Legislation to Protect Tenants from COVID
Update on our legislative advocacy
Our legislative partners, including Representative Tom Walsh and Senator Joan Lovely, have determined that the first step is to bring our concerns to the newly formed Joint Standing Committee on COVID-19 and Emergency Preparedness and Management. That body will be tasked with oversight of the state’s pandemic response and take on an advisory role for the Legislature. It will also weigh broader issues of disaster preparedness, emergency management and communication.
Depending on the results of their consultation with the new Committee, we can file appropriate legislation taking into account our issues and concerns.--JH February 19, 2021
February 15, 2021
I am pleased to submit a petition to amend Chapter 93 of the Acts of 2020 to prevent the spread of COVID-19 including new variants in multi-unit housing for elderly and disabled persons, the “elder care facilities” defined in Chapter 93.
We propose
- to make use of available data on COVID infections/deaths in a timely way, distributing it: online; to and by the housing landlord; and by the local health department to people in housing;
- and to initiate community efforts, intervention, oversight and accountability over tenants and landlords by the local health department.
This amendment is needed because:
- Although the legislature had intended through Chapter 93 to create transparency and ready access to data about COVID-related infections and deaths in elder care facilities, the Governor and the Department of Public Health have failed to implement the collection of reports and publication covering public and subsidized housing and other facilities as mandated by that law; and the Commissioner of Public Health forbids sharing of such data save to first responders.
- Timely knowledge of infection is essential to protecting and assisting the infected person(s) as well as to initiate actions to prevent the further spread of disease; the lack of disclosure of infection has been shown to allow the spread of infection and death that could have been prevented, i.e., the Holyoke Soldiers Home, many nursing homes in Peabody and elsewhere.
- The housing provider (landlord or public housing authority)and the public health authorities have the right and obligation to promulgate and enforce rules, including emergency orders and guidance associated with the COVID-19 State of Emergency, for the protection of the elder care housing community.
- The lack of data about the prevalence of COVID-19 in elder care facilities, including public and subsidized housing, can enable the possibly erroneous assumption that there is no significant problem in such housing and thus make it harder to allocate resources, such as urgently providing on-site testing and vaccination programs to elderly and disabled people where they live, rather than effectively excluding those who are unable to travel to a distant central site.
- The information that is already being collected by the public health system on COVID surveillance and other data could be used in a timely way so that housing providers, staff, tenants, and others can work with each other and the local health department to limit the spread of infection in the residential facility. The data is collected and shared through the MAVEN system and other sources of reports are also available to the public health authorities
We can use this data to trigger intervention. Thus, we need to enable the distribution of that information through the Department of Public Health and to the housing providers and to tenants; and to allow the local health department to use and share that information. Currently there is a limitation on the use of location-specific information, however the chance to save lives is surely of overriding importance; and we don’t have to name or identify any individual, only to identify the facility.
I can add, from my personal experience, reports I have received, and from my ongoing research, that the proposed amendment addresses actual situations that lead to infection. Basically, no one is safe unless everyone in the community acts prudently. If any of the following elements are present, we see failures of action, oversight, and accountability:
- Landlord/housing provider (public housing authority or private developer of subsidized housing) fails to enforce rules of behavior in the common (public) areas of the property;
- Public health officials fail to enforce health regulations on tenants or hold landlord accountable;
- Group bullying and mobbing prevent the development of positive, supportive community life and prevent the regulation of behavior by the landlord;
- Lack of official data about the current prevalence of disease.
In Lowell Public Housing, Lynn Costello got COVID-19 when she let down her guard at a time when the management and tenants had relaxed their prior efforts at education, enforcement, and compliance. In Fairweather Peabody, a subsidized building owned by Preservation of Affordable Housing, many tenants failed to mask and distance; no effective efforts were made by management to enforce the rules; and the local department of health insisted that the management was responsible, but failed to hold the management/landlord to account. Although I had not left the building and I followed with great care all protective measures, I could not leave my apartment without encountering people who were not masking and distancing; and nevertheless was infected and had to be hospitalized for COVID. Clearly, I was infected in the building by those who failed to follow the simple rules on masking and distancing, people who were not held accountable, nor was management accountable for failing to enforce the rules.
Landlords and managers in other settings have demonstrated that it is possible to prevent the spread of COVID-19. In Chelsea and in Cambridge, housing managers strive to protect their tenants, but are hampered by the lack of data.
With timely and effective intervention, we can help to save many from illness and death.
Thank you for the opportunity to file this legislation, in which I am joined by Professor Michael Siegel, our advisor on public health, and Bonny Zeh, our co-founder.
