Gov. Phil Murphy Signs Four Bills to Address Long-term Care Facilities Resiliency, Preparedness in New Jersey

Gov. Phil Murphy signed into law four measures that lawmakers believe will improve long-term care facilities that were at the heart of the coronavirus pandemic.

“These are big steps forward to make sure that we live, we learned, 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,” said Murphy at a press briefing Sept. 16. “They will have both immediate and long term impact.”

Murphy said the recommendation stemmed from the Manatt Health report delivered in June which, after conducting 50 interviews with various shareholders including employees in the state’s department of health, outlined recommendations for the state to strengthen emergency response capacity, stabilize facilities and bolster workforce, increase transparency and accountability and build a more resilient and higher quality system. 

Huttle Sponsored Legislation

Assemblywoman Valerie Vainieri Huttle (D-37), Chair of the Assembly Aging and Senior Services Committee, said the four bills will help prepare long-term care centers that were “woefully underprepared 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. The system as a whole needs to be reformed,” said Vainieri Huttle. 

New Jersey Department of Health Commissioner Judith Persichilli on July 23 announced some of the recommendation that were already implemented, including the development of a comprehensive testing plan for residents and staff, clearing a backlog of complaints and create a long-term care emergency operations center to provide centralized command structure to manage the emergency response to COVID in long-term care facilities.

Four New Laws

The four new laws establishes certain requirements concerning the state’s preparedness and response to infectious disease outbreaks, including the COVID-19 pandemic; the creation of the New Jersey Task Force on Long-Term Care Quality and Safety; minimum wage requirements for certain long-term care facility staff; direct care ratio requirements for nursing homes; a nursing home care rate study; and authorizes temporary rate adjustment for certain nursing facilities with a price tag of approximately $62.3 million.

“This package of bills will improve the resiliency and quality of our long-term care facilities and strengthen their emergency preparedness,” said Persichilli in a press statement. “Most importantly, they provide the recognition the Certified Nursing Assistants (CNA) deserve through wage increases and career ladder opportunities.”

Vainieri Huttle added “It is critically important that we support the certified nurse aides in long-term care centers who are on the COVID-19 front lines day in and day out. If there’s ever a time to enhance wages for our severely underpaid and overworked nurse aides, it’s now.”

Medicaid Funding

Human Services Commissioner Carole Johnson noted the action will deliver new Medicaid funding of $130 million—a 10% increase—over the remainder of the fiscal year to nursing homes to increase wages for the frontline certified nursing aide workforce and to support facilities’ compliance with health and safety directives, including COVID-19-related infection control, personal protection equipment, cleaning, staffing, and other needs. 

“As we look to a potential second wave of COVID-19 in the Fall, we must make sure long-term care facilities have the resources needed to mitigate the spread of the virus,” said Assemblyman Gordon Johnson (D-37). “This includes, perhaps most importantly, the heroic CNAs who care for elderly and disabled residents in long-term care facilities and often work multiple shifts at several facilities to make ends meet.”

”Increased wages will mean current CNAs won’t have to stretch themselves thin financially, as well as help to attract new staff hires, which in turn will improve quality of care for residents.”

Bipartisan Legislation

Assemblyman Chris DePhillips (R-40) said the bipartisan legislation acts upon the lessons learned from the COVID-19 response. 

“In particular, the new Long Term Care Emergency Operations Center will provide greater preparation and coordination across the state in the event of a future outbreak,” said DePhillips. “Moreover, the legislation will ensure that long-term care facilities are more closely tied to the system of care in the state and have emergency plans in place to respond to a public health emergency.”

State Sen. Richard Codey (D-27) added “Establishing the New Jersey Task Force on Long-Term Care Quality and Safety would allow us to develop and implement improvements across the board. Our most vulnerable residents and their caretakers deserve better and this legislation would make sure improvements are realized.”

Daily Data

As of Sept. 16, the cumulative number of coronavirus cases in New Jersey reached 197,792 with 447 new cases and nine new deaths, bringing that total to 14,263. The state probable death count increased to 1,791, bringing the overall total to 16,054.

State officials noted 13 deaths occurred in the last 24 hours of reporting that have not yet been lab confirmed.  

Of the total confirmed deaths in North Jersey, Essex County has the most with 1,895, followed by Bergen at 1,600, Hudson with 1,353, Passaic at 1,108, Morris at 686, Sussex at 161 and Warren with 158.

In regards to probable deaths, Bergen has 243, Essex has 229, Hudson has 160, Morris at 145, Passaic at 143, Sussex has 37 and Warren has 13.

State Testing 

The daily rate of infections from those tested as of Sept. 12 was 1.6%. By region, the north has a rate of 1.4%, central at 1.9% and the south at 2.8%. The state is no longer using serology tests as health officials explained those results show a past presence of the disease as well as a current one. 

As for the rate of transmission, it reamiend at 1.06 for the third consecutive day. Officials have continually cited transmission rate and positivity rate as health data they rely on to track how the coronavirus is being contained in New Jersey, guiding them in determining when restrictions have to be tightened or lifted.

Officials reported 462 patients are hospitalized, with 226 confirmed and 236 awaiting confirmation. Of those hospitalized, 100 are in intensive care units and 38 on ventilators, while 30 patients were discharged.

Bergen Tops County Count

Bergen has the most cumulative cases in the state with 22,030, followed by Essex at 20,723, Hudson at 20,422, Middlesex at 18,931, Passaic at 18,719, Union at 17,355, Ocean at 11,897, Monmouth at 11,287, Camden at 9,563, Mercer at 8,526, Morris at 7,674, Burlington at 6,801, Somerset at 5,611, Gloucester at 4,178, Atlantic at 3,920, Cumberland at 3,702, Sussex at 1,429, Warren at 1,422, Hunterdon at 1,273, Salem at 1,028 and Cape May at 981.

Another 320 cases are still under investigation to determine where the person resides.

Demographic Breakdown

The racial breakdown of the record deaths was 54% White, 20% Hispanic, 18% Black, 6% Asian and 2% another race. Murphy has noted the rates in the black and Hispanic communities are running about 50% more than their population in the state. 

In regards to the underlying disease of those who have passed, 56% had cardiovascular disease, 45% diabetes, 31% other chronic diseases, 18% neurological conditions, 17% lung diseases, 15% chronic renal disease, 10% cancer and 14% other. Persichilli has stated most cases have multiple underlying conditions which would push the percentage of 100%.

A census of ages for confirmed deaths shows 48% of deaths are of those 80 year old and up, 31% in the range of 65-80, 16% between 50-65 and 5% under the age of 49. 

Long-term Care Facilities

Health officials noted 159 long-term care facilities are currently reporting at least one case of COVID-19, accounting for a total of 7,755 of the cases, broken down between 4,843 residents and 2,912 staff. 

Cumulatively, 695 long-term care facilities reported a case infecting 24,978 residents and 13,465 staff, for a total of 38,401 cases. 

The state’s official death total will now be reported as those that are lab confirmed, sits at 7,138 on Sept. 16. The facilities are reporting to the state 6,757 residents deaths and 121 staff deaths. 

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