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September 20, 2017

Haunted by nursing home horror, task force joins rush to make sure it isn’t repeated

Frederica Wilson

via @ceostroff

In a crowded North Miami Beach City Hall chamber, elected officials, first responders and healthcare workers gathered to establish a task force to better regulate senior facilities, in the wake of eight deaths in Hollywood.

The task force, started Tuesday, aims to combine efforts to enact national, state and local policies to ensure the safety of those in assisted living facilities in the wake of a disaster. Last week, eight at the Rehabilitation Center at Hollywood Hills died after the building’s air cooling system failed in the aftermath of Irma.

“I am livid,” said U.S. Rep. Frederica Wilson, a Democrat whose district includes the Hollywood nursing home. “We should all be beside ourselves.”

Wilson said the task force will split into smaller groups looking at first responders, utilities and other areas of concern. Mental health was added to the list during the meeting at the behest of one attendee.

Wilson said she wants to amend the Stafford Disaster Relief and Emergency Assistance Act to make hospitals and nursing homes a top priority in disaster response. She also will work to require that the Federal Emergency Management Agency prioritize critical care facilities to be up and running again quickly after disaster.
 
Wilson also wants to enact legislation to require that assisted living facilities have a backup generator or power source if they want to be eligible for federal funds.

“We do not want another Hollywood Hills,” she said.

Read more here.

Governor releases state's own timeline as death toll at Broward nursing home climbs to 9

Hollywood Hills flowers Al Diaz@MarbinMiller and @MaryEllenKlas

Four days after the owners of a Hollywood nursing home released a detailed time line casting blame for the deaths of nine elders on Florida health administrators and a local utility, Gov. Rick Scott’s administration issued a time line of its own — declaring that the Rehabilitation Center at Hollywood Hills “failed to do their basic duty to protect life.”

The time line, and a release of 159 pages of records, fueled an ongoing finger-pointing war between the nursing home and Scott, who was himself a healthcare executive before running for office.

As the parties fought, the death toll rose: Late Tuesday, the Hollywood Police Department reported that a ninth resident from the nursing home, identified as 93-year-old Carlos Canal, had died.

 

Canal joined eight others who perished the morning of Sept. 13, when a partial power outage, combined with the failure of portable air coolers, turned the home into a deadly hothouse. The deaths are the subject of a criminal investigation by the Hollywood Police Department, together with administrative reviews by two state agencies, the Agency for Health Care Administration and the Department of Children & Families.

The nursing home is adjacent to a private psychiatric facility, Larkin Community Hospital Behavioral Health Services, and the two are affiliated with a troubled South Miami Hospital called Larkin Community Hospital. The nursing home and psychiatric facility sit across a parking lot from Memorial Regional Hospital, to which many of the 142 residents were evacuated after several began to succumb to the heat. Story here. 

Photo: Dawn Schonwetter stops to look at a memorial of flowers and messages left on the sidewalk of the Rehabilitation Center at Hollywood Hills on Saturday, Sept. 16, 2017. Nine residents of the nursing home died in the wake of Irma, including one an who was added to the toll on Tuesday. AL DIAZ adiaz@miamiherald.com

Nursing homes, accustomed to Rick Scott admin's soft touch, scramble to meet hard deadline

Hollywood Hills Rehabilitation Center@MaryEllenKlas

Florida’s nursing homes and assisted-living facilities find themselves in an unfamiliar place this week — pushing back against Gov. Rick Scott’s administration over new rules that require them to purchase generator capacity by Nov. 15 to keep their residents safe and comfortable in a power outage.

With 56 days remaining before the state imposes $1,000-a-day fees, full panic mode has set in on an industry that is more accustomed to dealing with the gentle touch of state regulators and industry-friendly legislators than it is with facing new rules.

The board of directors of LeadingAge, an industry association that represents 350 non-profit senior homes, on Monday voted to ask the governor’s office to delay the mandate as impractical.

Another group, the Florida Health Care Association, which represents 550 for-profit nursing homes, announced it was convening a “summit” on Friday to voice its concerns about the timing, the logistics and the cost of the new rule. And the national board of Florida Argentum, which represents assisted living and memory care facilities, said Tuesday it is hoping for more time to pay for the new rules in Florida — which it estimates carry price tags of $75,000 to $200,000 per home.

“Our members almost uniformly agree with the spirit of what the governor is trying to accomplish — the idea of keeping residents safe in an emergency — but our members have concerns about the practical implications of the rule,” said Steve Bahmer, president and CEO of LeadingAge Florida, which is also hosting the summit.

Like others in the senior care industry, these groups say they support the idea, but they also want some flexibility in the 60-day deadline as they seek contractors, buy generators, hire engineers, retrofit buildings and find financing.

