NURSING HOME VISITORS: IMPROVEMENT, BUT NOT MUCH

CALIFORNIA FOCUS
FOR RELEASE: FRIDAY, JULY 31, 2020 OR THEREAFTER


BY THOMAS D. ELIAS

    “NURSING HOME VISITORS: IMPROVEMENT, BUT NOT MUCH”

The good news in California nursing homes this summer is that some are allowing their residents to see visitors at long last, but almost exclusively outdoors and in very controlled circumstances where the guests have little chance to see what’s happening inside the homes.

This small, far-from-universal change is largely the result of a slight improvement in a key state guideline governing nursing homes.

The change: The state Department of Public Health (DPH) no longer merely recommends that nursing homes allow residents to designate one person to visit during the COVID-19 pandemic if the visitors distance, don masks and other personal protective equipment. In late June, the DPH began mandating that nursing home denizens “shall” be allowed to pick a guest.

That’s a big improvement for the relatively few residents of the homes who now get occasional visits. Previously, all visitors had been banned from the homes, even state inspectors. This amounted to carte blanche for many nursing home managements to reduce staff (especially with state staffing requirements suspended early on) and keep disabled residents in bed for days at a time. Even on days when they’re allowed out of bed, staffers often stash them back there around mid-afternoon because workloads are so large they would not otherwise have time to serve dinner to all their patients.

Essentially, visitors have lost their previous role as the main watchdogs over nursing home practices.

The intent of the original visitor ban was to keep the coronavirus plague out of the homes. That policy has failed, what with about 49 percent – almost half – of all California COVID-19 deaths occurring among those residing in nursing homes, as of early July.

“(The ban) has been an extreme hardship for most nursing home patients,” said Lori Smetanka, executive director of the National Consumer Voice for Quality Long Term Care. “It has led to significant physical, social and psychological harm for many thousands of residents. Their needs are worsening without families to visit them.” She added that even when virtual visits via services like Zoom and Facetime are arranged, “they often prove disruptive to residents, especially those with cognitive impairments.”

That adds to a climate described this way by one 76-year-old physically handicapped nursing home resident who retains all his mental faculties: “The nursing home establishment makes people feel like ‘throw-aways,” he wrote in an email. “We feel much like abandoned pets or children with disabilities. This makes it difficult to maintain the attitude and motivation you need to feel like a human being in here.”

          Lawyer Tony Chicotel of the California Advocates for Nursing Home Reform organization describes the last four months for a typical resident of this state’s nursing homes as “very much like solitary confinement,” adding that most are even worse off than that, because they share rooms and get little privacy outside their own thoughts.

          “This is institutionalized isolation,” Chicotel said. “Some call it a form of solitary confinement. It’s become inhumane and cruel. This has been done to people without any consultation or due process. And the no visitor policy has been a colossal failure, too.” In fact, most of the COVID-19 that has so severely hit nursing homes came into them with staffers, who often must work two jobs because of their low pay. Even if one home where they work is “clean,” they can become infected at their second job or in crowded conditions where they live.

          Then there’s assisted living, where residents often pay large sums for rooms and apartments. They also have had no visitors, reports Chicotel. But unlike nursing home residents, they are allowed out for excursions, medical appointments or other needs. The rub, says Chicotel: On their return, most assisted living homes require residents who leave even for short times to quarantine for 14 days, never leaving their rooms during that time for any reason.

          As a result, few ever leave and many residents suffer isolation similar to nursing home patients.

          If a society can be judged by the way it cares for its grandparents and other elders, what does all this say about California and the rest of America, where the same situations apply almost everywhere?

