Nursing home care and the Georgia Legislature

Episode 112
Categories: Regulations

Nursing home care and the Georgia Legislature

The Georgia Legislature @AssemblyGeorgia  is one of the principal vehicles for the protection of nursing home residents.  In today’s episode, nursing home abuse lawyers Rob Schenk and Will Smith talk welcome Georgia Representative Sharon Cooper @repsharoncooper onto the podcast to discuss legislative actions aimed at protecting Georgia’s seniors.

Schenk: Hello out there and welcome back. My name is Rob Schenk.

Smith: And I’m Will Smith.

Schenk: We have a fantastic show for you today and that’s not just an April Fool’s joke. We have a fantastic episode because we’re going to be talking about advocacy of our elder population here in Georgia and the Georgia legislature. And we somehow were able to get – this is the first time we’ve ever had a guest that’s an actual Georgia Congressperson – state Congressman.

Smith: Yeah, well I point this out because I’ve got a very good friend who is in the legislature, and she is constantly getting mad when even her constituents call her a Congresswoman and she has to point out to them, “That’s not the nomenclature. I am a legislator.”

Schenk: Ah, Georgia legislator. That’s correct.

Smith: Yeah, “So I’m a legislator.”

Schenk: All right, so we’re proud to have on for the first time a Georgia legislator.

Smith: Yeah, a member of the Georgia House.

Schenk: Of Reps.

Smith: Yeah.

Schenk: That person is Representative Sharon Cooper out of East Cobb. So Will, can you tell us a little bit about Representative Sharon Cooper?

Smith: Yeah, she’s originally from Houston, Texas, not Houston, like we say here in Georgia.

Schenk: That’s right.

Smith: And she is proud to have called East Cobb County, Georgia, home since 1970. She was first elected to the House of Representatives in ’96 and chosen Legislator of the Year by the Georgia Republican Party in 2000. In 2002, she was elected Minority Caucus Chairman by her Republican colleagues in the Georgia House. In 2004, she was elected Majority Caucus Chairman, which at that time made her the highest-ranking woman in the Georgia House, an amazing feat. In 2007, in response to her increasing responsibilities as chair of the Health and Human Services Committee and her membership of the powerful House Rules Committee, she assumed the role of Caucus Chair Emeritus.

Representative Cooper holds several degrees, and this is what makes her so fascinating. She has a B.S. in child development, an MA in education and an MSN in nursing, and has even written textbooks on psychiatric nursing. She’s also authored a book called “The Taxpayer’s Tea Party,” which is a how-to book to encourage the average citizen to become politically active. She’s even updated this book for second edition in July of 2010, but with that kind of background, you can see why it’s so fascinating to have somebody like her advocating for the elderly, and we’re very proud to have her on the program.

Welcome to the show, Representative Cooper. How are you?

Sharon: I’m fine, thank you. How about you?

Smith: We’re doing well.

Schenk: Fantastic.

Sharon: Good.

Smith: So we want to go ahead and talk about some of your background because it’s very unique and very interesting. Your background is actually in nursing.

Sharon: Yes, I mean I was a regular nurse and then went on to get higher degrees and taught nursing school and I practiced with my husband who was a family practitioner. So I had a very varied background and now I help make the laws for Georgia.

Smith: And it’s very unique and we mentioned this in our introduction of you that you’ve actually written textbooks on psychiatric nursing.

Sharon: I have, a long time ago when I was teaching, I did.

Smith: Well that’s got to give you a unique perspective. How does it affect your perspective when you’re approaching legislation?

How does personal history affect view on the role of the Georgia Assembly?

Sharon: From being a registered nurse?

Smith: Yes, ma’am.

Sharon: Well from that perspective and my background, I laugh and say that I trained longer for – back when large schools were just starting and I was in the South, I went to a diploma program run by nuns, and nuns tend to be either the nicest people in the world or they’re really mean. And when it comes to the ones that used to run the hospital, the only time I found them mean was when it had to do with patient care, they were adamant about quality patient care. And so that was my first introduction to taking care of patients and so it has been the bedrock of my foundation since then. I am for quality patient care and the patient comes first with me.

