Recent editorials of statewide and national interest from Pennsylvania’s newspapers:
State must meet duty on recovery homes
The Citizens’ Voice
Even if the unfolding vaccination effort against COVID-19 has the desired effect of suppressing the pandemic, Pennsylvania still faces another public health emergency.
The scope of the COVID-19 emergency has worsened the opioid addiction crisis.
Pennsylvania is one of the states most heavily affected by the addiction crisis. To the state government’s credit, it had reacted aggressively to the challenge. The Wolf administration enacted a series of emergency measures to expand access to the lifesaving antidote nalaxone. It, the Legislature and the medical community worked together to quickly reform prescribing standards for opioids and establish a statewide tracking system to prevent doctor-shopping and excess prescriptions.
It is likely, however, that much of the progress that had been made has been lost because of COVID-19. It’s clear that the state government must reinvigorate its efforts on opioids as COVID-19 recedes. And that should begin with one important business to which the government did not attend before COVID-19 arrived.
Drug treatment operations are regulated heavily by the state. But “recovery homes,” where many people suffering from addiction seek aid before or after treatment, are not regulated.
Due to the lack of regulation, some recovery homes serve as advertised, keeping people off the street and helping them prepare for formal treatment or helping them to continue their progress after receiving treatment.
Others simply have taken advantage of residents for their own profit. A 2019 statewide grand jury report, for example, revealed a scheme by a now-defunct recovery home company that repeatedly cycled clients through the treatment process to maximize billing.
Due to multiple problems with unregulated recovery homes around the state, the Legislature passed a law in 2017 requiring the Department of Drug and Alcohol Programs to develop regulations and a licensing and certification program by June 2020. But the administration missed the deadline.
To be sure, the COVID-19 emergency took precedence over other state programs. But now that there at least is a game plan in place to finally get the upper hand on COVID-19, the administration should expedite care home issue and prepare to again accelerate the fight against opioid addiction.
Frustrated by lack of answers and urgency in protecting Pennsylvania nursing homes
At The Gardens at Stevens, a skilled nursing and rehabilitation facility in Denver, 39 residents had died of COVID-19 as of the publication of LNP ' LancasterOnline journalist Nicole C. Brambila’s investigative article published in the Jan. 17 edition. “The Gardens at Stevens is a troubling outlier in Pennsylvania,” Brambila reported. “The death toll is second only in Lancaster County to the 446-bed Conestoga View Nursing and Rehabilitation in Lancaster Township, which is five times larger. Statewide, only about 20 of Pennsylvania’s nearly 700 nursing homes have had more deaths.”
So, what went wrong? Brambila asks that question early in her article detailing the devastating, outsize loss that has occurred at the small Denver facility during the pandemic.
We’d like the answer to that, too.
Unfortunately, the surrounding issues are complex and we’ve seen little meaningful response from those who should be accountable.
No explanation was forthcoming from the owners of The Gardens at Stevens, who did not respond to Brambila’s multiple requests via email and phone for an interview with LNP ' LancasterOnline.
We find that shameful. Families who have lost loved ones and current residents of the facility deserve answers.
They are the human faces of all this unimaginable heartbreak.
Brambila talked to the family of 73-year-old Charles Christian Groff. They were given short notice that the man they lovingly called “Pop” didn’t have long to live, so they made the long drive from central Florida for the opportunity to goodbye.
“Groff had fallen at his East Earl Township home, fracturing several ribs and two vertebrae,” Brambila explained. “Following a hospital stay, he was sent to The Gardens at Stevens to recover. Less than three weeks later, Groff had COVID-19.”
Brambila also talked to Don Eshelman, whose 69-year-old wife, Sue, had gone to The Gardens at Stevens to recover from an ankle injury.
She was diagnosed with COVID-19 five weeks after arriving and died shortly after Thanksgiving.
Don Eshelman never had a chance to cook the turkey he had waiting in the freezer — he had promised his wife they’d celebrate Thanksgiving together.
