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How the Inadequate Supply of Protective Equipment Takes a Toll on Nurses


Two nurses tell their stories as union rep says ‘conflicts between hospital administrators and medical staff’ are increasing

This story was written and produced by NJ Spotlight. It is being republished under a special NJ News Commons content-sharing agreement related to COVID-19 coverage. To read more, visit njspotlight.com.

Full story link – HERE.

By Ian T. Shearn

Pam Tavarone, a veteran  ICU nurse at St. Mary’s General Hospital in Passaic, suited up for work last Friday in the makeshift safety uniform she had been wearing for the past week and a half — a white Tyvek painter’s suit, goggles and an industrial-grade respirator mask — all of which she had acquired herself. Supplies of personal protection equipment at the hospital were in short supply. The heavy-duty mask had left bruises on each side of her nose from her 12-hour shifts.

But on this particular day she was uncommonly troubled. She had been experiencing tightness in her chest and shortness of breath for three days. “I could feel something was going on. It was knocking me out,” she said. Her “gut” was whispering  bad news. She has a history of asthma; two of her three daughters have underlying conditions — diabetes and asthma. She needed to be tested.

At first, “they didn’t want to give me a test, because I didn’t have a fever. But I pushed, and they gave in.” The results came back Saturday: Her gut was right; she was positive.

Now, Tavarone is quarantined in her home. At first, the hospital refused to prescribe medication for her, she said. But again, she “pushed” and they relented. She is taking hydroxychloroquine (Plaquenil), the experimental anti-viral drug, which has yet to be confirmed effective for COVID-19.

Tavarone blames no one

Tavarone is stressed, she is afraid — more for her children than herself — but remains resolute in her optimism, a common trait of ICU nurses. She blames no one. She did everything she could to protect herself, and she harbors no ill will for a hospital outmatched and overrun by the pandemic. An administrator told her that reinforcements in the form of nursing volunteers will arrive Tuesday. And “they keep tell us they’re trying” to get more gear,” she says.

Not all of her colleague feel the same way. At least three nurses at her hospital have already contracted the coronavirus, Tavarone said, and four have resigned out of fear — two walked out and two have given notice. Nurses there are given one mask and one gown per shift. Some have taken to wearing garbage bags over their flimsy plastic gowns. Fear has consumed the hospital. Morale, she says, is “sub-zero.”

“During this current COVID-19 outbreak, we are experiencing the same trials and challenges as every hospital in New Jersey and the nation,” wrote Vanessa Warner, a spokeswoman for St. Mary’s. “We are completely focused on the safety of every member of our staff and each patient they so valiantly care for.”

The depletion of personal protection equipment (PPE) and a shortage of nurses, has caused anxiety to rapidly escalate among frontline health care workers throughout New Jersey and beyond. It is a problem that won’t be solved until more PPE can be produced. But hospitals like St. Mary’s can’t close down in the middle of an outbreak because they lack protective equipment. They must soldier on.

Some nurses told to store masks between shifts

“When COVID patients first began arriving at our members’ facilities, medical workers changed gowns and masks after each encounter with an infected patient,” said Douglas Placa, executive director of JNESO District Council 1, the union that represents 5,000 nurses in New Jersey and Pennsylvania, including Tavarone (who is her local’s president). “Soon, they were instructed to  keep their protective gear on until the end of their shift. At some hospitals, nurses are now being told to store their masks in a paper bag between shifts.”

For reasons hard to understand, the dearth of masks, gloves and gowns continues to plague America. The federal stockpile is deficient and the manufacturers thus far have been unable to meet the overwhelming demand. Hospitals and state governments are engaged in international bidding wars to purchase masks for exorbitant prices. President Trump has invoked the Defense Production Act, but has not yet ordered U.S. manufacturers to produce more medical supplies.

For New Jersey nurses, it certainly did not go unnoticed when two New York city nurses died from COVID-19 in the past two weeks. New York is the epicenter of the coronavirus in the U.S., and New Jersey is ranked second. Passaic County, where St. Mary’s is located, ranks fourth in the state with 3,227 cases and 42 deaths. Cases continue to spike and both states expect that to continue for weeks.

Nurses here wonder if Europe is providing a terrifying preview of what’s in store. In Italy, France and Spain, where hospitals have been overrun by the pandemic, more than 30 health care professionals have died of the coronavirus, and thousands of others have had to self-isolate. In Italy alone, more than 11,000 medical personnel have been infected.

