants are allowed to help residents eat and drink, especially at meal times.

The workers would be required to complete a state-approved course to quality to be hired for the new position.  Currently nursing facilities rely primarily on CNAs, registered or licensed practical nurses to assist residents with eating and drinking.  However, volunteers and family members also may assist with these tasks.

At this time, there is no provision in federal regulations for the employment of nursing facility workers to perform only a single task without competing 75 hours of nurse aide training.

The proposed rule change published in the March 29 issue of the Federal Register would allow facilities to hire workers to perform a single task with training on feeding techniques and some basic information that is currently part of CNA training requirements.

“Meal times can often be the busiest time in nursing facilities,” says CMS Administrator Tom Scully.

“Feeding residents is often a slow process and competes with m ore complex tasks, such as bathing, toileting and dressing changes, as well as urgent medical care,” he added.

“Trained feeding assistants will free nurses and nurse aides to focus on residents’ other health care needs. The result will be that residents will receive better nutrition and care,” Scully noted.

The American Health Care Association (AHCA), a Washington, D.C.-based trade group, that represents both profit and non-profit nursing facilities, gives the new federal rules a thumbs up.

‘Simple common-sense dictates that when our nation’s health care system is being undermined by a chronic nursing staffing shortage, and the greater needs of increasing sicker patients, we should do everything conceivable to better the lives of our patients,” stated Dr. Charles H. Roadman II, president and CEO of AHCA. “The rule will also help the overextended nurses and nursing aides already on the job cope with competing important tasks.”

Hugh Hall, executive director of the Johnston-based Cherry Hall Manor Nursing and Rehabilitation Center, supports the federal government’s approval of the single task workers who feeds nursing facility residents.

“The prior regulation was not logical or practical when prohibiting other nursing home workers other than registered nurses, licensed practical nurses and CNAs from feeding, but allowing volunteers and families to participate in the feeding process with little training,” he said.

Hall, the former president of the Rhode Island chapter of AHCA, said the health care community would prefer that the federal government develop long-term care programs to recruit fully trained certified nursing assistants and to financially support those initiatives.

Roberta Hawkins, who serves as the state’s nursing facility ombudsman and executive director of the Alliance for Better Long-Term Care agrees.

“The federal proposal is only a Band-Aid fix.” Hawkins says, calling on the federal government to put more funds into the nursing facility reimbursement system to enable facilities to pay better wages to hire permanent full-time staff and to create career ladders.

“Even though you may teach an aide to just feed residents, they are not trained to spot medical changes in the resident, Hawkins told Everything About Seniors.  More important, she said, “they will not be familiar with the specific needs of the residents.”

Hawkins believes that the Bush administration’s proposal can become an obstacle in providing continuity of care in nursing facilities.

A state commission, chaired by Human Services Director Jane Haywood, is currently looking at Rhode Island’s staffing shortage and how the existing Medicaid reimbursement system can be improved.

Recommendations for a new and improved system coming from Haywood’s group might just fix a long-time systemic problem, enabling nursing facilities to better recruit and retain CNAs.

Hopefully, Haywood’s long-awaited proposals will be seriously considered by the administration and General Assembly and won’t end up on a dusty shelf or a circular file.

While allowing the use of single-tax workers, proposed by the Bush administration, it is a step in the right direction. Gov. Lincoln Almond, state lawmakers and state policymakers must not lose sight of the real issue – inadequate Medicaid payments- which fuels an ongoing CNA shortage in many of the state’s nursing facilities.

Almond and the General Assembly are currently at odds over subsidized gambling in the Ocean State.

During this year’s budget debates, overshadowed by a projected $70 million plus budget deficit, let us not forget about Rhode Island’s 10,000 nursing facility residents or the growing elderly population who may ultimately require that level of care or community-based long-term care services.

If the General Assembly can easily find $ 15 million next year to keep the greyhound racing industry afloat, lawmakers might dedicate some time and a little energy and effort in finding state dollars to increase funding to Rhode Island’s long-term care delivery system.

For older constituents and the state’s aging baby boomers it is the right thing to do.