As the Kentucky General Assembly prepares to use its new powers in a special session to deal with the pandemic, its joint health committee meeting held a special meeting Thursday, at which hospitals and nursing homes sought help to deal with staffing shortage and a patient surge that is overwhelming hospitals.
The three-hour meeting concluded with a list of what to expect from the legislature in a session that could begin as early as Tuesday.
"We've got to start finding out how are we going to address the immediate crisis, which is our unvaccinated patients who are acutely ill and require hospitalization or acute treatment of an active infection," said Republican Sen. Ralph Alvarado of Winchester, chair of the Senate Health and Welfare committee.
Alvarado told leaders of the hospital and nursing-home associations that the legislature will work on funding to help retain and recruit staff, including nurses, aides, respiratory therapist and emergency medical service providers.
Alvarado said legislators will also work to provide more rapid coronavirus testing, extend liability protections and open regional clinics to administer monoclonal antibodies, a treatment for Covid-19 if given early. He also mentioned flexibilities that would allow paramedics to work in hospitals and expanding the emergency scope of practice for other health professionals.
As for increasing vaccinations, Sen. Danny Carroll, R-Paducah, asked that the lawmakers find ways to reduce the red tape required to give Covid-19 vaccines in doctor's offices, saying he had talked to physicians who chose not to offer it because there was too much paperwork involved.
Alvarado, a physician, agreed with Carroll. Earlier, he said shaming unvaccinated people into getting immunized is not effective, and it is more likely they would be convinced by their personal health-care provider to get a shot.
"We're going to be asking probably for an easier way to be able to get those [vaccines] in to doctor's offices, because that one-on-one conversation happens and somebody says, 'Okay, I'll take it,' you can give it right then and there instead of sending them someplace else where they might lose their courage or change your mind," Alvarado said.
Legislators are preparing for a session to pass their own pandemic response plan, under a state Supreme Court ruling that upheld laws they passed last winter to limit the governor's emergency powers.
The testimonies from the hospital and nursing-home lobbies were concerning.
Nancy Galvagni, president of the Kentucky Hospital Association, said Covid-19 hospitalization across the state have grown from around 500 patients at the end of July to more than 2,000 at the end of August, a 340% increase as hospitals suffer from "a devastating shortage of nurses and other qualified workers" to care for patients.
"The number of Covid hospitalizations is now higher than what we saw at the previous peak last November and December," she told the committee. "And I hate to say, with each passing day, the situation is getting worse."
She said Covid patients occupy half of all beds in Kentucky's intensive-care units, and only 135 staffed ICU beds were available Wednesday, with 54% of hospitals having no openings and 35% having fewer than five.
Galvagni said beds used for medical and surgical patients aren't much more available, with only 17% of these staffed beds free on Wednesday. She said many hospitals are postponing "medically necessary procedures," including knee replacements and certain cancer treatments.
"The facts on the ground are very harsh, I can assure you," she said. "Our hospitals are filled with real patients, not theoretical ones. Our hospitals are being overwhelmed by an absolute deluge of patients with Covid-19. Hospital beds across the state are full or nearly full."
She asked the legislature to continue to Beshear's declared state of emergency, with its relaxed regulations; to pass laws to temporarily provide some flexibility to expand the scope of practice for some health-care workers; and to provide money to help hospitals cover the rising cost of staff.
Betsy Johnson, president of the Kentucky Association of Health Care Facilities, which represents 272 long-term care providers, said their main issue is staffing, a problem that pre-dates the pandemic: "Our primary need and the reason we're here today is to ask for support to build back our workforce."
Johnson said her members fear staff losses from the coming federal mandate that all nursing homes must require their employees to get vaccinated for Covid-19 or lose their essential funding from Medicare and Medicaid, because they can move to other health-care facilities that don't have such a mandate.
She said a recent survey found that 43% of their corporate members said they expect 11% to 20% of their staff will leave due to the mandate. She said about 85% of the state's long-term care residents are vaccinated, but only 51% of the long-term care workforce has been.
"Unless this federal mandate is applied to all health-care providers, this mandate is going to negatively impact our skilled nursing facility, workforce, and most importantly, the care that our elders receive." Eleven major hospital systems in Kentucky are imposing vaccine mandates, and others may be.
She added, "Due to staffing shortages, some of our members are reporting that they're shuttering their beds due to staffing concerns and are unable to accept transfers from our overwhelmed hospital systems."
Johnson said that while wages have improved in nursing homes and other long-term-care facilities because of federal pandemic funding, they are still below what many fast-food places offer.
Johnson asked the lawmakers to consider how other states have provided funding for the long-term-care workforce, including travel and relocation costs for new hires and covering the cost of using staffing agencies, "which have skyrocketed during the pandemic."
Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.