The message from Italian doctors

A group of doctors from a hospital in Bergamo, Italy — treating more than 4,000 COVID-19 patients with just 48 ICU beds — offered this sobering account in the New England Journal of Medicine:

“We are learning that hospitals might be the main Covid-19 carriers, as they are rapidly populated by infected patients, facilitating transmission to uninfected patients. … Health workers are asymptomatic carriers or sick without surveillance; some might die, including young people, which increases the stress of those on the front line.”

While Tavarone and her colleagues have been jerry-rigging their own safety equipment, one South Jersey nurse was reprimanded and sent home for bringing in her own mask — the coveted N95, which is in short supply across the country.

Dawn Kulach, a nurse at Virtua Voorhees Hospital in Camden County, was elated when she was recently informed her COVID-19 test result was negative. She had been placed in mandatory quarantine, suffering only from pneumonia. It meant that not just she, but her spouse and son were OK. But her relief and her sense of well-being were short lived.

When her fever subsided, she returned to work last week. Knowing the hospital was also perilously short of PPE, she turned to her personal supply. She knew the precious N95s were being kept under lock and key at their hospital and given only to those dealing directly with infected patients, which she was not. She had been able to accumulate a couple dozen N95s on her own.

As she was preparing to leave for work, her 10-year-old son started crying. He pleaded for her not to go, Kulach said. She showed him her mask, and assured him it would keep her safe.

‘Thinnest mask I have ever seen’

Upon her arrival she was taken aback when no one took her temperature, or anyone else’s, before she entered the building. She reported to her unit, a pulmonary unit that included coronavirus patients and was handed “the thinnest mask I have ever seen.” She wasn’t assigned any confirmed COVID-19 patients, but three of her patients had heavy coughs and fevers. “All safety protocols have been thrown out of the window,” she said. She put that mask over her own N95.

She was soon confronted by a supervisor, taken to a conference room with a security guard standing silently by. She was told to remove her unauthorized mask. She refused, saying “if the hospital can’t protect me, I have to protect myself, my patients and my family.” She said her manager then ordered her “to clock out and go home.” And then the kicker, according to Kulach: “She strongly suggested that I rethink my career.”

“Conflict between hospital administrators and medical staff is becoming widespread,” Placa said. “The main topic of concern is the appropriate use of PPEs and safety of our members and their patients.” Placa said he was informed by one nurse that “she was given a mask and management told, ‘Use this for the week.’”

Kulach is scheduled to meet on Tuesday with her superiors to discuss her employment status. She fears she will be fired.

She will be accompanied by a union rep and intends to tell hospital officials that “this is not what I signed up for. … I didn’t go into disaster nursing, and we are not getting any disaster pay. … I have the right to protect myself and my family. I didn’t refuse to treat patients. … If I have the means to protect myself, I’m going to.”

The collective good

If they don’t let her wear her own N95 mask, she said she simply will not return to work. “I promised my son I would wear the mask. … Maybe I will have to rethink my career.”

Dr. Reginald Blaber, executive vice president and chief clinical officer for Virtua Health, Virtua Voorhees’ parent company, declined to comment on Kulach’s situation, but did offer this: “The collective good must supersede any individual’s choice or desires during these challenging times.

“Like all health systems in the country, we are working with a limited supply and an ongoing shortage of N95s and other forms of personal protective equipment.

“Recognizing the global shortage of supplies, we must be meticulous stewards of our resources so we never find ourselves without what we need.”

Told of Kulach’s story, Tavarone was supportive: “I guess they would have sent me home every day.”

In the meantime, Tavarone is riding it out in quarantine. But now her husband has developed a cough, and she said she will “push” to get him tested. And when she recovers, she said, she will return to work.

She had lost track of the death count at St. Mary’s, but last week, before she was tested, she and her colleagues “celebrated our first success story” when one of their ICU patients became well enough to be discharged from the unit.

 

Header: Photo by Jeff Rhode / Holy Name Medical Center

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Pregnancy and Parenting in the Time of COVID


“In motherhood, love can manifest most powerfully as fear.”  This quote is from the new book by Sarah Menkedick, with the timely title “Ordinary Insanity.” One might argue that our current situation is one of madness framing our mundane daily activities. Pregnant women and new families are living through an extraordinary historic moment doing the most ordinary things: carrying, birthing and parenting children. Yet there is nothing normal about our lives right now. This is a time of chronic concern for all humans on the planet, but for parents, especially new families who haven’t yet acquired their self-confidence as parents, it can be a recipe for anxiety.

