This Week in Healthcare

NJ Enacts Nursing Home Reforms: New Jersey Gov. Phil Murphy (D) has signed into law several bills bringing reforms to the state’s nursing homes, where more than 6,700 residents and 120 staff have died from COVID-19. The measures include AB 4547, allocating $62.3 million for a nine-month increase in the Medicaid rate to raise the salaries of direct care workers and pay for personal protective equipment; AB 4482, raising the minimum wage for direct care staff at long-term care facilities $3 above the state’s minimum wage starting in July of next year and authorizing the Department of Human Services to establish a minimum “direct care loss ratio” that would determine how much profit could be made in relation to the amount workers are paid; and AB 4476, creating a Long-Term Care Emergency Operations Center in the state’s Department of Health to respond to future epidemics at long-term care facilities. Other legislative reforms were still being considered. (NJ.COM)

NYC Opens Own Lab for COVID-19 Testing: With major lab companies swamped by coronavirus testing demand from all over the country, New York City has opened a lab last week that will prioritize local residents as the city enters an ambitious new phase of reopenings, including public school classes and indoor dining at restaurants.

The new Pandemic Response Lab, located in Manhattan and operated by robotics firm Opentrons, is expected to initially run just a few thousand tests per day, mainly from the city’s public hospital system. But officials say the lab will eventually be able to handle more than 40,000 tests a day with turnaround times under 48 hours, allowing the city to expand its already robust testing system, which assesses the COVID-19 status of over 200,000 people - more than 2 percent of the city’s entire population - each week.

“It will give us more capacity just in terms of sheer numbers,” said Dr. Jay Varma, who advises the city on its coronavirus response. “It will also give us control because this is a laboratory really dedicated to New York City.” (NEW YORK TIMES)

Quarter of AZ Nursing Homes Cited by Feds for Pandemic Missteps: Forty-three Arizona nursing homes - 25 percent of the total number in the state - have been cited by federal inspectors since April for mistakes that could have spread COVID-19. The errors included failing to maintain social distancing among residents, neglecting to sanitize medical equipment and improper mask use by staff.

The cited facilities included for-profit, non-profit and government-run homes. Twenty-six of them had previously been cited for infection-control failings, some multiple times. Understaffing doesn’t appear to have been a contributing factor in more than half of the facilities.

Collectively they reported 277 COVID-related deaths and 1,084 infections among their roughly 3,400 residents. (ARIZONA REPUBLIC [PHOENIX])

Health in Brief

Many Not Cooperating with Contact Tracers in NJ: New Jersey Gov. Phil Murphy (D) said this month that three-fifths of those contacted by the state’s contact tracers have refused to cooperate with them. The governor suggested people were worried about the contact tracers passing along information - especially if it pertained to a party where there was underage drinking - to law enforcement. (ASSOCIATED PRESS)

WA Contact Tracers Falling Short of Goals: According to a report from the Washington Department of Health, the state’s contact tracers have been reaching 49 percent of people who test positive for SARS-CoV-2 within 24 hours and 70 percent of those who have had close contact with an infected individual within 48 hours. Those rates are short of the program’s goals of contacting 90 percent of diagnosed individuals within a day and 80 percent of close contacts within two days. (SEATTLE TIMES)

Search for New Health Department Director Continues in OH: Hours after being announced this month as Ohio Gov. Mike DeWine’s (R) pick to be the next director of the state’s Department of Health, Dr. Joan Duwve withdrew herself from consideration for personal reasons. Duwve was supposed to have replaced interim director Lance Himes, who, in turn, replaced former director Dr. Amy Acton, who left the post in June after coming under criticism from some conservatives for her actions in response to the coronavirus pandemic. DeWine’s office said the search for a new director would continue. (COLUMBUS DISPATCH)