Sincerely,
Jerry Halberstadt, Coordinator, Stop Bullying Coalition
Michael Siegel, MD, MPH; Professor, Department of Community Health Sciences, Boston University School of Public Health
Bonny Zeh, Co-founder, Stop Bullying Coalition
References
MAVEN: Infectious disease surveillance data collected by the Bureau of Infectious Disease and Laboratory Sciences (BIDLS) are maintained in the Massachusetts Virtual Epidemiologic Network (MAVEN). MAVEN contains epidemiological, clinical, laboratory, and case management data utilized for case investigation and surveillance purposes on approximately 90 reportable infectious diseases.
Current policy prohibits the publication of location information:
In accordance with https://www.mass.gov/doc/order-of-the-commissioner-of-public-health-reg…, local health departments are able to share information about addresses of confirmed cases only with public safety first responders.
Text of Chapter 93 of the Acts of 2020, with proposed revisions.
An Act Revising COVID-19 Data Collection And Disparities In Treatment.
Note: New and revised language is shown in bold italics.
Whereas, The deferred operation of this act would tend to defeat its purpose, which is to protect forthwith the health and wellness of the residents of the Commonwealth, therefore it is hereby declared to be an emergency law, necessary for the immediate preservation of the public health.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
SECTION 1. (a) As used in this section, “elder care facilities” shall include: (1) the Soldiers’ Home in Massachusetts located in the city of Chelsea; (2) the Soldiers’ Home in Holyoke; (3) a convalescent home, nursing home, intermediate care facility for persons with an intellectual disability, rest home or charitable home for the aged licensed pursuant to section 71 of chapter 111 of the General Laws; (4) a skilled nursing facility; (5) assisted living residences licensed by the executive office of elder affairs; (6) elderly housing facilities; (7) any residential premises available for lease by elderly or disabled individuals that is financed or subsidized in whole or in part by state or federal housing programs established primarily to furnish housing rather than housing and personal services, as set forth in a listing established by the secretary of elder affairs, and that was never licensed under chapter 111 of the General Laws; or (8) any other facility licensed as a long-term care facility by the department of public health.
b) Notwithstanding any general or special law to the contrary, elder care facilities shall report daily to the local department of health in the municipality where said facilities are located and to the department of public health data including without limitation the number of known COVID-19 positive cases among residents; the number of known mortalities among the residents; the number of known positive cases among the staff; and the number of known mortalities among the staff.
(c) Notwithstanding any general or special law to the contrary, the department of public health shall, on a daily basis, collect and compile data from all boards of health, as defined in section 1 of chapter 111 of the General Laws, and from any person, corporation, association, partnership or other legal entity over which the department has regulatory authority, that is related to the outbreak of the 2019 novel coronavirus, also known as COVID-19, in the commonwealth. Said data shall include, but shall not be limited to, the following: (1) the total number of people tested for COVID-19 within the previous 24 hours; (2) the aggregate number of people tested for COVID-19 since the governor’s March 10, 2020 declaration of a state of emergency; (3) the total number of people who have tested positive for COVID-19 within the previous 24 hours; (4) the aggregate number of people who have tested positive for COVID-19 since the governor’s March 10, 2020 declaration of a state of emergency; (5) the total number of people hospitalized due to a probable or confirmed case of COVID-19 or from complications related to COVID-19 within the previous 7 days; (6) the aggregate number of people hospitalized due to a probable or confirmed case of COVID-19 or from complications related to COVID-19 since the governor’s March 10, 2020 declaration of a state of emergency; (7) the total number of people who have died due to a probable or confirmed case of COVID-19 or from complications related to COVID-19, as reported in the previous 24 hours through the department’s receipt of vital records; (8) the aggregate number of people who have died due to a probable or confirmed case of COVID-19 or from complications related to COVID-19 since the governor’s March 10, 2020 declaration of a state of emergency; (9) the number of known COVID-19 positive cases among elder care facility residents; the number of known mortalities among the residents; the number of known positive cases among elder care facility staff; and the number of known mortalities among the staff; and (10) demographic information for all individuals tested for, found positive for, hospitalized due to a probable or confirmed case of or who died from a confirmed case of COVID-19, including, but not limited to: (i) gender; (ii) race; (iii) ethnicity; (iv) primary city or town of residence; (v) age; (vi) disability; (vii) primary language; (viii) occupation; and (ix) any other demographic information that the department deems important to understand the disparate impact of COVID-19 on certain populations; provided, however, that demographic information for individuals tested for COVID-19 and individuals hospitalized due to a confirmed case of COVID-19 shall be compiled and reported not less than every 3 days.