                  

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    Email Thomas Elias at tdelias@aol.com. His book, "The Burzynski Breakthrough: The Most Promising Cancer Treatment and the Government’s Campaign to Squelch It," is now available in a soft cover fourth edition. For more Elias columns, visit www.californiafocus.net

MISSING WORD MAKES GAS TAX CAMPAIGN MISLEADING

CALIFORNIA FOCUS
FOR RELEASE: TUESDAY, JULY 31, 2018 OR THEREAFTER

BY THOMAS D. ELIAS
       “MISSING WORD MAKES GAS TAX CAMPAIGN MISLEADING”

          One dropped word can make almost any written passage wholly misleading and confusing. Imagine if President Trump’s 2016 election slogan had lacked the word “great.” What would “Make America Again” have done for his campaign? Not much.

          This year in California it’s the opposite. One missing word gives the current initiative to repeal last year’s gasoline tax increase much of its impetus and popular appeal (the measure had just over 50 percent support in the first public polls taken after it qualified for the November ballot as Proposition 6).

          That word is “increase.” When Republican gubernatorial candidate John Cox and other proponents like former San Diego Councilman Carl DeMaio take to their campaign rally microphones, they almost always shout “Repeal the gas tax.” Only rarely do they include that extra word “increase.”

          In fact, Prop. 6 would not end the gas tax. No state initiative can do that by itself, since the current total tax of about 77 cents per gallon includes 18.4 cents in federal taxes, something state officials can’t touch. Instead, the current proposal would merely eliminate an increase of just over 12 cents per gallon imposed last year after a narrow legislative vote.

          This, of course, is not the first time initiative backers have been misleading. Back in the late 1990s, when tobacco companies sought to rid themselves of local laws regulating smoking in restaurants and bars, they campaigned for “statewide smoking controls.” Any new statewide law would have overridden the local measures already in place by then in most California cities and counties, the real aim of Big Tobacco.

          Don’t expect the failure of that pro-tobacco measure masquerading as an anti-smoking one – or the failures of most other misleading initiative campaigns over the decades – to deter today’s repeal campaign.

          As of early July, backers of the repeal had raised more than $3.2 million, with more to come, some of it likely from the national Republican Party, which sees the initiative as a way to get GOP voters to the polls in a non-presidential election year when the party doesn’t even have a U.S. Senate candidate. The Republican aim is to preserve some congressional seats now in danger of flipping to the Democrats.

Some of the millions of dollars used to put the initiative on the ballot came from top national Republicans like House Speaker Paul Ryan of Wisconsin and House Majority Leader Kevin McCarthy of Bakersfield. They are almost certain to kick in again this fall.

          But voters would be wise to examine some essential realities of the gas tax increase repeal that would eliminate almost $5 billion in highway and road maintenance funding the measure will produce if it goes forward for the next three years. The measure would also make it harder for legislators to raise gas taxes in the future by subjecting all hikes to popular vote approval. Under another proposition passed in June, no gas tax money can be used for anything but transportation.

          What Cox, DeMaio and other repeal advocates don’t say is that for most motorists, the gas tax increase represents a pretty good investment. The Los Angeles Chamber of Commerce, normally hypercritical of tax increases, reports that every dollar spent on road, highway and bridge improvements saves $5.20 in car repair costs, while improving road safety and fuel economy.

          Plus, the non-partisan legislative analyst reported while the gas tax increase was under consideration that rough roads cost the average California driver about $700 a year for extra repairs.

          The law threatened with repeal also will see electric vehicle owners start contributing to road maintenance funding for the first time in 2020, at $100 per year. That’s less than the average of $280 a year now paid by gasoline users, but it’s a start toward zero emission vehicles paying their fair share for using California roads.

          The repeal campaign won’t tell voters any of this. And it remains to be seen whether tax increase supporters like Gov. Jerry Brown can effectively communicate this rather complex information to voters. So far, they’ve raised more than $11 million to facilitate that.

          The bottom line question: Will California voters see through this latest attempt to mislead, an effort marked by the simple omission of one key word?

