The Veterans Memorial Home at Menlo Park in Edison. (Ed Murray, nj.com/TNS)
(Tribune News Service) — Facing mounting criticism for bungling the pandemic response at state-run veterans homes where 200 have died, state lawmakers and Gov. Phil Murphy intend to propose a new state agency focused solely on the need of veterans.
In a major restructuring of the state’s military announced Wednesday, the administration and legislative leaders outlined a plan to split the Department of Military and Veterans Affairs into two new agencies — one whose responsibilities include New Jersey’s National Guard and the F-16s flying for the Air National Guard, and a newly created Department of Veterans Affairs that would focus on veterans services, including the state-run nursing homes.
The legislation would also establish an independent veterans advocate and seek an outside monitor to oversee the overhaul at New Jersey’s three veterans homes, located in Edison, Paramus and Vineland.
Unions representing the front-line workers at the veterans homes were informed of the sweeping proposals in a meeting Wednesday morning.
In a statement, the administration and legislators involved in the effort described the massive proposed changes.
“After thoughtful discussion, today we are announcing a conceptual agreement to pursue structural reforms to the delivery of veteran services in New Jersey. As highlighted in both the United States Department of Justice and the State of New Jersey Commission of Investigation reports, comprehensive reform — from ensuring we have adequately paid staff, to upgrading communication and physical infrastructure, to instilling a thorough understanding of best practices — is necessary,” they wrote.
The extraordinary shakeup comes on the heels of a scathing report last month by the Justice Department that found the Veterans Memorial Homes in Paramus and at Menlo Park in Edison failed their residents.
The findings by the Justice Department’s Civil Rights Division said while COVID-19 was spreading through many of the nation’s long-term care facilities, New Jersey was unable to provide adequate clinical care or provide oversight in a manner that kept the residents of the veterans homes “safe from harm.”
Those facilities had the some of the highest number of publicly reported resident COVID deaths of all long-term care facilities in the state, claiming the lives of more than 200 residents and staff. Federal officials said the actual number of COVID deaths was likely much higher.
In their announcement, those involved in the proposed restructuring said they anticipated the appointment of a federal monitor to oversee improvements at the veterans homes, noting the progress made 20 years ago with a similar effort that led to the New Jersey Department of Children and Families in the wake of major tragedies in the child welfare system.
“A federal monitor can work with the state to create a thorough plan of correction, set clear targets for improvement, and hold us accountable with continuous and transparent reporting,” they wrote.
State Sen. Joseph Vitale, D- Middlesex, chairman of the Senate Health, Human Services and Senior Citizens Committee — who worked on the proposed legislation with state Sen. Joseph Cryan, D- Union, Sen. Patrick Diegnan, D- Middlesex and Sen. Joseph Lagana, D- Bergen — sponsored the laws that created the Child Advocate and the Department of Children and Families.
He said veterans deserve the same commitment from the state.
“It was a model that worked,” Vitale said of the restructuring of the child welfare system 20 years ago. “We created a new department with reforms and accountability and many years later we are coming out of the lawsuit and we are a model for the country.”
Under the legislation, veterans’ services currently provided by the Department of Military and Veterans Affairs, including oversight of the Veterans Memorial Homes, would come under a “veterans-centric” cabinet level position, much like the federal model and that of several other states.
“This elevated departmental position will provide an ongoing, visible, institutionalized voice for veterans and their families at the highest level of government,” the statement said.
Officials said it would also establish a veterans advocate to investigate complaints and ensure we are providing effective, appropriate, and timely responses to our most vulnerable veterans. The advocate, they said, would served as an “independent check on our commitment that will outlive any federal monitor.”
Matters related to active members of the military would remain under the purview of the presently-named Department of Military and Veterans Affairs.
Over the past two years, New Jersey agreed to two out-of-court settlements to pay $68.8 million to those who lost loved ones in the Paramus and Menlo Park facilities in the early days of the coronavirus pandemic, resolving claims without admitting fault that the state’s negligence and incompetence were largely to blame for the deadly outbreak.
In February, the federal government threatened to terminate the Menlo Park home from the Medicare and Medicaid programs — denying it the funds it needs to operate — absent major changes there within the next six months.
Vitale said the veterans homes had been a “battlefield” for years.
“Caregivers were struggling left and right. Many did not know what that virus could do. There was a lot of learning on the fly and they made some extraordinary mistakes,” he said. “We have to restructure how we hire and pay these professionals from the ground up.”
Cryan, chairman of the Senate Military and Veterans Affairs Committee said the legislative proposal came together because the executive branch and the Legislature worked together toward a common goal.
“All sides agreed we needed significant changes,” he remarked.
