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A REPORT ON THE MARCH 2, 2003
Prepared by Jews United for Justice
Judaism teaches us time and time again that we are also supposed to be a community that cares for the most vulnerable among us -- to care for the sick and the weak and the poor. We are supposed to make sure that ANY senior citizen who is in need has a place to be cared for, has a place where he can live with dignity, has a place where her beauty and grandeur can shine. The JCA is supposed to be that kind of place. The JCA is supposed to reflect and fulfill the values of the Jewish community. That is why the proposed cuts to the number of Medicaid beds at the JCA have caused such uproar in the community. We simply don't believe that these cuts are ethical, or right, or the Jewish thing to do. We have come together today to try to understand why this has happened. We have come here to ask questions and to hopefully receive honest answers. And we have come in the spirit of cooperation -- to try to work together to find a way to save the Medicaid beds at the JCA…
Rabbi Andrea Goldstein
March 8, 2003
A REPORT ON THE MARCH 2, 2003 Introduction This report was prepared and distributed by Jews United for Justice. Jews United for Justice is a community organization dedicated to equality and justice for the most vulnerable in our community. JUJ’s priority work includes health care, education, and workers’ rights. The report includes: • Background and description of the problem • Goals and format of the Public Forum • Summary of comments from the Forum • Outcome of the Forum Inquiries can be directed to JUJ at 314/560-2994 or info@jujstl.org.
The mission of the Jewish Center for the Aged is to care for elders in a nurturing environment, regardless of individual resources within a context of fiscal responsibility. Historically this has meant that all or nearly all of their 276 beds have been certified for Medicaid. Medicaid is the government program that pays for nursing home beds for the elderly when their assets and resources are below $1,000. Just because a bed is certified for a Medicaid, doesn’t mean only a patient on Medicaid can use it. It does not cost anything to maintain Medicaid beds if they are not used for this purpose. Since no additional Medicaid beds are being certified by the state, it is almost impossible in this era of extreme budget cuts to re-certify Medicaid beds. In January, the JCA Board decided to drastically reduce the number of Medicaid eligible beds and the staff informed the residents and their families of this pending reduction. Many family members were encouraged to find a Medicaid bed in another facility quickly so that they wouldn’t risk losing their bed at a later date. This generated deep concern among JCA residents, their families and in the Jewish community. The JCA is close to completion of a new luxury facility that will replace the current home and will have the same number of beds. This combined with the CEO’s salary that is more than 3 times higher the average nursing home director, raised serious questions about the JCA’s priorities and commitment to its mission. In February, some family members of residents received a second letter assuring them that their loved ones would have a place in the new facility. There was no assurance in this letter that the JCA’s would continue to serve the elderly poor in the future.
JUJ’s goals for the forum were: • To reach greater understanding of the problems facing current and future low and moderate-income elders in our community. • To encourage the JCA Board to work with JUJ and the community toward a recommitment of its mission to care for the elderly regardless of their individual resources. This includes both current and future residents. • To issue a report that summarized the Public Forum. The agenda included prayers and words of inspiration from Rabbi Hayim Shaffner and Rabbi Randy Fleisher. A letter was read from Rabbi Andrea Goldstein about doing this work in the context of Jewish values. David Lander, president of JUJ, described the goals and work of Jews United for Justice and the purpose of the Forum. Linda Holtzman, JUJ staff, gave an overview of the problem at the JCA and suggested ground-rules for speaking at the forum involving respect and compassion. A letter was read from Joseph Rechter, President of the JCA Board. He was unable to attend because he was out of town but indicated that the JCA is committed to its mission in a manner that responsibly acknowledges the financial situation. He indicated that the JCA and the Jewish Federation had formed task forces to further investigate the issues and will report their results to the community. People were called up to speak in order that they signed up. There were JCA Board members present who they were there for the purpose of listening rather than responding immediately . Art Silverblatt, JUJ member and son of a JCA resident, summed up the meeting and urged everyone to think of this as a problem that belongs to all of us and is one to solve as a community.
