Whitehouse Pushes for COVID-19 Senate Proposal to Protect Residents, Employees

Published in the Pawtucket Times on March 1, 2021

As the one-year anniversary of the coronavirus disease (COVID-19) pandemic approaches, U.S Senator Sheldon Whitehouse (D-RI) joins Senators Bob Casey (D-PA), Raphael Warnock (D-GA), Richard Blumenthal (D-CT), and Cory Booker (D-NJ) in introducing a legislative proposal to save lives of nursing home residents and employees and assist with vaccinations.   At press time, over 1.3 million nursing residents and workers in long-term care facilities have been infected with COVID-19 and more than 170,000 have died so far, accounting for approximately 35 percent of COVID-19 deaths nationwide.

Taking a Close Look at S.333

Last week, S.333, “The COVID-19 Nursing Home Protection Act,” was thrown into the legislative hopper.  Initially introduced last Congress, the latest version, now being considered by the Senate Finance Committee, would provide funding to give nursing homes the needed resources to keep residents and workers safe; funding would go towards providing vital infection control assistance and organizing local health and emergency workers – known as “strike” or “surge” teams – to manage COVID-19 outbreaks and care for residents.  At this time no House companion measure has been introduced.

S. 333, introduced on Feb. 22, would provide $210 million for the Secretary of HHS to contract with quality improvement organizations to provide essential infection control assistance to nursing homes. 

Moreover, the legislative proposal would also send $750 million in funding to states to implement “strike” or “surge” teams. States are using “strike” or “surge” teams to ensure a sufficient number of aides, nurses and other providers are available to care for residents. Such teams also help manage COVID-19 outbreaks within a facility, particularly as vaccinations proceed in these settings. Since August, approximately 20 percent of nursing homes have reported each week that they do not have a sufficient workforce to care for residents.”

The impact of the pandemic has been devastating to minority communities, where reports have indicated that facilities serving significant numbers of Black and Hispanic residents were twice as likely to have COVID-19 infections. S. 333 would require the HHS Secretary to collect and make public demographic data on COVID-19 cases and deaths, including information on age, race, ethnicity, and preferred language. 

Whitehouse supports President Joe Biden’s call for the implementation of strike teams in his American Rescue Plan to help address these persistent shortages as well as the collection and dissemination of data on suspected and confirmed COVID-19 cases and deaths by race, ethnicity and preferred language.

Controlling COVID-19 Outbreaks in the Nation’s Nursing Homes

“Nursing home residents and staff have been through a traumatic year,” said Whitehouse who sites on the Senate Finance Committee.  “We need to prioritize vaccinating and caring for the Americans who live and work in these settings.  That means providing additional staff as needed to control outbreaks and making sure every resident and care worker who wants a vaccine can get one.,” said the Rhode Island’s junior Senator who has served since Jan. 4, 2007.

“As more than 170,000 residents and workers in nursing homes and other long-term care facilities have died from COVID-19, it is critical that Congress pass the COVID-19 Nursing Home Protection Act,” says Sen. Bob Casey, Chair of the U.S. Special Committee on Aging.

“This bill would address persistent staffing shortages in nursing homes by utilizing strike teams, promote infection control protocols and require that demographic data is collected on COVID-19 cases and deaths,” notes Casey.

Adds Casey, “The challenge this terrible virus poses are unprecedented and requires an immediate and extraordinary response. That is why my colleagues and I are advancing strategies to give states what they need – funding for ‘strike’ teams to help address staffing shortages in nursing homes and assist with vaccinations in these settings. We have an obligation to protect our most at-risk citizens.”

 “We applaud the efforts of Senator Whitehouse and his colleagues to provide funding for the protection of nursing home residents and staff,” said Scott Fraser, President and CEO of the Rhode Island Health Care Association, an affiliate of the Washington, DC-based American Health Care Association.  “We are especially pleased with the creation of strike teams to address the critical issue of staffing shortages during times of crisis.  This is a suggestion that RIHCA brought to Senator Whitehouse’s attention this past Spring when our homes were in critical need of additional staff due to the pandemic.  We thank him for listening and taking action,” he says.