MD Spending $7.5M on New Fast Covid-19 Tests: Maryland will be the first state in a 10-state compact to purchase large numbers of a new type of rapid COVID-19 test for use in places that are prone to outbreaks such as nursing homes and prisons. The $7.5 million needed to purchase the 250,000 rapid antigen tests will come from a grant from the U.S. Centers for Disease Control and Prevention. (BALTIMORE SUN)

NM Targeting Nursing Home Abuse: The office of New Mexico Gov. Michelle Lujan Grisham (D) announced last week that the state was launching a new multiagency effort to prevent abusive treatment of residents at nursing homes and other long-term care facilities in the state. The office said state’s attorney general, state auditor and long-term care ombudsman would be working with health and aging agencies to ensure that abuse complaints are handled promptly. (SANTA FE NEW MEXICAN)

HI Lab Still Not Conducting COVID-19 Tests: A partnership between Honolulu and the University of Hawaii announced in May that was supposed to provide “surge capacity” of 50,000 COVID-19 diagnostic tests by the end of the year still hasn’t resulted in a single test. Delays in the delivery of CARES Act funding and infrastructure setup have kept UH’s John A. Burns School of Medicine (JABSOM) Tropical Medicine Clinical Laboratory from accepting any patient samples. (HONOLULU CIVIL BEAT)

-- Compiled by KOREY CLARK

Politics and Leadership

Lawsuit Temporarily Disrupts WI Absentee Voting Process: Preparations for absentee voting in Wisconsin were thrown into disarray this month when the state’s Supreme Court ordered election officials to stop sending out absentee ballots while the justices considered whether to hear a lawsuit concerning the omission of the Green Party’s presidential ticket from the state’s Nov. 3 ballot. The 4-3 ruling, with the high court’s conservatives in the majority, left open the prospect of the state having to reprint more than 2 million ballots, as many as 378,000 of which had already been mailed to voters, less than two months before an election in a swing state President Trump carried by less than a percentage point in 2016.

But days later, in another 4-3 ruling, this time with conservative Justice Brian Hagedorn joining the court’s liberals, the court determined that Green Party presidential nominee Howie Hawkins and his running mate Angela Walker had waited too long to challenge the state Elections Commission’s disqualification of those candidates from the ballot because Walker had included two addresses on the paperwork she submitted.

“Even if we would ultimately determine that the petitioners’ claims are meritorious, given their delay in asserting their rights, we would be unable to provide meaningful relief without completely upsetting the election,” the majority stated in an unsigned opinion.

The second ruling also vacated the first, allowing absentee ballot mailings to resume. The outcome could help Democratic presidential nominee Joe Biden and his running mate Kamala Harris in November. They stood to lose at least a modest amount of votes to the third-party candidates. (MILWAUKEE JOURNAL SENTINEL, ASSOCIATED PRESS)

Judge Throws Out Challenge to Voting-By-Mail in VT: Five Vermont Republicans, including state Rep. Brian Smith (R) filed a federal lawsuit against Secretary of State Jim Condos (D) this month alleging that his plan to send ballots for the Nov. 3 election to every active voter in the state would deprive them of their individual right to vote and lead to widespread voter fraud. But last week U.S. District Judge Geoffrey Crawford dismissed that suit on the grounds that the plaintiffs lacked proper legal standing.

Crawford rejected the plaintiffs’ contention that the universal mail-in voting plan might disenfranchise them if they failed to receive a ballot in the mail and didn’t realize they had to vote in person on Election Day as a result.

“These are sophisticated voters who have gone to considerable lengths to obtain counsel skilled in election law and to file a lawsuit in federal court,” he wrote in his 11-page ruling. “Of all people likely to be confused about how to vote, these plaintiffs may be last on the list.”

Crawford also concluded that the plaintiffs wouldn’t suffer any more from voter fraud than the rest of the state’s electorate.