(d) Notwithstanding any general or special law to the contrary, the department of public health shall publish a daily report on the data compiled, including data from the elder care facilities and local boards of health, and all other relevant data, including but not limited to the data from contact tracing that is aggregated under the MAVEN program, pursuant to subsections (b) and (c) on its website. Said report shall include data broken down as follows: (1) geographic location, including statewide, by county and by municipality with 25 or more confirmed cases; provided, however, that such data shall reflect the primary residence of the impacted populations; (2) data on all elder care facilities reporting or otherwise reported to have COVID-19 positive cases or mortalities including but not limited to the data from contact tracing that is aggregated under the MAVEN program, and the aggregate known number of COVID-19 positive cases and the aggregate known number of mortalities among residents, at each residence or facility, as well as the aggregate known number of COVID-19 positive cases and the aggregate known number of mortalities among staff, by occupation, at each residence or facility; and (3) state and county correctional facilities, including the aggregate number of COVID-19 positive cases and mortalities among individuals who are incarcerated, as well as the aggregate number of COVID-19 positive cases and mortalities among staff, by occupation, at each facility.
The department shall also report on its website, for each state and county correctional facility: (1) the total number of residents per correctional facility; and (2) the number of residents within each facility who are housed in a cell: (i) alone; (ii) with 1 other person; or (ii) with 2 or more other people; provided, however, that the department of correction and each sheriff shall provide this residential housing count information not less than weekly to the department of public health.
(e) Each daily report shall be structured in a manner that permits the comparison and stratification of data and the identification of trends, testing, infection, hospitalization and mortality based on demographic factors collected under this section. All data collected pursuant to this section shall be available for download from the department of public health’s website in a machine-readable format consistent with commonly available data analysis software.
(f) The department of public health shall report to the clerks of the house of representatives and the senate and the joint committee on public health on its implementation of this section. Said report shall include, but shall not be limited to, information on the issuance of relevant guidance and the implementation of training protocols for and compliance by relevant entities regarding the collection and reporting of data under this section to the department and a summary, prepared by the executive office of health and human services, of actions being taken to respond to disparities identified through data collected under this section. Said report shall also identify any barriers to receiving or reporting data pursuant to this section and specify the manner in which the department shall seek to improve compliance with this section.
(g) An elder care facility shall notify residents and each resident’s health care proxy, emergency contact, legal guardian or other legally authorized representative by 5:00 P.M. the next calendar day if: (1) there is a new confirmed case of or mortality due to COVID-19 among residents or staff; or (2) 1 (one) or more residents or staff at the residence or facility present with new-onset of respiratory symptoms within the previous 72 hours and/or if 1 (one) or more residents or staff at the residence or facility have been diagnosed and/or tested as infected by COVID.
Chapter 93 of the acts of 2020 is hereby amended by adding the following new section, SECTION 11:
Notwithstanding any general or special law to the contrary, this Section shall apply to all housing providers of elder care facilities as defined in Section 1 under Section 1, Paragraphs 6 and 7.
(a) Providers shall distribute daily the aggregate reports of new or current deaths and infections from COVID related to the facility to all staff and tenants as well as professional and other service people who frequent the affected building(s), and shall not release the identification of any persons known or suspected to have COVID.
(b) The Commissioner of the Department of Public Health shall create such regulations as may be needed to enable local health departments to advise and assist housing providers, staff, and tenants to carry out effective efforts to prevent infection; and to enforce laws and regulations for the prevention and control of infectious disease in order to assure compliance by housing providers as well as tenants.
(c) Notwithstanding the provisions of any other general or special law to the contrary, local boards of health are hereby authorized and directed to apply, investigate, and enforce with sanctions, as provided in local ordinance or by-law, all COVID-related public health mandates and best practices; covering landlords, their agents, and tenants; in all multi-unit public and subsidized housing for elderly and disabled; and in multi-unit housing where elderly and disabled have a voucher subsidy, including common (public) areas in all facilities.
(cc) The Commissioner of the Department of Public Health shall create such regulations as may be required to direct housing providers to use their authority under landlord-tenant laws and tenant leases to enforce such rules and procedures as will serve to protect staff and tenants.
(d) Housing providers shall task licensed professionals including and Resident Service Coordinators with assisting tenants to understand and follow the procedures, and they shall reach out to local service agencies to provide services to support individuals in isolation after exposure or during recovery; and to provide information and guidance to enable staff and tenants to respect the privacy and difficulties of the persons with or suspected to have COVID.
(e) this paragraph deleted
SECTION 2. This section covers a task force which was scheduled to complete its work last year, and is therefore omitted here.