“I still feel if she would have stayed home and I’d taken care of her, she’d still be alive,” he said.
Areas of concern
Long before COVID-19, myriad issues have dogged the nursing home industry and impacted the quality of care some of them can provide.
Staffing shortages have been a persistent nationwide problem. Quality of care is strongly tied to staff size, “but staffing — as with most businesses — is expensive and is sometimes kept artificially low to maximize profits,” Brambila wrote.
In this pandemic, insufficient staffing can be a prime contributor to the rapid spread of the novel coronavirus.
But weak Pennsylvania guidelines have also played a role.
Federal research states that average direct-care staffing of 4.1 hours per resident per day is needed at nursing homes, given the age and morbidity of residents.
Pennsylvania, however, requires a state minimum of just 2.7 hours per resident per day. That figure hasn’t changed in more than two decades.
Looking at The Gardens at Stevens, Brambila found that, on average, it provided 3.34 hours of direct care per resident per day in the third quarter of 2020. That surpasses the state minimum, but falls short of the federal number.
Richard J. Mollot, executive director of the Long Term Care Community Coalition, a New York-based nonprofit organization focused on improving the quality of nursing home care, called Pennsylvania’s minimum “woefully inadequate.”
The state Department of Health must use its authority to bring Pennsylvania swiftly in line with the federal guidance on daily hours of direct care per resident – and then strictly enforce that figure.
Brambila also detailed the “perfect storm” of staffing issues that hit The Gardens at Stevens during its deadliest month.
Last autumn, many state nursing facilities had difficulty finding the workers they needed to fill gaps left by sick staff members. That shortage dovetailed with the worst of the health crisis at the Denver facility.
“Once the first residents were infected in mid-November ... the virus tore unimpeded through the facility, sickening all 67,” Brambila reported. “Within three weeks of the first reported COVID-19 fatality, 36 residents were dead.”
Where was the state Department of Health during this time? The pandemic had been underway for more than half a year at that point. Early on, nursing homes had been identified as being incredibly vulnerable.
What were state officials doing to provide support for The Gardens at Stevens while three dozen people were dying?
Nate Wardle, a state health department spokesman, could not tell LNP ' LancasterOnline anything specific that had been done for the Denver facility.
“As we continue to combat this public health and economic crisis, accountability and oversight are just as important as ensuring that facilities have the resources they need — like PPE, testing and vaccinations — to combat the virus and protect residents and workers,” Democratic U.S. Sen. Bob Casey told LNP ' LancasterOnline in an email. “We must conduct ongoing reviews of what is going wrong and what can be improved.”
Casey has the right idea.
But is the Wolf administration listening?
We continue to be outraged at the seeming lack of urgency to protect Pennsylvania’s most vulnerable residents. We are approaching the second year of the COVID-19 crisis, and it’s past time to find that urgency.
Philadelphia attorney Marty Kardon, representing Gardens at Stevens families, “filed a lawsuit in April with three other firms against the Pennsylvania Department of Health for failing to inspect nursing homes during the first outbreak,” Brambila reported.
“This is not their first rodeo,” Kardon said of the state. “Everyone knows infections can run rampant in a congregate setting.”
Lawsuits can’t get loved ones like “Pop” Groff and Sue Eshelman back.
But maybe they will bring the answers and commitment to change that have eluded us thus far.
The maestro makes a sound suggestion for the arts. Biden should listen.
The Philadelphia Inquirer
Bravo to Philadelphia Orchestra music director Yannick Nézet-Séguin for urging the Biden administration to create a cabinet-level arts and culture post. In an open letter last week, Nézet-Séguin — who is also music director of New York’s Metropolitan Opera — said the pandemic’s crippling impact on the creative economy makes “a voice at the table” in Washington, D.C., even more critical.
The fact is, the pandemic has only served as the latest threat to arts and culture. Government support for the arts has never been robust, but it has grown anemic in recent times. For example, the $162 million budget for the National Endowment for the Arts remains at the same level it was in 1984. And every year of his administration, President Donald Trump proposed eliminating it altogether, along with the National Endowment for the Humanities.
