Vermont Legal Aid Town Hall on Long-Term Care

thank you so much for joining us for Vermont legal aids Town Hall today my name is Amelia Schlossberg and I work at the office of the healthcare advocate at Vermont legal aid from a legal aid is hosting these town halls at 10:00 in the morning on Thursdays we are recording these town halls so you can watch them later the recordings are posted on our Facebook page where we are also broadcasting this this town hall and the recording is also posted on our website that’s WWBT la help org our website is a joint project of Vermont legal aid and legal services for Mont we’ve been covering various civil legal issues over the past several weeks we’ve talked about housing we’ve talked about unemployment we’ve talked about health care than some other topics and we’ll have a guest and you can ask questions if you’re joining us via zoom you can type your questions into the Q&A box and I’ll ask those questions of our guests you can also see a type answer in zoom as well to each question if these questions will be answered and if you have a private and a confidential question you want to ask us you can always call the phone number 1-800 eight eight nine two zero four seven is the phone number to reach Vermont legal aid and legal services Vermont our help is always free and confidential so if there’s a question you don’t want to ask here you can ask it there if you’re joining us on Facebook you can type your questions into the comment section of the Facebook live video and we’ll get your questions answered that way and if you’re calling in again you don’t have a way for you to ask questions over the phone during the the Town Hall but you can call us at that number to get your questions answered if you don’t hear an answer during the town hall and you don’t see an answer on our web page one more quick note before we get started with today’s guest we are hosting a virtual legal and ice clinic for that we’ll give free legal assistance to Vermont seniors that’s folks living in Vermont that are aged 60 and over will answer your legal questions about kovat 19 or any civil legal question that means things like health care Social Security debt housing unemployment and more you can give us a call and leave a message to have your free 20 minute appointment this clinic is on Wednesday June 10th from 9:00 a.m to 11:00 a.m. and to schedule an appointment you call us at 8:02 three one eight four one six nine that’s eight zero two three one eight four one six nine leave us a message to schedule an appointment so that’s a free legal advice clinic for Vermonters over sixty years old so thank you for asking your questions and typing them into the Q&A box and let’s see I think the the next step here is to welcome our our guest today so um our guest today is Sean Maude again so I’m gonna turn your video on or ask you to turn your video hello hi Shawn hello um and I’m gonna ask you I start your video too sorry I think I’d stopped you from doing that before okay thank you so much for joining us John so again my name is Amelia my guest today is Shawn Lonnegan I’m Shawn monoghan is Vermont’s long-term care Ombudsman thank you so much for being here Shawn well thank you very much for the opportunity magnification wonderful so Shawn what is long term care so long term care is a broad range of services and one end would be medical services so be things like you know they’re seeing physical therapy occupational therapy and if the other end would be non-medical services and would be things like personal care so if a person had an ability to do activities of daily living they would get personal care so

depending on the person’s condition and needs and preferences they would get you know the services that they need that continue got it and so where does long-term care take place so long-term care complaing of places it can occur in long-term care facilities so long trunk episodes would be a nursing home residential care home and assisted living facility and you can also get long-term care in the community such as as your home okay thanks Shawn um so tell me more about Vermont long-term long-term care Ombudsman project and in your office and what do you do so the long-term care budget project is an Agassi group project the special project of Vermont legal aid and we advocate for right and also individuals who received choice of the care in the home and we also try to promote change that would lead to better care long-term care and quality of life or individuals receiving long-term care how does looks reach the the project time maybe just have someone to get help they can do that in various ways I guess the best way now would be through you know our 1-800 number so one eight hundred eight nine two zero four seven there are a button projects been around for for many years so some some people already know about that so you can contact busman directly we also can take you know we used many times we spend time communicating with long-term care facilities so that’s another way you can do it through our website but right now probably the best one it would be to give an office a call and then depending on where you’re from you in each county in Vermont has their own ombudsman so at some point that Ombudsman would give you a call back okay got it so it sounds like if you need help from a long-term care Ombudsman you would call the 1-800 eight eight nine to zero four seven number and let’s leave a voice message and let them know where you are what nursing home you’re living in or where you’re getting that home health care and the person that’s assigned to that County a your long-term campus on the local one wall we’ll get back in touch with you exactly great and it sounds like usually you’re going into nursing homes and you’re going into residential care facilities and and sort of checking up and visiting people maybe even proactively before they call you right so the Ombudsman project we have a number of duties and responsibilities but I guess generally speaking we investigate concerns or problems that people have about their long-term care we help individuals make decisions about their long-term care we educate staff about resident rights we monitor conditions at long-term care facilities and we also track policy legislation that would impact long-term care residents and finally we try to give Vermonters just general education and education around long-term care services Thank You Sean um sounds like you do a lot of things so let’s talk about a lot of really important things during this pandemic especially let’s talk about what