Senate bill would create advisory committee on protecting seniors during emergencies

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Sen Marco Rubio (R-FL)
Sen Marco Rubio (R-FL)

A 15-member panel would advise local, state and government officials on how to prepare and care for older adults during emergency situations under a bill introduced Tuesday by four senators.

The introduction of the Protecting Seniors During Disasters Act follows an incident, captured in a photo that went viral on social media, wherein residents sat waist-deep in water for hours at a Houston-area assisted living community during Hurricane Harvey before they were evacuated, as well as the death of nine residents of a Hollywood, FL, rehabilitation center after Hurricane Irma knocked out the facility's air conditioning.

“Not only has the tragedy in Hollywood left wounds across the state of Florida, but it has exposed other examples of potential mismanagement at assisted living facilities in the state,” said Sen. Marco Rubio (R-FL), who introduced the bill with Sens. Bill Nelson (D-FL), Susan Collins (R-ME) and Bob Casey (D-PA). All are members of the Senate Special Committee on Aging, of which Collins is chair and Casey is ranking member. “This bill is a necessary step in preventing similar tragedies in the future and ensuring Florida's seniors are taken care of during natural disasters,” Rubio added.

Argentum CEO: Preparedness efforts must be clear, collaborative

“States that are the most successful in integrating the needs of seniors in their emergency preparedness plans are those that offer clear, collaborative efforts between their emergency management and health agencies, and long-term care providers,” Argentum President and CEO James R. Balda said in written comments submitted for Wednesday's hearing of the Senate Special Committee on Aging.

Assisted living communities in each state are required to have emergency management plans in place for natural disasters and other emergencies, he said.

“Professionally managed senior living communities are structured to cope with the distinct needs that older adults pose in the face of natural disaster,” Balda said, adding that staff member familiarity with residents' care plans offer a benefit for residents over shelters and other relief organizations.

Senior living communities affected by Hurricanes Harvey and Irma put into action lessons learned during 2005's Hurricane Katrina, he said. “During the recent hurricanes in Florida and Texas, wrist bands with names and community were immediately placed on resident wrists along with medication identification. Families were notified where their loved ones would be taken in case of evacuation,” Balda said.

Members of the organization are in discussions with officials in those two states to learn more about regulations that have been effective, he said.

“For example, Texas in 2011 passed a law prioritizing assisted living communities for restoration of electricity following an extended power outage. Assisted living is not on such a priority list in Florida,” Balda said. “We must have thoughtful discussion about the role for generators, adequate fuel supply and safety considerations such as significant fuel storage on the site of a caregiving community. Several of our member companies were unable to access fuel to power their community generators and buses post-Hurricane Irma and searched for gas as far away as Maryland and Tennessee.”

Read the entire letter here.

The bipartisan bill would amend the Public Health Service Act to require the secretary of Health and Human Services to establish a National Advisory Committee on Seniors and Disasters, made up of federal and local agency officials as well as nonfederal healthcare professionals with expertise in disaster response.

Once established, the panel would be charged with providing guidance to local, state and federal officials on how to better prepare seniors for “all-hazards emergencies,” how to better evaluate their health needs during such emergencies and what activities should be carried out when such emergencies are declared.

The advisory committee would be required to meet at least twice a year and would disband Sept. 30, 2021.

The legislation is headed to the Senate Committee on Health, Education, Labor and Pensions for consideration.

Casey discussed the bill Wednesday at a committee hearing on the topic of disaster preparedness and older adults.

“This is a good, bipartisan bill, and we should pass it,” he said, adding: “That's one thing that we can do together to better plan for and respond to these challenges in the future.”

A witness at the hearing, Paul Timmons Jr., CEO and president of Portlight Inclusive Disaster Strategies, proposed the establishment of a National Center for Excellence in Inclusive Disability and Aging Emergency Management.

“The initial focus of the center should include community engagement, leadership, training and exercise development, evacuation, sheltering, housing and universal accessibility,” he said, suggesting a five-year, $1 billion budget.

More oversight for assisted living?

Hearing witness Kathryn Hyer, Ph.D., M.P.P., a professor and director of the Florida Policy Exchange Center on Aging at the University of South Florida, said that assisted living communities need more direction regarding their readiness for emergencies.

“Assisted Living communities require more disaster preparedness oversight than they currently receive,” said Hyer, who is a member of the Center for Excellence in Assisted Living Advisory Council. “We know older adults and disabled people want care in the community in less-restrictive environments. Nevertheless, assisted living communities routinely accept patients that would only have received care in a nursing home a decade ago. Waiver payments for residents with Medicaid have also increased, thereby making the federal government an interested party in assisted living regulations. Currently, we don't even know whether a particular Medicare-Medicaid patient resides in an assisted living facility. This inadequacy in disaster response must be rectified.”

Hyer said she was “proud” of Florida Gov. Rick Scott's emergency rules requiring assisted living communities and nursing homes to obtain generators and enough fuel to enable them to sustain operations and maintain a temperature of no higher than 80 degrees for at least 96 hours following a power outage. The rules were issued Sunday following the aforementioned reports of deaths of residents of the Rehabilitation Center at Hollywood Hills.

She recommended that assisted living communities and nursing homes make their emergency plans available to residents and their families before move-in; that evacuation plans consider storm size and severity as well as the ability of buildings to withstand wind and storm surge, and residents' needs; that facilities be built to enable sheltering in place, in case doing so is necessary; that facilities not be built where regular flooding is a risk; and that legal protections be considered for facilities that abide by regulations and provide care during disaster scenarios.

Claims data can help, witness says

Witness Karen DeSalvo, M.D., M.P.H., shared her experiences working as health commissioner of New Orleans from 2011 to 2014.

Digitized health records, she said, can help providers access information about the health conditions, medications and more of those affected by natural disasters and other emergencies, a capability that is especially important with older adults, who are more likely to have multiple chronic conditions and complex medication regimens.

DeSalvo, who was acting assistant secretary for health and national coordinator for health information technology at HHS after serving as health commissioner in New Orleans, also discussed a 2013 New Orleans pilot program using Medicare claims data, which proved 93% accurate in identifying individuals with electricity-dependent durable medical equipment so their needs could be prioritized during responses to emergency situations. Information was securely relayed to a local health department, she said.

“Of the 611 people that the claims data had identified in the New Orleans community, only 15 were on our medical special needs registry,” she said.

The effort, since named emPOWER, now is available through HHS to help first responders' planning and response actions for events such as hurricanes and tornadoes and smaller-scale emergencies such as boil water advisories, DeSalvo said.

“The reach of a tool like emPOWER should be expanded to a broader group of at risk individuals using data from Medicaid and private payers,” she said.

Watch the Senate Special Committee on Aging hearing here:

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