Fri July 17 COVID-19 Update from Senator Lela Alston

Friday July 17, 2020

COVID-19 & Long-Term Care Facilities;

The Eviction Moratorium

Dear Friends,

Today’s COVID-19 update focuses on our long-term care facilities (LTC) and the extension of Governor Ducey’s eviction moratorium—two issues that affect many people in multiple ways.

To provide current information concerning our LTC’s and their challenges in keeping residents and staff safe during the pandemic, I reached out to Dave Voepel, Executive Director of the AZ Healthcare Association, Dustin Schaffer, Executive Director of Haven Health in Scottsdale and AZ AARP. I am particularly excited to share Haven Health’s information about the Certified Nursing Assistant (CNA) program that Haven Health is launching and AARP’s helpful list of questions everyone with a loved one in a LTC should be ready to ask.

Governor Ducey’s eviction moratorium was scheduled to end on July 23, 2020. In his July 16 press conference, Governor Ducey announced the moratorium will be extended to October 31, 2020 and new funding for households in need. This newsletter provides information about the funding and community partners helping with distributing the funds.

This is a packed newsletter, so let’s get started…..

As the Executive Director of AZ Health Care Association (AHCA), Dave Voepel is one of AZ’s most respected voices in LTC. The organization is the state’s largest professional LTC association and advocacy organization, representing skilled nursing facilities and assisted living communities. AHCA member facilities care for more than 18,000 of Arizona’s elderly citizens.

I asked Dave about the struggles that LTC’s are contending with as we battle to level the COVID-19 curve.  What are the signature issues that need to be addressed to make residents and staff safe?

Long term care is struggling with increased numbers of COVID-19 cases, which is a direct reflection of the rise in cases throughout Arizona. Baseline testing in skilled nursing facilities has been completed, but there is no further funding to continue testing. ADHS is expected to start a testing initiative in assisted living communities; assisted living communities are especially vulnerable because of a lack of Personal Protective Equipment (PPE) and the growing high acuity of residents. Our signature issues in long term care continue to be:

1) Overall funding, considering reimbursement has been behind costs for decades.  In addition, we are advocating for increased funding for ongoing testing in both nursing homes and assisted living;

2) The increased cost and limited availability of PPE, especially in the assisted living world;

3) The challenges we face with workforce development and the ability to recruit and retain both clinical and frontline workers in the face of this pandemic.

How is AHCA working with members to get the supports they need on state and federal levels?

AHCA is working collaboratively with Governor Ducey’s office, the Arizona Department of Health Services and the AHCCCS administration to secure state and federal funds to ensure the financial well-being of LTC facilities during this crisis. We believe more direct funding must be allocated to fight this battle as the cost of managing COVID -19 continues to accelerate. We need these dollars for covering the increased workforce costs, PPE and testing. We also have fewer Medicare rehab patients since elective surgeries have been reduced and our “skilled” census is suffering. So, we have less revenue coming in and higher costs for our current residents who have complex medical conditions and are targets for COVID-19.  It is a perfect storm. AHCA is working to document these needs and advocate for needed state and federal assistance. It is our top priority. We are also fighting to ensure new regulations imposed during this pandemic are reasonable and not duplicative. We need all hands-on deck to fight the virus and additional administrative burdens should not be imposed at this time.

Haven of Scottsdale—A Boots on the Ground Perspective

Dustin Schaffer is the Executive Director of Haven of Scottsdale, one of Haven Health Group’s skilled nursing facilities (SNF). I met Dustin earlier this year during a healthcare provider lobby day at the capitol and was very impressed with him and the work Haven of Scottsdale is doing. I asked Dustin to provide information about Haven of Scottsdale’s CNA training program, as well as information about Haven of Scottsdale’s efforts to keep staff and residents safe during the pandemic and he had a lot to say. (Photo of Haven of Scottsdale team)

 Haven Health’s new CNA training and certification program:

SNF’s face a unique challenge when hiring CNA’). As the eyes and ears of the facility, CNA’s arguably have the hardest job, as they are responsible for providing all assistance with daily routines. Statistically, CNA’s receive lower wages, endure more injuries and are among the highest in turnover. Embracing the challenge during this pandemic, Haven Health, the parent company of Haven of Scottsdale, has supported the Community’s efforts to become the 6th of 17 Haven properties which offer a CNA Training Program. The 5-week, online, interactive program is certified through the Board of Nursing and ultimately provides an opportunity for individuals to become a certified nursing assistant and start their career without any costs to the learner. After the online portion of the curriculum is completed, the students will have a normal clinical rotation at the facility and then finish with final exams.

