This Week in Health Care

FL, VA Prioritize Long-Term Care Facilities in Initial COVID-19 Vaccination Efforts: Florida plans to use strike teams from the state’s Department of Health, Division of Emergency Management and National Guard to administer 21,450 of its initial supply of 179,400 Pfizer-BioNTech COVID-19 vaccines to areas of the state with a “high concentration of [long-term care] facilities,” Gov. Ron DeSantis (R) said last week.

DeSantis said that effort would “supplement” the work of federal Operation Warp Speed partners CVS and Walgreens, which will administer over 60,450 doses of the Pfizer vaccine at long-term care facilities around the state.

“Our top priority is residents of long-term care facilities,” DeSantis said. “They are at the greatest risk and this vaccine could have a positive impact on them, not just protecting them from COVID, but allowing them to return to a more normal life.”

The state’s other 97,500 initial doses of the vaccine will go to five hospitals, including two in South Florida.

West Virginia is also prioritizing residents and workers at long-term care facilities along with healthcare workers in its initial vaccination effort. The state is working with small, local pharmacies, in advance of the launch of the CVS and Walgreens vaccination campaign there on Dec. 21, to vaccinate all long-term care facilities within three weeks. With 40 percent of the state’s pharmacies unaffiliated with chains, state officials believe partnering with local pharmacies will allow them to reach smaller communities.

Marty Wright, head of the West Virginia Health Care Association, which advocates for nursing homes and assisted living communities, said close to 2,000 doses of the vaccine were administered at 18 care centers on Dec. 15, and pharmacies expected to administer 7,000 doses at 48 facilities by the end of that week.

“We’re making progress towards being the first in the nation to vaccinate all nursing homes and assisted livings in our state,” said Wright. (MIAMI HERALD, ASSOCIATED PRESS)

Pandemic Lengthens Wait Time for Psychiatric Care in AR: Before the coronavirus pandemic began, Arkansans seeking inpatient psychiatric care at Youth Home, which offers both inpatient and outpatient mental healthcare services for youth, would be admitted about a week after completing the paperwork. But now, with so many suffering from anxiety and depression during the pandemic, the wait time is at least two months.

“There’s most definitely a wait list,” said Peggy Kelly, chief clinical director for the private, nonprofit provider.

The Arkansas chapter of the National Alliance on Mental Illness also reports issues with mental health admissions.

“It’s horrible actually. Since COVID’s come, a lot of hospitals, they’re not even taking patients unless they go to the ER and have testing,” said Buster Lackey, NAMI-Arkansas’ executive director.

But there was some good news from Youth Home’s Kelly.

“There is a lot of help available on an outpatient basis right now,” she said. “We’re normally able to get people an appointment pretty quickly.” (ARKANSAS DEMOCRAT-GAZETTE)

Health in Brief

OR Releases New Crisis Care Guidelines: The Oregon Health Authority has released new “equity-driven” guidelines for allocating medical resources like beds and ventilators if hospitals become overwhelmed by the coronavirus pandemic.

The state was scrapping its previous guidelines, released two years ago, because of their “potential for perpetuating discrimination and health inequities” against those with disabilities, the elderly and minorities, among others. (OREGONIAN [PORTLAND])

Some Reluctance to Get COVID-19 Vaccine Among ME Nursing Home Residents, Staff: Only 60 percent to 70 percent of Maine nursing home residents and family members are willing to get the coronavirus vaccine, according to an informal poll by the Maine Health Care Association, which represents nursing homes and assisted living facilities across the state. The survey also found that only 60 percent of nursing home staff are willing to get the vaccine. (WGME [PORTLAND])

RI Nursing Homes Still Have to Wait for COVID-19 Vaccine: Although healthcare workers in Rhode Island began receiving coronavirus vaccinations last week, residents and staff of nursing homes in the state won’t start getting vaccinated until Dec. 21 at the earliest. That’s when CVS and Walgreens are scheduled to begin distributing the Pfizer-BioNTech COVID-19 vaccine to such facilities under their partnership agreement with the federal government. (PROVIDENCE JOURNAL)

-- Compiled by KOREY CLARK


Budget and Taxes/Politics and Leadership

Push for COVID-19 Relief for Restaurants in CT: Republicans in the Connecticut House have proposed legislation aimed at helping restaurants and bars that are struggling due the coronavirus pandemic. The legislation would create a $50 million fund to provide grants of between $5,000 and $25,000 to such businesses. It would also delay municipal tax payments for 90 days, suspend food license and liquor permit fees for a year and direct the state’s Department of Economic and Community Development to establish low-interest loan programs for the industry.