it’s some of the big changes that you’re seeing during the pandemic for Vermonters that are living in nursing homes and other long-term care facilities so what what do you what do you see right now if you’re living in a nursing home where are some of the changes that you’re seeing right so you know some big changes are issues that residents are facing now or around visitation you also kind of group that means within long-term care facilities so either that dining of social activities there’s issues around coming and going so you know if you’re a resident you’ve got to be the luncheon care facility either to you know just maybe to go home or to receive medical services so position rebound coming and going it’s also issued around transfers and discharged probably more transferred because a lot of facilities now are designating certain areas of facilities sections colder than on coal grid so it may mean that residents are being asked to move rooms and usually they make it a heads up about that in advance but giving makovan that may happen more rapidly I guess you can also other issues may be on staffing staffing shortages and maybe um you know transparency in the sense of maybe individuals not necessarily residents on and Families not necessarily always knowing you know what’s happening within facilities given

some of the restrictions as we mentioned that visitation would be you know one thing got it so thank you Sean let’s talk a little bit more about visitation we have a question here coming in from Facebook and the person is asking when do you think we will be able to see our families and facilities yes that’s a really difficult question but your I guess the to answer your question we have seen moving coal that these restrictions on presentation are a result of you know Cogan and in Vermont we’ve kind of flattened the curve we’ve kind of put in place in infrastructure in regards to testing tracing and as a result of that and we see in Vermont as a whole start to be open and oh and the country and recently CMS which is the Centers Center for Medicare and Medicare services issued their recommendations regarding opening of their some homes and it’s a three-phase prom so it’s my understanding that the state and long-term care facilities are looking at you know how the reopening of nursing homes is going to look over the coming months no real decisions have been made but you know that the reopening is obviously gonna address this issue or visitation it’s a complex issue for various reasons and I already hope that in that process of the state and facilities making that decision that residents their concerns their voice their preferences would would be considered in how you know visiting what look going forward thanks Sean so um tell me more about how residents are staying connected with family members and loved ones during the pandemic without having in-person visits are there any other ways people have been able to stay connected right so facilities they have become n residents have become creative in ways and trying to stay in touch so many facilities have established regular communication you know with family members so that’s one way an example of a way in which families can know it within the facilities soft phone calls with the family members regularly right and even the Smithsonian’s made contact kind of meetings with families where their expression you know telling you okay this is what’s happening in the facility this is what we’re doing this is what we’re seeing and so that’s one way in which family members can least have an idea what’s happening within facilities and inspires communication with family members with residents you’re seeing things like virtual visits like you said phone calls you’re also you may have heard of window visits where you know if elderly members can I mean residents concede family members you know from outside and I should note that with the family with the weather getting warmer some facilities have started you know outdoor visiting again kind of practicing social distancing and taking other precautions but that’s kind of a more face-to-face visit so we’re seeing some facilities do that so those are some of the ways in which families and residents are trying to overcome the current prohibition on visits and facilities got it so Shawn to get back to the original question it sounds like for someone asking when will I be able to see my my loved one in a nursing home facility in person we don’t have a clear timeline yet because it’s going to depend on what happens in the state but we do know that that people are seeing their loved ones through virtual visits from a video or a conference call or a telephone call they’re also visiting and seeing them through windows and we did have a resident or someone who asked us a question here and said what about outsides you’re saying that yes there are places that are doing some outside visits that are at least six feet apart as the weather gets warmer maybe with other protections like masks and keeping that distance but being in person right yeah I wish I could give that that person neighbor right that question a certain date certain but I don’t think that that’s possible all I can say is that you know that’s something definitely that facilities and stay here are looking wanting to address mm-hmm yeah and it sounds like you’ve been saying that when the state starts making more changes and

allowing more opening of nursing homes for long-term care residents in various settings it’s really important to have people that are living in nursing homes have the residents themselves be at the table and have a voice in this and these decisions most definitely that really should be happening because you know residents are obviously part of the equation and you know facilities and even the state when and then thinking about reopening you should take in consideration you know what residents are feeling and had to say on these you got it Sean we’ve got some really great questions coming in more about these changes you’ve been talking about and so here’s a question that says I understand the limiting of visitors but when do you think residents will be able to dine with each other yeah again right so there’s again limitations we talked about some of the things and sense of you know group activities within facilities and not not happening so initially we’ve heard you know people just residence just being eating inside their rooms by themselves so again as things as we’ve learned learn more I guess I heard of facilities where residents are eating together but again