Through the Dignity Votes 2022 initiative, Dignity Alliance Massachusetts has invited candidates for constitutional office to respond to a set of questions drafted specifically for each office. The responses of the Lieutenant Governor are below.
LG Questions and Answers
|Lieutenant Governor Candidates
Kim Driscoll has been Mayor of Salem since 2006. She served as a Salem City Councilor from 2000 through 2003. She is a graduate of Salem State University and earned a law degree from the Massachusetts School of Law. She has held positions as Beverly’s Community Development Director and the city of Revere’s Chief Legal Counsel and later as Deputy City Manager.
Most Massachusetts residents know someone who has needed long-term services or care due to issues related to aging or disabilities or experienced it themselves.
Has anyone close to you needed nursing home care, congregate living arrangements, or home and community-based services? What implications for public policy and regulatory enforcement do you draw from this experience?
|I have had several family members and people close to me who have needed and relied on both nursing home care and home-based services. My takeaway from this experience is that we really don’t have an “elder care system”, but rather a patchwork of services that exist independently and that require family members to research and navigate. The ability to access these services varies widely depending upon income, availability of community resources, knowledge of benefits, city/town, health care system provider, etc. As Mayor, I have invested in our age-friendly planning efforts and in our social worker infrastructure at our city-owned Community Life Center, as a means to help family members and caregivers obtain the information and assistance they need. As more of us are living longer and in need of varying degree of care, we need an integrated elder care system operating within our communities that breaks down the barriers to access and affordability, enabling older adults to age in place with dignity.
Pre-pandemic home and community-based staffing was a challenge. Post pandemic it has become a crisis, forcing many to suffer from lack of available caregivers and often forced into a nursing home.
As the legislature has begun to prioritize enhanced staffing with additional funding for wages in the FY 23 Budget, what will your administration do to address this crisis across the full spectrum of Long-Term Services and Supports in facilities as well as in home and community-based settings?
|Caregivers, social workers, and other home and community-based human service employees play a pivotal role in our Commonwealth, as they help improve people’s well-being, especially the most vulnerable among us. As the Mayor in Salem, I was proud to fund the addition of more social workers at our Council on Aging and establish a paid social work internship at the COA to help build the professional pipeline for future social workers. In addition, we have routinely ensured that our public schools have a full complement of social workers as we provide a range of student and family services in all PreK-12 schools that seek to ensure every student has what they need to thrive in school and the community. School social workers are key in our efforts and we are grateful to have embedded a number of social workers and certified school counselors across the district to assist teaching staff and learning environments both in and out of school. The COVID pandemic taught us many things about public health and the delivery of essential public services - including where we need to improve or strengthen what we do as a Commonwealth. One of the keystones of our community’s response were our care workers, who served as crisis responders with some of our most at-risk residents during the pandemic. Whether it was our homeless and housing insecure residents or our seniors or students, these workers were instrumental in connecting the various populations with food security, mental health supports, and public health services like testing and vaccines. As Lieutenant Governor I would continue to be an advocate for these workers, particularly in this challenging labor market, to ensure they have the compensation, resources, and respect necessary to keep our care workforce strong and robust.
I3. The Commonwealth provides some affordable home and community-based services to assist low-income people, however, the number needing services far exceeds resources available. Additionally, middle-class elders and those living with disabilities remain at elevated risk of premature nursing home placements because they cannot afford market-rate home care and are ineligible for subsidized assistance.
As Lieutenant Governor, what would you do to expand the availability of affordable, accessible home and community-based services for all?
|As a voice for our communities and working families, I see the Lieutenant Governor's role as one who can champion the expansion of available community and home services for those in need. In addition to working collaboratively with our next Governor to prioritize this work, I would partner with municipalities, local agencies and nonprofits, and other community leaders to leverage federal funding opportunities, make essential connections, and elevate the public awareness of reforms that may be necessary on the state and federal level to address the lack of access to subsidized assistance for both low and middle-income residents of our Commonwealth.
