Tag Archives: hospitals

Coronavirus Policy and Financial Failures Put Nursing Home Workers at Risk

New Orleans       Is the coronavirus a pandemic and economic catastrophe or a hiccup along the road to progress as the President promises?  Who knows?  What already seems clear is that for all of the talk about China not being ready for this, it also seems that America has our pants down around our ankles as well.  Cases in point would have to include nursing home workers and people who are quarantined.

In Washington State many of the deaths so far occurred in what is described as a nursing home.  The Washington State Nurses Association has been critical of the preparations for their people in the home and in area hospitals.  There have been reports that the first arrivals for quarantines at military bases found the medical workers without hazmat suits and other preparations, meaning that they could be Typhoid Mary’s to the general population.  At first glance, none of this has looked like an A-game.

Local 100, United Labor Unions, represents nursing home workers in Shreveport, Napoleonville, and other Louisiana cities, as well as community home workers in Baton Rouge, Lafayette, and elsewhere, all of whom serve vulnerable communities and clients.  We are reaching out to the owners and management to determine a plan for the clients we serve, but also what they have in place to protect the workers that we represent.  We’re worried that what we are going to hear is not going to sound pretty!

Why?  None of the nursing homes are nonprofit.  None of them got any better than a barely passing grade on state inspections in Shreveport.  Workers often complain about shortages of basic supplies, including adult diapers.  Are such healthcare facilities given an inside track for masks, gloves, and other preventive equipment?  Do they have the capacity to quarantine on-site or where?  Some do, and some don’t.  Nursing homes are generally more prepared than most because common viruses like the flu are potential killers for such vulnerable populations, but we worry about how easily we could be overwhelmed.

What happens if workers get exposed?  Is this workman’s compensation eligible?  With limited sick pay provisions, workers invariably will try to stay on the job.  How can they be compensated in these situations?  These are unanswered questions.

Reports from quarantined individuals are similar.  If they are placed in private, rather than government facilities, there are already stories of individuals released from quarantine, but getting “surprise” medical bills.  They were directed to a mandatory quarantine by the federal government.  Why are they personally responsible for the bills, if the government sent them to a private facility?

Is this an area for FEMA relief for both the workers and those quarantined?  FEMA does stand for Federal Emergency Management Agency.  It may not be a pandemic yet, but the coronavirus is absolutely an emergency if you are a healthcare worker or someone caught in a room waiting for the all clear to leave.

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Now is the Time to Press Hospitals for Community Benefit Agreements

New Orleans       Community benefit agreements have increasingly become part of the conversation in cities throughout the country when it comes to major developments at the intersection of private interest and public authority, regulations, and landholding.  Few large cities under assault from major and minor sports interests to support stadium projects have not found themselves engaging in negotiations around community benefit agreements for example.  There are other opportunities though, as we discussed with Enid Eckstein on a recent Wade’s World radio interview that was triggered by her article in Shelterforce advocating for community benefit agreements with hospitals, particularly nonprofits.

Eckstein knows the healthcare industry well, both inside and out.  She was an officer in SEIU’s giant healthcare local, 1199, based in Boston, and more recently has been a researcher and advocate focusing on the role of hospitals and healthcare in communities.  The notion of community benefit agreements or CBAs has gained a lot of traction in Massachusetts in no small part, Eckstein argued, because of aggressive work by the Attorney General of the state in stepping up to regulate and codify the requirements under Massachusetts law that hospitals provide community benefits that were something other than developments of their own programs and self-interest, whether expanding a clinic or marketing their services.

Massachusetts is pathbreaking in this area, partially because they were a leader in providing mandatory health care in the state that was an inspiration for the Affordable Care Act.  The ACA also sets the stage for activity in this area because it requires that hospitals do a community assessment survey of health needs every three years, and mandates that the assessment integrate the community itself into the process.  The amendments offered by Senator Chuck Grassley (R-IA) put the Internal Revenue Service in this play because of his concern that nonprofit, tax exempt hospitals need to prove that they were providing charity care and if not, the IRS should pull their exemption.

The IRS has only recently begun enforcing some of the ACA regulations on penalties for smaller businesses not providing insurance for their workers, so it is unlikely that they are doing much in this area yet either.  Nonetheless, as Eckstein argues from the Massachusetts experience the opportunity is there for organizations of all shapes and sizes to start pushing hospitals to do right and do more.

And, why not?  One of the most compelling examples she offered in her Shelterforce piece occurred in Portland, Oregon, which like so many cities nationally, is facing an affordable housing crisis.  As part of a hospital CBA, $21 million was set aside by the hospital to build affordable housing and that leveraged almost $70 million for the project.

Now is the time to start pressing everywhere for hospitals to open up the doors to community organizations and others to be part of their required community assessment process.  Once in the door, we all need to press for real community benefit agreements while we have the opportunity.

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