“A vote cast by fraud or mailed in by the wrong person through mistake has a mathematical impact on the final tally and thus on the proportional effect of every vote,” he wrote. “But no single voter is specifically disadvantaged.” (VT DIGGER [MONTPELIER], SEVEN DAYS [BURLINGTON])

Politics in Brief

SC General Assembly Expands Absentee Voting: South Carolina lawmakers approved legislation in special session last week that would allow voters to cast an absentee ballot without an excuse in the November election. A witness signature would still be required for such ballots. (WLTX [COLUMBIA])

Judge Orders Limited Expansion of Absentee Voting in LA: U.S. District Judge Shelly Dick ruled last week that Louisiana should increase access to absentee voting for the Nov. 3 election, including by expanding the early voting period and allowing COVID-19 ballot applications but not by completely eliminating the state’s excuse requirement. “Clearly, based on the data and advice from state and federal authorities, the pandemic is ongoing in Louisiana and calls for the implementation of measures to mitigate the risks of appearing in person to vote,” the judge wrote in her decision. (ADVOCATE [BATON ROUGE])

Orioles to Allow Voting at Camden Yard: The Baltimore Orioles announced last week that they will allow a restaurant in Camden Yards Stadium to be used as a voting center on Nov. 3. The news is part of a broader effort by Major League Baseball to encourage voter engagement. (BALTIMORE SUN)

-- Compiled by KOREY CLARK


Herbert Says UT COVID Spike Could Force New Mandates: Utah Gov. Gary Herbert (R) said new health mandates are definitely “on the table” after the Beehive State experienced a sharp spike in new COVID-19 cases.

Over the last week, the rolling daily average of cases grew from 381 to 661 per day.

Herbert said it is imperative for Utahans to adhere to safety protocols if they expect to contain the virus and have their lives return to normal. If not, he said “It won’t make any difference. The pandemic will run wild.”

State Epidemiologist Dr. Angela Dunn expressed specific concern about Utah County, which produced 40 percent of the new infections in spite of only making up roughly 20 percent of the state’s population.

Dunn said parts of Utah County were experiencing infection rates of 1,400 cases per 100,000 people, which she noted “is approximately six times greater than the state’s infection rate and we are on pace to match or exceed infection rates that we have seen in the Navajo Nation and in New York City.”

Dunn further noted that the bulk of those new cases are otherwise healthy young people between 15 and 24. 

Herbert said he was particularly disturbed by the willingness of so many to ignore state health guidelines.

“I’m alarmed by people who ignore health guidelines and those who are out there promoting social gatherings, almost in defiance of the recommendations by our best minds in science and medicine that say, you know, ‘social distancing is an important aspect of how we slow the spread and how we maintain our economy to stay open,’” Herbert said.

Even so, Herbert said he is still reluctant to impose new mandates just yet. The governor said he will be meeting with local and state officials to determine “if the state needs to intervene or the local health department or the state health department on more aggressive approaches.” (KPCS [PARK CITY], KJZZ [SALT LAKE CITY])

Parson Wins Some, Loses Some with MO Lawmakers: Missouri lawmakers last week opted not to override any of the vetoes or bill alterations issued by Gov. Mike Parson (R) this session. But that success did not carry over to Parson’s proposals on violent crime, most of which died as the House abruptly gaveled out on Wednesday.

Parson had called a special session to deal with his proposals, which included a call to allow the state attorney general’s office to intervene in murder cases in the city of St. Louis. Lawmakers, however, rejected that and four other measures on the governor’s list.

Other proposals that failed to gain consideration included a measure to codify a U.S. Supreme Court standard for hearing certain witness testimony, another that would have required judges to at least consider trying every juvenile accused of felony gun crimes as an adult, and a bill that would have enhanced penalties for adults who provide minors with guns.

Lawmakers did endorse Parson’s proposals to end residency requirements for St. Louis law enforcement and other emergency responders and a bill to create a witness protection fund.

Undaunted, Parson framed getting only two of seven proposals as a victory.

