Connecticut’s efforts to monitor coronavirus outbreaks among seniors has a sizable hole that Gov. Ned Lamont hopes to plug — a gap that impacts thousands of elderly in assisted living facilities.
Simply put, while Connecticut has regulated the medical agencies that serve assisted living communities since the mid-1990s, it doesn’t require these agencies to report COVID-19 or any other viral outbreak as it does nursing homes.
Lamont, who recently expanded the public release of infection level data from nursing homes, is searching for a remedy, including possibly using an executive order to mandate reports from assisted living centers, a spokesman for the governor’s office said Wednesday.
The issue came to the forefront earlier this week when state and local officials coordinated a team response to a coronavirus outbreak at an assisted living facility in Stratford, which put out an urgent call for help when a number of residents fell ill with the virus.
A regional medical reserve corps and Yale-New Haven Hospital sent a doctor and nurses to bolster medical staff at Spring Village at Stratford following appeals Saturday from Stratford Mayor Laura Hoydick and from the Department of Public Health.
Spring Village did not report how many residents have tested positive for COVID-19, but state health officials said the outbreak led to more than 30 residents being tested and some medical staff quarantined with coronavirus symptoms.
Two organizations representing assisted living facilities and a coalition representing the medical service agencies issued a joint statement Wednesday pledging to work with the Lamont administration.
“Every day assisted living providers are doing their part to aggressively prevent and mitigate the spread of COVID-19 and they welcome the state’s partnership and assistance in this effort,” wrote Mag Morelli, president of Leading Age Connecticut; Matthew Barrett, president of the Connecticut Association of Health Care Facilities; and Christopher Carter, president of the Connecticut Assisted Living Association.
Morelli, Barrett and Carter added that assisted living communities would welcome additional support from the state during this crisis.
“Assisted living providers play a valuable and vibrant role in the aging services continuum,” they wrote. “And, because public health officials have identified older people as at high risk of getting very sick from COVID-19, they along with their fellow aging services providers, find themselves on the front line in the battle against this virus.”
Assisted living residences serve residents age 55 and older who need some health, nursing care, or other assistance with daily living activities, but not necessarily the skilled care provided by a nursing home.
But while Connecticut monitors a wide array of functions at nursing homes, its approach to assisted living is far less thorough. Technically the state doesn’t even license assisted living facilities, but rather only the Assisted Living Service Agencies [ALSA] that provide medical services for residents.
Department of Public Health regulations require an ALSA to regularly assess residents’ health conditions and refer them to appropriate medical providers when necessary. A registered nurse must be on call 24 hours a day.
There are more than 110 ALSAs currently licensed by the health department. Licensed agencies only can work at managed communities that provide core services like daily meals, housekeeping and laundry, transportation, maintenance, social programs, and 24-hour security. But the state doesn’t actually regulate how these non-medical programs are delivered.
State Rep. Vincent J. Candelora, R-North Branford, one of the first legislators to raise concerns about state tracking of COVID-19 rates among the elderly, said closing the loophole is key for two reasons.
First, Connecticut needs to ensure all elderly, not just those in nursing homes, are getting the care they need, he said. But Candelora also said assisted living residents — in general — are younger and more mobile than those at nursing homes.
“If we don’t have this critical piece, how will we know if surges of the virus are coming from assisting living facilities out into the rest of the community?” Candelora asked. “We need to avoid widespread increases in transmission wherever they happen.”