LOS ANGELES - With roughly 45% of Los Angeles County's coronavirus deaths occurring in institutional settings like nursing homes, county supervisors are set today to review proposals aimed at strengthening protections for residents and workers.
Supervisor Mark Ridley-Thomas recommended calling for the county's legislative advocates to work with Gov. Gavin Newsom and state health officials to expedite testing for nursing home staffers and residents, issue standard protocols for dealing with coronavirus cases and set staff-to-patient ratios.
The motion also calls for additional pay, overtime and sick leave for nursing home employees during the crisis and paying a higher rate to workers caring for residents who have tested positive for the virus, among other measures.
The motion also proposes that skilled nursing homes be required to readmit patients once they are no longer acutely ill with the coronavirus.
Separately, county health officials have expanded testing for COVID-19 to include all residents and staff at nursing homes, regardless of whether they show any symptoms.
During a Monday briefing, the county's top public health official apologized for not being aware in the early stages of the crisis that people without symptoms could spread the virus.
"Early on in this pandemic, we were all unaware that COVID-19 could be spread by people who were infected but did not have any symptoms, and this unfortunately has resulted in the spread of the virus even where everybody has been doing their very best to implement infection-control measures with the information that we had at the time," Barbara Ferrer, director of the county Department of Public Health said. "So I apologize on behalf of all of us for not knowing enough at the start of this epidemic to take additional steps in our congregate living facilities to make sure we were doing everything possible to protect residents and staff."
On Friday, a county health order was issued barring non-essential visitors and suspending all communal dining and activities at nursing homes. It also requires staffers to wear surgical masks at all times and residents to wear masks or cloth face coverings outside of their own room.
Supervisors Janice Hahn and Sheila Kuehl have co-authored a motion asking the relevant health authorities to quickly detail their plan for expanded testing at nursing homes to the board, and to come up with a way to keep nursing homes from sending patients who don't need hospitalization to acute care hospitals.
"Our data indicate that there are now well over 1,000 confirmed cases of COVID-19 amongst the staff of nursing homes, homeless housing sites, and other institutional settings,'' according to the motion.
The doctor who leads the county's hospital system highlighted the importance of working with state officials to impose additional requirements on nursing homes, which are licensed by the state.
"Without such measures in place, the potential for outbreaks that can overwhelm the county health system remains high," said Dr. Christina Ghaly. "During this period marked by so much uncertainty, we are firm in our commitment to assist our health partners across the continuum of care as we all work together to confront and battle this terrible illness."
As of Monday, at least one COVID-19 case has been reported at 312 institutional settings in the county -- including nursing homes, skilled nursing facilities, assisted living facilities, shelters, jails and prisons, according to Ferrer. There have been 423 deaths in such settings, the vast majority of them at skilled nursing facilities, she said.