Haven’s success in keeping facilities COVID-19 free and/or reducing the spread:

Keeping resident safety as our number one priority, Haven has had early success at preventing COVID-19 from entering and/or spreading throughout their properties. Haven’s Leadership encouraged neighboring Haven properties to collaborate; with one facility accepting new hospital admissions while the other sheltered in place. Haven secured PPE in early March and provided employees with N95’s and cloth coverings. We took action to restrict visitation, construct quarantine units and update infection control policies and procedures based on new information from CMS and the CDC. Education, disinfection and social distancing has become second nature. As COVID testing occurred, positive asymptomatic cases became more prevalent. Haven of Scottsdale is proud to remain COVID-19 free at the time of this article.

Challenges and the Emotional toll COVID-19 isolation has on residents:

For many residents, the precautions they have to take have become a hard concept to comprehend. Nearing 5 months of restricted visitation, group dining and activities, there is concern that residents are losing hope. Haven caring professionals have made it their mission to keep our residents engaged and happy. Examples of such efforts include our Mother’s Day Family Car Parade, decoration contest and Christmas in July.

COVID-19 challenges that Haven Health is confronted with:

Staff:

The ongoing challenge has been finding coverage for staff who fall ill or have been exposed to COVID. Depending on the circumstance staff must remain home for an undetermined time. The average wait time for COVID lab results are 11 days, causing additional pressure to this staffing challenge.

Family members:

Due to risk of potential exposure, family members are unable to visit inside the SNF and, unfortunately, continuous media coverage has caused many families to become fearful. Haven has made it a priority to stay connected by scheduling virtual visits through our iPads, allowing building side window visits, and providing phone updates to calm the nerves of our resident’s family members.

COVID-19 is a unique challenge, but with a commitment to infection control perfection, adaptability after new information, solid communication, and a healthy dose of laughter, we will overcome this pandemic, together.

If you would like additional information about Haven of Scottsdale’s CNA program, reach out to Dustin at dschaffer@havenhg.com.

AARP’s Questions Everyone Should Ask

Arizona is fortunate to have a strong AARP and they have been diligent in their advocacy for transparency and testing in our SNF and LTC’s during the pandemic. AARP’s list of questions that everyone who has a loved-one in a SNF/LTC should ask is one to keep and share. Thanks to Executive Director Dana Kennedy, Sr. Program Specialist Brendan Blake and Communications Director Steve Jennings for leading the exceptional AZ AARP staff and volunteers.

The Eviction Moratorium Extended

At Governor Ducey’s July 16 press conference, he announced that the eviction moratorium, due to expire next week, would be extended to the end of October. The governor also added needed funds to programs supporting property owners and renters. This action is a relief to the many households impacted by COVID-19 and one the House and Senate Democrats have been advocating for. Jeremy Duda’s article in today’s Arizona Mirror details the governor’s July 16 press conference, the extension of the eviction moratorium and the new funding for those at risk of eviction. The link to the article is here and I encourage you all to read it.   https://www.azmirror.com/2020/07/16/ducey-extends-covid-19-eviction-moratorium-until-october/

As of July 10, 17,804 households applied for rental housing assistance, but only 1,177 applications have been approved, at an average of $949.27 in rental assistance per household. Arizona has more than 950,000 in rental housing units and the multi-housing industry estimates that 1-3% of rental households are most at risk of getting evicted. Statewide, 9,500 – 28,500 households would be impacted by the eviction moratorium expiring next week.

The Arizona Multi-Housing Association (AMA) has compiled information about government agencies and community partners who are providing supports to those at risk of eviction. The attachment below provides information about assistance throughout the state and I am including links for Maricopa County and Phoenix. Thanks to AMA for providing this valuable list of resources that I know everyone will want to save and share.

According to AMA, rental assistance has been very slow to deploy, however things are starting to move in a positive direction.

City of Phoenix rental assistance started accepting applications last week through 4 of their 11 partners and the remaining 7 partners should be available soon. Maricopa County is going to start a soft launch of their program on July 16th.  Pima County is set to vote to allocate $15M to towards eviction prevention, rental and utility assistance while Tucson has up to $8M available. The state and local governments combined have $128 M already dedicated or available to be used towards eviction prevention, rental and utility assistance, but the funding assistance needs to get the residents most in need.