The maestro’s call is perfectly timed. The role that the arts can play in helping the country heal and overcome the massive challenges it has grappled with in the past year needs no more evidence than the rhapsodic reception to former Youth Poet Laureate Amanda Gorman’s performance at the inauguration.
Arts and culture’s importance to the health of the economy is also critical. A survey conducted last fall by the Greater Philadelphia Cultural Alliance found that 266 local arts organizations large and small expect to lose a combined $214.4 million in the 12 months that will end this March. Philly’s creative economy lost 1,277 jobs as of October.
The Philly region’s arts and culture economy helps propel the tourism and hospitality industries and adds vitality not only to Center City but throughout the region. Venues of all sizes have been shuttered for months, and some, like South Philly’s beloved Boot & Saddle, have closed for good.
While $15 billion in “Save Our Stages” funding was approved as part of the December stimulus package, the Small Business Administration has yet to begin the application process and no date for doing so has been announced. President Joe Biden should see to it that this money is put to work soon.
Other help has come in payroll protection funds through the first stimulus last year, which some museums, performance venues, and other arts organizations received. Pennsylvania provided $20 million in COVID-19 relief assistance to museums and cultural organizations across the state. The William Penn and Mellon Foundations have provided $8 million, and Philly’s Office of Arts, Culture and the Creative Economy worked with the alliance and others to set up the $4 million COVID-19 Arts Aid PHL Fund. But all this is not enough.
Given that a Brookings study found the creative economy lost 2.7 million jobs and more than $150 billion in revenue between April and July of 2020 alone, a cabinet position or “arts czar” would have a substantial portfolio. New York Times arts critic Jason Farago recently suggested that Biden establish a national program to put arts and culture professionals to work, a la Franklin Roosevelt’s New Deal.
That approach is worth supporting.
President Biden can take a step in the right direction by taking the advice of maestro Nézet-Séguin — and enabling the arts to play a larger role in America’s recovery from the pandemic.
Clamoring to be ‘most eligible’ in the vaccine sweepstakes
What does it mean to be eligible?
It is the right to do something, the right to get something. If you are looking to fix your daughter up with the perfect guy, you are looking for the most eligible bachelor — the guy who will check all the boxes. To be eligible generally means something good. You are eligible for contests or honors or opportunities.
And right now, the word “eligibility” is partnered with the coronavirus vaccine.
The list of people eligible to get the covid-19 shot was short when the Pfizer approval was given in December. It began in the hospitals where the battle against the disease was being fought. It made sense, especially because those people had a high instance of contracting covid because of their exposure.
Since then, the eligibility has expanded.
It went to nursing homes. The staff and the patients — people whose age and pre-existing conditions put them most at risk — needed to be protected.
Then there were more additions. All of them were important, and all of them were needed. The state is in Phase 1A of vaccinations, and health care workers of all kinds, from pharmacists to dentists to prison clinicians are included. So is anyone older than 65. So is anyone with a list of high-risk conditions like cancer or heart disease, regardless of age.
It’s an expansion that might mean next to nothing given providers are reporting there isn’t enough vaccine to go around.
So how do we know who is getting the shot? How do we know eligibility means what we think it means?
“People are asked at the time of requesting a covid-19 vaccine, and again when they arrive for vaccination, to answer ‘yes or no’ when asked if they have any of the underlying medical conditions that the CDC lists as placing them at higher risk for severe covid-19 illness,” UPMC spokeswoman Taylor Andres said.
But no one has to prove they have a sickle-cell disease or a kidney condition to sign up for the shot. There is no requirement that you present documentation the same way you would to qualify for a driver’s license or a passport or food stamps. It’s all about the honor system.
The problem is that expanding who is in 1A is frustrating for people in 1B who are every bit as deserving.
Let’s take smokers, for example. There is logic to moving smokers up. Cigarettes put them at risk for a number of respiratory diseases such as emphysema and cancer, both of which are on the list of pre-existing conditions.