In the past two weeks, New York area hospitals banned pregnant women’s spouses (and other romantic partners) and their midwives from assisting with births. Understandably those near their due dates panicked and scrambled to switch hospitals or flee the area; some even considered birthing at home. Then, just as abruptly, the hospitals reversed course and announced that one support person could be present at delivery. But the damage had already been done. Pregnant women now fret: “Will my hospital rules change again? Is the hospital even safe? Will I be discharged before I’m ready? What if my labor nurse is infected?”

In addition, all the fun things pregnant women expect to enjoy—a “babymoon,” yoga and childbirth classes, baby showers—have been put on hold or rearranged to comply with our solitary confinement.

This is not to say that COVID-19 has been all bad for new parents. Spending time indoors with no distractions and partners home for a potentially much longer paternity leave constitutes the perfect postpartum bubble.

But those bubbles burst with age.

“I feel like right now I’m a terrible mother and a terrible employee,” one mom confessed in a virtual support group. She’s not alone. All parents working from home are feeling divided by their pressing work and childcare obligations. Maybe in the past you spent a few days working from home when your sick child couldn’t go to daycare, but this is different. With daycares closed and babysitting help too risky, there is no reprieve; the weeks are grimly stretching out before us.

In a recent session of a support group for moms with toddlers, parents shared tips on how to create a makeshift playpen while on a conference call. “The one benefit is all of us are in the same boat—my boss, my colleagues, our CEO. It’s a great leveler.” One popular approach is for one to parent to work while the other watches the baby or children—but if you’re a single parent, this is obviously impossible. So, some single parents are leaving their homes and hunkering down with their own parents.

“I don’t know what I would have done without my mom,” says Alison, a single mother of twins. “It’s just too much for one person to juggle. We’re not supposed to work and take care of babies at the same time, but I have no choice!”  This combination of work and childcare is fueling unprecedented stress levels.

I spoke with Mollie Busino, director and psychotherapist at Mindful Power, a counseling practice in Hoboken. Many therapists have begun treating their patients in a virtual format like Zoom or Skype, and that has made counseling much more accessible. “This is a time of worry, and families need to protect themselves, especially in situations where anxiety is likely to escalate. I’m recommending that parents limit their time on social media, watching the news, and listening to a friend or relative who is consumed with panic about the Coronavirus,” Busino said.

Likewise, birth-workers, yoga instructors and other educators are creating virtual support groups to help new moms navigate this situation.

Still, parents are losing their ability to cope.  “If one more person says ‘this is the new normal’ I’m going to lose it!” says Lauren, a mother of two under age four. “I’m trying to work, my husband is trying to work, my four-year-old has no preschool to go to, and my baby is oblivious to the lack of adult attention right now.”

In Jersey City, parents are accustomed to utilizing our beautiful parks, playgrounds, interactive music and yoga classes; we have it all here, but much of that is on hold for the moment. In a recent new moms support group, I spoke to a mother of a newly toddling one-year-old, and she sounded heartbroken. “This is the time I should be watching my daughter run around, play on the swings, see her cherished friends—and we’re stuck inside with too much screen time and no fresh air.” When I suggested she go to a less-populated park (like Liberty State Park), she shrugged off the suggestion. “I think that’s worse,” she said. “Then I worry that the air we breathe, the things we touch, the person who walked—they’re all threats.”

So what to do?

Don’t let your anxiety spiral into depression. If the strain of this quarantine is starting to overwhelm you, take measures to protect yourself in the same way you would against the Coronavirus: Look for virtual new moms’ groups, seek online counseling, consider taking medication (which you may need only temporarily). Every day during this period of isolation feels long and repetitive, prompting lots of “Groundhog Day” memes. But perhaps you can connect virtually face-to-face with relatives and friends, something you might have done via only text or phoning before. Maybe you’d feel better expressing thanks—even for small, seemingly inconsequential things. I thing I can assure of you of is that this will end—and when it does, we are really going to appreciate the little things in life; we are really going to smile at that slice of pizza on the pedestrian plaza.

