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[INSPRATIONAL MUSIC] - Hi, I'm Steve Adubato.

This subject is so important to so many, let's get right into it.

We are honored to be joined by Laurie Brewer, who is New Jersey's Long-Term Care Ombudsman.

Thank you so much for joining us, Laurie.

- I'm happy to be here.

Thanks for the invitation, Steve.

- Let's clarify this, Laurie, your office has been established by what is called the Older Americans Act, a federal law that established an office to what, monitor how nursing homes are being managed and regulated by the states?

- Actually, we're resident centered, so the purpose of the Ombudsman's Office is to advocate for residents of long-term care, by investigating allegations of abuse, neglect, and exploitation.

As part of that function, obviously, we have a lot of insight into what's going on in long-term care facilities.

We also do a lot of public policy and legislative work to try to improve conditions in long-term care facilities.

- So as we do this segment, I wanna make sure we put up the phone number and the website for your office for people to report, to share, to find out more.

And I actually saw you for the first time, Laurie, on the great "NJ Spotlight News."

I saw you do a segment there, and they cover this issue on a regular basis.

But, this is the pressing issue that caused me to wanna have you.

8,000 plus people who were in nursing homes died of COVID.

There were decisions made by the Murphy administration to send people who were in nursing homes and got COVID back into those nursing homes.

In retrospect, for those residents and others there was that a mistake?

- Well, in fact, I was on some of those calls, and what the nursing homes were told was that you needed to cohort residents, meaning you needed to separate them, and if you could not effectively do that, you needed to let the Department of Health know that and not accept people with COVID.

So, I think that there, you know, there's a little bit more to the story of just sending people with COVID into long-term care facilities.

In fact, there were many long-term care facilities that were seriously confused about what was a pretty straightforward message, which was, if you can't handle people with COVID, if you can't separate them, if you don't have the staff necessary to segregate, essentially them, then you should not take people with COVID.

But one of the things I found throughout this whole entire terrible two years is that there's just a lot of confusion in the long-term care space about what the guidance was, about what the expectations were.

We found that especially with the issue of visitation.

Visitation was completely shut down, and there were situations where it was actually allowed under federal law and under the State Department of Health guidance, but I can't tell you how many long-term care facilities just shut their doors and wouldn't let any family members or anybody in.

So again, confusion about the guidelines.

It's kind of been the hallmark of our work in the last two years.

- Let me do this.

We're taping in the middle of March, it'll be seen later.

So again, there's a lot going on, as it relates to nursing homes right now.

If I'm not mistaken, there are 45,000 New Jerseyans in nursing homes as we speak, correct?

- I actually think the number in nursing homes is lower because the census is down.

It has not rebounded.

- But, here's the question.

Because of the COVID experience, because of those 8,000 people in nursing homes dying because of COVID, what, if any, specific concrete changes have been made, A, and B, need to be made, to protect those who are living in nursing homes in New Jersey?

- A lot of changes have been made, but I think there's a lot more that needs to be done.

- Specifically, what's been done?

- Well, what's been done is every long-term care facility is now required to have two months worth of personal protection equipment available, right.

That's something that was in short supply at the beginning of the pandemic.

Every long-term care facility is required to report in their staffings to the State Department of Health on a daily basis to monitor.

- And staffing is too low.

There are not enough professionals in nursing homes working right now.

That's, just a fact, they're just, staffing is a problem.

- Yeah, I mean, it certainly is a fact, and I think that, you know, that is one of the long term systemic problems that really needs to be looked at.

Long-term care is, you know, definitely requiring more people in the direct care space.

What are called Certified Nursing Aides are really in short supply.

The salaries have been increased.

The state has increased salaries and has actually increased the rates that are paid to long-term care facilities.

- One second, one second.

I'm sorry for interrupting again, but the state is increasing salaries, but what if a nursing home is a privately owned nursing home?

How can the state increase?

- No, the state, I should clarify that.

The state pays, Medicaid pays more than 60% of the cost of long-term care, okay, in nursing homes, and so they have a lot of leverage around what happens in the long-term care space.