COVID-19 RENTAL ASSISTANCE RESOURCES

($128,549,726 TOTAL STATEWIDE)

AZ DEPT. OF HOUSING ($5,000,000 AVAILABLE, $33,550,000 AVAILABLE THROUGH COVID-19 RELIEF FUND – to date only $250,000 dedicated to rental assistance)

HOW TO APPLY:

WEBSITE: https://housing.az.gov/general-public/eviction-prevention-assistance

PHONE: Dial 211, press 6 for COVID-19, press 1 (English) or 2 (Spanish), press 5 for Eviction Prevention

REQUIREMENTS/DETAILS LIMITATIONS
The following supporting documentation is required to be submitted electronically:

  1. Copy of your current lease/rental agreement
  2. Paystubs or other documentation of your monthly income pre-COVID 19
  3. Paystubs or other documentation of your current monthly income
  4. Copy of your Driver’s License or State Issued ID

 

If you are unable to provide any of the above documentation, would like to explain any unique circumstances or possibly request a waiver, upload a short letter under “Other” describing your situation or why you are unable to provide the information. Some applicants, such as those that are self-employed and do not have pay stubs, may find that submitting bank statements is helpful in documenting a loss of income (pre and post COVID-19).

Eligibility is restricted to applicants with income levels at 100 percent of the area median income adjusted for household size (see chart here) and varies by county.

Applicants will be responsible for paying 30% of the total current gross monthly income of the household for rent; households with rent payments that are at or below 30% of their total gross monthly income will not be eligible for assistance.

Income received in the month prior to the month for which you seek assistance (e.g., March gross income for April rent due.) will be annualized (e.g., $1,000 in gross income would be annualized to $12,000), including any earnings, Unemployment Benefits, and Stimulus Funds you received from the federal government.

MARICOPA COUNTY ($34,400,000 AVAILABLE)

HOW TO APPLY:

WEBSITE: https://www.maricopa.gov/5526/Apply-for-Eviction-Prevention

PHONE: Dial 211, press 1 (English) or 2 (Spanish), press 1 for Emergency Rental Assistance

PHOENIX ($25,000,000 AVAILABLE)

Apply directly through the partners listed below. 

Wildfire is coordinating the efforts for City of Phoenix

WEBSITE: https://wildfireaz.org/about/covid19/#toggle-id-6

PHONE: 602.604.0640

FOUNDATION FOR SENIOR LIVING

City of Phoenix Partner

WEBSITE: https://www.fsl.org/rent-mortgage-and-utility-assistance-for-those-impacted-by-covid-19/

PHONE: 602-285-0505 ext. 180

TRELLIS

City of Phoenix Partner

WEBSITE: https://trellisaz.org/phoenix-cares-grant-for-those-affected-by-covid-19/

PHONE: 602-258-1659

St. Vincent de Paul

City of Phoenix Partner & State of AZ Partner ($250,000)

WEBSITE: https://www.stvincentdepaul.net/programs/homelessness-prevention

PHONE: 602-261-6883

Lutheran Social Services of the Southwest

City of Phoenix Partner

WEBSITE: https://www.lss-sw.org/get-help#rent

PHONE: 480-654-4539

Final Thoughts

The number of homeless community members who are setting up make-shift housing close to the capitol is upsetting on many levels—the blistering heat, the increasing number of older Arizonans who find themselves homeless, the number of military veterans living on the streets, families living in their cars, the seriously mental ill (SMI) people that are homeless, and the fact that our “tent city” seems to be expanding with each passing week—are all reflected in this photo.

I am grateful that the governor extended the eviction moratorium, but I also know that we have much to do to support the families, small businesses, essential workers and vulnerable community members impacted by COVID-19. At this point, we do not know if or when the governor will call a special session to address the impact of the pandemic, but I remain hopeful that it will take place sometime in August of September.

I value your comments and questions so please continue writing to me. It is vital that we stay engaged with our communities, families and friends, particularly now.

**On Friday July 24, I will be providing an update on our schools—the start of the new school year and what various districts are doing to keep students and faculty safe. The governor is also scheduled to make decisions about the start of the school year and that update will be included in next week’s newsletter.

  • Remember that the safest place is home
  • Wearing a mask in public is the best way of curbing transmission
  • Wash your hands frequently
  • Avoid large gatherings of people
  • We can do this!

As of Friday July 17, Arizona has 138,523 recorded COVID-19 cases, an increase of 3,910 from yesterday.

We have 2,583 recorded deaths, an increase of 91 from yesterday.

Lela Alston

Arizona State Senator, LD 24

lalston@azleg.gov

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