“So many contractors and engineers are involved with the recovery process statewide, it’s going to be very difficult to comply,” said Susan Anderson, vice president of policy for the ALF association, Florida Argentum.

It’s an about-face for most of the senior care industry and for the governor. Since Scott took office in 2011, he has significantly rolled back oversight of the powerful industry that represents more than 73,000 seniors in 683 certified nursing homes, and tens of thousands of others in 3,109 assisted living facilities and memory care centers across the state. Story here. 

September 19, 2017

Puerto Rico prepares for 'catastrophic' Hurricane Maria

09MariePuertoRico_CPJ
@PatriciaMazzei

SAN JUAN -- The relieved sigh Puerto Ricans heaved after Hurricane Irma’s menacing eye just missed them two weeks ago has long been forgotten now that Hurricane Maria, Irma’s wicked cousin, has everyone on the Caribbean island holding their breath.

Maria is coming straight for them.

“Today, I’m afraid. This is a biggie,” said 79-year-old Barbara Royce, a 40-year Puerto Rican resident of San Juan’s Toa Baja neighborhood. “This one’s coming, and we can’t get away.”

National Hurricane Center forecasters warned of a “potentially catastrophic” Category 5 storm, with 165 mph winds Tuesday. President Donald Trump declared a preemptive state of emergency. Gov. Ricardo Rosselló asked “for America’s prayers.”

But true to laid-back Caribbean form, Puerto Ricans didn’t quite panic.

Under gray skies, shoppers streamed into a Walmart Supercenter in the San Juan neighborhood of Santurce early Tuesday afternoon, grabbing last-minute supplies from shelves empty of water. But they also sat down for leisurely hot lunches at the store’s cafeteria. Workers continued to stock fresh bananas.

The only bona-fide frenzy took place when employees wheeled in a pallet of battery-operated fans, so recently arrived that they didn’t yet bear price stickers — and so coveted that a gaggle of employees stood guard around the cache. A rush of people lined up — it seemed as if every customer left clutching at least one, for $20 a pop — but there was a catch.

“There are no batteries,” 26-year-old Juan Carlos Contreras, fan in hand, said with a shrug.

More here.

Photo credit: Carl Juste, MIami Herald staff

Puerto Rico will need billions in federal help after Hurricane Maria

Tropical_Weather_67855

@alextdaugherty 

Puerto Rico’s power grid is a mess.

The island’s utility provider filed for a form of bankruptcy in July, and two months later Hurricane Irma passed just north of San Juan, knocking out power to nearly 1 million people and causing an estimated $1 billion in damage.

With thousands still without power, Hurricane Maria is approaching. It will likely be Puerto Rico’s first direct hit from a Category 5 hurricane since 1928.

“No generation has seen a hurricane like this since San Felipe II in 1928,” said Puerto Rico Governor Ricardo Rosselló in a statement on Tuesday. “This is an unprecedented atmospheric system.”

The Puerto Rican government, which sought bankruptcy relief in exchange for supervised fiscal belt-tightening in May, will need federal assistance to recover from Maria and Irma. Repairing and replacing power lines and stations throughout the territory after Maria will likely cost billions, though the island doesn’t have any voting power in Congress.
 
“No member of Congress is going to want to see thousands of people die in Puerto Rico,” said Rep. Darren Soto, a Florida Democrat of Puerto Rican descent whose Orlando-based district includes a large number of Puerto Ricans.

“Certainly... the fiscal crisis has made PREPA [the Puerto Rico Electric Power Authority] less financially prepared to do this on their own and the fact remains that this is part of the U.S,” Soto added.

Congress passed a Hurricane Harvey relief bill two weeks ago after Texas sustained billions in flood damage. The $15.25 billion package was part of a deal between President Donald Trump and Democrats that included raising the nation’s debt ceiling and a continuing resolution to fund the federal government through December.

Florida Sen. Bill Nelson said Tuesday that Irma and Maria will require “much more” than $15 billion in federal relief.

“We’re going to have to put the full resources of the federal government in there because this is a Cat 5 and they lost power on the last hurricane that brushed them,” Nelson said. “This is going full bore right into the island.”

Read more here.

Corcoran's hurricane panel faces clashes with Senate, Democrats

Corcoran091917House Speaker Richard Corcoran’s select committee on Hurricane Irma won’t meet for three weeks. But questions about it flew quickly on Tuesday, and Senate President Joe Negron immediately rejected Corcoran’s call for a ban on hometown spending in lawmakers’ districts.

Corcoran announced formation of the 21-member panel, chaired by Rep. Jeannette Nuñez, R-Miami. It includes 14 Republicans and seven Democrats, most of them from counties hit hardest by the storm.

Corcoran, a free-market conservative who supports less regulation -- especially in health care -- floated ideas that would invite more regulation, such as underground utilities or forcing fuel companies to store reserves of fuel to get to gas stations more quickly.