At press time, 12 Democratic Senators join Sens. Whitehouse, Casey, Warnock, Blumenthal, and Booker, becoming cosponsors to this legislation.  They are: Sens. Maria Cantwell (D-WA), Bob Menendez (D-NJ), Jeanne Shaheen (D-NH), Tina Smith (D-MN), Amy Klobuchar (D-MN), Tammy Duckworth (D-IL), Chris Van Hollen (D-MD), Sherrod Brown (D-OH), Catherine Cortez Masto (D-NV), Jack Reed (D-RI), Maggie Hassan (D-NH) and Mazie Hirono (D-HI). 

A Call for Bipartisan Support

With the Senate now under Democratic control, there is a good chance that S. 333 will be considered by the Senate Finance Committee and if passed sent to the floor for consideration.   During the 116th Congressional session, the former Senate GOP Majority Leader, Mitch McConnell, of Kentucky, who often called himself the “Grim Reaper,” sent Democratic legislation to a legislative graveyard, refusing to act on Democratic legislation, even proposals with bipartisan support.

It’s time for Senate Republicans to support a Democratic proposal that protects the health and safety and the wellbeing of nursing home residents and workers in the nation’s 15,600 nursing homes. 

Partisan politics shouldn’t play a role in Senate Minority Leader Mitch McConnell’s decision to not urge his caucus to support this worthy legislative proposal.  S. 333 truly deserves bipartisan support and enactment, especially during the ongoing COVID-19 pandemic.

Report on Falls, Injuries Released

PUblished in Woonsocket Call on October 20, 2019

Last Wednesday morning in Dirksen Senate Office Building 562, the U.S. Special Committee on Aging held a hearing to put a spotlight on the economic consequences on falls and to explore ways to prevent and reduce falls and related injuries. At the one hour and 55-minute hearing, titled “Falls Prevention: National, State, and Local Level Solutions to Better Support Seniors,” its annual report, Falls Prevention: Solutions to Better Support Seniors, was released.

According to the Senate Aging Committee, falls are the leading cause of both fatal and nonfatal injuries among older adults that incur $50 billion annually in total medical costs. That number is expected to double to $100 billion by 2030, and the majority of these costs are borne by Medicare and Medicaid.

“Falls are the leading cause of fatal and non-fatal injuries for older Americans, often leading to a downward spiral with serious consequences. In addition to the physical and emotional trauma of falls, the financial toll is staggering,” said Sen. Susan Collins (R-Maine), who chairs the Senate Aging Committee. “Now is the time, and now is our opportunity, to take action to prevent falls. Our bipartisan report includes key recommendations to take steps to reduce the risk of falls,” the Maine Senator noted in an Oct. 16 statement.

Pushing for Positive Change in Releasing Fall Report

“We must dispel our loved ones of the stigma associated with falling so that they can get the help they need to age in place – where they want to be – in their homes and communities,” said Sen. Robert P. Casey, Jr. (D-Pa.). “I am hopeful that our work over the past year will propel the research community to do more, get more dollars invested into supporting home modifications and encourage more older adults to be active,” said the Special Committee’s Ranking Member.

At the hearing, the Committee unveiled a comprehensive report that provides evidence-based recommendations on ways to reduce the risk of falling. The Committee received input from multiple federal agencies, including the Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, and the Food and Drug Administration. In addition, approximately 200 respondents representing falls prevention advocates, hospitals, community organizations, home health agencies, and others shared their expertise on this issue.

The 34-page Aging Committee’s report made recommendations as how to raise awareness about falls-related risks, prevention and recovery at the national, state and local levels. It suggested ways of improving screening and referrals for those at risk of falling so that individuals receive the preventive care necessary to avoid a fall or recover after one. It noted ways of targeting modifiable risk factors, including increasing the availability of resources for home safety evaluations and modifications, so that older adults can remain in their homes and communities. Finally, it called for reducing polypharmacy so that health care providers and patients are aware of any potential side effects that could contribute to a fall.