practicing social distance so it might not be that you know you have six men six residents around the table it may be that you know you have two presidents at that table and then tables just you know in a way in which it’s so statistic so I can’t say the airplane there get infected so I think that that’s happening in some facilities again lots of times some of these things are gonna be facility specific right so it’s not gonna be like a red line or every facility doing the same thing it may depend on the facilities what they think that they’re capable of doing so in some facilities we are seeing again not the the group meals that we’ve seen before but opportunities for you know residents to eat together but in a socially you know I guess Justin’s in a responsible way got it Thank You Sean so I guess I have a follow-up question for that if someone if I’m in a nursing home or a long-term care facility or residential care home and I’m not getting the connection that I need whether that’s you I’m feeling isolated in my room or I’m not getting a chance to to to connect into to be in community what are some resources for me in that situation right so one resource will be definitely the Ombudsman program right so if your feelings though you know you have concerns questions about your care and you you know want to talk things talk things out you can certainly give our office again contact our office and we can talk with you and we can go through your options in the sense of about how you can have that concerned address and there’s a number of things we do and the Ombudsman can talk with you about about that so I guess I would recommend contacting us but I guess if you want to take the initiative you can you know always bring up any concern residents have a right to make complaints so if you have concerns or complaints about your care you can definitely bring that up you know with an administrator a nurse was a staff person at the facility and express yourself but feel free to give us a call and we can help support you in doing that got it Thank You Sean there’s another question along those lines and this is so what if someone has this concerned someone’s s s an anonymous question and about residents that have been combined to your room and allowed to walk in hallways consequently you may lose your ability and stamina to walk so what if you’re concerned about losing your ability to walk or stamina to walk because you’ve been confined to your room and not allowed to walk around right yep again you can contact the Ombudsman and that’s something that should be addressed you know nursing homes have a responsibility to maintain a person’s for example physical capabilities as you know best as possible so it does seem in my view unreasonable that that person would have to be combined to their room because no for example I’ve been sheltering in place doesn’t mean I have to be combined to my room you know I for

example individuals according to the governor’s order as essential activities would be to get exercise so again if individuals have a specific need facility should be taking that in consideration and care planning around that so there should be a way in which there’s it really shouldn’t be any reason why in my view given that that question the information provided that that person should be confined to their room all the time and not able to be able to walk you know around the facility or even outside so they should definitely give us a call and we can work with them to address that concern Thank You Shawn that was a great question okay are you ready for more questions long that’s lying the sort of people are responding to these changes sure yes okay great so um it’s a really great question here this is a someone saying we provide hospice services in several nursing and assisted living facilities many of these have restricted visits from our social workers and chaplains a few facilities are still on ready to allow our nurses and aides in to provide care for these patients um the most of them have arranged for virtual visits but virtual visits are not as comprehensive as in-person hospice visits are well there be guidance from the state about provider business as well as having visits so what about these visits that are not from family members or loved ones these are from hospice services around social workers and chaplains are those restricted right now would you navigate that if someone wanted that hospice care from a chaplain or a social worker in person and was being told no you can only get it over the video chat right so yeah the pro based on the governor’s order visits are prohibit prohibited in nursing homes for example and with only two exceptions those two exceptions being medic medic medic Oh necessary personnel and also end-of-life circumstances hmm so it’s pretty strict Ombudsman in but in those circumstances also issued compassionate care so so the governor’s or is a little bit stricter than maybe some of the CMS we talked about Centers for Medicare and Medicaid Medicaid so in that situation again I think they can this the questioner can certainly reach out to Ombudsman program and we can kind of think about that and see how best to address that but I guess there was a little bit of leeway right there with that compassionate care um so and it can be an individual basis so and again as things are again opening up it does seem as though facility should be taking consideration these types of services and maybe even making the argument that they’re medically necessary so I think it’s a way in which we can brainstorm and and look at the situation and figure out if there’s a way in which we can have those services provided in person like the questioner said which which are better for the resident so I guess that’s my my initial thoughts Thank You Sean it sounds like there’s also already an exception for end-of-life care so Hospice might threaten that row baby should fit in that though on how that’s being interpreted it sounds like if it’s being an interpreter in a way that’s not following what the resident is looking for that’s when the Ombudsman would really want to be able to help out yeah why certain things sometimes like you know the end of life end of life you know at the end there but yes but but it kind of should be here at an individual perspective if you look at CMS guidance and so again there should be a kind of more comprehensive looking and facilities are saying you know are in my view that something should not have be happening right it does seem as though again looking at the individual situation and see you know how best to do that would be a more appropriate way I don’t so Sean I’ve brought you into all these individual questions and I want to kind of bring you back to sort of the general things that everyone should know for the last couple of minutes of these 30 minute townhall before we get into more of these really wonderful questions and so what are some other big changes or things people should know about what’s happening during the pandemic maybe things that they can do or things that long-term care facilities or home health agencies are doing um in response to help keep people safe that either either good or they are tough to navigate right so I guess in response to cope in 1950 should be kind of assessing their infection control procedures and policies they should be