Corcoran forged a newfound alliance with Gov. Rick Scott last spring. But picking apart the state’s preparation and response to Irma could be seen as a criticism of Scott’s leadership. Moreover, Republicans could find themselves in the unaccustomed role of supporting an activist government in regulating private businesses, such as utilities and nursing homes (both of which have been loyal supporters of the Republican Party).

“We know now, after this catastrophic storm, that gas wasn‘t readily accessible,” Corcoran told Capitol reporters. “Why does a state in the richest country in the world -- third-largest -- why don’t we have a significant gas reserve in the central part of the state?”

He added: “What we should be doing is asking ourselves, what can we do to protect the people of this state in the best way possible? That‘s what this committee exists for.”

Asked if he personally supports Scott’s emergency rule to require nursing homes to install generators within 60 days, Corcoran wavered. “I think that’s up to the committee,” he said. “But you can solve all of that in many different ways,” suggesting stiffer fines or increased transparency.

Corcoran also suggested that the House and Senate consider putting at least $638 million into recovery efforts next year, the amount of what he called “pork projects” in the current budget.

Negron told the Times/Herald that the Senate rejects Corcoran’s call for a moratorium on member-sponsored spending projects.

“Senators are out in their communities. They‘re in the best position to know what projects are most important,” he said. “Let’s keep our constitutional roles straight. The Legislature is the appropriating body. The Legislature should always have the prerogative and flexibility to write the budget.”

Senate Democratic Leader Janet Cruz, D-Tampa, also questioned the select committee’s mission.

“This should not become a backdoor attempt to weaken existing regulations,” Cruz said. “If Irma has taught us anything, it is that we need to modernize and strengthen regulations that protect every Floridian in times of natural disasters.”

New York crowd gets glimpse of President Jeb(!)

Jeb

via @katieglueck

He was gracious and measured, stern but sober—and tough on Russia—as he addressed the greatest challenges facing the United States.

Standing in a hotel ballroom a few blocks from the spot where Donald Trump was threatening to “totally destroy” North Korea, Jeb Bush offered a glimpse of the presidency that could have been.

“At some point the president is going to have to go from this ad hoc diplomacy, or whatever the foreign policy is, to something that’s clear and coherent,” Bush, one of Trump’s vanquished 2016 opponents, told a hawkish hotel ballroom audience gathered Tuesday for the United Against Nuclear Iran conference. “Because at the end of the day, too much chaos, and being unreliable, creates real dangers.”

Bush, the former Florida governor, was once considered the overwhelming favorite to win the GOP presidential nomination. Instead, he was forced out well before the primary season was over, his efforts at a “joyful” campaign rooted in a muscular view of American leadership trampled by the nationalist Trump and his rowdy, populist-leaning campaign.

The sharp contrasts in tone and ideology that played out during that race—which have divided the Republican Party ever since—unfolded again Tuesday morning, within the span of two hours and less than a mile apart here in Manhattan.
As Trump mocked North Korean leader Kim Jong Un as a “Rocket Man” who is “on a suicide mission for himself,” Bush opted for the traditional if overused term “rogue nation,” noting that Pyongyang needs “to be called out.”

As Trump glossed over threats from Russia to focus on other adversaries, Bush referred to Moscow as a “curse for President Trump”--remarks that come as Trump's White House grapples with probes into Russian influence in the 2016 election and possible ties to his campaign.

And as Trump leaned into his longtime campaign message of “America First,” Bush warned of dangers when the U.S. leaves “a void,” embracing the more internationalist view the Republican Party has recently represented, until now.

“Our vacillation, our pulling back…there was a big void and Russia took full advantage of it,” he said, when asked by MSNBC host and former George W. Bush communications director Nicolle Wallace whether America is doing enough to make Russia play a more constructive role in Iran.

 

Read more here.

 

Trump threatens Venezuela and puts Cuba on notice

United Nations General Assembly

via @francoordonez

President Donald Trump threatened “further action” against Venezuela on Tuesday and promised not to lift sanctions against Cuba until the government in Havana makes fundamental reforms.

“We cannot stand by and watch,” Trump told world leaders gathered at the United Nations.

In a speech that moved quickly from criticism of America’s adversaries to dire warnings of nuclear war, Trump turned his attention briefly to communism, singling out Venezuela and Cuba for, he said, delivering only “anguish and failure” to its people.

 

He called on world leaders to do more to help the people of Venezuela and not look the other way as their government destroys democratic institutions.

“I ask every country represented here today to be prepared to do more to address this very real crisis,” Trump said. “We call for the full restoration of democracy and political freedoms in Venezuela. The problem in Venezuela is not that socialism has been poorly implemented, but that socialism has been faithfully implemented.”
 
