In 2020, residents of long-term care (LTC) facilities accounted for 23% of Minnesota’s total COVID-19 cases and experienced 81% of total COVID-19-related deaths. More than $150 million has been spent in emergency health response at LTC facilities in Minnesota. It’s been just over two years since the pandemic. The omicron variant is still hitting long-term care facilities, with many reported cases in these facilities.
Some of the main issues associated with this problem include the lack of total workforce vaccination, poor-quality control and regulation and the vulnerability of LTC facilities residents. However, there is an urgent need to address the low staff COVID-19 vaccination rates as data suggests a strong correlation between COVID-19 incidence among LTC facilities staff and residents.
But how can Minnesota reduce the incidence and death rates of COVID-19 cases in LTC facilities in Minnesota as COVID-19 continues to linger in our communities? To connect the dots looking forward, we must look backward. Some of the problems that plague LTC facilities can tie back to their history in the United States. These include the historical social acceptance of poor infrastructure and services provided by LTC facilities, the lack of financial protection for low-income older adults who do not qualify for Medicaid, and the industrialization of LTC facilities.
Although recent efforts such as the five-point battle plan unveiled by Gov. Tim Walz aim to solve this issue by providing personal protective equipment against COVID-19 and improving the staffing levels in LTC facilities in Minnesota, it has only somewhat been successful in tackling this issue. Due to the pandemic, LTC facilities still report inadequate COVID-19 protective equipment like face masks and low staffing levels. Nonetheless, the five-point battle plan serves as a window of opportunity for effective health policies to tackle the disproportionately high incidence and death rates among residents of LTC facilities in Minnesota.
In my opinion, a definitive solution to this problem is to create a task force within Minnesota to distribute funds to LTC facilities with at least 80% fully vaccinated staff. This policy proposal mirrors the Center for Medicaid and Medicare Services (CMS) vaccination requirements for health care providers, which requires health care workers participating in Medicare and Medicaid to be fully vaccinated or lose their federal funding.
The health care system has historically responded to financial incentives. The CMS’s total workforce vaccination mandate for the health care system has laid the foundation for this policy to be very successful. Following its implementation, vaccination rates in nursing homes have risen. Current data show that the COVID-19 booster shot rate is comparable to the national average for adults over 65 years of age. Therefore, creating a task force to distribute COVID-19 relief funds to only qualifying LTC facilities with at least 80% total workforce vaccination should complement the CMS’s mandate to improve the vaccination rates across all LTC facilities in Minnesota.
The CMS complete health care workforce vaccination policy faced numerous legal challenges and pushbacks, especially from red states, notably Texas. However, a favorable Supreme Court ruling proves this policy will withstand political challenges. Nevertheless, creating a criterion for governmental aid for health-related matters will have equity implications despite serving a greater good. Since this purposely selects only qualifying long-term care facilities to receive funding, these LTC facilities might not be the ones in the greatest need of governmental funding.
The favorable Supreme Court ruling on the CMS total workforce vaccination on Jan. 13 provides evidence within the authority of the secretary of Minnesota’s Health and Human Services to decide which long-term care facility qualifies to receive state government funding through the task force. However, there is uncertainty about its impact since it is voluntary for LTC facilities to adhere to the proposed policy, but a gamble, I believe, is worth taking.
Dr. Praise Emukah-Brown, a practicing physician, is currently completing a masters in Public Health Administration and Policy at the University of Minnesota’s School of Public Health.
The author must have missed the CDC saying 2 shots, plus a booster or 2 will not stop the person from getting or giving COViD. The problem was not the staff, it was returning sick patients back to LTC facilities while they were still contagious. Many states kept those patients away from LTC facilities until they were not contagious…. Minnesota did not.
Low vaccination levels creates a dangerous living situation for seniors. Not just true for Covid. If staff are pressured to work sick, it makes it worse.
Sure, pay the facility more, but why not offer year end bonuses based on vaccination levels. The largest for employees who have every vaccination recommended, but less amounts for those who have had some shots. Carrots work better than sticks. Documented vaccination only. And even better vaccine clinics at work for staff, with time off and free shots.
In some cases employers extend this to family members. Fully vaccinated households are a little backup protection. The same courtesy should be extended to spouses who visit their loved ones.
Let’s do this right and with generosity of spirit, and maybe the stubborn will relent.
Doesn’t the most recent data normalized per population show a much higher infection incidence among people vaccinated/boosted vs people with fewer/no vaccines? If anything it sounds like this plan would make things worse.
Are we still in denial that the mRNA”vaccines” do not prevent getting or spreading Omicron, and the fact that natural immunity is more robusr than the “vaccines”?
Cutting federal funding will merely reduce the number of options for elderly care, making the problem worse.
Given that staff is already hard to find, dismissing those willing to work leaves the facilities with no workers. Visitors continue to be allowed into the facilities with no proof of the same vaccination requirements (which is the real source of new infections I believe). The court system will take years to decide whether these ideas are legal.