The state actually increased Medicaid rates.

The state legislature and the governor signed a bill that requires that 90% of all Medicaid funding that goes into nursing homes go toward direct care, and the vast majority of that goes towards salaries.

So I would actually say New Jersey, in part because it was hit so hard, has really leaned into some major reforms that other states have not caught up to us with yet, among them is requiring 90% of the Medicaid funding to go toward direct care.

That is very unique.

There are only two other states that have done that, New York and Massachusetts.

- So I wanna be clear.

The Department of Health regulates nursing homes in New Jersey, correct?

- Yeah, they do.

- Okay, so if the state in fact has a mandate for those working in nursing homes to be vaccinated and boosted, when that happens, what will be the impact of those who do not get boosted, who are not vaccinated?

Will that not exacerbate the staffing problem?

- Well, you know, I think that's kind of been a tough issue all along, right, because the mandates have made people actually get vaccinated.

And there are a number of healthcare facilities who have reported that, in fact, some long-term care chains, that when they required it on their own, they really lost very few employees at the end of the day.

I think a lot of the people, and a sad fact is that a lot of the people who are not gonna get vaccinated are not gonna get vaccinated, okay, and they're not gonna get vaccinated no matter when the deadline is.

And I think they've had plenty of warning, and a lot of those people have probably already left and found other jobs.

So, you know, I think that there's this balance there.

When you lose 8,000 people in the long-term care space, you have residents who lined up.

- You mean, when 8,000 died.

- I'm sorry, 8,000 who died in this.

You know the state takes this obviously, very seriously, thus, the mandate, thus, the requirement for PPE, thus, the requirement that you have an infection control specialist in every long-term care facility.

That wasn't required before, a lot of things have changed.

And the residents, when the vaccines came along, the residents were the first ones to say, "I'll take my vaccine.

"I want freedom of movement.

#*I wanna be able to have my family visit me."

It was the staff that were lagging behind.

- Well, I got a few seconds left, and I hope that we've been putting up the website, and we'll do this in post-production, the website and the telephone number for people to call in, if they have a question, a concern, an issue, particularly, about a loved one.

Before I let you go, this is not a New Jersey issue exclusively.

This is a national problem, an issue, as it relates to nursing homes, long-term care facilities.

Is this an opportunity for us to change national policy A, and what would that be, in 30 seconds or less?

- Absolutely, in fact, the Biden administration just, you know, just announced some reforms, but, you know, we need staffing ratios.

You need some minimum staffing ratios, New Jersey has them.

- Patients to staff.

- [Both] Patients to staff.

- We have that in New Jersey.

You need the kind of direct care ratio that we have in New Jersey, where you require that a certain percentage of spending goes toward direct care and not toward profit.

You need transparency into the profitability of some of these private equity firms that are buying up nursing homes in the state of New Jersey.

Do we need to potentially increase funding down the road?

That's a distinct possibility, but you know what, Steve, we really need to know where the public dollars are going.

- Laurie, I, again, we'll have you back to monitor the situation.

We're taping this in the spring of 2022.

We thank you for the work you're doing, and I'm confident you'll be getting a lot of calls, unfortunately, and people visiting the website, 'cause there are a lot of serious challenges.

Laurie Brewer, thank you so much.

- That's what we're there for Steve.

Thanks.

- You got it.

Thank you.

I'm Steve Adubato.

More importantly, Laurie Brewer will be right back.

(grand music) - [Announcer] To watch more State of Affairs with Steve Adubato, find us online and follow us on social media.

- Welcome back folks.

I wanna welcome once again, Tom Weatherall, good friend, president and CEO of Make-A-Wish New Jersey.

And for the first time, Jaime Spiliotes, who is a Make-A-Wish parent of a beautiful, talented wonderful eight-year-old, her daughter, Violet.

First of all, Jaime, thank you for joining us, Tom, thank you for joining us.

- Pleasure.

- Thank you - Jaime, do this for us, and we'll be putting up the Make-A-Wish website so people can find out more and also there're a whole range of other reasons why you should check out Make-A-Wish.