Even though informed written consent is required, about one of four MA nursing home residents is administered anti-psychotics, a drug that can be deadly to elders. This is one of the highest rates in the country. Furthermore, misdiagnosing nursing home residents with schizophrenia, an ailment of young people and for which anti-psychotics are allowed, means dispensing anti-psychotics with impunity. Nearly 10% of MA nursing home residents are diagnosed with schizophrenia, even though it occurs in less than 1% of the US population.
What would you do to reduce the usage of anti-psychotic medications as well as ensure meaningful compliance with existing requirements?
|As Lieutenant Governor, I would work with the Governor and administration, as well as the appropriate department secretary and their team, to ensure resources are sufficient to provide better awareness of and enforcement of the regulations against this dangerous practice.
Under state law and federal requirements, the Massachusetts Department of Public Health (DPH) has the primary responsibility for ensuring the safety, well-being, and effectiveness of care for all nursing home residents including adherence to resident’s rights. Over the past few years, DPH’s performance has come under criticism in several state and federal studies. Additionally, nursing homes with recent state-approved changes of ownership experienced significant care giving failures. There also have been changes in DPH’s key staffing. All put into question the adequacy and efficacy of nursing home oversight, licensure adherence, and quality of operations within the Department.
What steps should be taken to ensure that strong and comprehensive nursing home oversight and a thorough and transparent nursing home licensure process are vital responsibilities for the Department?
|Nursing home residents are among our Commonwealth's most vulnerable individuals and it is the responsibility of the state to ensure there are sufficient resources and capacity to provide the oversight necessary for their safe operation. Massachusetts has benefited recently from record revenues and I would work in partnership with the Governor and legislature to advocate for greater support for DPH so that it more fully engages in this critically important work.
Issues regarding the safety, well-being, and rights of disabled and older persons living in both public and subsidized housing include but are not limited to failure to protect victims from bullying and mobbing; failure to grant reasonable accommodations to disabled persons; and evictions leading to homelessness and emotional and physical trauma. Accountability is lacking.
How will your administration assure the safety and rights of people in these situations?
|As perhaps the only Mayor in Massachusetts to serve on a Housing Authority board, I am well aware of the challenges facing disabled and older persons living in subsidized and public housing, particularly when it comes to the risk of trauma, bullying, and the challenges posed by reasonable accommodations. I would bring those experiences to the administration, working directly with individual residents in need of someone to be their voice, and fighting against unjust evictions and discriminatory actions.
Most older adults with behavioral health challenges can be supported in their own homes. Many persons under age 60 who need behavioral health services are at risk of being in shelters, or worse, living on the streets. Programs are being developed to meet the needs of individuals at risk such as Elder Mental Health Outreach Teams- (EMHOTs) and the Mass Rehabilitation Commission’s (MRC) effort to provide comprehensive, coordinated behavioral health services.
Would you support expansion of these services? What other strategies do you have to meet the needs of persons with behavioral health challenges?
|I would support the expansion of these important services. I also would support efforts to fund innovations and new approaches, including the deployment of hub models used in homelessness prevention efforts, coordinated and continuum of care models, and other proven strategies that might have applicability to behavioral health services.
The ownership of nursing homes is increasingly under the control of out-of-state, investor groups. The organizational structure has been segmented into many components, often under common ownership, e.g., a real estate entity, management company, therapy services, and more. This make it difficult to determine who is controlling major staffing, operational and business decisions and who has responsibility and accountability. Consequently, it is critical to analyze how MassHealth funds are being used. Periodic, independent, comprehensive, and transparent public audits are necessary to assess how nursing homes operate and public funding is spent.
Will you advocate for this type of audit on an ongoing basis? Would you support legislation to ensure transparency and accountability of nursing home ownership interests and control?
|Absolutely. During the earliest days of COVID it was challenging to identify the ownership of some nursing care facilities because of the lack of transparency and accessible documentation. I would support efforts and measures to improve this dangerous situation.
