The Rhode Island House of Representatives passed a resolution last week creating a commission to assess the status of nursing homes, effectively side tracking Senate-approved legislation that would require nursing homes to provide 4.1 hours weekly of direct care per resident.
The state Senate passed the Nursing Home Staffing and Quality Care Act on July 16, which called for 4.1 hours of direct care per week with each resident in a nursing home. The House didn’t take up the legislation, but instead passed a resolution to form a commission to study nursing home care quality, reimbursement, staffing, the financial condition of nursing homes, employee recruitment and retention.
As this resolution calls for a House commission and not a joint one, the Senate does not need to approve it. However, the House would have needed to approve the Nursing Home Staffing and Quality Care Act because the Senate did not make it Senate-exclusive internal legislation.
The commission will hear testimony from different groups such as CNAs and nursing home owners this fall, as well as study what other states are doing for nursing homes. The commission will report findings by April 15, 2021.
“Rhode Island’s nursing homes are facing tremendous challenges,” House Majority Leader Joseph Shekarchi said in a press release from the State House. “COVID-19 has placed their residents and workers in potential danger, Medicaid reimbursement has been dramatically reduced, and it is difficult to hire and retain the necessary amount of staffers to deliver the care that patients deserve. This is a complex issue that needs to be studied and addressed so that the nursing homes, their patients, and their staff are properly supported and fully operational.”
Commission members will include three House members, the president of the Rhode Island Health Care Association, the Service Employees International Union (SEIU) State Council Director, the director of the Rhode Island Executive Office of Health and Human Services, the director of the Rhode Island Department of Health (RIDOH), the director of the Rhode Island Department of Labor and Training, the executive director for the Rhode Island Partnership for Home Care, the president of the Hospital Association of Rhode Island, the president of Lifespan, a member of the public, an administrator of a not-for-profit nursing home, an administrator of a for-profit nursing home and a registered nurse who is licensed and employed in a nursing home.
House of Representatives Communications Director Larry Berman said that the House version of the Nursing Home Staffing and Quality Care Act did not make it past the House Finance Committee.
“The House finance meeting on the bill lasted several hours with a lot of compelling testimonies from nursing home workers who felt that 4.1 hours of care was needed and nursing home owners and industry leaders who say nursing homes will be put out of business,” Berman said. “So there’s a lot of strong opinions on both sides. That’s why we felt no consensus could be determined this year so we can reach a compromise for next year.”
Dist. 20 Rep. David Bennett, a co-sponsor for the Nursing Home Staffing and Quality Care Act in the House, said that he and other supporters had hoped to create a compromise, but said those opposed his bill did not seem interested in negotiating.
“I don’t think we need to study it anymore than it’s already been studied,” Bennett said. “It needs to be fixed, especially because the coronavirus has made such an impact on nursing homes. Seventy-nine percent of COVID deaths in Rhode Island have been connected to nursing homes. Now it is time to help those people, patients and staff. As a registered nurse myself, I do not support [the commission].”
Some of those who supported the Nursing Home Staffing and Quality Care Act feel a study would only delay reforms that need to be addressed during the pandemic.
“Even before we had this pandemic that we’re going through now, we knew we had issues with nursing homes,” said Providence Sen. Ana Quezada, who cosponsored the Senate version of the bill. “Many people were not able to do the work that the elderly need because they had too many patients. I think with COVID it made the issue an emergency. We owe the elderly time. I think they need to find information from family members, the people who work there, the people who see what’s going on in nursing homes. But if it’s what they decided, there’s nothing we can do.”
Berman countered that the House would be unable to get the bill passed before the legislative session ended.
“We get it, but we want to have enough time to work on it in order to enact legislation in the next legislative session,” Berman said. “ I don’t think the date is that important because we’re not going to be able to reach a consensus before then. We’ll be doing the budget in August, but other than that the legislative business is pretty much wrapped up.”
Scott Fraser, president of the Rhode Island Health Care Association, will be a member of the commission. He supported its creation because it would address more than just the staffing issues presented in the Nursing Home Staffing and Quality Care Act.
“We’re supportive of the commission because what that will do is study all aspects related to nursing homes, it won’t just be the staffing issues,” Fraser said. “It’ll address Medicaid funding and the financial situation of nursing homes as well as staffing.”
Adanjesus Marin, an organizer for SEIU, felt that the commission did not have enough representation of certain groups.
“The commission is dominated by employers and has zero representation from seniors, advocacy groups or groups for people with disabilities,” Marin said.
Multiple nursing homes have seen some of their workers go on strike due to contract demands, including a request for 4.1 hours of direct care. Marin said that a protest last Thursday at the State House drew about 150 supporters.
“We will continue to advocate for fixing the staffing situation for all Rhode Island nursing home residents, but also as a health care union we have the unique ability to negotiate in our contract for our residents,” Marin said.
RIDOH will be a part of the commission, but Annemarie Beardsworth, a former RIDOH public information officer filling in for the current public information officer Joseph Wendelken on Monday, said that RIDOH’s main job is supporting whatever legislation comes out of the General Assembly regarding health.
“Our role is oversight, so whatever the folks across the street feel is what we go with, and we’re happy to help with that,” she said. “We fully support the committee and we are happy to be an active part of the discussion and contribute our expertise.”