Smith: Well it’s very clear that that’s the case. As a matter of fact, we had another podcast recently, we were talking to Kathy Floyd who’s the director of the Georgia Council of Aging. We had asked her to just tell us a couple of representatives that have always advocated for patients and the elderly. She included your name and outgoing Representative Willard as well as some of the biggest advocates out there.

Sharon: Well and I appreciate that. My whole adult life, as far as my work adult life, has been with patients, and it’s very nice to have somebody recognize that you really care. And I do care.

Schenk: And so Representative Cooper, could you walk us through, again, the audience of this show is made up of families who have loved ones in nursing homes, and usually the topics are going to be related to that, but you serve on the Health and Human Services Committee in the Georgia House of Representatives. Can you tell us what your role is with that and actually what the Health and Human Services Committee actually does?

What does the Health and Human Services committee do?

Sharon: Well I chair the Health and Human Services Committee and have since the Republicans took over in 2005. Before that, the chairman was a retired telephone lineman with a GED and they wouldn’t let anyone with a health background be on the committee, which made me very mad. And I tried for eight years to get on the health committee, and finally the Republicans took over.

And so you know, not only as a chairman, bills come before my committee that have to do with any aspect of health. Now bills can be put anywhere in the legislature. The Speaker is the one who assigns the bill in the Georgia, and if he wants a health bill to go to Agriculture, he can do that. Usually those are bills that they don’t want to pass, like we had a seatbelt bill for older children that one of the senators that was a doctor had pushed for years, and it always had got assigned to the Agriculture Committee, because the guys down in south Georgia didn’t want to have to wear seatbelts in their pickup trucks and all. And all of a sudden, one year it gets assigned to me, and I think it’s a mistake because I’m telling the guys and they’re coming to me, “No, that’s a mistake. It goes to Agriculture.” And of course, the Speaker had put it in House because he wanted it passed. That senator was retiring and a good friend of the Speaker and he wanted to give him that bill.

So a bill can go anywhere. Normally if it has something to do with health – bills on what doctors can do, what nurses can do, about communicable diseases, about palliative care, those bills come to my Health Committee. As a chairman in Georgia, I decide what bills I will hear. It gives me a great deal of power. Normally I will hear them if I think it has any chance of passing and is not ridiculous. The only time I can tell you one bill I wouldn’t let come out was I had one of my colleagues come to me and one put in a bill in that you could only donate organs if the person signed up as a donor before they died, which meant no family member after a person’s death could donate a person’s organs. That would have cut our organ donations by 65 percent in Georgia, so I just told him that I wouldn’t hear that bill.

So I hear all these bills that come before me, and my committee members, then we vote and decide what’s going to move as we try to move a bill to the floor for a vote from the House. Sort of the long way, sorry, I didn’t mean to be so long-winded about it.

Smith: No, please.

Schenk: Please, this is great information.

Smith: Very informative.

Schenk: Yeah. So Representative Cooper, I was recently reading an article about a terrible case of a resident of a nursing home who had developed and died from a rabid scabies infection. And in that article I read, you were quoted as talking about how right now, it’s difficult for the Department of Public Health to communicate with the Department of Community Health with regards to outbreaks of infection and regulation of long-term care facilities. Can you kind of speak to where you were coming from with that and what that means?

How does the Georgia Assembly address communication between agencies?

Sharon: Well, first of all, I’m not sure if the person, they died indirectly from the scabies, apparently. This is a court case and I’m not privy to all the information to that court case, so I really can’t speak about that specific case. However, when people are elderly, very often, they don’t have just one problem. They have multiple problems. They may be diabetic, they may have chronic lung disease, they may have heart disease or they may have two or three or four of these ailments, and their immune system is being compromised and that makes them more likely to come up with other problems, such as infections and what this case said. And then usually death in an older person is not just from one system if they’re that sick.

But what concerned me and what I was hearing and hearing it in that court case, and I’m not privy to all that information, was that it seemed to be a breakdown maybe to begin with in our Public Health, because they, apparently, Public Health was notified by the nursing home of the problem. They sent them a manual to follow. And when I dug into it, I said, “Well how did they make a decision to send a manual and not go out and see what was going on?” And they said, “Well somebody decided that it wasn’t severe enough,” and I said, “Well how can you tell how severe it is if you don’t go out and see it?”

