Andover Rehabilitation and Subacute Care nursing home, which was “overwhelmed” with bodies amid a COVID-19 outbreak, seen from the air on April 16, 2020.
Acting on recommendations by consultants hired to investigate New Jersey’s deadly COVID-19 outbreaks at nursing homes, Gov. Phil Murphy signed a package of bills into law Wednesday designed to address some of the many shortcomings at long-term care facilities in the pandemic.
The four bills Murphy signed will raise the pay of nursing home staff, raise Medicaid reimbursement rates at those facilities, create a centralized command center and set up a task force to study safety and quality-of-care improvements.
“These are big steps forward to make sure that we live, we learn, that we can address what was an uneven performance in that industry and put some pieces in place that will have permanent significance and will allow us to weather future storms,” Murphy said at a coronavirus press briefing in Trenton before signing the bills.
Judy Persichilli, Commissioner of the New Jersey Department of Health during New Jersey Governor Phil Murphyâ€™s daily press briefing at the the War Memorial in Trenton, NJ on May 19, 2020, regarding updates on the corona virus. (Photo: Chris Pedota, NorthJersey.com-USA Today Network)
Nursing homes have been a glaring weakness for Murphy in a response to the pandemic that has in many other areas gotten high marks. Fatalities at long-term care facilities account for about half the state’s death toll of more than 16,000, the second-highest in the nation, according to Johns Hopkins University.
“Long-term care centers were woefully under-prepared and under-resourced to respond to a global pandemic. Many nursing and veterans homes in New Jersey have been cited for inadequate infection control policies, and few had consistent direct communication with hospitals and health departments before the pandemic,” Assemblywoman Valerie Vainieri Huttle, D-Bergen and chairwoman of the Assembly Aging and Senior Services Committee, said in a statement. “The system as a whole needs to be reformed.”
Long-term care operators generally faced condemnation by Murphy and lawmakers for putting profits over safety, operating with little transparency and paying workers poorly. The Attorney General is investigating the facilities.
The administration’s readiness and response at nursing homes in the pandemic have come under sustained criticism, too, not only by political opponents but also from experts within the Department of Health.
Ambulance crews are parked outside Andover Subacute and Rehabilitation Center in Andover, N.J., on Thursday April 16, 2020. Police responding to an anonymous tip found more than a dozen bodies Sunday and Monday at the nursing home in northwestern New Jersey, according to news reports. (AP Photo/Ted Shaffrey) (Photo: Ted Shaffrey, AP)
A group of unnamed health officials have said they argued for a more proactive response at the care facilities but that the department, led by Commissioner Judith Persichilli, prioritized hospitals to receive coveted testing and protective gear. Consultants from New York’s Manatt Health confirmed in their “rapid review” earlier this year that hospitals got greater focus by the administration and found that nursing homes were largely unprepared for the virus.
Murphy had hired Manatt Health in May at a cost of $500,000 after the virus raged through the state’s roughly 600 nursing homes, killing more than 4,000 of the most vulnerable residents (more than 7,000 residents and staff have now died).
The firm’s review said the coronavirus exacerbated “long-standing, underlying systemic” issues at long-term care facilities, though it did not include the three state-run veterans’ homes, where 81 people have died.
The consultants suggested a range of short- and long-term reforms to address those issues of chronic underfunding, low-paid workers and the state’s poor readiness and communication. The bills Murphy signed, which all take effect immediately, move toward addressing those flaws, though time will tell whether they make a meaningful difference in the level of care.
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One of the bills raises the minimum wage for direct care staff in long-term care facilities to be $3 higher than the prevailing wage. The current minimum wage is $11 with annual increases until reaching $15 an hour. That’s the same rate certified nurse assistants earned on average last year, while other staff earned close to minimum wage, according to the Manatt Health report.
The state will spend $62.3 million to raise Medicaid reimbursement rates to help pay for the wage increases and for COVID-19-related costs such as infection control and protective gear, according to another bill Murphy signed. The federal government will contribute $68 million for a total investment of $130 million.
Another bill creates a Long-Term Care Emergency Operations Center in the Health Department in an effort to streamline communications between the state, long-term care operators, unions and advocates in a public health emergency. It’s designed to ensure supplies and equipment get deployed where needed; identify shortages in staff and supplies; and make sure all policies and state guidance are effectively communicated, according to the bill.
Persichilli said the Health Department has already established the operations center and is being led by Dr. David Adinaro, a deputy commissioner.
Finally, the administration will form a 27-member Task Force on Long-Term Care Quality and Safety charged with developing recommendations to improve care, resident and staff safety and quality of care. The bill requires the task force to submit a report of its recommendations to the governor and lawmakers within one year, then disband.
Murphy said he expects all the measures but the task force bill to strengthen the resiliency at nursing homes in case of an expected second wave this fall or winter.
“Of the four, three of them have very short-term impact and the fourth one is a longer-term look,” he said.
Sen. Joseph Vitale, chairman of the Senate Health, Human Services and Senior Citizens Committee, said the bills combined Manatt Health’s recommendations and extensive discussions with residents and people in the industry.
“At the onset of this pandemic our mothers, fathers and grandparents faced a compromised, exposed and impossible situation,” Vitale, D-Middlesex, said in a statement. “These laws will help ensure that New Jersey does not ever let that happen again.”
Dustin Racioppi is a reporter in the New Jersey Statehouse. For unlimited access to his work covering New Jersey’s governor and political power structure, please subscribe or activate your digital account today.
Email: [email protected] Twitter: @dracioppi
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