Increasing Medicare Funding for Bone Density Testing

In an opening statement, Collins noted that falls are often times attributed to uneven sidewalks or icy stairs, medications, medical reasons or muscle strength. But one key cause of falling is osteoporosis, which can be especially dangerous for people who are completely unaware that they suffer from low bone density, she says.

According to Collins, although Medicare covers bone density testing, reimbursement rates have been slashed by 70 percent since 2006, resulting in 2.3 million fewer women being tested. “As a result, it is estimated that more than 40,000 additional hip fractures occur each year, which results in nearly 10,000 additional deaths,” she said, noting legislation, Increasing Access to Osteoporosis Testing Beneficiaries Act that she has introduced with Sen. Ben Cardin,” to reverse these harmful reimbursement cuts.

Casey stated, “I am particularly interested in sharing this report with the relevant agencies and learning how the recommendations will be implemented. Not just put in a report. Implemented,” adds Casey.

Peggy Haynes, MPA, Senior Director, of Portland-based Healthy Aging, MaineHealth that offers A Matter of Balance, an evidence-based falls prevention program, came to the Senate hearing to share details about its impact. “The health care community has a critical role to play in fall prevention – beginning with screening for falls, assessing fall risk factors, reviewing medications and referring to both medical and community-based fall prevention interventions. Our health system is focused on preventing falls in every care setting,” says Haynes.

“The need for a range of community-based options led MaineHealth to be a founding member of the Evidence Based Leadership Collaborative, promoting the increased delivery of multiple evidence-based programs that improve the health and well-being of diverse populations,” adds Haynes.

Haynes noted that older participants attend eight two-hour sessions to help them reduce their fear of falling, assisting them to set realistic goals for increasing their activity and changing their home environment to reduce fall risk factors. A Matter of Balance is offered in 46 states reaching nearly 100,000 seniors.

Virginia Demby, an 84-year-old visually-impaired retired nurse who is an advocate for Community and Older Adults, in Chester, Pennsylvania, came to the Senate hearing to support the importance of fall prevention programs. Despite living with low vision, Demby remains physically active by participating in exercises classes for older adults at the Center for the Blind and Visually Impaired in Chester. She is an advocate for older adults and now helps the local senior center wellness manager recruit more seniors to take falls prevention classes and find new places to offer the classes.

Kathleen A. Cameron, MPH, Senior Director, Center for Healthy Aging, of the Arlington, Virginia-based National Council on Aging, discussed the work of the National Falls Prevention Resource Center, which helps to support evidence-based falls prevention programs across the nation and highlighted policy solutions to reduce falls risk.

Finally, Elizabeth Thompson, chief executive officer, Arlington, Virginia-based National Osteoporosis Foundation, testified that bone loss and osteoporosis are fundamental underlying contributors to the worst consequences of falls among older Americans: broken and fractured bones. Osteoporotic fractures are responsible for more hospitalizations than heart attacks, strokes and breast cancer combined, she noted.

For details of the Senate Aging Committee report, go to http://www.aging.senate.gov/imo/media/doc/SCA_Falls_Report_2019.pdf.

Caregivers Flying Blind in Providing Complex Medical and Nursing Care

Published in the Woonsocket Call on April 21, 2019

Half of the nation’s 40 million family caregivers are performing intense and complicated medical and nursing tasks, managing multiple health conditions for their family members and friends, says a newly published AARP report.

AARP’s special report, “Home Alone Revisited: Family Caregivers Providing Complex Care,” released April 17, 2019, takes a close look at specific medical and nursing tasks (including giving injections, preparing special diets, managing tube feedings and even handling medical equipment) that family caregivers are currently doing. It’s a follow-up report to AARP’s 2012 Home Alone Study that took the first in-depth look at how caregivers managed providing complex medical and nursing care that was formerly offered by trained professionals.

Changes in the Health Care System Can Support Family Caregivers

“This report shows the extent of complex tasks that millions of family caregivers are providing every day. They are largely alone in learning how to perform these tasks,” said Susan Reinhard, RN, Ph.D., Senior vice president and Director, AARP Policy Institute, in a statement announcing the release of the a 56-page report. “About half of family caregivers are worried about making a mistake. We need to do a lot more across the health care system—with providers and hospitals—to help support these family caregivers,” says Reinhard.