Hundreds of millions of dollars of state and federal funds have been provided to Massachusetts nursing homes during the pandemic. There has been little to no analysis and accountability of the use of these funds. It is important to know if these expenditures were effective in order to direct future allocation decisions. It is equally essential to provide public assurance that the funding was used as intended.
Will you support the requirement for a comprehensive public audit of the use of pandemic-related spending as an early priority?
|Yes, I would support this. Every other use of federal and state pandemic relief funds is subject to rigorous scrutiny and attention - and rightfully so. I do not believe any one funding area should be excluded from this important accounting practice. It ensures greater public confidence in our efforts to recover and to prepare for future crises.
Affordable accessible transportation which is safe and reliable is lacking across the state affecting older adults and persons with disabilities whether they live in urban, suburban, or rural areas.
How will your administration ensure elders and those with disabilities can access dependable, safe, and affordable transportation to allow them to live fully with dignity in their community? Will you support steps to ensure ADA access throughout the MBTA system? Will you support better funding for the Regional Transportation Authorities?”
|I strongly support all measures to broaden ADA compliance in the MBTA systems, including buses, trains, and the T. Salem is one of just half of Massachusetts municipalities to have a completed ADA Transition Plan. The MBTA, as well as all state agencies and facilities, should be expected to do the same. I also strongly support and have advocated publicly for RTA funding and regional ballot initiatives, to generate the revenues necessary to support more accessible transportation systems. Salem was a leader in complete and shared streets, with one of the earliest complete streets policies in the Commonwealth. The state can do more to incentivize cities and towns to enact, and then implement, these policies at the local level by funding transportation alternative projects like bike shares, multi-use paths and trails, and safer pedestrian ways. Expanding public transit is the second tool at our disposal with more east to west and north to south rail links, subsidized public rideshare shuttles like what we’ve successfully piloted in my community with the Salem Skipper, and a better supported bus and rail system. As Lt. Governor, I will bring my experience on the work I have led in Salem and the region. I will also continue to be a strong advocate for coupling new housing with mobility options and land use options that support walkability within the context of neighborhood needs. I believe that Massachusetts can benefit from an accessible local and regional transportation system that provides alternative modes of transportation and choices for everyday responsibilities that encourages travelers to safely use the streets. As mentioned earlier, we launched the Salem Skipper, a low-cost public on-demand ride share program. The Skipper has provided over 70,000 rides to date and recently expanded our partnerships to include Salem State University. Data shows most trips are from our most economically disadvantaged neighborhoods and its popular trip destinations are grocery stores, medical appointments, and the commuter rail station. Moreover, most riders have indicated they do not own a car and the service is available to older adults and students as young as middle school. It’s been very successful and serves a diverse mix of our population, across the income bracket. These types of initiatives are important to replicate and broaden for municipalities across Massachusetts to have the systems in place to support aging members of our community, as well as those with disabilities.
Lastly, I fully support providing additional funding for RTAs across the state to ensure we are meeting their needs and in return they can provide reliable, safe transportation for residents. We must also work towards full electrification as soon as possible. In order for this sustainable transition to occur, the state must identify funding sources to support cities and towns to strengthen their respective transit systems. Here, in particular, we should explore investing ARPA funds, federal infrastructure funds, and engage with our federal delegation to secure additional funding to support this necessary effort.
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Kim Driscoll (Democrat)
August 19, 2022
- Moderator: Barbara L’Italien is a former State Senator, and is currently the Executive Director at Disability Law Center. She has short brown hair and is wearing a dark suit.
- Panelist: Sandy Novack is a social worker and advocate in the broad field of disability rights. Sandy has glasses and long grey hair.
- Panelist: Richard Moore is a former State Senator. He has the Dignity Alliance sign in the background.
- Panelist: Candace Kuebel is Executive Director of Massachusetts PACE. She is wearing a blue shirt, and has short blond hair.
- Mayor Kim Driscoll (Salem) is running for Lieutenant Governor and is in a yellow suit.