DV Journal

Thanks to the bipartisan leadership of the Pennsylvania General Assembly and Gov. Tom Wolf in the last state budget, Pennsylvania took a good first step in support of Pennsylvania’s long-term care industry. In total, Pennsylvania’s 2022-23 budget invests more than $600 million in state and federal funds so that it can help care for one of the nation’s largest senior populations.

So often we hear how government leaders won’t work together or how they place politics above good public policy. This is not one of those stories. Rather, it’s an example of how government, industry and labor can come together to improve care for older adults.

It’s important to understand what brought us to this point. For far too long, nursing homes struggled to keep dedicated workers, in part because Medicaid funding remained flat for years, making it impossible to keep up with even basic inflationary costs. The pandemic only made this worse. Pennsylvania has lost nearly 1,000 skilled beds over the last four years (source: CMS.gov), and a LeadingAge PA member survey showed the number of nursing beds pulled offline grew fourfold from 2019 to 2021. In addition, 14 nursing homes have closed entirely since 2020

The human toll is much worse than the statistics. With closures and loss of beds, where have these older residents been receiving their care? Unfortunately, some families have been forced to find care in an unfamiliar location, farther away from home. This undoubtedly led to social isolation for residents and feelings of depression and helplessness by their loved ones. As a speech pathologist and post-acute care clinician, I know too well the impact that has on one’s mental state and overall health.

That’s why this tremendous effort by government, industry and labor comes at such a critical time.

This $600-million infusion will begin to allow aging services providers to compete with other industries for skilled employees. It also helps to create some breathing room as long-term care communities continue to deal with the pandemic. The crisis is not over for aging services. Providers continue to bear the financial and operational burden of adhering to extensive infection prevention protocols, managing the cost of personal protective equipment and supplies, maintaining onerous and duplicative reporting, and continuously right-sizing staff and other resources based on the latest influx of cases. Now that the virus is becoming a part of everyday life and the threat has lessened, it’s time to rethink and reverse the rules and regulations that are no longer necessary and inhibit residents’ quality of life.

This new funding is a good start in the right direction, but there’s much more that needs to be done legislatively to help address ongoing challenges.

Early in the pandemic, the government provided a pathway to ease staffing burdens by creating the temporary nurse aide (TNA) program; however, this program ended in June following the termination of the federal waiver. Congress should pass legislation (H.R. 7744) to reinstate and extend the TNA waiver. In the interim, the state should apply for a federal waiver to extend the Oct. 6 testing deadline in light of testing capacity issues, which are making it difficult for these caregivers to become certified nursing assistants (CNAs).

We also need to make sure our current CNAs are given opportunities to advance, and that providers can remain competitive with other industries. Lawmakers can help communities by providing greater flexibility for CNAs to move up the career ladder, including allowing qualified nurse aides to train to become medical administration technicians. In addition, transparency and oversight of temporary staffing agencies and pricing protection are needed to ensure that older Pennsylvanians have access to needed care.

Pennsylvanians should be proud of the work accomplished in the state budget on behalf of long-term care. It will help improve the lives of countless older adults and their loved ones. But let’s not stop now. Too much important work remains in ensuring Pennsylvanians have access to these critical supports.

As we just saw, by working together – anything is possible.

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When they faced off two years ago in House District 146, incumbent state Rep. Joe Ciresi (D-Royersford) easily bested his GOP opponent, Thomas Neafcy by about 5,000 votes.

But the politics of 2022 are very different. President Joe Biden is polling in the low 30s, gas prices are soaring, and polls show voters are ready for a change. Enough change to flip this district? That is what Neafcy is hoping.

Thomas Neafcy

Ciresi, who is seeking a third term, is quick to note he is willing to buck trends in his own party.

“I know some of my colleagues get upset with me because I’m not progressive enough at times. I am progressive, but I look at a different way to get there. I don’t believe that tomorrow everything should be renewable. I believe it all needs to be renewable, but you need to buy into that.”

One thing both candidates agree on is the economy is the most pressing issue.

Republican Neafcy, a former Limerick Township supervisor, blames Biden’s policies for a historic surge in inflation that has raised the price of gas, food and rent.

That is squeezing Pennsylvanians, especially families and retirees on fixed incomes, said Neafcy, who secured the GOP nod through a write-in campaign in the May primary.

“We’re heading into a recession. People on fixed incomes or retired are scared to death,” said Neafcy, who counts himself among those who are worried after retiring following more than 30 years working for PECO. “We’re in terrible shape under President Biden. Inflation’s out of control. Gas prices are out of control. Jobs aren’t what they should be. We’re in trouble and it’s going to hurt for a while.”

Ciresi pointed to the state’s $42.8 billion spending plan that allocated more than half a billion dollars in additional spending for K-12 education as providing some relief for taxpayers.

Nearly $250 billion is going to help the state’s 100 poorest districts, the Associated Press reported, along with  $140 million in direct property tax relief for residents through a one-time bonus rebate program proposed by Gov. Tom Wolf (D).

“We all know the economy is a major issue,” Ciresi said. “And it continues to be an issue. This budget that just came out helped a lot of people.”

After giving up his supervisor seat last year following decades in public service, Neafcy said was drawn into the race after the Montgomery County GOP failed to put up a candidate in the primary. He said he felt a responsibility to step up after serving virtually every level of local government in Limerick Township.

“I have one philosophy, and I’ve always kept it. I will give you an honest answer,” Neafcy said. “You may not like it, but I’ll tell you the truth. You can take it to the bank. I don’t play that game. I believe in honesty and integrity.”

Ciresi, a former Spring-Ford School Board member, comes from a plain-speaking Italian family whose influence is obvious in how he carries himself.

He littered his interview with DVJournal with colorful language and jokingly told a childhood story of how his mother brusquely laid into an irritated motorist who honked at them while they were broken down at a light.

He hopes his straight-talking ways and commitment to doing the “right d**n thing” no matter what appeals to voters who are disillusioned with Democrats because of Biden’s unpopularity.

Neafcy attacked his opponent’s record on education, claiming he is a “special-interest” candidate aligned with his biggest donors, including the teachers unions.

Neafcy supports school choice and was critical of legislation that Ciresi sponsored aimed at changing charter school laws and the way schools are funded.

“He’s trying to defund charter schools,” Neafcy said. “He’s not working for the kids. He’s working for the teachers’ unions.”

Ciresi, who serves on the House Education Committee, has been critical of the state’s funding formula, particularly an antiquated “hold harmless” policy, around since 1992 to ensure school districts aren’t funded less than they were in previous years. He believes it created steep imbalances among schools with shrinking or increasing student enrollment.

“It was a good idea at one point. It doesn’t work,” Ciresi said. Growing school districts raised property taxes to offset the state’s underfunding. This year’s budget includes a $225 million increase for Level Up aimed at addressing the iniquities, he said.

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