Tell us a little bit about Violet.

She's eight years old, and she is a cancer survivor, has been through a heck of a battle, right Jaime?

- Correct.

She is eight years old now, she was diagnosed with cancer when she was five, she's at almost three years in remission already.

And she is doing everything she can to give back to everyone who helped her when she was sick.

- So Tom, let me get this straight.

So we've been together a long time, the folks at Fedway brought us together, we're part of the Fedway family, if you will, big supporters of Make-A-Wish.

What I'm curious about is this, so Violet's first wish was to cure cancer?

- It was, yeah.

- Okay, good, Violet, then I'll go to Jaime, and then I'll go to Tom after you.

So your daughter said she, it was supposed to be for what the kid wants, and she wanted the, go ahead.

- She wanted, the Make-A-Wish in New Jersey actually has a castle with a wizard who will grand your wish.

So she went up to the wizard and asked for them to cure cancer, and she was told that wasn't possible.

And she asked for a unicorn, and was also told that wasn't possible so she has a very strong spirit and she said, "I'll just find my own unicorn."

So just gave me a camper, and I'm gonna go find one and prove they exist, so... - Tom, what makes that so special?

Well Jaime, it's Wish moms like you and Wish dads, but it's the Wish kids who steal this man's heart.

And Steve, Violet is, just like the ones before, this brave little girl, who, as I was told, had a tumor removed from her.

Oftentimes, Steve, you might hear an adult even express a description like a golf ball size tumor, or a softball size tumor.

A watermelon size tumor is what was explained to us, was removed from this little girl who's now three years in remission.

And so Violet's wish, when we asked her, "If you could have one wish, what would it be?"

She settled on a camper.

And this camper, not just any camper, Steve, but it'’s to go in search of unicorns.

we have some video of Violet, and I believe she's there with the camper, and she has a special message to everyone.

This is Violet with a very powerful message.

- Hello, it'’s me, Violet.

I know I have a message, but this is on purpose, because I love marshmallows!

- (Mom offscreen) Have you found a unicorn yet?

- Nope, I just started.

I don'’t think everybody expects me to find it on the first try.

- (Mom offscreen) I did.

- I didn'’t.

- (Mom offscreen) Oh, okay.

- Follow me on #UnicornCamper on Instagram.

- (Mom offscreen) Great.

- My wish came true, and I got this camper out of it.

- (Mom offscreen chuckles) - Make other people'’s wishes come true too.

- (Mom offscreen) How can people do that?

- By donating on the link on top.

- (Mom offscreen) Awesome.

So that's Violet.

And so Jaime, she's asking for people to reach out to Make-A-Wish, to help other children.

How the heck did you get such an amazing daughter?

- Aw, thank you.

She's pretty amazing.

She doesn't just wanna find the unicorn, she wants to use the camper to give back.

So on the back of her camper, she has her Instagram site, which is Unicorn Camper.

And right now she has a link people to give back to Make-A-Wish.

So her goal is to raise $10,000 which is the average cost of a wish.

So she'd like to give back a wish.

- And going across the country with the camper?

- Well, maybe not across the country just yet, it's just me and her.

So we're taking it slow.

So, just a little...

Eventually she wants to go to the Redwood forest.

So we will be going across country.

But it's a beautiful camper, it was designed by Stephen Brown of Glitterville, she was watching his videos and she decided to ask him and he made it absolutely fabulous.

It even has her on the back.

So when people see it, they get happy, it brings them joy, and her hope is that they give back to Make-A-Wish when they see it.

And after she raises 10,000 for Make-A-Wish, she plans to change the link to another organization that helped her so she can give back to everyone who helped her.

- We are talking about a very special young lady.

Hey Tom, let me ask you something, real quick on this, COVID's impact on Make-A-Wish.

We're a not-for-profit, you're a not-for-profit, we have to raise money, you have to raise money for a much greater cause than what we're involved in.

But did you stop granting wishes?

- No Steve, we never stopped.

Even two years ago, that March of 2020, when everything came to a standstill, everything but Make-A-Wish and wish granting came to a standstill, Steve.