SECTION 3. Notwithstanding any general or special law to the contrary, the department of correction and each house of correction shall provide to the department of public health any data necessary to implement sections 1 and 2.
SECTION 4. Notwithstanding any general or special law to the contrary, the department of public health may enter into interagency agreements with other state agencies to facilitate the collection of data requested pursuant to this act.
SECTION 5. Sections 1 and 3 to 4, inclusive, are hereby repealed.
SECTION 6. The governor shall certify in writing to the state secretary when the department of public health has not received a report of a positive test of COVID-19 in the commonwealth within the preceding 30 days.
SECTION 7. Section 5 shall take effect upon the certification required by section 6.
Approved, June 7, 2020.
Revision proposed February 15, 2021
Legislative language for this bill, February 18, 2020
An Act Revising COVID-19 Data Collection
Whereas, The deferred operation of this act would tend to defeat its purpose, which is to protect forthwith the health and wellness of the residents of the Commonwealth, therefore it is hereby declared to be an emergency law, necessary for the immediate preservation of the public health.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
SECTION 1. Chapter 93 of the acts of 2020, is hereby amended, in subsection (a) of section 1, by inserting after the words, “assisted living residences licensed by the executive office of elder affairs,” the following, this revision of the act shall apply only to elder care facilities listed at SECTION 1a (6) and (7)
SECTION 2. Chapter 93 of the acts of 2020, is hereby amended, in subsection (d) of section 1, by inserting after the words, “elder care facilities and local boards of health,” the following, and all other data relevant to tenants of elder care facilities listed at SECTION 1a (6) and (7), including but not limited to the data from contact tracing that is aggregated under the MAVEN program.
SECTION 3. Chapter 93 of the acts of 2020, is hereby amended, in subsection (d) of section 1, by inserting after the words, “impacted populations,” the following, (2) data on all elder care facilities listed at SECTION 1a (6) and (7), reporting or otherwise reported to have COVID-19 positive cases or mortalities including but not limited to the data from contact tracing that is aggregated under the MAVEN program,
SECTION 4. Chapter 93 of the acts of 2020, is hereby amended, in subsection (g) of section 1, by inserting after the words, “An elder care facility” the following, listed at SECTION 1a (6) and (7)
SECTION 5. Said subsection (1:g) is hereby further amended by striking, “or 3 or more,” and replacing with the following new item; or (2) 1 (one)
SECTION 6. Said subsection (1:g) is hereby further amended by striking, “or (2) #,” and replacing with the following new item; (2) data on all elder care facilities reporting or otherwise reported to have COVID-19 positive cases or mortalities including but not limited to the data from contact tracing that is aggregated under the MAVEN program,
SECTION 7. Said Chapter 93, is hereby further amended in subsection (g) of section 1, by inserting after the words “residents or staff, the following; or (2) 1 (one) or more residents or staff at the residence or facility have been diagnosed and/or tested as infected by COVID.
SECTION 8. Chapter 93 of the acts of 2020 is hereby amended by adding the following new section:
Notwithstanding any general or special law to the contrary, this Section shall apply to all housing providers of elder care facilities as defined in Section 1 under Section 1, Paragraphs 6 and 7.
(a) Providers shall distribute daily the aggregate reports of new or current deaths and infections from COVID related to the facility to all staff and tenants as well as professional and other service people who frequent the affected building(s), and shall not release the identification of any persons known or suspected to have COVID.
(b) The Commissioner of the Department of Public Health shall create such regulations as may be needed to enable local health departments to advise and assist housing providers, staff, and tenants to carry out effective efforts to prevent infection; and to enforce laws and regulations for the prevention and control of infectious disease in order to assure compliance by housing providers as well as tenants.
(c) Notwithstanding the provisions of any other general or special law to the contrary, local boards of health are hereby authorized and directed to apply, investigate, and enforce with sanctions, as provided in local ordinance or by-law, all COVID-related public health mandates and best practices; covering landlords, their agents, and tenants; in all multi-unit public and subsidized housing for elderly and disabled; and in multi-unit housing where elderly and disabled have a voucher subsidy, including common (public) areas in all facilities.
(d) The Commissioner of the Department of Public Health shall create such regulations as may be required to direct housing providers to use their authority under landlord-tenant laws and tenant leases to enforce such rules and procedures as will serve to protect staff and tenants.
(e) Housing providers shall task licensed professionals including and Resident Service Coordinators with assisting tenants to understand and follow the procedures, and they shall reach out to local service agencies to provide services to support individuals in isolation after exposure or during recovery; and to provide information and guidance to enable staff and tenants to respect the privacy and difficulties of the persons with or suspected to have COVID.
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