Trump was interrupted by a smattering of applause throughout the 40-minute speech. The clapping was loud and unified when he spoke of supporting the people of Venezuela, but was punctuated with pockets of silence when he blamed socialism.

The Trump administration has been ratcheting up the pressure on Caracas since Venezuelan President Nicolás Maduro engineered a vote for a new constituent assembly that stripped democratically elected lawmakers of their power. Maduro has been the administration’s main target as he has led the once-mighty nation sitting on the world’s largest oil reserves as it has plummeted into a deepening economic crisis amid rising inflation. In recent months, anti-government demonstrations have broken out daily as desperate citizens take to the streets to protest the lack of even the most basic goods.

“This corrupt regime destroyed a prosperous nation by imposing a failed ideology that has produced poverty and misery everywhere it has been tried,” Trump said.

Venezuelan leaders immediately slammed the speech; Foreign Minister Jorge Arreaza accused the United States of seeking "a change of regime by force."

Trump “pretends to rule the world, but does not even rule his own country,” Arreaza told reporters in New York after the speech.

Unsatisfied with the international response to Venezuela, the White House is using the United Nations General Assembly to build and strengthen an international coalition of support against Caracas. Trump’s speech was an expansion of concerns he raised Monday night during a dinner with Latin American Presidents Michel Temer of Brazil, Juan Manuel Santos of Colombia and Juan Carlos Varela of Panama as well as Argentinian Vice President Gabriela Michetti.

He reminded them of their trade relationships, which he called a “critical foundation for advancing peace and prosperity” among neighbors.

“Was one of the wealthiest countries in the world for a long period of time,” Trump told the group on Monday. “The people are starving and the country is collapsing. You didn't think that was possible. Their democratic institutions are being destroyed....Our goal must be to help them and restore their democracy.”

The leaders of the four countries were among 12 Latin American nations who signed a joint declaration in Lima last month, condemning the “breakdown of democratic order” in Venezuela and said they would not recognize any action taken by its “illegitimate” new constituent assembly.

Read more here.

GOP senator wants Scott to create hurricane oversight commission

Republican Sen. Jeff Brandes of St. Petersburg urged Gov. Rick Scott Tuesday to form a statewide oversight commission to review how state and local disaster managers, utilities, medical facilities and others responded to Hurricane Irma.

“I ask that you form a commission to review any after action reports created by state and local EOCs, utilities, state agencies, medical facilities, or other critical service providers, and to evaluate and oversee recovery projects,” Brandes wrote to Scott Tuesday. “This would ensure that state and county needs are triaged and met in a manner that leverages every disaster relief dollar, and that the assessments of the response and recovery actions taken by both public and private entities become best practices to prepare for future events.

“Establishment of similar oversight commissions consisting of representatives of state agencies, counties, cities, utilities, and other public and private parties is an established best practice that has been used to efficiently facilitate long-term recovery from disasters like the Deepwater Horizon and Hurricanes Sandy and Katrina,” Brandes wrote.

The Pinellas lawmaker asked the governor to act on his request in the next few weeks.

Airlines were accused of price gouging before Irma. Some are capping fares before Maria

Packed4 airport lnew cmg (2)

via @chabeliH

Taking a page from Hurricane Irma’s book, Florida Sen. Bill Nelson is asking airlines to proactively limit the cost of their flights for travelers trying to get out of Hurricane Maria’s path.

And airlines are agreeing.

On Monday, Nelson sent a letter to CEOs at 10 major U.S. airlines asking them to regulate the prices of their flights to areas that will likely be impacted by Maria — and to do it earlier than they did in the case of Hurricane Irma earlier this month.

Prior to Hurricane Irma making landfall in Florida, airline fares skyrocketed into the thousands of dollars due to a spike in demand, a regular practice for last-minute tickets that nevertheless had frantic travelers claiming price gouging. Eventually, some airlines started capping flights out of Florida at $99, but not until after the outcry.

In his letter, Nelson, the ranking member of the Senate’s Commerce, Science and Transportation Committee, thanked airlines who ultimately capped their flights, but encouraged them to do so sooner with the case of Category 5 Maria, which is on track to hit the U.S. Virgin Islands and Puerto Rico.
 
“I urge you to begin the process now for implementing capped airfare and ensuring that refunds are promptly issued for canceled flights. I also request that your policies on capped airfare be communicated clearly and in writing so that affected residents can evacuate quickly and safely,” he wrote. “Individuals and families should not be forced to delay or cancel their evacuation efforts because of confusion over the cost of airfare.”
 
Nelson’s letter was sent to American Airlines, United Airlines, Delta Air Lines, JetBlue Airways, Southwest Airlines, Spirit Airlines, Alaska Airlines, Hawaiian Airlines, Frontier Airlines and Allegiant Air.
 
Read more here.