Advocacy – Goals and Objectives

Dignity Alliance Massachusetts has endorsed a set of transformative goals in March, 2021. Download Dignity Alliance Massachusetts Mission and Goals March 2021.docx.

OUR MISSION

Dignity Alliance Massachusetts is dedicated to transformative change to ensure the dignity of older adults, people with disabilities, and their caregivers. We are committed to advancing new ways of providing long-term services, support, living options, and care, while respecting choice and self-determination. Through education, legislation, regulatory reform, and legal strategies, this mission will become reality throughout the Commonwealth.

Our Transformative Change Goals

Goal # 1: Nursing Home Reform that is person-centered and respectful of human dignity with oversight, accountability and transparency.

Objectives:

• Protect skilled nursing facility residents for spread of COVID-19, other communicable diseases, and resulting isolation and neglect
• Resident-centered care with single occupancy rooms, full-time infection prevention, falls prevention, abuse prevention, strengthened family councils,
• Support redesign of nursing homes preferring small (maximum 12 residents) facilities.
• Access to palliative care and palliative care clinicians
• Improved transitions of care between nursing homes and hospitals and return to community
• Support increased nursing services for residents demonstrated to improve quality and safety. – 24/7 RN coverage, 4.1 HPRD (Hours per Resident Day) of nursing care and oppose including unlicensed or uncertified personnel in calculations
• Medical loss ratio rebates for payments calculated by taking the amount spent on medical claims and qualified health quality initiatives and dividing it by the premiums collected, minus certain federal and state taxes and fees
• Minimize use of psychotropic medications
• Safe visitation policies in all nursing facilities
• Nursing facilities to be the last option among choices for long-term care.
• Strengthen oversight and enforcement through full annual surveys with public reporting of complaints and findings even during pandemic with appropriate attention to safety protocols
• Rescind waivers of regulations and reporting during public health emergencies detrimental to residents
• Improvements to the response to complaints and deficiencies in skilled nursing facilities.
• Strengthen vetting of new owners and management companies to ensure qualification
• Non-profit or public ownership of nursing facilities over for-profit ownership
• Support transparency and accountability concerning ownership and management, including finances
• Enhance Long-Term Care Ombudsman Program advocacy

Goal # 2: Congregate Living (other than skilled nursing facilities) and other opportunities for independence, informed choices, and integration in the community.

Objectives:

• Safe visitation policies throughout all types of congregate living residences similar to those required of nursing facilities
• Evidence-based falls prevention programs.
• Complaint resolution program for independent living and public elderly housing.
• Support basic health services for assisted living residents
• Strengthen rights of residents living with dementia in memory care units at assisted living residences
• Require assisted living residences to provide special diets (e.g., Kosher, diabetic, gluten-free)
• Improvements in care and treatment for older, frail inmates of correctional institutions.

Goal #3: Home and Community-Based Supports and Services improvement and expansion of opportunities.

Objectives:

• Adoption of a Community First provision in the 1115 Medicaid Waiver scheduled for renewal in 2022.
• Age-friendly, ADA-compliant communities with affordable, accessible public transportation.
• An end to ageism and ableism in every community in the Commonwealth.
• Accessible, affordable, integrated housing to assist people to remain in their homes and communities.
• Fully including older adults and people with disabilities in work and community spheres such as voting, serving on boards and commissions, and positions of leadership.
• Policies for older adults and people with disabilities must recognize the those living in rural areas or in underserved neighborhoods in urban areas may lack broadband, access to technology, access to health providers, etc.

Goal #4: Strengthen Support of Long-Term Care workers whether in career, volunteers, or family members.

Objectives:

• Living wage and enhanced benefits for caregivers.
• Improved caregiver training in areas such as infection prevention, resident abuse prevention, and communication skills
• Require more than 75 hours certified nurse assistant (CAN) training
• Broadest possible education in geriatrics for all health care professionals and staff.
• Behavioral health and wellness programs for long-term care staff.
• Minimize multi-facility employment by care staff
• Educate staff on the importance of vaccinations to protect selves and residents

Goal #5: Strengthen Accessible, Universally-Designed Emergency Procedures and Responses.

Objectives:

• Enhanced emergency plans in coordination with the Massachusetts Emergency Management Agency.
• Establish mutual aid agreements with all congregate care facilities
• Underwrite membership of all certified long term service providers in Mass Mutual Aide Association, entitling them to educational conferences, annual emergency training
• Provide adequate supplies of testing, personal protective equipment (PPE), and vaccinations for individuals living in the community and home care aides along with residents and staff of skilled nursing facilities, assisted and independent living residences.
• Promoting an emergency plan and an emergency supply kit for all older adults and people with disabilities who live independently, as recommended by the Centers for Disease Control and Prevention (CDC)

Advocacy and Policy