implementing those control policies they should be sending communicating regularly with the state in terms of getting guidance has been seeking help when they help and they should also be setting up a regular chain of communication with family and residents to keep that kind of update updated on on things it’s a you know I don’t need to tell anybody like the environment is fast-paced and changing changing so good communication with residents and essential the state should be doing things like testing they should be doing things like contact contract racing they should also be again working with facilities to provide technical assistance based on what’s happening with individual facilities they have a certain situation that they have an outbreak so if they have an outbreak obviously the facility should be communicating and working with the state how best to mitigate that outbreak and in addition for that the state should be pushing out information that’s coming from then and also from the federal government in regards to policies and procedures best practices and then finally the state should also be regulating facility so in regards to you know certain things that facility should be doing and response aid the kovin um so the state should be ensuring that they’re enforcing those rules and again you know working with facilities to make sure that for example friction control is maximized and being done in a proper way great Thank You Sean um that sounds like a lot of really important changes that are happening right now in really important ways to help limit the spread of this disease I know that in in Vermont and across the country nursing home residents and and people that are getting long-term care really been very mean very vulnerable and kind of experience a lot of a lot of illness and a lot of harm from this pandemic so so some really important so any last last comments from you before we go into these more individual questions which are just these are fantastic questions and I’m excited to get to them anything else folks should everyone should know about long term care right now I guess the one thing that does could pop into my mind is the stimulus checks that Americans most Americans I should say twelve on our dogs received and I just regards those stemless checks I just want to emphasize that those of the residents stim was checked so for example of a residents on monitoring care Medicaid that stimulus is not considered income they so it no in no way impacts your benefit your benefit generally speaking and it shouldn’t be going towards like a higher patient here and that’s money your money to be doing whatever personally you want to spend that on so I just want to emphasize that and those checks that are going out and mid-april so hopefully you know people are residents if you seen that if you have any questions or concerns about you know the stimulus check again feel free to give the ombudsman program call and I guess the other points I just want to make would be that you know the Ombudsman program is still open so again we had mentioned that word we’re unable to visit facilities because of the restrictions that we talked about but we’re still open and working remotely and in contacting facilities and residents during the pandemic and going forward we’re free so you know any services that we provide are free and in word confidential so anything that residents or any callers say to us this is stayed between you know the caller and us unless we get permission to do that you know facility so residents coming to us as a confidential relationship and we’re resident directed so we don’t do anything unless we get permission for the resident or their representative to go forward so Shawn that sounds like are you saying that you’re not meeting the reporter so really there’s no exception so that confidential your your confidential and you’re always going to take that direction from from the person you’re talking to from from the resident themselves correct we’re not mandatory reporters and we picture resident directive so we just follow you know what the residents want us to do got it so it sounds like that $1,200 is yours to keep it does not go back to Medicaid or anywhere else doesn’t count for Medicaid and you have a free confidential resource and the phone number is

but if that resident was seeking legal advice or legal representation and that’s one way in which that could be pursued or polished we would certainly make that referral that’s what the resident wanted okay thank you okay so lots more questions and here’s a question that says I got some clients that only got half of their money can we refer them to you to find out why does someone only got half of their stimulus check yeah they can definitely calling you or yep they can definitely call our office because that shouldn’t be you know happening and actually yes that’s that’s that we would want to know why that was happening so feel free to give us a call great so yes definitely a good referral um okay next question about these stimulus taxes is a great topic is there a certain amount of time people need to go before the $1,200 is counted against their Medicaid eligibility um so for example if they haven’t spent it and it’s been an entire year from now then what happens this is great cuz I things happen change after a full year correct yep you’re right Amelia so if a resident did not spend that money within approximately 12 months yeah yeah then it could possibly count as a resource and you know impact benefits but you have a resident has up to 12 months to spend that money got it so if you’re over the in kind of resource limit after 12 months then then it might put you over the resource alone but it’s not gonna do anything in the meantime so don’t and if you need help figure out how to