But for corrections officers, whose job requires them to be in close quarters with a contained population where disease is spread easily, that can feel like a slap in the face.
“Our members are overworked, exhausted and are working massive amounts of overtime due to covid-19 illnesses within their ranks. The mental anguish of passing the virus to their loved ones also takes a tremendous toll,” said Pennsylvania State Corrections Officers Association Vice President John Eckenrode. “It’s time for this administration to use common sense in its vaccination plan.”
The state has yet again tripped over its own good intentions, as it has repeatedly since March. The pandemic is a triage situation that makes it important to prioritize not just need but the ability to help all groups by helping one. It’s like when the oxygen masks drop on an airplane, and adult passengers are told to put on theirs before helping children.
Expanding eligibility for 1A would have been a morale issue if there was plenty of vaccine to go around for that first phase. Expanding eligibility when there wasn’t enough just invited more problems.
York High grad Bruce Arians’ story, personality may make him Super Bowl star
The York Dispatch
From now until Feb. 7, folks in York County can expect to get a heavy dose of Bruce Arians.
Fortunately, that’s just what the doctor ordered for those suffering from pandemic exhaustion or from political exasperation. At this point, that includes just about all of us.
We all desperately need some harmless fun to distract us from our real-world problems. That’s what Super Bowl 55 should deliver, especially in these parts. Because, when it comes to having fun, York High graduate Bruce Arians is an expert.
Arians, with his trademark kangol hat and Mr. Cool persona, is far from your typical, buttoned-down, say-nothing NFL head coach. The Tampa Bay boss will say exactly what is on his mind. Just ask legendary quarterback Tom Brady, who found himself the target of Arians’ barbs earlier this season when the coach felt the QB wasn’t performing up to standards.
Much of what Arians says is humorous, sarcastic or acerbic, but don’t let that fool you. Arians is also a tremendous football coach. In just his second year in Tampa, he’s led his Buccaneers into the Feb. 7 Super Bowl against the Kansas City Chiefs.
Arians may become a star: The Super Bowl, even during a pandemic, is sure to be a media extravaganza, and the candid and witty Arians could become the star of the show, and not just because of his personality.
Arians also has great story to tell. For nearly four decades, Arians was a coaching journeyman, bouncing from one NFL assistant job to another. Then, finally, at age 61, he got his first shot at a full-time job as an NFL head coach with the Arizona Cardinals in 2013. He made the most of it, taking a moribund franchise and making it into a consistent winner.
He resigned after the 2017 season, only to reemerge as Tampa’s head coach in 2019, where he’s again excelled.
Now the two-time NFL Coach of the Year is in the Super Bowl, which is nothing new. Arians won two Super Bowl titles as a Pittsburgh Steelers assistant in 2006 and 2009.
Overcoming health scares, promoting diversity: Arians has accomplished all of that while dealing with a series of serious medical issues, including a cancer scare. He’s overcome those ailments to become a late-in-life success story. Now 68, he’s reached the pinnacle of NFL coaching success.
Arians’ success, however, extends beyond X’s and O’s. He’s also become a champion for coaching diversity. All of three of his coordinators are Black, and when he was the Cardinals’ head coach 2015, Arians hired the first female NFL assistant in history.
Arians’ open-mindedness was forged in York. He lived through the city’s riots in the late 1960s and he’s well aware of the damage that prejudice can cause. It’s made him determined to do what he can to alleviate the problem.
Remembering his roots: Finally, Arians has never forgotten his York roots. He married a York girl and still has friends and relatives here. He’s returned to speak at his alma mater in an effort to encourage the city youngsters.
Put it all together and you have a compelling narrative. It’s one the media is sure to latch onto, and it’s why Arians may become a breakout Super Bowl star. As stars go, you could do a lot worse, because Arians is a fun-loving guy with a big heart and an engrossing story to tell. He’s also a pretty fair football coach.
Of course, the folks in York have known that for a long time.