Last week, the Florida Health Care Association (FHCA), which represents almost 700 nursing homes and assisted living facilities across Florida, released its 2021 legislative priorities for long term care.
Topping the list of priorities are protecting the 2020-2021 Medicaid funding increase, enacting COVID liability protections for long term care, and addressing long term care centers’ workforce challenges by making the Personal Care Attendant Program permanent.
Florida’s long term care providers have faced challenges during the COVID-19 pandemic while protecting their residents, who are especially vulnerable to COVID-19 due to advanced age, underlying medical conditions, and communal living arrangements.
Throughout the crisis, long term care providers continued to adjust their practices as they worked through a multitude of obstacles, including personal protective equipment (PPE) shortages, lack of rapid and adequate testing, and guarding against an individual’s ability to spread the virus without signs or symptoms.
Personal protective equipment, infection control supplies, and overtime and heroes pay, along with physical plant upgrades to mitigate spread, represent significant cost increases for providers. Those increased expenses are exacerbated by a 15 percent drop in occupancy levels resulting from fewer elective surgeries and lack of admissions. Prior to COVID, Medicaid underfunded the cost of nursing center care by $13.79 per patient per day (over $337,000 per center annually); today, that funding gap continues to widen.
While Federal CARES Act funding has helped with some COVID-related expenses, more assistance is needed as the pandemic continues. FHCA will be urging lawmakers to protect the $105-million Medicaid funding increase in the state’s 2020-2021 budget to ensure that residents continue receiving the high-quality long term care they expect and need.
The COVID-19 pandemic has also created an environment ripe for opportunistic litigation. FHCA is advocating for COVID liability protections for long term care to ensure that providers can continue to operate and recover from the pandemic and keep their resources focused on resident care needs.
“Caregivers were left to make clinical, life-saving decisions in the most difficult of circumstances,” said Mel Beal, a spokesperson for Facility Support Company and a Florida Health Care Association Board Member At Large who testified on Thursday as part of a panel discussion on COVID-19 liability protection before the House Health and Human Services Committee. “Without protections, I fear the liability risks will divert precious resources from resident care and send a dangerous message to the health care heroes on the front lines – that those clinical, life-saving decisions they made to safeguard our residents will be used against them.”
“Our health care heroes on the frontlines showed up every day, putting themselves in harm’s way to protect their residents. Our long term care facilities deserve liability protection to prevent opportunistic lawsuits that would exacerbate their already strained budgets and strip them of the vital resources needed to continue keeping residents safe,” said Emmett Reed, the FHCA’s executive director.
Workforce recruitment and retention is another pressing challenge confronting long term care providers today, and FHCA will be advocating to make the Personal Care Attendant (PCA) program permanent to support nursing centers’ direct care staffing needs.
The Agency for Health Care Administration approved the PCA program in the early stages of the pandemic last March, to give nursing centers additional staff to meet residents’ care needs while also meeting minimum staffing requirements. The program expands the long term care workforce by creating a pathway for individuals to learn the skills to become a certified nursing assistant (CNA) and gives out-of-work Floridians an entry point into the long term care profession.
The PCA Program has shown proven success since it was established, with over 1,000 individuals joining the long term care workforce as PCAs to date. Many have passed the certification exam or are awaiting their test date to advance into the CNA role. However, the program will expire when the COVID-19 State of Emergency ends unless the Legislature makes it permanent.
“This is a time when we should be focused on protecting the long term care sector, which was more challenged than any other, and redoubling our efforts toward workforce recruitment, training and retention, appropriate funding and substantive reforms that will ensure centers can continue delivering high-quality care,” Reed said.
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