Adds Rani E. Snyder, program director at The John A. Hartford Foundation, “Family caregivers are the linchpin in our health care system, particularly for older adults,” “This study shines new light on the diversity of family caregivers performing complex tasks—from men to millennials to multicultural populations—and is a rallying cry for an all hands-on-deck approach to creating age-friendly health systems that better support and prepare these often forgotten members of the health care team.”

The new statistics in this report shed more light on the demands of family caregiving,” said AARP Rhode Island State Director Kathleen Connell, a former nurse. “These described caregiving responsibilities sound like a task list for a team of home nurses, aides, dieticians, physical therapists and personal drivers who work without weekends off, much less vacations. Is there any question that people worry about making a mistake that compounds existing issues?,” she says.

“The takeaway is quite clear,” Connell added. “Caregiving is stressful and we need to expand efforts to provide assistance. And it’s a very big ‘we’ that I am speaking of. Families need to help out and share more responsibilities as well as offer respite for primary caregivers. Neighbors and extended family also can lend a hand. And we need government to continue to provide assistance through legislation that supports family caregivers. Caregiving responsibilities can be both daunting and exhausting. It’s the new reality. The good news is that as we raise awareness we can work together to improve the lives of caregivers, “ says Connell.

A Sampling of the AARP Report’s Findings

AARP’s Home Alone Revised Report report found that almost half of the caregiver respondents (48 percent) prepare special diets multiple times per day. Preparing these meals often involved taking precise measurements, following specific dietary guidelines, constant monitoring, and the use of special equipment for preparation and feeding.

Thirty percent of the respondents say preparing special diets are hard to manage, this being more challenging to men. Younger caregivers found it more difficult to manage this task than older caregivers.

The caregivers also reported that 54 percent of the survey’s respondents say they manage incontinence multiple times a day. Most say managing incontinence is more difficult than managing medications, helping with assistive devices and performing wound care. Seventy-six percent say they learned how to manage incontinence on their own. More than one in four would appreciate having assistance from another person to help.

According to AARP’s report, 70 percent of these caregivers are dealing with the emotional stress of managing pain relief in the middle of a national opioid crisis. More than four in 10 expressed concerns about giving the optimal dose. About four in 10 faced difficulties in controlling the pain of the care recipient.

Finally, 51 percent of the survey respondents assisted with canes, walkers, and other mobility devices while over a third (37 percent) dealt with wound care.

The researchers conclude that “uncomplicated world of ‘informal’ caregiving” no longer applies” to the nation’s caregivers. “In the current health care environment, it is presumed that every home is a potential hospital and every service that the person needs can be provided by an unpaid family member, with only occasional visits by a primary care provider, nurse or therapist,” say the researchers,” they say.

AARP’s Home Alone Revised Report is a must read for Congress and state lawmakers who can easily address the challenges caregivers face when providing medically complex care by crafting policies and programs that will provide support and resources to the nation’s growing number of caregivers.

This caregiving issue might be a good one for the U.S. Senate Special Committee Aging to study.

A Final Note…

AARP gathered the study’s data through a nationally representative, population-based, online survey of 2,089 family caregivers. This study employed an oversampling of multicultural groups, taking a closer look at difficult tasks, and putting greater attention on available resources and outcomes. The study’s sampling strategy ensured multicultural representation and investigated generational differences. Additionally, the researchers also explored certain topics in greater depth, including special diets, incontinence, pain, and the impact of social isolation on the caregiver.

The AARP Home Alone Study is a special report from the Founders of the Home Alone Alliance℠ (AARP, United Hospital Fund, Family Caregiver Alliance and UC Davis-Betty Irene Moore School of Nursing). With funding from The John A. Hartford Foundation to the AARP Foundation, the study took an in-depth look at the specific medical/nursing tasks that family caregivers are doing.

To read the full report, go to: https://www.AARP.org/ppi/info-2018/home-alone-family-caregivers-providing-complex-chronic-care.html.

Note: Updated April 22, 2018…