For help with perinatal mood disorders:

Peggy Kraft, Clinical Social Work/Therapist: https://www.psychologytoday.com/us/therapists/peggy-kraft-jersey-city-nj/122489

Mollie Busino, Psychotherapist, Mindful Power: https://www.psychologytoday.com/us/therapists/mollie-busino-hoboken-nj/77480

The Seleni Institute: Perinatal Mental Health: https://www.seleni.org/

The Motherhood Center: https://www.themotherhoodcenter.com/

Partnership for Maternal & Child Health: 973-268-2280 x 154: ygonzalez@partnershipmch.org

 

Header: Distancing in Liberty State Park, photo by Jayne Freeman

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Business Groups, State and Federal Programs Try to Help NJ’s Small Businesses Stay Afloat


The question is whether loans, grants, tax credits and expanded unemployment benefits will be able to fully meet the growing demand for help

This story was written and produced by NJ Spotlight. It is being republished under a special NJ News Commons content-sharing agreement related to COVID-19 coverage. To read more, visit njspotlight.com.

Full story link – HERE.

By John Reitmeyer

The month of March started out fairly normal for Caruso Physical Therapy and Nutrition, LLC in Allentown, Monmouth County, but by the middle of the month, things took a major turn.

Cancellations soared amid concerns about the ongoing coronavirus outbreak, and as Gov. Phil Murphy began urging people to stay home to prevent further spread of the disease, said business owner Olivia Caruso.

Fast forward a few more weeks, and Caruso said she is now concerned about the viability of her 10-employee business, even as it has remained open, unlike many other small businesses deemed “nonessential” by the governor that have been forced to close altogether under a social-distancing executive order Murphy issued last month.

The current situation is “very scary,” said Caruso, a mother of two who is also caring for her husband as he fights brain cancer.

A huge role in state’s economy

While small businesses don’t always receive the same attention — or significant tax breaks — that often goes to large corporations, they play a huge role in the New Jersey economy, employing some 50% of those employed throughout the state during normal times.

But the coronavirus pandemic and the ongoing government response to it has made things anything but normal for the thousands of small-business owners like Caruso who are now fighting for their survival.

“We’re not bringing in enough to pay the bills,” she said in an interview this week with NJ Spotlight.

New unemployment figures the state released on Thursday shed some light on the scope of the economic damage being caused by the pandemic. A total of 206,253 new benefits claims were filed last week, according to the new unemployment data, topping the record for new claims that New Jersey set the prior week. Industries like food services and some health services like dentists’ offices, which are generally run as small businesses, were hit particularly hard.

What defines a small business is a subject of some debate, and it can vary from industry to industry. Federal data suggests small businesses with 100 or fewer employees account for the largest share of small-business employment in the U.S., but some federal programs also allow businesses with 250 or more employees to qualify as small businesses, depending on the industry.

Across the nation, new research released on Thursday by the National Federation of Independent Business (NFIB) found that 92% of the group’s members surveyed earlier in the week reported being negatively impacted by the coronavirus outbreak, with 80% of that group reporting slowed sales.

Eileen Kean, state director in New Jersey for the NFIB, said this comes as business owners already face challenges caused by the general high cost of doing business in New Jersey.

‘Struggle to survive’

“Now business owners who have spent decades building their companies face an uncertain future as they struggle to survive,” Kean said.

While federal and state lawmakers have tried to meet the new demand for unemployment benefits by boosting funding and expanding existing programs, there is also a big concern about maintaining the profitability of small businesses so that laid-off workers, including those in New Jersey, still have a job to return to when the outbreak begins to ease.

The state and federal governments have rushed out several new programs in recent weeks in response, and they’ve also found new sources of funding to support things like grants and loans, all in an effort to backstop small businesses. But it remains to be seen whether what’s been created amid the emergency will be able to fully meet the growing demand for help.

At the federal level, a number of new or expanded programs were established with small businesses in mind in the $2 trillion legislative package enacted by the Congress and President Donald Trump last week.

Forgivable loans for payroll, mortgages, rent

Among the federal offerings is a forgivable loan program that provides qualified small businesses with up to $10 million each to help cover things like payroll, including salaries and paid time off, according to Ray Cantor, vice president of government affairs at the New Jersey Business & Industry Association (NJBIA). The funding is also available for things like mortgage or rent payments, he said.

And the application process — which can be started by going to the federal Small Business Administration website — has also been streamlined to make it easier on small-business owners.

“The money should be (going) out quickly,” Cantor said.

Meanwhile, the federal government has also expanded the pool of people who can qualify for unemployment benefits to include small proprietors and independent contractors. It’s also making available tax credits for businesses to reward employee retention and changing other tax rules to help get businesses through these difficult times.

But Cantor said the new programs should be considered a stopgap, suggesting there will be many more needs that will eventually have to be reckoned with.

“There’s still a whole bunch of gaps in this,” he said.