“We believe relief needs to be brought to this industry so that they’re here to survive into 2021,” said House Republican Leader-elect Rep. Vincent Candelora. “We want to target our mom and pop stores [with this grant program].”

Candelora said funding for the grants could come from federal CARES Act money.

Rep. Holly Cheeseman (R) also pointed out that neighboring state Rhode Island has provided grants of up to $30,000 to restaurateurs, and Massachusetts has provided grants of up to $75,000.

“This is an immediate need,” she said. “If the CARES Act money is there, we need to use it.”

The GOP is the minority party in both chambers of Connecticut’s General Assembly. But Gov. Ned Lamont (D) has supported grants for the state’s small businesses, and Democratic legislative leaders seem at least open to the Republicans’ proposal.

“Everybody wants to help the restaurants, it’s just a question of how, and how quickly we can do it,” said Rep. Sean Scanlon (D), House chair of the legislature’s finance committee.

He said a lot depends on what happens with the $900 billion COVID-19 relief bill under consideration in Congress.

“They look like they’re finally zeroing in on a deal, and in that deal I do believe there will be assistance for restaurants,” he said. “The question is, is it enough to help the Connecticut restaurants? If it’s not, what do we need to do?”

And in a written statement, House Majority Leader Jason Rojas (D), said: “Expanding grant programs that build upon previous efforts by Governor Lamont to support these small businesses provides us with an opportunity to work on bi-partisan solutions to address the impact that the pandemic has had on operators and their employees.” (HARTFORD COURANT)

OR Employers Hardest Hit by Pandemic About to Get Big Tax Bill: The Oregon businesses that have suffered most from the coronavirus pandemic are about to suffer some more. Unemployment insurance taxes in the state go up when the jobless rate does in order to replenish the fund that pays unemployment benefits. But employers have to pay more when they lay off workers, which has worked fine in normal economic times. But now it means 20 percent of the state’s employers will be responsible for most of a projected $183 million increase in unemployment taxes next year, as well as another sharp rise in 2022. That could mean an increase of several hundred dollars per employee for some businesses.

“Unless we get more federal assistance before spring it’s going to be really, really dire,” said Ryan Sherman, owner of a Portland restaurant that had to lay off all 15 of its employees. “I really want to know why nobody saw this coming and did something about it six months ago.”

The state is looking into doing something about it now, with two potential legislative fixes under consideration, according to Greg Astley, a lobbyist for the Oregon Restaurant & Lodging Association. One of those proposed fixes is using federal CARES Act money to cover some of the employers’ unemployment tax obligation. The other is exempting pandemic-related layoffs from the formula used to calculate those taxes.

“We’re certainly hopeful that this rises to the level of COVID-19 related relief and that legislators take a look at this and agree that this is not our doing, not our fault,” Astley said. (OREGONIAN [PORTLAND])

Budgets in Brief:

COVID-19 Relief on the Way for MD Businesses: Maryland Gov. Larry Hogan (R) announced a financial assistance package for businesses this month. The package includes unemployment tax relief for small businesses - in the form of an exclusion of the 2020 fiscal year in the calculation of their 2021 tax rate - and the forgiveness of $75 million in emergency loans provided to businesses during the pandemic. (BALTIMORE SUN)

OR to Hold Special Session on COVID, Wildfire Relief: Oregon Gov. Kate Brown (D) called for a special session on Dec. 21 to consider a package of coronavirus and wildfire relief legislation. The legislation includes $50 million in aid for tenants, $150 million in assistance for landlords, and $600 for the Emergency Board committee’s account, with $100 million of that sum going toward wildfire response and $400 million toward the pandemic. (SALEM STATESMAN JOURNAL)

--Compiled by KOREY CLARK



Inslee Unveils WA Climate Plan: Saying “the time to act is now,” Washington Gov. Jay Inslee (D) unveiled a new climate change package that focuses on a renewed push for a clean fuels standard and capping some greenhouse-gas emissions as part of his 2021-22 budget proposal.

“This plan will help create jobs, reduce pollution, increase investment in critical infrastructure and help families through these troubled times,” the governor said in announcing the plan.

The proposal would impose a cap on greenhouse gas emissions, electrify more public transportation, set hard goals for carbon reduction in public buildings and require an environmental justice assessment for all of the state’s climate related investments. It would also create a state advisory panel to analyze how those investments impact communities being impacted the most by climate change.

The plan also calls for the state to invest $428 million in these projects, but Inslee said those investments would have a net positive impact on the state’s economy.