spend that money and we’re not gonna tell you how to do that but if you want to talk through some ideas if you’re worried about losing your medicaid talking through ideas and on how to keep medicaid it’s definitely something that Vermont rates so what once generally speaking it shouldn’t impact your medic Medicaid and yeah so it’s kind of like a extra personal needs allowance presidents may be familiar with that they get a person B’s allowance but 72-66 think so they can spend that money has they see fit so the same thing kind of applies does apply in stemless Jack it’s kind of $1200 in which they can spend how they how they however they want to spend money on their personal needs and things that they know they want to buy or need thanks Sean okay so another great question here what is the current Vermont guidance for additional restrictions after a resident has left the long-term care home for a doctor’s visit yep that’s going to depend on facilities generally speaking if an individual leads the facility and goes to see a doctor it could be that they are isolated in some fashion from the rest of the residence for up to 14 days so generally speaking if you know someone’s going to you know regular dialysis or someone went home for a weekend you probably need to talk with the facility and maybe it’s a good idea to find us out beforehand and they they should have some kind of policy and they’d be able to explain to you what’s going to happen but it is possible that you know one one thing that could happen would be that they would be isolated for a period of time given the fact that they left the facility and kind of come back thanks Sean so is that um specific to one is that the side nurse’s if Accor residential campus specific or is there general Vermont guidance of all facilities are following yeah it’s it’s all long-term care facilities we probably generally following that you know guidance and again it’s guidance so you know facility for various reasons may say well we’re not going to you know do the 14 days or whatever so again that’s guidance that’s general guidance is that you know if you’re for some reason you’ve left the facility for a period of time coming back you’re gonna be and due to coping you might you’re going to be isolated potentially so it’s limited interaction with the rest of the facility for a period of time due to that kind of we mentioned comings and goings so that’s an example an issue that residents are facing when they leave what happen when I come back mm-hmm and again if they have questions or concerns they can certainly come to the contact and on buzzing we can talk that through and you know work with the facility ask the facility what what is your policy and

and try to get an understanding what they’re doing mm-hmm thank you Shawn I’m swing back West here a question here about testing and this person’s asking are a lot of residential care facilities having contaminations tests haven’t been available in the one that my loved one is in so it’s no one has shown any symptoms but what statistics do we have in Vermont and is the state going to provide this kind of information right so there’s multiple questions there the first one I’ll say that the snake does in regards to information about launching facilities at the end of each week the Department of Health does issue kind of a summary of what’s happened up to that point and in regards to Cove it’d giving a breakdown of the demographics and one criteria is like long-term care and over the past weeks approximately 50% of fatalities in Vermont to dacovia are related to long-term care so that’s one way in which they don’t break it out you know I haven’t seen anything along those along those lines but so that’s one way in which you can figure out kind of what’s happening monitoring their facilities and regards to total fatalities testing no it’s if there’s an outbreak in a facility the facility will be given the option everybody so if there’s a staff member that tests positive or a resident test positive Department of Health will notify the facility that there’s you know been at positive Kovach either a resident or a staff don’t give the facility staff and residents the option of being tested and then they’ll follow up do follow-up testing based on that so I think is initial passed and then three days after that initial test and seven days 10 days 13 14 days so that’s what we happen but if there isn’t in she mentioned the residential care home so that’s a little bit different nursing homes do have the option potentially to do more testing but what I know as far as I know is that residential care homes you they’re not going to be at this point given the option that was do testing without probably a positive test happening there okay so it sounds like there’s not necessarily widespread testing in facilities where there have been no symptoms um what do you do if you are living in a in a long-term care facility and you want to get tested but you haven’t had symptoms or you’re not sure if you have symptoms yeah so again again not everybody can get tested but if you had had reason to believe that you should be tested you had symptoms or you would need to get an order for that testing and then you would get tested through that process I know this is kind of complicated you know bond doesn’t pop up test now where people can call up and throw out for money and get their you know own tests so I guess a staff member could do that and again if you’re there’s different rules here a guidance depending on the facility so nursing homes you might have the option of getting and they talked about enhanced protocols which includes more testing but if you’re a residential care assisted living you’re probably not going to have that option so I don’t know if I did a good job of answering that question but if you wanted to get testing you would probably have to do it in a way outside that outside the facility if there aren’t people with symptoms then right testing probably wouldn’t come to you we might be able to figure out a way to go to the test right okay got it thank you Shawn okay so another really wonderful question here on a different topic when will nursing homes be able to admit new residents so our nursing home submitting new residents now okay yes so that’s good to the very eye it’s gonna vary depending on the facility there’s no rule that facilities can’t admit new residents facilities may make that decision on their own for various reason they might be a legitimate right because they may be concerned about bringing kovat in they might not feel as though they had the staff to manage you know the staff so but there’s no prohibition for new admissions and the cyllage should have again I guess I should I’m saying it’s so there’s no reason why I facility there’s no prohibition so if so they feel insulation