And so I did call a meeting and we did look at that, and also the Public Health Department did not let DCH, and the department, DCH, that regulates nursing homes, they didn’t apparently think it was necessary to tell them. And how I think that would help – well first of all, the Public Health nurse said she used to go out and check on things like this, and if we are going to oversee diseases in our state, I think we need to be on the front line. And when it’s something like this occurs, I think somebody needs to visually and on the site inspect these kinds of things.

And part of the problem we run into is we have state Public Health, but just like the school systems in Georgia, we have county health boards. And they make up the rules and sort of oversee the actual oversee the day-to-day what’s happening in the Public Health Department. And a lot of what the state Public Health Officer can do, commissioner and other members, is only suggest that they do something. And if these county boards of health don’t want to do it, we apparently at this point have no mechanism to make them change. It’s like the school board. The state school board can often make suggestions, but we have local school boards in local control. And all of this, it leads to some bureaucratic problems when you get this kind of cross. It’s good in many ways like local control in the schools and all, but it can have some problems.

So I thought that somebody should have let DCH know. Now if I had been at DCH and I certainly think I would have sent an inspector out or somebody to look, but at least I know I would have if this had been a nursing home that had multiple complaints over the convening years.

Schenk: And I didn’t mean to put you on the spot, Representative Cooper, about this particular case. I guess I should have framed the question more in general. Moving forward, should there be more communication between the Department of Public Health and Department of Community Health, I guess?

What are some bills regarding elder safety coming up in the Georgia Assembly?

Sharon: Yes. Yes. And they made that decision after the meetings that I called.

Schenk: Right.

Sharon: And they came and testified and we got into what happened and how we dropped the ball, and by “we,” I mean the state, and they have now instigated a different procedure where Public Health will let departments know.

Schenk: Very good. Very good.

Sharon: It didn’t take us passing a bill for that, thank goodness.

Smith: But speaking of bills that you have passed, what can you tell us about – it looks like we have Senate Bill 202, but as I understand, that got gutted and it’s actually House Bill 635, the Disabled Adults and Elder Persons Protection Act?

Sharon: Well elder abuse and elder problems is something that, believe it or not, is fairly new for a lot of people to start thinking about. It’s sort of like child abuse laws 35 years ago when people, somebody was practically beating their kid in a Walmart because that child was screaming and crying because they wanted a toy, people just turned around and went, “That’s a parent, that’s their business.” We’ve learned a lot about child abuse now and turning a blind eye to that would not happen, most likely would not happen. But it’s taken us – year by year, we changed our child abuse laws and some people would think that some states have gone too far, and sometimes I question that. I’m still a proponent of a little good whack on the rear end, not leaving a handprint, sometimes might be useful for some of these kids. Now I don’t want to be promoting child abuse on that, but I’ve got a few whacks on my rump when I was growing up and I don’t really think it hurt me. They never left a handprint.

But we are now and have been just sort of recognizing what child abuse, I mean what elder abuse and spreading that word among people. So we have this great group of volunteers in Cobb County, not related to Cobb County government, that started an elder abuse task force. And they started bringing together bankers because of financial abuse, the police, sheriff’s office, the hospital, the VA, anybody that they can think about, legislators, several of them, to start talking about elder abuse cases, whether it be the kind where they start these personal care homes and they’re taking their people who are low-income and only have their Social Security checks, and they take those and say they’ll take care of them and they let them live in squalor, to financial abuse. Somebody in my district got taken for millions of dollars.

Schenk: Oh wow.