We pivoted, we simply pivoted.

So as you know, so many of our wishes involved, well, prior to the pandemic, 85% involved some form of travel, particularly by air, We pivoted, and instead, we were granting wishes to, I wish to have, rather than I wish to go.

And wishes like Violet's, wishes for a backyard pool, wishes for a hot tub, which brings great therapy to many of these kids, wishes for a bedroom makeover, wishes for a camper.

And Steve, when I hear and heard of Violet wanting to pay it forward, you know, part of my job, your job, we sit across from philanthropists on any given day, we sit across from corporations who wanna learn how to engage with us and bring us support.

But when I hear that a child wants to pay it forward for another child, there's nothing that humbles me more.

- Yeah.

I wanna be clear, Tom, the children who are granted wishes, these are children who have serious illnesses.

- Life-threatening, critical illnesses, Steve.

That's right, yeah.

- Before I let you go, real quick on this, Jaime, the design of the camper, Stephen and Fiona, Stephen Brown and Fiona, is it Gubelmann, I don't wanna say it.

- Gubelmann.

- Why does that matter?

Why is that important?

- Well, they just gave their time to give back as well.

The funniest story behind it is Stephen Brown had reached out to Make-A-Wish a few weeks before asking if he could get involved in any way.

And Violet randomly asked him, and he was like, "I just asked to get involved."

So it was kind of serendipitous.

We actually went out to Tennessee to meet him, and the two of them hit it off, so... - They're important because they're part of a group of people who care and make a difference and try to help others.

So, Tom, thank you, Jaime, thank you, especially, could you thank Violet for us please, Jaime?

- Absolutely.

Yeah, thank you.

- Make-A-Wish is a heck of an organization.

Thank you folks.

Stay with us, we'll be right back.

(grand music) - [Announcer] To watch more State of Affairs with Steve Adubato, find us online and follow us on social media.

- We're now joined by Dr. Juan Rios, who is a professor of social work and the director of the master of social work program at Seton Hall University, one of our higher education partners.

First of all, thank you for joining us, Dr. Rios - Thank you for having me, Steve.

It's a pleasure.

- The most significant social and emotional impacts, or the impact, if you will, on younger people two years plus into this pandemic, where have they suffered the most?

- Honestly, Steve, it's a lot that's happening with young people not being able to have that social emotional development that they normally would obtain from the interactions with each other and with their peers.

And I really do believe that one, what our research is showing is over the past year there's been a 30% increase in young people going to the emergency room as a result of anxiety, 25% increase amongst adolescents for depressive symptoms, 4% increase of suicide rates amongst boys, adolescent boys, and a 51% increase of suicidal ideation and a trip to the hospital amongst adolescent girls.

So it's clearly evident that the lack, as a result of the pandemic, is definitely increasing a lot of the emotional challenges, specifically amongst our youth.

- Doctor, let me ask you this.

Again, we have teenage children, and we also have a young girl, a young daughter, who's 11.

And I'm struck by, listen, non-verbal communication is, you know, 90+% of the entire communication equation, if you will.

But that being said, I am struck by how challenging it is for her, for some of her friends, to actually just engage in conversation.

Now, that's pre-pandemic.

Social media, staring at the phone, constant whatever.

Has that been exacerbated?

- Absolutely.

- The inability to just have this kind of conversation, like that's so hard.

- Absolutely.

Well, you know, adolescents aside, you know, adolescents are dealing also with the developmental stages of individuating, developmental stages of building their own identity.

Us as adults, it's been difficult for us to be in social spaces.

We also have to really relearn what it's like to engage in a conversation that's larger than 180 characters.

We have to be able to engage in conversations where it truly builds connection.

Because connection, what we find, is one of the factors to really combating depression and building resiliency.

So if we don't have genuine connection, although we're communicating more through the use of our phones and technology, is that true connection and engagement?

And that's what we really need to ask ourselves.

And how do we build that in to our interactions that are not happening through the use of physical interactions?

And how can we really supplement that in spaces that alternatively, we have not?

- You know, we're doing this interview remotely.