I can accept someone they can do so so I guess that’s up what I would take enough guess if I hear a negative whoa we’re not accepting our residents I would try somewhere else to see whether or not that would be different and again it could be in a case-by-case basis where a facility is evaluating whether or not they feel so they can appropriately care for that person so there’s no prohibition on admissions at this time got it so far the question when will nurse assumes to be able to admit new residents they can admit new residents right now but they may be choosing not to exactly you answer that much better than I did something I’m just summarizing what you’re saying okay more questions about resources here so are there this question says when my Adult Day programs reopen so are their Adult Day programs that are open right now that you know of yes thanks for what those resources look like adult they have been closed right under the governor’s orders at some point yes there will be reopening I don’t know necessarily exactly when that’s gonna happen but I would still contact adult days because they are providing some services including services in people’s homes so even though they’re not operating like they used to three months ago they are still providing services so I guess if you’re familiar with adult daycare or been kicking receiving services there be previous I would contact them to get an idea of when they’re gonna you know when they think they’re gonna reopen and also whether or not they may be able to provide you some services in the meantime perfect thank you okay so more questions about facilities are there any limitations with switching facilities if you’re unhappy I guess the only limitation would be that facilities it probably has been to accept new residents for the reasons we just talked about before right in the sense of being unsure whether than that they want to miss someone that they have unfamiliar with and you know what are the possible ramifications of that I can admit you know kovaydin cause you know that that concern so nope if an individual desires to you know move from a facility that’s their preference the facility should be working with them it may be harder but they can certainly try to do that okay and so it sounds like there’s sort of two pieces just wishing facilities one piece is the leaving one facility and the next is getting into the other facility and so where it sounds like there may be some slow process around getting into the next facility and you probably wouldn’t want a big gap in between there right hopefully it’s a fairly smooth switch so um you would want to work so what about someone that wants to leave it and doesn’t want to go to another facility but wants to go home or to go live you know get home health care or live with with loved ones right so individuals that are nursing homes when they first and you know admitted to a nursing home they are asked their preferences you know would they want to go home and so but at any point so that may change over time right so but if any point the resident says well I want to go home then the facility should be working with that resident to accomplish that I’m so it’s called discharge planning right and I’m saying that I want to return to my home and if I need services home health services they should be working with me to make that happen so I have a safe discharge to home so a resident certainly can say you know I have a home that come back so they could be obstacles right if you don’t have a home or that going home could be difficult so but the point being is if you have a preference your preferences that you want to leave the facility the facility has an obligation to work with you and busman can be part of this process to make sure everybody’s doing their job and the sense of of trying to I’m sure that this residence preference is met that can certainly um happen one thing I want to say is you know unfortunately no one’s guaranteed a spot into a nursing home so even if you need nursing home level of care it doesn’t automatically mean that someone has to accept you so going back I know we’ve already covered this question but admitted to a nursing home can be difficult even during ordinary times and then so this times it could be a little bit more difficult so I guess if I’m thinking about transferring or going to admitting or going to a new facility that’s one of the things I have to keep in the back of my mind is that it may be more difficult at this time to leave to get into a nursing home or any facility or to go to a different one under these circumstances got it so that’s always a little bit of a complicated situation and it may be much more complicated now given a pandemic okay Thank You Shawn so we have another question here um have you received any

complaints about lack of personal protective equipment PPE s from long-term care facilities and/or people receiving home health care is there anything your office can do to help with this right so an adorably we’ve heard reports that you know this staff members at facilities haven’t had the PPE and I think if you know you talked to the state that would be confirmed you sense even facilities themselves in the sense of not always having enough protective personal protective equipment if individuals are you know having difficulties with that we can certainly talk with them we are advocates for residents but at the same time we do talk to you know stab so if that felt as though they weren’t getting that we can certainly provide them with some ways in which they could they get that concerned address including you know making a report to the state for example so if they stack our mandatory reporters right so if there’s something that’s compacting the health and self well-being of residents they may be in a position where they shouldn’t be reporting those things but yeah and I guess I would say that you know the personal protective equipment has been an issue and we can certainly talk with them about you know how they can mummy get their complains addressed um got it Thank You Sean so it sounds like you are predominantly you’re primarily there to support residents and residents a separate questions not staff but these kinds of questions do impact residents that’s right maybe you would want to hear about them and you have heard about these