Newsletter

                                                    January,  2004                                                                           

Mark your calendars!  Our next statewide meeting is Saturday,February 21, 2004  from 10:30 - 2:30 at the Lake Superior Room, Library of Michigan,717 West Allegan, Lansing, MI.  Subsequent meetings will be held on April 17, 2004 and June 19, 2004  at the same time and place.  Please plan to join us!!

1.  Sarah Slocum Named New State Long Term Care Ombudsman  – In the late fall, Michigan Office of Services to the Aging Director Sharon Gire named Sarah Slocum as the new State Long Term Care Ombudsman, effective December 1.  Sarah worked for 10 years at Citizens for Better Care as an assistant state ombudsman, spent seven and a half years as the Director of the Medicare/ Medicaid Assistance Program (MMAP), and most recently served as the Associate State Director of AARP Michigan where her responsibilities included facilitating AARP’s long term care initiative.    Sarah attended the last Statewide Campaign meeting in December.  She said she looked forward to working closely with the Campaign and focusing on consumer issues and resident advocacy.   The Campaign extends a warm welcome to Sarah.

          Consumers who seek help from the Ombudsman can still call their local long term care ombudsman office directly or call the state ombudsman’s toll free line: 866-485-9393.   One of Sarah’s first decisions, in response to consumer requests, was to have all calls to the State hotline routed to local offices, instead of to a central office in Lansing, so that consumers can speak directly to local ombudsman staff who are familiar with facilities in their area.

2.  State Considers Permitting Nursing Homes to Hire Feeding Assistants for Residents at Nursing Home Industry’s Request; Campaign’s Objections and Concerns about Residents’ Welfare Cause State to Reconsider Plan and Invite Consumer In-put – In September, 2003, the federal Centers for Medicare and Medicaid promulgated a rule that created a new category of paid worker in nursing facilities called “feeding assistants.”   For the first time since the federal Nursing Home Reform Law was enacted in 1987, federal rules allow paid workers with less than 75 hours of training to feed residents who cannot eat on their own.  States had the option of deciding whether to allow facilities in their state to  train and use feeding assistants. 

          In the late fall, at the request of nursing home providers and with no consumer in-put, the Michigan Department of Consumer and Industry Services began drafting a proposal to permit Michigan facilities to hire feeding assistants.  The Campaign learned of this development by chance in January and immediately alerted the State and the State Long Term Care Ombudsman of several serious concerns with the proposed use of feeding assistants and demanded that consumers have a voice on this issue.  As a result, the state immediately agreed to hold off on the proposed plan and to invite consumer in-put. 

          Of course, the Campaign is very concerned about understaffing in nursing homes and the tragic fact that many residents who cannot feed themselves are malnourished because there is not enough staff to feed them.  Nevertheless, after lengthy discussion,  we decided to join the National Citizens Coalition for Nursing Home Reform, the Center for Medicare Advocacy, and other groups in opposing the federal government’s new rule permitting feeding assistants because we do not think this is the right answer to the staffing and malnourishment crisis in nursing homes. Among are concerns are:

*           Since no additional reimbursement will be provided to pay for feeding assistants, they will likely replace, not supplement, existing staff. Thus, facilities will remain understaffed, but the staff who are present will have less training, fewer skills, and probably lower pay than nursing assistants.

*             Feeding residents who have significant disabilities can be a complex task. Failure to recognize and deal appropriately with some of these health issues can lead to dehydration, malnutrition, aspiration pneumonia, and asphyxiation.

*            The federal rule permits feeding assistants to feed residents in the residents’ rooms and to simply ring the call bell if a problem arises. If a resident is choking and a feeding assistant lacks  the ability to respond successfully to that emergency, residents could die before a more skilled staff person answers the call bell.

  *            Under  the federal rule, nursing homes do not need to check the state’s nurse aide registry            before hiring a feeding assistant to assure an applicant has not abused or neglected residents in            another facility and facilities are not required to report such activities by feeding assistants to            the registry.

*         While nursing assistants must have a minimum of 75 hours of training and demonstrate competency in the areas of the training to be certified, feeding assistants need only 8 hours of  training and  are not required to demonstrate competency before they begin to feed residents.

*              Although feeding assistants are supposed to be single task workers, in chronically understaffed facilities, we anticipate feeding assistants will nevertheless be performing other functions such as transferring and toileting  residents for which they have no training.

*              Allowing workers to focus on only one resident function such as feeding is inconsistent with all the progressive efforts that focus on a holistic approach to care giving. The creation of feeding assistants is a huge step backwards toward treating residents like products on an assembly line instead of people with complex and interrelated needs.

We understand that Citizens for Better Care and the State Ombudsman share many of our concerns and we look forward to working with them to protect residents on this issue. We will be discussing this issue at our next statewide meeting on February 21.