The core of the Forum was the comments from the community. Speakers were encouraged to speak of their experiences and observations regarding the problems at the JCA. The tone of the forum was very emotionally charged. Some speakers at the forum asked that their names not be used and some attendees expressed a desire to speak but declined because of their concern that there might be consequences for their loved ones. A summary of the community speaker’s remarks is below. Janet Hinton’s mom is a 79-year-old resident of the JCA. Janet had heard about the JCA’s great reputation and was glad that they accepted her mom even though they knew her funds would not last more than 9 months. Janet recounted how her mom was treated callously. On January 17, Janet was told that they were reducing Medicaid beds and she would have to find a new facility for her mom. She panicked because her mom had only been at the JCA for 8 months and was very ill. She had just started to be social and was bonding with her roommate when she was told she would have to move. If she had known this move would be coming, she would have put her mother on a waiting list somewhere else. Janet was not told that the transfer was voluntary. She was told to move quickly because she could be in a situation where she would need to move her mother in a week. She called the long-term care ombudsman who said that her mother was under no obligation to move. Janet has not received a letter from the JCA ensuring her mother’s bed at the new facility. Janet asked that the JCA honor their agreement to care for her mother, to reverse their course and not pursue a policy that puts profits before care and quality. Maxine and Arthur Blat went to Le Chateau to see the display rooms of the new facility. They said it is not a center for the aged, it is a country club. Both of their mothers had spent their last years at the JCA. All the rooms at the new facility are single occupancy, which Maxine said is not good for the social and emotional well-being of most residents. When her mother fell, her roommate was able to notify the nursing staff right away. Maxine wants to know how the JCA can spend so many millions of dollar on the new facility and not have any more beds than the current facility. Hilda Markowitz said she gets very upset and emotional when she discusses this. She said, "Isn’t it a shame we have to be afraid to give our names for fear of retaliation?" Her husband has Parkinson’s disease and is in a wheel chair. Mrs. Markowitz said she never knows what to expect when she goes to the JCA. She has seen ant infestations, she has seen her husband left sitting in his own excrement, her husband has not gotten his medicine when he’s supposed to (which renders him completely unable to communicate) and she has seen him be treated poorly. Residents are afraid to speak up. They need tougher state rules and better-trained aides. She said we have to fight and stand up to make sure they are cared for properly. Sarah Nadler said her father was at the JCA from 1980-88 and there has been such a change that she cannot begin to describe it. Sarah continued to be a JCA volunteer until 2000 when the JCA took away the van for volunteers. She noticed that everything Jewish was being removed. They tried to take Jewish out of the name and tried to remove the kosher kitchen. Terry Siegel has a close friend who has been at the JCA for 12 years since having a massive stroke. She turns over all of her friend’s social security and pension plus the Medicaid to the JCA. Terry wondered if money is such an issue, why are they making all of the rooms in the new building single occupancy. Another person who asked that his name not be used is concerned about the medical care. He said there are enormous communication gaps between medical and social services that need to be improved. Nancy Hirsch said that there is a need for improved communication among the staff, between the staff and responsible parties, and between the administration and responsible parties. She said while it’s true that there are some problems with the care given by nurse’s aides, they are certainly not paid well enough nor trained well enough to do their jobs as they could. There seems inadequate effort by management to appropriately train care-giving staff. She would have liked to hear from the JCA at the Public Forum. We cannot wait for months for more information about the move to the new facility. Nancy would be glad to serve on one of the task forces. Ed Kaskowitz said his mother is a candidate for the JCA and brochure only talked about luxury- not price. Ed said the JCA Executive and Board have lost touch with the community and urged them to keep to its mission. He urged the JCA to re-evaluate its purpose and values, get new board members and change the way it operates. Rabbi Jeffrey Stiffman was present as the Chair of the Rabbinical Association Task Force. He said that the JCA and Federation Task Forces and the Rabbis agree that the Jewish community must take care of our own. He urged everyone not to jump to conclusions until all the facts are known. He said it’s important that the results of this meeting go to the JCA. He thinks it’s a good idea that people at this meeting be part of the task forces. We need to get to a solution quickly so no elderly person needs to be afraid. Stan Braude is an interested community member, with no family at the JCA. He said the community supports the JCA through the Federation. If the JCA were not caring for the elderly poor, why should the community want to continue to give money? Jean Wahl’s dad has been at the JCA for the last 4 1/2 years with Alzheimer and Parkinson’s. Her father can still communicate and she has repeatedly asked to have her father moved to another division because his roommate does not speak English. The JCA told her that such a move was inadvisable because the stress of the move would be too much for her father. Because she had been told this, Jean was shocked when she got a call from the JCA telling her that they had found Medicaid beds at 2 other institutions and suggested she move her father that same day. She did not receive a letter from the JCA indicating that her father would have a bed at the new facility. She received a fax of the letter two days ago after asking for it. Shulamith Simon was a JCA Board member from 1976-1989. Shu directed her remarks to JCA Board members in attendance She stated that as a member of a board of a not-for-profit, it is not unusual to attend monthly meetings, get staff reports and rubber stamp the decision that have been made. She said, "You cannot do that. If that is what has been going on, it needs to stop." She said she understands that board members are not involved in JCA affairs and decisions every day, but as a member of a board that have an obligation to fulfill and if they are not prepared to meet that obligation, they should resign. Myrna Fictenbaum was very emotionally distressed listening to the stories of the JCA families. Myrna sees a direct relationship between care for the residents at the JCA and the people who give them care. She urged the attendees and community to think about that. She emphasized that it is immoral that one person can earn over $400,000 compared to the salaries of the people working in a job that none of us would want, but is the most crucial job for the lives and well-being of our loved ones. Ms. Fichtenbaum said that the workers want to do a good job and be proud of their work. They need to be able to feed their families. She acknowledged that we want people who care for our elders to do a good job. People who are respected do a good job.
150 people attended the Public Forum. Many people spoke out about their concerns for the future of care for low-income elders at the JCA. People who talked and people who listened were visibly moved about the difficulties that so many residents and their families are experiencing. The message was loud and clear that advanced age, disability and illness are enough to face without facing such insecurity and uncertainty about the future of where and how they will live. The next steps for Jews United for Justice and many of the people attending the forum are: • To work with the JCA to reclaim its mission by reaffirming commitment to full Medicaid certification for both its current and future residents; and • To convene a Community Council to create an open and accountable process to work with the JCA to find strategies to meet its mission. This Council will consist of JUJ, JCA family members and all of the Task Forces that have been formed to seek solutions. |