kinds of things they are like right got it um okay thank you so more questions here we’ve been talking about how difficult that it can be for you to switch between facilities if you’re a resident and you live in a nursing home and you want to live in a different one instead we’re switching between assisted living or switching between residential care homes this question here is a bit different but all on the same themes this person’s asking are there restrictions on staff working in more than one facility historically many staff that have multiple part-time sorry historically many staff have had part-time jobs at multiple healthcare facilities which would increase the risk of transferring infection between facilities so what about that situation where staff are switching between facilities yeah there’s no prohibition you know written and regulation that says that stack can’t have multiple you know working multiple facilities and that is problematic and so what you say the questioner says it is correct it could be that that would increase the likelihood of transmitting you know or spreading the virus given that they’re working in multiple facilities and I guess one of the things in thinking about coded and how to you know its impact on nursing homes one of the things long-term to think about is that it’s it’s no secret that salaries pay for support staff and contractor facilities is is very low so that forces many times staff to take on multiple jobs in order to you know pay their bills and you know earn a decent living so that’s like kind of a function of the industry and certainly you know things like you know extra hazard pay legislation north in Vermont now for example for essential workers should include you know staff and long-term care facilities and then going forward it should kind of be an examination of the rates that staffs see so yes that that can certainly with that questions asking that would increase the likelihood of spread and it’s a function of the industry itself effect okay thank you um that’s helpful information and it sounds like there is additional risk and I’m part of that risk that you’re saying is somewhat it’s a problem but it’s also understandable given the the no secret that it’s a low paying position okay um okay um a really great question came in just now from Facebook what if the facilities sorry what is the facilities obligation to tell a new admission if there is an individual who has or as was being tested for kovat 19 so tell me more about if you live in a nursing home and is the facility required to tell you if someone there has tested positive or what if you’re going to a new nursing home what’s the requirement people to

tell you you may be entering a space where someone’s tested positive is there a requirement there right so I think I would you know residents have a right to keep their confidentiality of their medical you know our records so I guess the first thing would be that they wouldn’t I don’t think that facility would disclose who has Kovac unless they have permission but certainly they should be disclosing to residents that you’ve had an you know case that’s either stab or residents and they should be if that’s happening the residents and staff in that facility should be told that that’s happening and this is what we’re planning to do to try to mitigate or address that issue so there’s again you wouldn’t be try to identify that person but you would be required to say well this is what’s happening and occurred and you see what we’re gonna do certainly if you if you’re looking to go into a nursing home you one of the questions you want to ask you know what are your policies around phobic you know when you do it was it out breaking do you have any current cases right now you could certainly should ask those questions out front so you have an idea of you know what you’re getting into you know so can feel satisfied that the facility has a plan going forward if there is no break or if they have current cases Danny thank you sorry let’s we have another question from Facebook here can a facility issue an emergency discharge of a resident if the resident is not following the facilities covered 19 protocols or precautions if they can do that where would that resident go if they had other placement options so what if can you be kicked out of a nursing home if you’re not following the coab in 1902 pause well III don’t think there’s a yes-or-no answer to this question certainly individuals once you’re into a nursing home or a bunch activity there’s only specific reasons why you can get involuntary discharge meaning have to be forced to leave against your will and one of those is that if you’re a threat to the health and well-being of other residents right so if you want if you want to take that forward and an individual was being neglectful or in regards to them exposing themselves and then possibly putting other people at risk you can see how a facility could possibly make that argument you know whether or not that argument is enough to get that person involuntary discharged on the facts of the case and the decision maker so I guess the thing his ear is possible that could happen but but again it’s to depend on the facts then you would also hope that the decision maker were taken to consideration that if this person doesn’t have a place to go that’s willing to take them then it doesn’t seem safe to involuntary discharge that person so it’s a very good question very complex it’s going to depend on multiple factors and there’s you know it may be again it’s not like a strict rule but it’s going to be kind of like fact specific it could happen but there’s many things to think about before that should happen Shawn if you are being you know if you are in the process of being discharged whether it’s emergency discharge or just I don’t know a slower discharge I didn’t say it’s not what you want you want to stay is the long-term care Ombudsman project support for you most definitely so if something like that’s happened if you’re getting discharged involuntary is there a certain process that they need to fall one of the things you should receive notice written notice you know that’s happening and why and if you get a notice even if you don’t get a notice and you’ve been told that’s gonna happen the Ombudsman package should certainly call us and we can help you you know fight that discharge if that’s what you want to do at it so it sounds like you help people that are that are in the nursing home or long-term care facility setting and they want to leave voluntarily they won’t leave on purpose you would help them figure that out and you help someone that’s living in a long-term care facility and does not want to leave but they’re someone’s trying to make them leave you would help those people stay so do both oh great perfect okay wonderful so I’m not different okay this is a follow-up question or sort of a related question about that people that are being forced to leave their home and in a long-term care facility or where they’re living that they don’t want to leave this one person is asking what if the person who is able or not willing to follow the protocol around Kovac 19 has a disability or mental illness but that change how you hope that the facility