You know, we'd prefer to be in the studio.

You teach, and to disclose, I've taught and I continue to teach at Seton Hall as a visiting fellow there.

And I happen to be blessed to be able to do that in person this semester.

It's a huge difference.

- Huge.

- When you have to be remote, you're remote, but explain to folks the dynamics, the difference, Professor, between being in a room with students versus doing this, the old-school "Brady Bunch" thing - Right.

So it's the subtle nuances that occur in the classroom.

It's being able to look at someone in their eyes, with their real eyes.

It's being able to lean forward and start to notice that that nonverbal communication is showing that empathy, that concern, that being heard and listened to.

It's being able to face and walk towards someone, which is that phenomenon of connection, of attachment.

It's being able to just have that physical space wherein we are unified amongst both space, time, and our engagement, our full engagement, that I'm not looking at you through a screen but I'm actually typing on the other end, that I'm here fully, here and here, I'm with you.

And our students begin to notice that.

They see that difference, because it's, they can't run from that.

They can't shut down their screen just when things get tough.

And that's the resiliency piece that we have to be able to consider, is that when our youth and our adolescents in schools, when they're being challenged and pushed together to be able to answer some questions, to be able to work through and problem solve together, and through what we call distress tolerance, that helps build resiliency.

That helps build character and confidence, that as sometimes we really feel safe through this screen, and we feel safe with our mask in front of us.

- You know, it's so interesting.

I appreciate the way you've described it in such a scholarly fashion.

When I teach, when I coach, when I do what I do in my other world as a trainer, as a coach, and as someone who teaches, I call it forced engagement.

You know, I will call someone out and say, you know, "Juan let me ask you, what would you say the biggest takeaway is from chapter whatever?"

And some people have said to me, "Why do you call someone's name out, Steve?

Why do you ask them a direct question?"

I said, "Because I want to force engagement."

"Well, you're making people uncomfortable."

And my response is, "Look, I want to invite you into the party.

I want you to participate.

If you feel uncomfortable, that won't last forever."

But if you just let people back away, and two or three people manage the conversation, or they're the ones who are most confident, and I'll get off my soapbox now, that's not healthy.

Please, professor.

- Right, absolutely.

So we all learn and develop our emotional intelligence through challenging our comfort zones and our comfort levels.

And that's what you're doing, whether you're doing it in sports or whether you do it in social engagement.

Of course, there are individuals that are on the spectrum.

And it's a little, it's a bit more challenging.

- That's different.

That's different.

- That's very, very different.

We're not talking about that.

We're talking about in our classrooms and engaging students to be able to show up as their best selves in order to increase their own arc of emotional development.

- That's right.

- Because our resiliency to be able to fight through some of those challenges is what's able to help us show up the next step.

So, which is why it's super important to be able to build this type of, you know, forced engagement, as you mentioned, so that you and I can be able to develop those skills.

So where what we're doing is, I can hear your argument and not shut down emotionally - That's right.

- because you have a different perspective or a different point of view.

And if we don't begin to tap into those nuances, we're gonna move more into a polarized society.

Because then, we're not, we're using cancel culture rather than council culture as a way to be able to engage and interact with one another.

And that's a very important aspect that we're referring to here.

- So well said, Dr. Juan Rios, who's a professor of social work and Director of the Master of Social Work program at Seton Hall University.

Doctor, thank you so much for joining us.

You added so much to the conversation.

Appreciate it.

- Thank you so much, Steve.

It's a pleasure being here.

- That's Dr. Rios, I'm Steve Adubato.

Thank you so much for watching.

We'll see you next time.

- [Narrator] State of Affairs with Steve Adubato Is a production of the Caucus Educational Corporation.

Funding has been provided by Fedway Associates, Inc. New Jersey Sharing Network.

Johnson & Johnson.

Atlantic Health System.

The Healthcare Foundation of New Jersey.

The North Ward Center.

Delta Dental of New Jersey.

Valley Bank.

And by The New Jersey Education Association.

Promotional support provided by ROI-NJ, And by New Jersey Globe.

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