Senior Care Full Court Press Team Addresses Current Crisis

The Full Court Press Senior Living Team gathered virtually to address immediate concerns around COVID-19 and senior living.

As part of the Full Court Press initiative, the Senior Living Team aims to advance policies to develop a renewed model of senior living. The Team of Jewish Healthcare Foundation (JHF) and Health Careers Futures Board members first met in November, along with outside expert speakers. Recognizing the need for immediate action on the current COVID-19 surges in long-term care facilities, the Team dedicated their first meeting to brainstorming immediate solutions to support facilities and prevent further spread of the pandemic that has disproportionately affected seniors and those in long-term care.

Raising awareness of the issue will be crucial to mobilizing action in the coming weeks, the Team agreed. JHF's new documentary, "What COVID-19 Exposed in Long-Term Care," can act as a vehicle and a window into how the pandemic has ravaged unprepared long-term care facilities. The Team, who were among the first to view the documentary, shared rave reviews of the documentary's quality and its treatment of residents' and workers' stories.

Ken Ho, MD, MPH of the University of Pittsburgh shared the most recent COVID-19 treatment and prevention options for seniors and residents of long-term care facilities, noting that there are now three vaccine candidates showing sufficient efficacy to potentially be approved for use. The Team discussed ways to ensure that long-term care residents and employees will be prioritized to receive a COVID-19 vaccine immediately when it is available, as well as strategies to promote the vaccine's uptake by residents and the long-term care workforce.

A panel moderated by Seniors Team Chair Eric Rodriguez, MD, MPH, Associate Professor of Medicine, Division of Geriatrics at the University of Pittsburgh and geriatrics medical consultant with UPMC, then centered the discussion on immediate concerns about COVID-19 for long-term care and the necessary action for the next few months. Panelists included David Nace, MD, MPH, Chief of Medical Affairs at UPMC Senior Communities; Emily Jaffe, MD, MBA, Vice President and Executive Medical Director at Highmark Home and Community Services, and Molly Langford, MSN, CRNP, Senior Director of Clinical Practice at Genesis Physician Services.

The Team discussed concerns about whether long-term care will suffer funding deficiencies should further CARES Act aid fail to be allocated. Long-term care could receive a further blow if Pennsylvania's Regional Response Health Collaborative Program (RRHCP), for which JHF has been a lead educator, does not receive renewed funding into 2021. Those outside of PA have called the RRHCP a "crown jewel" of state COVID-19 long-term care assistance programs, according to David Nace. The program has connected academic medical centers and health systems throughout the Commonwealth, and it has been instrumental in providing PA long-term care facilities with vital supports (including testing, staffing, education, and resources) during the pandemic. The loss of these resources would be significant if the program is discontinued. "If the RRHC program is not re-upped, Pennsylvania doesn't have a plan to manage outbreaks in long-term care. There is no question about it. We don't have a plan B," Nace said.

Others expressed concerns about testing turnaround times and reliability, staffing, obtaining the necessary resources to keep staff and residents safe, and reimbursement. Speaker Marc Cohen, PhD, Co-director of the LeadingAge LTSS Center @UMass Boston and Research Director of Community Catalyst, shared details on the projected consequences of potential further cuts to Medicaid. Nursing homes are increasingly dependent on Medicaid financing, Cohen noted, and cuts would be highly detrimental to facilities and their residents. Further details on this issue will be shared in a forthcoming JHF-commissioned LeadingAge study, "Making the Case for Long-Term Care Reimbursement In Pennsylvania."

The meeting ended with a discussion of strategic short-term concerns that will need to be advanced at both the state and federal levels to assure that adequate funding and resources are made available during the ongoing and projected upcoming surges of COVID-19. The Team also noted that increased collaboration between health care and aging organizations will be crucial going forward. Moving into the new year, the Team will next meet in January to kickstart their long-term policy discussion about models for senior living.

Read Karen Feinstein's Health Affairs op-ed "What COVID-19 Exposed in Long Term Care" here.