         

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    Email Thomas Elias at tdelias@aol.com. His book, "The Burzynski Breakthrough, The Most Promising Cancer Treatment and the Government’s Campaign to Squelch It," is now available in a soft cover fourth edition. For more Elias columns, visit www.californiafocus.net

FAST LANES FOR THE RICH COMING SOON

CALIFORNIA FOCUS
FOR RELEASE: FRIDAY, JULY 31, 2009, OR THEREAFTER

BY THOMAS D. ELIAS
"FAST LANES FOR THE RICH COMING SOON"

Diamond lanes for the rich will soon be reality. Here in the land of legendary freeways, it will soon be mainly those willing and able to pay who can make really good time in congested areas.

That's the meaning of a plan promoted by Republicans who ran the federal Department of Transportation under ex-President George W. Bush and accepted gleefully by the Democrats who run the Metropolitan Transportation Authority in Southern California.

By the end of next year, more than 60 miles of existing carpool lanes along two major Los Angeles area freeways - Interstates 10 and 110, better known as the San Bernardino and Harbor freeways - will be turned into toll lanes for cars with one or two occupants. Cars containing two persons will still be able to use some stretches free and those with three will continue to get free use in all areas.

The upshot, though, is that solitary commuters able to pay tolls will enjoy all the benefits that now accrue only to carpools and owners of the most fuel-efficient gas-electric hybrid cars.

This won't sit well with commuters who already complain that hybrids with stickers issued prior to February 2007 have already so crowded things that carpool lanes often aren't much faster than others.

But this story is no harder to understand than many others: Follow the money.

The Republican-led feds dangled $210 million in front of the MTA, which is far better known for running a bus line than managing freeways. Democrats now in power have not changed this program because of its claim of easing rush-hour congestion and thus diminishing both automotive smog and greenhouse gas emissions. Which means that what's starting on two Southern California freeways will soon become policy in many other places.

No one yet knows if the traffic-easing claims are true, but the best guess of many veteran commuters is they're wrong. Anyone who's been in the traffic jams that plague much of Southern California, the San Francisco Bay area and the Sacramento region knows allowing single-occupant cars onto carpool lanes won't ease the flow of ordinary lanes much, if at all. Putting more than 50,000 hybrid Toyota Priuses and Honda Civics there certainly didn't speed things up in the other lanes, but it has slowed down the previously speedy high occupancy ones.

This program is billed as an experiment, but the history of traffic management "experiments" over the last 20 years shows few disappear, even if they're ineffective.

So the rich will soon be moving more quickly than ordinary folks, even if they're not going quite as fast as carpool lanes once ran.

And what does everyone else get in exchange? The MTA plans to buy 57 new buses to use toll/carpool lanes and will spent $80 million on a new bus parking facility to house its vehicles.

All this without so much as an environmental impact study, the normal requirement before any major project affecting hundreds - let alone millions - of Californians can proceed.

At least the new plan isn't quite as bad as it was when originally proposed. In early 2008, the former Bush administration and the MTA said they intended to take existing carpool lanes and make them available only to those paying tolls. The new version still leaves them open to carpools.

So this isn't precisely a bait-and-switch, as first planned. That proposal would have taken carpool lanes paid for with tax dollars and turned them over exclusively to those who can afford to pay extra. But it still makes the carpool lanes something far different from what voters thought they were buying when they aproved new gas taxes and bunches of highway bonds over the past decade.

Beyond all that, though, is the simple idea of justice. It's bad enough that gas taxes are as regressive as can be, with rich and poor paying precisely the same levy on each gallon. This plan will also let the rich zip right past the working poor when carpool lanes are running properly, morning and evening. The best ordinary commuters can hope for is that it so congests carpool lanes that wealthy drivers eventually conclude paying tolls isn't worth the trouble.

The bottom line: Here we have further evidence that money can persuade elected officials to do almost anything. Just think how much better off we might be if those same politicians actually tried to do something creative about traffic jams, like changing the work hours of government employees for a start, a simple notion that could instantly switch tens of thousands of rush-hour commuters into off-peak times.

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Email Thomas Elias at tdelias@aol.com. For more Elias columns, visit www.californiafocus.net