That was further underscored in a new report on Tuesday by the State Commission of Investigation, which said those in charge of the veterans homes had been unprepared for the massive absenteeism by staff in the initial weeks of the pandemic. At the same time, the SCI said administrators mismanaged securing replacement staff, “leaving existing employees overwhelmed.”
The SCI report also said the physical layout and outdated infrastructure of the Menlo Park and Paramus were not designed or equipped to handle isolation or quarantine situations. And it said the rapidly changing guidance on virus management from the Centers for Disease Control and Prevention had not been well communicated by state health officials to the veterans homes’ managers or within the homes, “creating confusion and upending planned strategies.”
The report called on the Legislature and governor to consider the creation of a new cabinet-level agency or commission with specific authority for the homes.
Even before the harsh Justice Department report, the veterans homes had been under siege.
Following a steady drumbeat of negative stories about problems in the facilities early in the pandemic — including directives that health workers not wear masks in the early days of the pandemic so as “not to scare residents,” and a lack of gowns and masks that led some workers to use plastic garbage bags as a jury-rigged form of infection control — Murphy later announced a major shakeup at the facilities.
The governor ousted members of the top leadership. Brigadier General Jemal J. Beale, the adjutant general in charge of the New Jersey Department of Military and Veterans Affairs, was replaced by Deputy Adjutant General, Col. Dr. Lisa J. Hou, a surgeon who now runs the department.
Despite the changes, state health evaluators last year brought to light new shocking violations during an inspection at Menlo Park, citing conditions they said had placed residents in “immediate jeopardy,” including charges of improper care and abuse, according to the inspection report.
The Department of Justice report in September found the failures continued into 2022. It described the facilities at Paramus and Menlo Park as “filthy,” with no one was washing their hands consistently in both veterans homes. One U.S. Veterans Affairs staffer found “ants and bugs everywhere” at Menlo Park.
Of even greater concern was the lack of segregating sick from well patients, resulting in the co-mingling of residents and staff that allowing the virus to spread throughout the facilities, investigators said.
The report also criticized the state for its missed opportunity to keep residents safe. Early in the pandemic, investigators noted U.S. Veterans Affairs offered to house veterans homes residents in federal facilities, which had additional space for keeping residents isolated. The offer never moved forward.
A roadmap for change
Cryan said more than 40 states also separate military operations from veterans affairs agencies, while the federal government keeps its military services apart from the Veterans Administration. But the roadmap for New Jersey follows that of the creation of the Child Advocate and the Department of Children and Families, more than 20 years ago.
Like the veterans homes, that effort also came in the wake of scandal.
Faced with the harrowing discovery in January 2002 of 7-year-old Faheem Williams’ body in a basement closet in Newark and the revelations that the Division of Youth and Family Services lost track of him and his surviving abused and neglected brothers, then-Gov. Jim McGreevey stopped fighting a 1999 lawsuit that accused the state of harming children under its care. He agreed to a settlement in 2003 that required New Jersey to report to a federal court monitor on the state’s progress meeting a long list of improvements.
This eventually involved extricating the child welfare system from the Department of Human Services, the largest state agency that also managed Medicaid, the health insurance system serving 1 million poor and disabled people the public welfare system among other services. A new cabinet-level Department of Children and Families was born to give the needs of thousands of mistreated children more attention and money.
The federal court supervision is expected to end next year.
McGreevey also signed legislation that year creating the Office of the Child Advocate, which had broad authority to investigate and sue the state for mishandling services to children. Gov. Chris Christie abolished the Child Advocate in 2010.
Cryan, Vitale and Murphy administration officials told NJ Advance Media that it was important the three veterans homes, as well as veterans services, remain the state’s responsibility. Nothing will be privatized, they said.
“We can look to the private sector, and bring in the experts to make it work,” Vitale said. But the nursing homes and the workforce will not be privatized, to keep them accountable to the public, he said.
The veterans advocate will be independent of the new department and will “have the legal authority to bring claims and take action,” Vitale said. “This won’t just someone pointing a finger; this is not just an ombudsman.”
Both lawmakers declined to speculate on how much the endeavors would cost or when they would be in place.
The Legislature is on hiatus until after the Nov. 7 election. Committee meetings are not scheduled until late November.
Cryan said he wants public input on the proposals. He doesn’t want to hold hearings during the “lame-duck” sessions that occur before the end of the year. “Others may not agree,” he added.
“I want to get it right,” and not rush the process, he said.
The senator said he wasn’t sure all of the veterans groups would agree with the proposals. “I am sure there will be discussion among cherished veterans’ groups but we are determined to make the necessary changes,” he said. He said he expected there would be support among the Republicans, the minority party in the Legislature.
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