Lamont, Gifford receive report on COVID-19 response in CT nursing homes

CDC/ Alissa Eckert, MS; Dan Higgins, MAM

HARTFORD, CT – Connecticut Governor Ned Lamont and Acting Public Health Commissioner Dr. Deidre S. Gifford announced on Tuesday that the state has received an interim report on COVID-19 in CT long-term care facilities from Mathematica Policy Research. Mathematica was retained to conduct a thorough review of the preparation and response to COVID-19 in Connecticut nursing homes and assisted living facilities after Governor Lamont ordered the independent, third-party review on June 8, 2020. The interim report as part of this review was delivered to the Department of Public Health on August 15th and Mathematica’s final report is due September 30, 2020. The interim report can be found online. In the report, Mathematica makes several recommendations aimed at preparing the state and long-term care industry for a potential second wave and for reducing future infections in long-term care facilities. These recommendations are based on interviews and analysis of data from CT and other comparison states.

“Like much of the country, Connecticut long-term care facilities were hit hard by COVID-19. Our preliminary assessment of the state’s response found that state officials made policy decisions and issued guidance based on the available knowledge at the time from national and state epidemiologists and public health experts, but that knowledge was undermined by gaps in the scientific understanding of the virus. Connecticut took an important step in supporting this independent research, and we believe our recommendations will help ensure that the state and long-term care industry are better positioned to respond to a potential second wave of COVID-19,” said Patricia Rowan, researcher at Mathematica and the project’s director.

“We know now that limited COVID-19 testing capacity and limited scientific knowledge about the novel coronavirus during the first difficult months of this pandemic made it very challenging to contain the spread of COVID-19,” said Governor Lamont. “Despite these limitations, CT

made some very critical decisions in our response to COVID-19 that saved lives and improved public health. Because of the hard work and sacrifice of long-term care workers, and residents and their families, we have seen a consistently low number of cases and deaths among staff and residents of long-term care facilities since early June. I am grateful for the thorough work done by Mathematica to help us learn from our response thus far so we can make improvements as needed as we work to avoid another surge in COVID-19 cases. I look forward to reviewing the final report, and working with the long-term care industry to keep our residents and families safe from COVID-19.”

“For the residents and families of Connecticut’s 214 nursing homes and the staff working long hours to care for them, I welcome this review of the impact of COVID-19 on our long-term care industry, and how we as the state responded,” said Acting DPH Commissioner Deidre S. Gifford, MD MPH. “Since the first case of COVID-19 in a long-term care facility in March, we have traveled a long way alongside the nursing homes and their residents. We have made important progress in testing, inspections, infection control and most importantly of our understanding of this virus and how it spreads. There is still much more to learn, and I look forward to reviewing the final report and working with the industry and other key stakeholders to adopt some best practices to improve the long-term care picture in Connecticut going forward.”

The interim report was presented earlier today to Connecticut’s legislative leadership as well as chairs and ranking members of the Public Health, Human Services, and Appropriations Committees. A link to that presentation can be found online.

Mathematica’s overall assignment was to:

• Assess the overall impact of the COVID-19 Pandemic in Connecticut compared to other states in the region and the country.
• Assess the overall impact of the COVID-19 pandemic throughout nursing homes and assisted living facilities and their preparation/response to the virus
• Identify significant circumstances that may have favorably or unfavorably impacted the severity of outbreak, including but not limited to:
o Timeliness of response in comparison to the progression of the outbreak
o Confirmed cases by age/race/ethnicity
o Confirmed deaths by age/race/ethnicity
o Rate of transmission within the facility.
o Staffing challenges
o Availability of personal protective equipment (PPE)
o Availability of testing
o Staff expertise and skill levels
o Establishment of COVID Recovery Facilities
o Funding enhancements
o Communication and coordination issues with other parts of the healthcare systems such as hospitals
o Other systemic issues and other epidemiology issues.
• Identify and describe industry best practices displayed during the pandemic response
• Review and complete an overall assessment of State response to the pandemic in Nursing Homes and Assisted Living Facilities in Connecticut. Specific areas to assess will include, but will not be limited to:
o Regulatory framework, including infection control, survey and certification
o Guidance
o Payment policies
o Communication
o Data availability and reporting
o Availability of Testing and PPE
o Any other relevant topic

Mathematica Policy Research conducted its review by looking at data and conducting interviews and consulting with the Departments of Public Health and Social Services; members of the legislative and executive branch; industry, residents and families, long-term care facility experts, and long-term care facility staff. The contractor will develop a report that synthesizes findings that emerge throughout the project and offers policy and programmatic recommendations for the Governor and legislative leaders. Mathematica is being compensated $449,411 for the review, analysis, and report.

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