“You’re not going to hit a home run every time in this building,” he said. “We’re very content with what we got. Anything we can do to help law enforcement, to help victims in this state to fight violent crime, is a win.” (ST. LOUIS POST-DISPATCH, KCUR [KANSAS CITY], SPRINGFIELD NEWS-LEADER)

Governors in Brief

SC Pols Want Oversight on Gov Emergency Orders: Some South Carolina lawmakers are calling for a more cohesive plan for addressing the ongoing COVID-19 pandemic, including more legislative oversight of Gov. Henry McMasters’ (R) ability to declare a state of emergency. Palmetto State law allows him to issue such orders, but requires legislative approval to extend one. McMaster has issued 13 emergency orders, many of which he has extended without conferring with lawmakers beforehand. (ASSOCIATED PRESS)

Lamont Says CT Mask Violators Will Pay a Price: Connecticut Gov. Ned Lamont (D) said residents who violate state mask mandates or limitations on gatherings will now face fines for their behavior. Lamont said residents who ignore the mask mandate could be fined $100, while attending a large, unsanctioned event will incur a $250 levy. Those who organize a large, unsanctioned event face a fine of $500. (HARTFORD COURANT)

Court Limits PA Gov’s Pandemic Response Powers: U.S. District Judge William S. Stickman IV ruled last week that key components of Pennsylvania Gov. Tom Wolf’s COVID-19 mitigation strategy are unconstitutional, including the decision to temporarily shut down businesses and limit how many people can gather in one place. Wolf said he would appeal the ruling and seek to temporarily block it from taking effect. (SPOTLIGHT PA)

CO Gov Extends Mask Mandate Again: Colorado Gov. Jared Polis (D) issued a second extension of his statewide mask mandate. The extension is for 30 days and began on September 12th. (DENVER POST)

Cooper Okays Kids Returning to NC Schools: Citing an improvement in the Tar Heel State’s COVID-19 metrics, North Carolina Gov. Roy Cooper (D) announced Thursday that school districts can reopen elementary schools for full-time, daily, in-person instruction starting Oct. 5. (NEWS & OBSERVER [RALEIGH])

- Compiled by RICH EHISEN

Hot Issues

Business: The MAINE Labor Commission finalizes rules to implement the nation’s first mandatory paid leave law. Under the measure signed into law by Gov. Janet Mills (D) last year, employees of businesses with more than 10 workers can earn up to 40 hours of paid leave. The Pine Tree State is the first state to require paid leave for use outside of illness (PORTLAND PRESS HERALD). CALIFORNIA Gov. Gavin Newsom (D) signs AB 2143, a bill that allows a Golden State employer to include a no-rehire clause in a settlement agreements with a worker if that employer has previously made and documented a good faith determination that the worker engaged in sexual harassment, sexual assault, or any criminal conduct (CALIFORNIA GOVERNOR’S OFFICE). CALIFORNIA Gov. Newsom signs AB 2049, which expands the methods that a reinsurer can be deemed worthy of issuing agreements that will be credited against a ceding insurer’s liabilities (CALIFORNIA GOVERNOR’S OFFICE). CALIFORNIA Gov. Newsom signs AB 685, which mandates that employers report a COVID-19 outbreak to local public health officials and report known cases to employees who may have been exposed to the virus within one business day (CALIFORNIA GOVERNOR’S OFFICE). The VIRGINIA Senate kills HB 5116, a House-passed bill that would have required employers to provide the equivalent of two weeks of paid leave for employees working 20 hours or more a week (VIRGINIA MERCURY).

Environment: The WASHINGTON Fish and Wildlife Commission adopts two new rules governing hunting in the Emerald State. The first excludes species that don’t currently have bag limits – such as coyotes, bobcats, crows, foxes and raccoons – from being eligible for hunting contests. The second makes it illegal to participate in a hunting contest not permitted by the Washington Department of Fish and Wildlife. Washington is the seventh state to ban such contests, following ARIZONA, CALIFORNIA, COLORADO, MASSACHUSETTS, NEW MEXICO, and VERMONT (ONE GREEN PLANET). The VERMONT Senate approves HB 926, which would establish criteria for mitigating development that breaks up forest ecosystems. The measure, which would also establish a framework for managing the state’s recreational trails, moves to the House (VERMONT DIGGER). The VERMONT House votes to override Gov. Phil Scott’s (R) veto of HB 688, a bill that allows citizens to sue the state if it does not reach certain greenhouse gas reduction goals by 2050. The Senate is expected to follow suit next week (U.S. NEWS & WORLD REPORT).  

