The horrors of the COVID-19 pandemic have ravaged long-term care nationwide. In state after state we are seeing tragic bills come due for our long societal neglect of the elderly and those with disabilities.
For New Hampshire’s long-term care providers, their staffs, and residents, it’s like living in a nightmare. Those providing direct care have long been marginalized by Medicaid underfunding. In nursing homes, 92% of nursing assistants are women, and 45% are 34 or younger. They care for a population that is 63% Medicaid.
The average long-term nursing home resident in New Hampshire is 83, compared to a national average of 79, and we’re one of nine states with the highest proportion of nursing home residents 95-and-older. The risk posed by COVID-19 to the very elderly and fragile is well-known now. Making things harder, emergency life safety restrictions are depriving these residents, and their loved ones, of the social interaction so essential to psychological well-being.
Government’s response must include emergency assistance to long-term care providers – whether they’re providing care in the home, in assisted living or in nursing homes. It is urgent that, like the other major New England states, New Hampshire use a 6.2% emergency increase in the federal Medicaid participation rate to augment payments to keep dedicated caregivers and staff on the job, as well as help procure personal protective equipment (PPE). One analysis suggests the new costs of PPE to keep residents and staff safe might approach $10,000 a day for a 100-bed nursing home.
COVID-19 plays no favorites. For example, an award-winning, family-owned nursing home – rated 5 stars on the federal 5-star system – was one of the first to suffer diagnosed cases. We have had terrible losses to grieve, and we will have more. Like the virus itself, New Hampshire also cannot play favorites in how it meets the funding needs of Medicaid providers doing battle to keep our vulnerable population safe.
In the home setting, beyond the huge number of unpaid family members who do the best they can to provide care to loved ones, 87% of paid home care workers are women. This group of caregivers has often been treated as invisible by policymakers, yet they are also essential. The rare assisted-living facilities that can afford to take the state’s bargain-motel rates for Medicaid suffer too.
As if it were not stressful enough that their wages and benefits have so long been depressed by Medicaid neglect, caregivers must now worry about getting sick themselves.
Dr. Deborah Birx, who is leading the White House COVID-19 response, has stated she wants to see active “testing in nursing homes, both the residents and workers, at all times.” But we do not yet have the tests for that, and, despite temperature screening and other precautions, there is always the risk of asymptomatic carriers.
Gov. Sununu has said he would love to see the day where we have “1.35 million tests for 1.35 million people” but until widespread testing occurs, the average citizen can help. As our heroes – our caregivers and support staff – go out into the community to shop for groceries and other personal needs, the average citizen can help safeguard those receiving long-term care by social distancing, covering one’s face in public and maintaining hand hygiene.
This is an unimaginable time, but also a moment of moral reckoning for us. Precious lives hang in the balance.
(Tom Blonksi is the president and CEO of Catholic Charities New Hampshire. Brendan Williams is the president and CEO of the New Hampshire Health Care Association.)