would would handle that situation it should it should be so the person should begin a reasonable combination for example example and the fact that they have you know disabilities should be care planned around so again there’s a big difference between someone like intentionally you know maybe doing things that put all the people at risk versus an individual who through you know other circumstances is you know something is happening so yes that that’s a totally different situation and again the facility should be care planning around that person’s unique needs around that and you know and that should result in a discharge discharge is like a last resort you don’t think it’s coming out of their home so all other alternatives should be consumed before you reach the conclusion that this person that needs to be discharged and you in addition you’re gonna do that to a person it sounds like that the long-term care Ombudsman would be helping that resident that doesn’t want to leave asked for a reasonable accommodation to stay and find a way to make it work that’s your we work you know whether it’s yes we that should that should not be happening again discharge is a drastic move pursued only after all our attorneys have been examined and explored and you know so yes thank you Shawn okay we’re nearing the end of our time here here’s another really wonderful question we’ve really answered so many wonderful questions today and this question is saying my mom has been admitted to long term care are there guidelines regarding time limits to going into her apartment and moving or closing up her apartment so time limits so you’re the resident has she’s moving into a lawn tractor facility and she has a separate apartment somewhere else is that what you think it’s my interpretation my guess is that this this in Dule that’s asking the question is not the person moving into the long-term care facility but she’s the person asking and saying oh my loved ones moving in can how soon or how long drive to wait before I can go into where she used to live and kind of close up that apartment or yeah I guess there’s whenever you leave somewhere you’re going to give notice that you’re leaving somewhere right usually 30 day notice and then you would want to take out you know the person’s any belongings so I don’t know if I’m completely following the question but but I guess there’s a time limit for her to move back in yeah I’m not sure I guess I’m curious is um this person saying my mom has been admitted to long-term care and I’m curious whether the mom wants um like what the mom wants here and I’m wondering if that’d be sort of where your where your had to be going to you know like if this person’s calling and saying okay here’s what’s happening what kind you next time I’m curious a part of the answer is well what is alright again I guess if that’s the mom’s apartment and that’s hers then yeah that has has to be factored in and I don’t know whether you know moved into on don’t care sometimes to go back up so I guess in this situation we would maybe want to flush out the details a little bit more so it does sound as though you know that the person writing this question isn’t a resident of a long-term care facility or isn’t receiving choice of the care in the community so we want to flesh out exactly what the issue is about you know long-term care before try to answer that so I don’t know if they did a bad job with that but I guess best thing would be but for that person to give us a call when we can flush that out a little bit more Thank You Sean so the phone number to reach the long-term care Ombudsman project and Sean and the other the local long-term care Ombudsman that work in each of the counties around the state of Vermont along with your long-term care Ombudsman volunteers that phone number is WWWE tela-health org webpage but you can find information about the long-term care Ombudsman and about long-term care there that website is a joint project of Vermont legal aid and legal services Vermont and again the Ombudsman’s help is always free and confidential and so you can always reach out and show and I know that we’ve been asking all these kind of quick like give a quick answer and I know that you’re used to and the Ombudsman you’re used to giving really thorough thoughtful advice with lots of information and it’s always specific to the person’s circumstances so you’re getting personalized information it’s pretty different from this Q&A here or

it’s just like quick snippet go right yes yeah so yeah I’m trained at the lawyer so I know I could be long-winded so I apologize for that that’s fine um let’s see we one more question here it sounds like would this be the right time to call your office sounds like someone’s loved one is mental health is declining and dealing with some depression and anxiety and perhaps some dementia that’s being intensified as well is that a place where were you your office could be a resource to sort of figure out some other resources for that person yes so that person’s are launched our capabilities and they’re you know they’re suffering and they seem to be like that they can certainly reach out to us and we can you know be a problem solver and you know hopefully think about some resources that that could maybe make that a situation for them better perfect so again the launch of care muslin project is free and confidential and helps people Vermonters people living in Vermont in long-term care facilities including nursing homes residential care homes and assisted living facilities as well as people that are getting choices for care long-term care at their homes okay thank you so much Sean I really appreciate your help today and your expertise and it’s really wonderful to have you in this town hall well I appreciate the opportunity and thank you very much for your help thank you alright thanks everyone again this was recorded and you can watch it again later