Health & Science: CALIFORNIA Gov. Gavin Newsom (D) signs SB 1159, which removes some barriers to access to workers’ compensation for front line workers - health care workers, firefighters and peace officers – who most likely got infected with SARS-CoV-2 at work (CALIFORNIA GOVERNOR’S OFFICE). The 2nd U.S. Court of Appeals rules that NEW YORK state may implement an opioid tax on the manufacturers and distributors of prescription painkillers. The court’s ruling supersedes a lower court’s ruling that overturned the 2018 law (ROUTE FIFTY).

Social Policy: The VERMONT House approves SB 234, which would automatically expunge low-level cannabis convictions involving the possession of two ounces or less. It has returned to the Senate (VERMONT DIGGER). CALIFORNIA Gov. Gavin Newsom (D) signs SB 145, a bill that would allow judges discretion in requiring someone to register as a sex offender if the case involves a man having sex with a minor. The law previously allowed judges that discretion only if the case involved a man having vaginal sex with a female minor (ASSOCIATED PRESS). A federal appellate court rules that convicted felons in FLORIDA must pay all fines, restitution and legal fees before they can regain their right to vote. The ruling from the 11th U.S. Circuit Court of Appeals overturns a lower court’s ruling that would have allowed felons to regain voting rights without conditions (ASSOCIATED PRESS).

Local Front: HAWAII Governor David Ige (D) signs Kauai County Mayor Derek Kawakami’s Emergency Rule 16, which allows the county to adopt a “resort bubble” policy that allows travelers to leave their hotel rooms while under the state’s mandatory 14-day quarantine in order to use approved resort facilities as long as they wear an electronic monitoring bracelet so that the property can track their movements within the established areas (HONOLULU STAR ADVERTISER). 

-- Compiled by RICH EHISEN

News by the Number

147 million: The number of drought-stressed trees killed by bark beetles in the Sierra Nevada mountain range since 2010. The huge number of dead trees has led some researchers to warn of even more massive wildfires in California than those that have already burned more than 3 million acres there over the last month.

500+: The Air Quality Index in smoke-covered Bend, Oregon on September 12, the highest figure recorded anywhere in the world. Like most of the West Coast, The Beaver State has been hit by a monstrous wave of wildfires that have collectively burned approximately 5 million acres across California, Oregon and Washington. 

$12 million: The settlement reached by the family of Breonna Taylor with the city of Louisville, the largest the city has ever reached over an officer-involved shooting. 

4.93 million: The number of confirmed COVID-19 cases in India, second only to the United States. As of September 17th, the U.S. has recorded 6.6 million cases and 196,680 deaths.

128: The number of new COVID-19 cases recorded in Wyoming on September 16th, a new single-day high for the Equality State. The state’s 10-day average of 53.4 total cases is also a new high. 

$860,000: The anticipated savings from New York City Mayor Bill de Blasio’s decision to impose a mandatory one-week furlough of 495 mayoral staff members. The furloughs will come between now and next March.

1.2 million: The number of local government jobs lost since March.

63 percent: The percentage of Millennials and Generation Z in a recent 50-state survey that did not know 6 million Jews were murdered in the Holocaust. The survey, conducted for the Conference on Jewish Material Claims Against Germany, also indicated that 11 percent of respondents believed Jews were responsible for the Holocaust.    

59 million: The number of American workers who performed some kind of freelance work in the last 12 months, an increase of 2 million over 2019. That figure represents 36 percent of the U.S. workforce.

-- Compiled by RICH EHISEN