Alarmed by stories of nursing home employees wearing trash bags and reporting to work sick, two committees of the state Legislature Friday approved a package of bills that would improve wages and working conditions and protect frail residents against future outbreaks of the deadly coronavirus.
The Assembly Aging and Senior Services Committee and the Senate Health, Human Services and Senior Citizens Committee approved an eight-bill raft of bills in under 90 minutes with little debate.
It was a departure from the joint three-hour public hearing on Aug. 13 that was tinged with bitterness and tears as people recounted the pandemic’s devastation inside New Jersey’s 678 long-term care facilities.
COVID-19, the disease caused by the virus, has killed 6,700 long-term care residents and 120 employees, according to statistics centers have reported to the state. As of Aug. 9, New Jersey has the second-highest death rate per capita in the nation, behind Connecticut, according to the U.S. Centers for Medicare and Medicaid Services.
“There is no question that New Jersey’s long term care facilities were amongst the hardest hit by the COVID-19 pandemic, and they were also severely underprepared and unequipped for the challenges of this outbreak,” said Assemblyman Valerie Vainieri Huttle (D-Bergen), chairwoman of the Assembly Aging and Senior Services Committee.
“In the face of these tragedies, we must act swiftly to ensure that our long term care facilities have the tools that they need to navigate future emergencies.”
Some of the legislative initiatives were recommended in the recent report by Manatt Health, the consultants hired by the Murphy administration earlier this year to look at the state’s oversight of state’s nursing homes and come up with fixes.
The bills would:
- A4476 – Create a Long-Term Care Emergency Operations Center in the state Department of Health to serve as a centralized command center to respond to future outbreaks in long-term care facilities including state psychiatric hospitals, as well as home health care providers.
- A4547 – Spend $62.3 million for a nine-month Medicaid rate increase that would raise direct care worker salaries and buy personal protective equipment. The bill includes certified nursing assistants and dietary, sanitation and recreational workers.
- A4483 – Allow employees in long-term care to earn paid sick leave. They would be allowed to start using paid time off 60 days after the law is enacted.
- A4479 – Offer hazard pay in the form of a one-time, lump-sum payment to long-term care staff who provided direct care services to residents during the COVID-19 pandemic.
- A4481 – Establish a task force to develop recommendations to improve the safety and quality in long-term care.
- A4007 – Require nursing homes within 60 days of the law taking effect to create an isolation prevention plan to prevent the spread of disease during a public health emergency.
- A4485 – Require the state Health Department and the Office of Emergency Management to dedicate a set amount of personal protective equipment for long-term care centers, home care operators, and group home providers serving people with developmental disabilities. N95s, the most protective of the face masks, is specifically identified as a necessity, Huttle said.
- A4482 – Raise the minimum wage for direct care staff in long term care facilities to $3 higher than state minimum wage, beginning in July 2021. It would also give the Department of Human Services authority to set a minimum “direct care loss ratio” to dictate how much profit is allowed comparing a facility’s revenues and expenses — in particular the amount spent on workers’ salaries.
Lawmakers said the lack of PPE for workers was a huge problem
“They were wearing garbage bags as shield protection. We need to do so much better. It was inexcusable,” Huttle said.
Assemblywoman Holly Schepisi, R-Bergen, a co-sponsor, agreed. The lack of PPE in nursing homes “was such an incredible failure,” she said. “Hopefully we never see anything like it again in our state.
Lobbyists for the long-term industry did not object to the pay raise, noting that many centers already pay above the state minimum wage of $11 an hour. But they balked at state having so much say over how they spend their money.
Theresa Edelstein, vice president for Continuing Care Services at the New Jersey Hospital Association, noted 14 years had passed since the state last examined Medicaid rates — the amount of money the state pays per day, per resident. New Jersey Medicaid reimbursement rates are the third-lowest in the nation, at $208 a day, according to the American Health Care Association.
There are several other bills pending that would give the state health department more tools to scrutinize the operations and financial transaction of long-term care providers, but they were tabled for “technical” amendments, sponsors said. They include A4477, which revises license, operational and reporting requirements; and A4478, which requires the Department of Health to establish a “scaling system” of actions and penalties for violators.
“We wanted to make sure we took our time to get it right,” Sen. Joseph Vitale, D-Middlesex, chairman of the Senate health committee.
Legislation that comes with a price tag must be approved by the Appropriations Committee in each house before going to the entire 80-member Assembly and 40-member Senate. Then, Gov. Phil Murphy must sign the bills in order for them to become law.
Asked about the package of bills during his regular coronavirus briefing Friday afternoon, Murphy said his administration had been “working quite closely” on them with lawmakers and expressed his “broad support.”
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