Sharon: By two men that came in, befriended this little lady in her 90s, and I mean it’s just terrible. So this elder abuse task force started this and they started working in Cobb, and then people from all over the state started calling and saying, “Will you come talk to my police and DAs and all?” I can’t tell you how many lunches I’ve donated money for, through my campaign funds thankfully, to buy lunch for police officers, not only fancy lunches, I’m talking about Chick-fil-A. So they come and they share the kinds of cases they get and the problems they’re getting and how they can work together, communication across county lines, to try to stop a lot of this. And I mean now, they’ve been to Muscogee County, up to Rome and all over. They now call it not the Cobb Task Force, but they call it the Northeast Georgia Task Force, and I don’t know how Columbus gets included in that, but they’ll go anywhere. And one of the big people in it is a former FBI agent who is very active.

And so out of that came the idea that we have child fatality review boards, and we don’t want this to be an elderly fatality review board. We want it to be a preventive board of elder board, and by bringing together from, we felt like if each jurisdiction, DA’s jurisdiction, in the state would set up these task forces, it would include people from the state and all sorts of law enforcement, and the people that deal with elderly, and they would talk about the problems they’ve seen and how to combat them, that we can prevent a lot of elder abuse, and that’s what that bill does.

Now I would have loved to make it mandatory, but everybody backs off and says, “Don’t tell me you have to do that. If you tell me I have to meet four times, you have to give me more money.” But what’s happening is the board, the association and the board that overlooks DAs in the state has put one young lawyer and his job is to go around and help educate the DAs and their staff on elder abuse and to help them set this up.

Smith: Who’s that? Do you mind if I ask?

Sharon: Who is it?

Smith: Yeah.

Sharon: Will Johnson.

Smith: Okay.

Sharon: He works under Mitch Skandalakis.

Smith: Oh, okay, out in Carroll County.

Sharon: Right, but they made Mr. Skandalakis the head of this and another target.

Smith: Oh really?

Sharon: So I’m trying think of what to call them.

Smith: Oh, okay, the Prosecuting Attorneys Council is probably the one.

Sharon: That’s it. That’s it. Right, and he said, Will, and I think half of Will’s job is…

Smith: Skandalakis is a great attorney. I was actually, early in my career, I was a criminal defense attorney, and I had worked with him. I was a defense attorney at the time, but he was an absolutely remarkable district attorney, so I’m happy to hear he’s involved in this.

Sharon: Right, and he’s been very active and coming. These bills have come before the legislature, not only Will comes to help us craft them so that we’re doing them right because I’m not an attorney, and he’s worked with us, and even Mr. Skandalakis has appeared to testify for us. So they have taken this on as something that’s very important to them, and they are helping educate people all over the state of Georgia along with our task force that originated in Cobb County.

Smith: That’s amazing. That’s very encouraging. I often go to different conferences around the nation and unfortunately, Georgia, and this is a bipartisan issue, Georgia is not really doing that well in terms of care for the elderly, but at the same time, our legislature is highly involved. Like I mentioned, I know Wendell Willard has always been pushing for protection for the elderly. I’ve got to give it to our legislators. You guys are doing a really good job combatting this.

Sharon: Well thank you. Wendell was my sidekick, and when one of these bills would come up and I would think it was too legal for me to carry, I’d go to Wendell and say, “Okay, Wendell, I’ve got one. I need a little help with this.” That’s the nice thing about the legislature, so Wendell was great. I’m going to really miss him.

Smith: Yeah, I know. It’s big shoes to fill. What about the other bill, the Georgia Alzheimer’s and Related Dementia Advisory Council?

What is the Georgia Alzheimer’s and Related Dementia Advisory Council?

Sharon: Well they’re saying that by 2030, Georgia’s going to be the number one state in the Southeast for citizens over 85.

Schenk: Really?

Sharon: Yes. By 2030, it’s not that far off – we’re close to 2019, that’s 11 years, and we will be the number one state for citizens over 85. I think that we’ll probably get there before 2030. People are moving out of Florida. They’ve had too many hurricanes that have blew them all out. For some reason, our coastline seems to miss a lot of that and we’re getting a lot of snowbirds that now come and they’re now going into the Georgia mountains or the Georgia seacoast, and then we’re just a good state to live in. We have low taxes and seniors are coming to our state. And I think that’s great. I’m a believe that elder people bring a lot of wisdom to us. That’s something our country used to respect, and that’s part of our problem, and then we want to go to a throw-away society, and that’s included our elderly.