3. State Reorganizes Depoartments and Assigns Nursing Home Oversight to the Michigan Department of Community Health –Governor Granholm has reorganized some State departments and moved the Bureau of Health Systems, which is responsible for licensing and  inspecting nursing homes, from the former Department of Consumer and Industry Services to  the Michigan Department of Community Health. At the December statewide meeting, Campaign members  decided the move created an excellent advocacy opportunity because MDCH’s Director, Janet Olszewski, is widely perceived as smart, sensitive to consumer concerns, and knowledgeable about long term care.  The Campaign is therefore drafting a letter outlining our longstanding concerns with the State’s oversight of  nursing homes and our suggestions for improving these important functions.  We hope to be able to meet with Ms.Olszewski soon.   

          Complaints against nursing homes can be filed by:

1. Calling the toll-free Complaint Hotline, 1-800-882-6006;

2. Mailing or faxing a letter that includes the   name and the address of facility, the nature of the complaint, the date of the incident, the complainant’s name, address, and a daytime telephone number (unless the complainant wishes to remain anonymous) to the Michigan Department of Community Health, Bureau of Health Systems, Division of Operations, Complaint Investigation Unit, P.O. Box 30664, Lansing, Michigan 48909, Fax Number: (517) 241-0093; or by  

3.  Filing a complaint on line at www.cis.state.mi.us/fhs/complaints/onlineform.htm.

4. State and Plaintiffs Settle  MiChoice Home and Community Based Waiver Litigation –       In December, attorneys for the plaintiffs (including the Campaign) and representatives of the State signed the final settlement in Eager v. Engler, the lawsuit challenging the closure to new applicants of the State’s MiChoice program which permits people who need nursing home level of care to receive that care in their own homes instead of in nursing homes. The judge is expected to sign a final Order any day and will retain jurisdiction in case any problems arise in the implementation of the settlement. 

          Under the settlement, the State will, contingent on approval from the federal government, spend an additional $25 million on the waiver program this fiscal year, provide a great deal of information to the public about long term care options including the MiChoice program, create waiting lists for MiChoice applicants, use the same screening tool to determine individual’s eligibility for the  MiChoice program and for Medicaid funded nursing home care, and create a Governor’s Task Force to examine ways to expand home and community based long term care services.  Advocates and consumers seem very pleased with this resolution of the case although there is still far too little funding and too many barriers to allow  all consumers who need long term care to choose  whether to receive it in a nursing home or in their own home.  The Campaign will continue to fight for better long term care options.

5.  AARP honors Campaign Chairperson Nadene Mitcham – On November 1, 2003, AARP Michigan held an elegant banquet to recognize seniors who are exceptional  volunteers. Among the honorees was our own Nadene Mitcham who was honored for her incredible contributions to the Campaign as well as her many other charitable  activities.  Congratulations, Nadene!!

6.  Thanks so much to our recent donors – Denise Bryant, in memory of Catherine Hunt; Elaine Weingarden; Eva Redwine; and Danny Mitch.  Please keep  those contributions coming by sending donations to: The Michigan Campaign for Quality Care, c/o  Chairperson Nadene Mitcham, 34216 Fountain Blvd., Westland, MI 48185.  Thanks!!

 

7. The National Citizens Coalition for Nursing Home Reform (NCCNHR) Needs Your Help Now!  – NCCNHR in Washington, D.C. is the only national voice for nursing home residents. During the past 29 years, the respected, dedicated, and determined staff of this small but remarkable organization have made an enormous difference in the lives of long term care residents and their families.

       It was because of NCCNHR's ceaseless efforts  that Congress passed the landmark Nursing Home Reform Law in 1987 and NCCNHR continues to fight to make the promise of the law a reality.  Every day, NCCNHR works on issues including effective enforcement of state and federal law governing long term care, improved staffing of long term care facilities, access to the courts for those harmed in nursing homes, and a host of measures that will improve the quality of life and care for residents of long term care facilities.  Moreover, NCCNHR answers thousands of questions every year from state and local long term care ombudsman, citizen advocacy groups like our Michigan Campaign for Quality Care, and consumers.  Finally, it provides superb and authoritative  newsletters and publications and sponsors an extraordinary annual conference.

   In recent years, NCCNHR has put far more energy into its substantive work than into fundraising and efforts to secure its own future. As a result, it faces very tough financial times and has already had to lay off a significant number of staff.  While NCCNHR's excellent leadership and active Board are working to improve NCCNHR's financial situation and steer the organization to a more secure future, it  needs your help now!     

  You can help NCCNHR in several ways:

1.      You can donate on line at www.nccnhr.org and you can make your tax deductible donation in memory or in honor of someone.  You can also mail a donation to NCCNHR, 1424 16th Street, NW, Suite 202, Washington, D.C. 20036-2211 or consider making a bequest to NCCNHR in your will.

2.  You can join NCCNHR as an individual member fora modest fee:  $2 for residents, $10 for students and nursing assistants, $25 for persons age 65 and older; and $40 for others.  With membership, you will receive NCCNHR’s newsletter, a reduced registration fee at the annual conference, and a 10% discount on NCCNHR’s excellent publications.

3.  You can purchase NCCNHR Publications including information on staffing, family councils, resident rights, and getting good care.  See NCCNHR’s website, www.nccnhr.org for information on prices and ordering. 

4.  You can tell someone you know about the importance of NCCNHR and ask them to help NCCNHR in any way they can!  Spread the word!  We need NCCNHR and NCCNHR needs our help!