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Bill Package Seeks To Improve Quality Of New Jersey’s Long-Term Care Facilities

The state Legislature recently held a series of hearings on the spread of COVID-19 in New Jersey’s long-term care facilities, which included a review of nearly a dozen bills aimed at strengthening the system against future outbreaks.

During an Aug. 13 meeting, the Senate Health, Human Services and Senior Citizens Committee and Assembly Aging and Senior Services Committee discussed 11 bills pertaining to long-term care that were recently introduced by State Sen. Joseph Vitale (D-19) and Assemblywoman Valerie Vainieri Huttle (D-37).

Besides ensuring better handling of public health emergencies, the bills call for improved quality of care for residents and safer working environments for staff.

Reform Legislation

“In less than two months since our initial hearing on long-term care in the Assembly, we have developed a package of legislation intended to reform and bolster our long-term care system,” said Huttle, chair of the Assembly Aging and Senior Services Committee.

During the nearly three-hour virtual meeting, facility workers and residents told lawmakers they support the legislative proposals, which include bills to increase regulatory oversight, penalties for violations, boost infection control requirements and raise pay for certified nursing assistants.

However, they told officials shortages of personal protective equipment and staffing levels still need to be address, especially if a second wave of the virus strikes later this year.

Huttle Calls For Swift Action

The feedback, Huttle said, “will guide us in improving this legislation to go further for residents and staff at long-term care facilities.” She also said the state needs “to act swiftly to reform and bolster our system.”

Since March, there have been 13,098 confirmed cases among staffers and 24,660 residents, according to the most recent state figures.

Of the 14,086 people who have died from coronavirus-related complications in New Jersey, more than 7,000 deaths were reported in a long-term care facility. The death toll includes 120 long-term care workers and 146 patients in the state’s three veterans homes.

Legislation Is ‘Critical’ Step

Vitale and Huttle called the numbers “staggering, heartbreaking and unacceptable.”

Several bills incorporate recommendations from the Manatt Health report, a state-commissioned review of how long-term care facilities and nursing homes responded to the pandemic.

In Manatt Health’s rapid-review, the half-million dollar report found nursing homes were unprepared to deal with the pandemic and presented a series of recommendations on how to improve oversight, staffing shortages and communications.

Manatt Guide

Following the introduction of the bills, they issued a statement saying, “The Manatt report showed COVID-19 did not create the problems in long-term care; it merely exacerbated them. Now, it’s our turn to take action to address long standing issues and ensure our long-term care facilities are prepared to get through this pandemic and future emergencies.”

Vitale said the bills may be tweaked as they move forward and additional pieces of legislation may be introduced soon.

“The first package is critical to making systematic changes for long-term care and our veterans,” he said. “We’re thankful for the cooperation of the administration and colleagues on both sides of the aisle.”

What’s Proposed

  • S-2790/A-4476 – Establishes certain requirements concerning the State’s preparedness and response regarding infectious disease outbreaks, epidemics and pandemics affecting long term care centers, including by creating a Long Term Care Emergency Operations Center in the New Jersey Department of Health (DOH) to serve as a centralized command and resource center for response efforts.
  • S-2789/A-4477 – Revises licensure, operational and reporting requirements for long term care facilities.
  • S-2786/A-4483 – Allows employees in long term care to earn paid sick leave.
  • S-2759/A-4478 – Requires the DOH to establish a scaling system of actions and penalties for long term care facilities in violation of State and federal requirements for operation, creates various reporting requirements, and establishes Long Term Care Facility Advisory Council to advise on long term care oversight and communicate with the public.
  • S-2788/A-4479 – Establishes a program to provide one-time, lump-sum payments to long term care staff who provided a certain volume of direct care services to residents during the COVID-19 pandemic.
  • S-2758/A-4482 – Raises the minimum wage for direct care staff in long term care facilities to be three dollars higher than state minimum wage and be annually adjusted based on cost-of-living increases.
  • S-2787/A-4481 – Establishes the New Jersey Task Force on Long Term Care Quality and Safety, which will develop recommendations to make changes in the long term care system to improve person-centered care, resident and staff safety, quality of care, and workforce engagement and sustainability, among others.
  • S-2791/A-4480 – Requires New Jersey Department of Human Services to review and evaluate any existing requirements for Medicaid managed care organizations (MCOs) to contract with any willing provider for the delivery of nursing home services, and determine whether to request amendments or waivers as may be necessary to allow MCOs to terminate or suspend a contract with a nursing home that has a history of multiple violations of licensure requirements that resulted in severe adverse health consequences for facility staff and residents.

Recommendations Enacted

New Jersey has already implemented several recommendations made by Manatt Health, including the distribution of 30 million pieces of personal protective equipment, testing of 310,000 residents and 495,000 staffers and completion of 450 infection control surveys.

State officials also recently announced a series of mandatory benchmarks that facilities must meet in order to reopen for visitors and resume normal activities.  The standards—which are based on guidance from the state health department and Centers for Disease Control and Prevention—include weekly testing for staff, mandates for resident testing, updated outbreak plans, a thorough communication strategy during an emergency with residents and their families, increased infection control measures, detailed cleaning procedures and requirements for stockpiling personal protective equipment (PPE).

Additionally, the state Department of Human Services unveiled a proposal that would provide long-term care facilities with a total of $155 million to support them in efforts to reopen.

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