One of the problems we’ve had in our nursing homes, I wish I could mandate that if you have a family member in a nursing home or assisted living, I wish I could mandate that people have to go see them once a week, because there is nothing better than checking on a loved one to make sure that they’re getting the care they need, but you can’t mandate that. And for many elderly, they are put in nursing homes and no one ever comes to see them. In fact, this is a season of giving, and I would encourage everyone to reach out to somebody in a nursing home and nursing homes often have programs where you can give somebody that wouldn’t get a gift or you can go at least and visit them. It’s so needed and the elderly have a lot to give our society, and it makes me ill about it.

So what this new bill does is an advisory committee to help us get ready for this tsunami, to look at the kind of care they’re going to need. If you reach 85, there’s about a one in two chance, almost 50 percent, maybe a little bit lower than that but not much, that you are going to have Alzheimer’s or dementia. One out of every two people, at least you’re going to start showing the signs of it.

And dealing with this kind of an elderly person is very taxing and it’s a great strain on caretakers, whether they be family members or nursing homes. And we need more work with our two-year colleges and even our four-year nursing schools and our medical schools to get more education about what our senior citizens need and how they’re different, and also to work on our workforce. We have a real problem in Georgia as we’ve become the number one state for employment, we are having trouble filling jobs. And working in a nursing home is not an easy job.

Smith: No, I did it for eight years. It is one of the hardest – I was a Marine and then I went and worked in a nursing home, and I can tell people without question, I honestly think the eight years in the nursing home may have been harder than the four years in the Marine Corps. It was the hardest thing that I’ve done.

Sharon: It’s emotionally hard. It’s taxing. Older people can be grouchy and grumpy at times.

Smith: They can be combative.

Sharon: Yeah, they’ve got aches and pains, and if they have them, then they are. Yeah, so it’s not an easy job. I’m glad to say we raised the rate we pay our nursing homes to help them cover the cost, but we still need to raise that more. I’m hoping that we’ll continue to do that. We went through a really bad recession, but we need to do that to help them get better people working in the direct care. There’s a shortage of registered nurses. There’s a shortage of LPNs. But we can’t just churn out people, like we can’t just take 500 more nursing students and not let them get the experience they need and be trained correctly.

So this is all a problem and what happens when you send down a packing store or you’re a new packing company to [28:12], Georgia or Ocilla, Georgia, and that packing company is going to pay $15 an hour, then guess where part of your staff goes?

Smith: Exactly.

Sharon: And it’s packing something, boxing up something is a much cleaner job than carrying bedpans and taking care of what happens in the elderly and that kind of thing. So we just had this workforce problem that we’ve got to deal with, but I am so glad to say we’ve been raising the amount of money that the nursing homes get because that’s the other thing. Americans are not saving for their retirement. Many think that Social Security is going to be enough to take care of them. They don’t plan on living to be 85, 90, and even if they do, sometimes their children look at what Mom and Dad have saved as their money.

Now I had an adoptive mom, unofficial, we were together 40 years and I was the heir to the state and everything, and she, because of diabetes, got the same symptoms of Alzheimer’s. She did not want to go in a nursing home or assisted living when it started, and it was her money. She lived almost four years, and for me to have round-the-clock care, this was in Maryville, Tennessee – thank goodness it was a small town, a really nice small town where I knew the doctors and she knew the doctors – but it was $110,000 a year for me to have round-the-clock care with her in her home and to keep the home up, but it was her money. I mean I would have inherited anything left over, but it wasn’t my money. It was the money she had saved after her husband had died and it went to taking of her. But that is not the attitude that many Americans have, and I don’t know how we change that, but people have got to realize that this care costs a lot of money.

Smith: Yeah, it’s also like you said, it’s the throw-away culture. The easy solution is to put Mom in a nursing home, then visit her on Christmas and maybe one time in the summer.

Sharon: Right.

Smith: But you guys are doing everything that you can, so that’s amazing. We really appreciate it. Is there anything else you wanted to bring up? I know you’re busy. I don’t want to keep you. Any last words that you wanted to talk about or anything you wanted to plug yourself?

