Senate, Assembly Convene Hearings on COVID-19 and SNFs

This week, the Senate and Assembly convened separate hearings on COVID-19 outbreaks in skilled nursing facilities (SNFs) throughout the state. Below, we detail the two hearings:

Assembly Health and Assembly Aging & Long-Term Care Committees Assess the State’s Response

On Tuesday, the Assembly Health Committee and the Assembly Aging & Long-Term Care Committee convened a joint hearing on the COVID-19 outbreak in skilled nursing facilities (SNFs) and the state’s response to the outbreaks. The hearing featured a discussion of what has worked, what has not, and what the state’s plans are for mitigating the impacts of the ongoing COVID-19 pandemic in SNFs and other similar care facilities.

In opening the hearing, Assembly Health Chair Jim Wood acknowledged the Newsom Administration’s activities in responding to the pandemic but expressed concerns that the state has let down our most vulnerable residents in skilled nursing and long-term care facilities. Wood discussed the most recent data on infections in SNFs, indicating significant challenges in stopping and preventing the transmission of COVID-19 persist. Assembly Aging & Long-Term Care Committee Chair Adrin Nazarian also provided opening comments, calling for the need to protect older and disabled Californians in congregate living facilities, urging improvements in SNF management and oversight, and decrying the Governor’s May Revision proposals cutting back on senior services as an example of “ageism.”

The hearing consisted of two panels featuring state regulators and skilled nursing facilities, as well as skilled nursing facility residents and advocates. CDPH Center for Health Care Quality Deputy Director Heidi Steinecker discussed the role of CDPH in implementing oversight and response activities of SNFs throughout the state, including deploying infection strike teams, conducting daily outreach to SNFs, and providing technical assistance to facilities. Steinecker detailed CDPH’s six-step COVID-19 mitigation plan for SNFs, indicating progress made in strengthening SNF infection prevention and control practices. California Department of Aging (CDA) Director Kim McCoy Wade discussed the role of CDA in serving California’s seniors during COVID-19, including through establishing a friendship phone line and expanding other supportive services for seniors and their families.

Other panelists included representatives from the California Association of Health Facilities, California Association of Long-Term Care Medicine, California Advocates for Nursing Care Reform, and California Long-Term Care Ombudsman Association. Testimony largely expressed concerns around state and facility response to COVID-19 outbreaks in SNFs and identified a number of areas for improvement, such as personal protective equipment (PPE), SNF staff training and turnover, staff compensation, stakeholder engagement, and inspection and enforcement activities.

Committee members queried panelists on a range of topics, including PPE procurement, SNF facility oversight, and the state’s role in providing technical assistance to at-risk SNFs. Assembly Health Chair Jim Wood, in closing comments, suggested the committees convene an additional hearing at a later date to further review the ongoing response activities statewide. Hearing materials, including an agenda and background paper, are available here. A video recording of the hearing is available here.

Senate Special Committee Convenes State, Local Officials to Examine COVID-19 SNF Response

On Wednesday, the Senate Special Committee on Pandemic Emergency Response held a similar hearing to examine state and local response activities to COVID-19 outbreaks in SNFs. Special Committee Chair Senator Lena Gonzalez opened the hearing by remarking on the ongoing COVID-19 cases and outbreaks amongst SNFs statewide and expressing concerns with SNF management and operations, staff turnover, and state oversight and accountability. Notably, committee member Senator Richard Pan, in opening comments, similarly expressed concerns with COVID-19 case increases statewide and SNF outbreaks. Senator Pan referenced recent health official retirements and resignations amid the COVID-19 pandemic, framing the issue as a “crisis” for local health officials and reiterating his support of the work of local health departments throughout the state.

Wednesday’s hearing featured CDPH’s Heidi Steinecker, as well as Santa Clara County Public Health Director/Health Officer Dr. Sara Cody and Los Angeles County Department of Public Health Chief Medical Officer Dr. Jeffrey Gunzenhauser. Representatives from the California Association of Health Facilities and the California Association for Nursing Home Reform also appeared as panelists during Wednesday’s hearing.

Drs. Cody and Gunzenhauser discussed local health department (LHD) activities in COVID-19 surveillance and monitoring, SNF infection prevention and control, and technical assistance and support provided to SNFs in their jurisdictions. Panelists also identified areas for improvement, including testing, PPE procurement, SNF infection control practices and training, and SNF management and staffing.

Committee members raised questions around the state’s role in working with SNFs, the impact of implementation of nonpharmaceutical interventions, SNF management and operations, testing strategies, PPE procurement and stockpiling, and SNF resident wellbeing, among other topics. An agenda from the hearing is available here and a background paper is available here. A video recording of the hearing is available here.