“These proposals would reduce nearly 30 million metric tons of emissions by 2030 — a 35 percent reduction from current projections. And these standards and investments — with justice at their core — will grow clean energy jobs in Washington,” he said, adding that the plan would “help create jobs, reduce pollution, increase investment in critical infrastructure and help families through these troubled times.” 

It might be a hard sell, however, to some lawmakers. In June, state forecasters projected a budget deficit through 2023 of over $8 billion. An unexpected uptick in tax revenues has cut that shortfall by more than half, but as House Majority Leader Pat Sullivan (D) said after the governor’s announcement, “We still have problems.”

But Inslee cited a season of disastrous wildfires among the many problems being made significantly worse by climate change. In that way, he likened those negative impacts to the impacts of the COVID-19 pandemic and the similar need to take immediate action.

“People’s tolerance for inaction is gone. People are exhausted having to deal with these climate emergencies because they know these trends will not reverse themselves on their own. We have to take action. And like COVID, climate change is something that is or can be and should be and must be under our control.” (SEATTLE TIMES, WASHINGTON GOVERNOR’S OFFICE, OLYMPIAN)

IA Gov’s COVID Spending Draws Scrutiny: Iowa Gov. Kim Reynolds (R) said she would return $21 million in federal COVID relief funds she spent on a new state computer system.

Reynolds argued in October that the system upgrade was necessary to deal with the pandemic, but the U.S. Treasury countered that the contract with cloud-computing company Workday had been signed months before the pandemic hit the Hawkeye State. The agency rejected her appeal and demanded she return the funds to the state relief fund by Dec. 18th. Reynolds said she would comply, but is still moving forward with spending almost $17 million in relief funds on a different state IT project.

It is not the governor’s only questionable use of COVID funds. A new state report shows Reynolds has used $10 million in relief funds to pay law enforcement salaries, even though officers have played only a small role in the state’s pandemic management. An analysis by the blog Bleeding Heartland showed she has also used relief funds to overcome a $448,000 shortfall in her own office budget. (ASSOCIATED PRESS, BLEEDING HEARTLAND, CEDAR RAPIDS GAZETTE)

Governors in Brief:

NC Gov Moves Sports Betting One Step Closer: North Carolina Gov. Roy Cooper (D) signed an amended gaming compact with the Eastern Band of Cherokee Indians, moving one step closer to making sports wagering legal in the Tar Heel State. State lawmakers approved sports betting at the tribe’s two gaming casinos last year, but that legislation also required an amended gaming compact between the tribe and the state. (CASINO.ORG, PLAY TENN)

CA Gov Orders Thousands of Body Bags: Citing a massive spike in COVID 19 cases and deaths, California Gov. Gavin Newsom (D) said last week he has ordered an additional 5,000 body bags to be distributed in San Diego, Los Angeles and Inyo counties. Newsom said the state has also secured the use of 60 refrigerated storage units in case they are needed for overflow from hospitals and county morgues. The Golden State reported 100,000 new cases in less than 48 hours last week, including a single-day record of 379 COVID deaths. (SACRAMENTO BEE, CALIFORNIA GOVERNOR’S OFFICE)

NV Gov Extends COVID Restrictions: Pointing to its own surge in COVID cases, Nevada Gov. Steve Sisolak (D) said the “statewide pause” he instituted in November to slow the rapid spread of the virus will be extended into January and that a moratorium on most residential evictions will be reinstated. Restrictions in that pause include stricter mask requirements and smaller capacities at restaurants, bars, casinos, gyms, bowling alleys and other areas of recreation or entertainment. (LAS VEGAS REVIEW-JOURNAL)

Walz Loosens Some MN Restrictions: Conversely, with the state’s infection rate slowly lessening Minnesota Gov. Tim Walz (D) announced he will ease restrictions on Gopher State gyms, amateur sports and private in-home gatherings. Indoor restaurants, bars, museums and theaters will remain closed through at least Jan. 10th. (MINNEAPOLIS STAR TRIBUNE)

OR Gov Facing Prisoner COVID Suit: A federal judge ruled last week that a lawsuit alleging Oregon Gov. Kate Brown (D) and other state officials failed to protect prison inmates from the spread of the coronavirus may proceed. U.S. Magistrate Judge Stacie F. Beckerman found that state leaders can face liability claims if they didn’t carry out safety measures according to policies adopted to stem the tide of COVID-19. (PORTLAND OREGONIAN)

-- Compiled by RICH EHISEN


Hot Issues

Business: NEW YORK Gov. Andrew Cuomo (D) signs SB 8298, a bill that bars the sale on public grounds of “symbols of hate,” defined as “symbols of white supremacist and neo-Nazi ideology or the Battle Flag of the Confederacy. Cuomo said the law, which takes effect immediately, will likely need “technical changes” to prevent running afoul of First Amendment free speech issues (NEW YORK POST).