Sharon: No, I’m very proud of the fact that we’re going to national background checks and the other thing is we’re trying to move people out of nursing homes and let them stay in their homes more. That’s less expensive and they’re happier, and part of this new law, it’s very hard – the feds don’t give out the information from background checks readily, but we’ve come up with a system where they will tell – there are certain things that if you do them somewhere in this country will make you ineligible to take care of an elderly person.

Smith: Amen. I don’t know why it hasn’t happened.

Sharon: And you won’t know what the person did. You’ll sort of get a green light or a red light, and my thing that I’m so proud of is that the first part of that will probably go into effect, because it’s taken us time in working it out with the feds, is the part is that if I’m taking care of myself when I’m older and I need someone to come into my home, whoever’s in charge of me, a friend or something because I have no children, can get a background check on that person. They’ll have to pay that $50 or something, but people out in the community that want to hire people in their home just like you would hire a housekeeper and all would be able to use this background system also to check. And I truly believe that that will help us decrease a lot of abuse out there. So I’m very proud of that.

The first roll-out of the part with the nursing homes goes into effect October 19th of this coming year where new hires will need to have the federal background check, because before, you could do something terrible to somebody over in Alabama and you come over to Georgia and we wouldn’t know about it.

Smith: And they didn’t know.

Sharon: And so this way, I’m very proud of that. That was a very hard thing to get through because of how delicate it is working with the feds and I thank them very much for working out a system with us to do that. So I’m just very proud of that. There’s so much more to be done, but we are doing a lot. We care. Members of the legislature, we all find our little slots in working – everything they do, healthcare is mine, but I’m so glad that my colleagues are paying attention to it, and when I go explain and talk to them, I don’t get any fallback from it. These bills pass with a lot of support and for that, I’m very thankful.

Smith: Well, and Representative Cooper, we’re thankful for you, especially losing somebody like Willard, we’re glad that you’ll be taking place and advocating for the elderly.

Sharon: Thank you very much for doing this and for the families that are listening. Thank you for caring about your families. And not all families put their loved ones away and never see them. For everybody who does that, I say thank you very much.

Smith: All right, well thank you very much.

Sharon: Thank you.

Schenk: Thank you.

Sharon: You’re welcome.

Schenk: All right, bye.

Sharon: Bye.

Schenk: Yeah, great to have Representative Cooper on and educate us on some of the system you’ve got up in the legislature. I keep thinking as she’s talking about those cartoons we would watch while we were kids about how bills become laws and things like that.

Smith: Oh, right. It’s a complicated process and it’s interesting to hear about, but thankfully, there is somebody out there in the legislature in Georgia fighting for elderly senior citizens.

Schenk: That’s right. And we – just one thing before we go, this will be interesting – I think Representative Cooper will appreciate this – is that she mentioned how she had to take care of things with her adoptive mother in Tennessee.

Smith: Maryville, Tennessee.

Schenk: This is how – in the same sense that if you say the words “Ponce de Leon Avenue,” we know that you’re from Atlanta or you’re familiar with Atlanta because you pronounced it correctly.

Smith: Yeah.

Schenk: You are East Tennessean if you pronounce that city as Maryville, when it reality it’s Maryville.

Smith: Oh.

Schenk: It’s spelled Mary-ville, but if you say Maryville, we know that you’re an outsider.

Smith: That you’re not from here. Yeah, it’s like if Martinez in…

Schenk: Martinez, Georgia.

Smith: Martinez, Georgia, or Ponce de Leon or Houston County.

Schenk: I remember, and if I remember correctly, because I went to the University of Tennessee in Knoxville, it’s slightly north of there, and I remember we had a professor from New York and was so confused because somebody kept telling him to go live in Maryville, and he had no idea what the guy was saying.

But anyways, that’s going to conclude this particular episode of the Nursing Home Abuse Podcast. You can catch new episodes of the podcast every Monday morning wherever you get your podcast from – Google Play, iTunes, Stitcher, Spotify, or you can watch it at our website, which is, or on our YouTube channel. We thank again Representative Cooper and with that, we will see you next time.

Smith: See you next time