Education: The University of SOUTH CAROLINA announces it will begin charging a fee to on-campus students who do not get monthly coronavirus tests. University trustees said students would receive a warning first, and could also face suspension if they continue to ignore the testing requirement (STATE [COLUMBIA]).

Environment: The WISCONSIN Department of Natural Resources sends Gov. Tony Evers (D) a 25-point plan for addressing the influx of per- and polyfluoroalkyl substances, or PFAS, in Badger State waterways and other natural sites. The so-called “forever chemicals” have been linked to cancer and other serious health conditions in people (MILWAUKKE JOURNAL-SENTINEL). NEW YORK Gov. Andrew Cuomo (D) signs SB 10803, a bill that makes it a felony to illegally dump construction debris or to participate in a dumping scheme. Violators could face up to four years in jail (NEWSDAY).

Immigration: NEW YORK Gov. Andrew Cuomo (D) signs AB 2176, a bill that bars federal immigration officers from surveilling or arresting unauthorized immigrants at Empire State courthouses (NEW YORK GOVERNOR’S OFFICE).

Social Policy: The MASSACHUSETTS Supreme Judicial Court decrees that a Bay State law banning panhandling is unconstitutional, ruling that homeless people can ask for donations on public roads without threat of arrest. The court said that asking for money on a public road poses “no greater threat to traffic safety than engaging in the same conduct for other non-prohibited or exempted purposes, such as gathering signatures for a petition, flagging down a taxicab, selling newspapers or soliciting donations for a nonprofit organization” (MASSLIVE.COM). The Supreme Court of the United States orders a lower court considering a challenge to NEW JERSEY Gov. Phil Murphy’s (D) restrictions on religious gatherings to reconsider an earlier ruling rejecting NEW YORK’S attempt to restrict similar get-togethers. The high court’s decision means the Garden State restrictions will remain in effect for the foreseeable future (NJ.COM). The MICHIGAN House approves SB 1254, a bill that would allow some people with first-time drunken driving convictions to get that record cleared. The House also approves SB 681, which would create a process to automatically set aside certain offenses for youth who stay out of trouble and seal juvenile court records from public view. Both return to the Senate for concurrence (DETROIT FREE PRESS). The OHIO House approves SB 260, which would prohibit doctors from using telemedicine to assist patients with taking two prescription drugs that induce an abortion. It moves to Gov. Mike DeWine (R), who is expected to sign the bill (CLEVELAND PLAIN DEALER).

Local Front: The WASHINGTON D.C. City Council approves Bill 23-965, a measure that would require employers in the hospitality industry to offer laid off workers their jobs back as soon as those positions become available again. The proposal, which requires owners of restaurants, bars, entertainment venues, and retailers that had 50 or more employees as of March 1 — or Dec. 1, 2019 for hotels — to offer reinstatement to workers whose jobs they cut during the health emergency, once their positions reopen, effective Feb. 1, 2021, moves to Mayor Muriel Bowser for consideration (WAMU [AMERICAN UNIVERSITY]).


-- Compiled by RICH EHISEN

News by the Number

$931 billion: The amount wagered on sports in New Jersey in November, the single highest total of any state in a single month to date. The new record surpasses the previous record of $803 million, set by the Garden State only the month before.

130,000: The possible number of New Mexico residents currently collecting unemployment benefits who will receive an extra $1,200 as part of the state’s COVID-19 relief plan.

5,000: The number of people in Los Angeles County expected to be hospitalized with COVID-19 by the time you are reading this. As of Dec. 15th, L.A. County had less than 100 ICU beds available for the 10 million people who reside within county boundaries.

474,790: Pending maintenance and repair orders for the New York Housing Authority, up from the 375,310 pending orders in March. The average number of days to address those repairs has also grown to 224 days, up from the previous average of 156 days. The New York City public housing system is the largest in the nation, with almost 400,000 residents. 

311,993: The number of deaths attributed to the COVID-19 pandemic in the United States as of Friday, Dec. 18th. The U.S. leads the world in total cases – 17,293,160 as of that same date – almost double that of India, which has over four times the population.

-- Compiled by RICH EHISEN