EDA helps stabilize small business

At the state level, the New Jersey Economic Development Authority (NJEDA) just launched several new programs and expanded others to help small businesses after state lawmakers rushed out their own economic-relief package last month.

One of those programs is making grants worth up to $5,000 available to help stabilize small businesses and hopefully prevent them from having to let go of or furlough workers. Another new program is providing loans for working capital worth up to $100,000, starting with no interest for the first five years. Among other loan programs is one that’s directed at helping entrepreneurs get through the emergency.

The EDA has also created an online information hub and “eligibility wizard” to help link business owners with the benefits they may now qualify for. The window for accepting applications for the EDA’s Small Business Emergency Assistance Grant Program was just opened up on Friday morning.

“Small- and medium-sized enterprises are the heartbeat of New Jersey’s economy, and it is crucial that we do what we can to provide the resources and assistance they need to withstand the outbreak of novel coronavirus,” said Tim Sullivan, the EDA’s chief executive officer, as the programs were rolled out last week.

Chris Emigholz, vice president of government affairs at the NJBIA, called the state’s efforts “a good start,” and he credited Sullivan and other officials at the EDA for launching the new offerings so quickly.

“They put the money they had in-house on the street as soon as possible,” Emigholz said.

Putting pressure on state finances

But he also suggested more resources will be needed to help the state’s small businesses. It’s possible that more funding will be made available out of the state budget to backstop what is initially being provided by the EDA. However, just as the coronavirus has strained the business community, it’s also putting pressure on the state’s own finances as some tax sources have slowed to a trickle.

Something as simple as giving small businesses more time to turn over the sales-tax revenue they collect for the state, or at least waive penalties for paying late, may be helpful for small businesses, Emigholz said.

That recommendation and several other small-business aid proposals were included in a letter that 40 business groups, including the NJBIA, sent to Murphy and lawmakers on Thursday.

And while statewide groups like the NJBIA and the New Jersey Chamber of Commerce — which is now putting out a daily update on issues related to the coronavirus and offering other enhanced services to members — are mobilizing to help small businesses, in some places in New Jersey, local officials have also begun their own efforts.

For example, city officials in Newark have just launched a program working with the United Way of Essex County to help local businesses with 10 or fewer employees by providing them with grants worth up to $10,000 to cover things like payroll, rent, taxes and inventory. (More information about the program is available at https://uwnewark.org.)

“We can’t stand by and wait for help from other sources,” said Mayor Ras Baraka as the new program was announced last week. “Here in Newark, we must solve our own problems.”

Some efforts to support small businesses have also been launched at the grassroots level, including in Westfield, where residents are using the Westfield United Fund to provide some help to the town’s independent businesses.

First Lady’s relief efforts

A nonprofit Pandemic Relief Fund has also been launched by First Lady Tammy Murphy to help raise money for those who are being hit the hardest by the pandemic, and among those who may receive assistance through that effort will be “low- to-middle-income residents and New Jersey’s small business community,” Tammy Murphy said in a news release announcing the establishment of the new fund-raising effort.

“We are committed to the task of identifying the most effective interventions, determining community needs, and raising essential funds and awareness as we battle this challenge,” she said.

Still, despite these efforts and others, circumstances for many small businesses remain extremely difficult, as they are for Caruso, the owner of the Monmouth County small business. And Number 1 on her wish list right now, she said, is some help managing the finances.

“To help us with what we have lost, only because of the virus,” she said. “If they could just help us stay afloat through these weeks.”

 

Header:  Courtesy NJEDA Facebook page

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New Jersey Tax Filing Deadline is Extended from April 15th to July 15th


The state income tax filing deadline and the corporation business tax filing deadline will be extended from April 15 to July 15, as part of the State’s response to the ongoing COVID-19 pandemic. This is an automatic extension. There is no need to file for an extension.

Governor Phil Murphy, Senate President Steve Sweeney and Assembly Speaker Craig Coughlin issued the following joint statement yesterday on the tax filing deadline and the state budget timetable:

“The ongoing COVID-19 pandemic has caused hardships, financial strain, and disruptions for many New Jerseyans and New Jersey businesses. As part of our response, we have reached agreement that the state income tax filing deadline and the corporation business tax filing deadline will be extended from April 15th to July 15th.

“Additionally, as part of the whole-of-government effort that is going into fighting COVID-19, we have agreed that the state fiscal year should be extended to September 30th . This will allow the Administration and the Legislature to focus fully on leading New Jersey out of this crisis, and to allow for a robust, comprehensive, and well-informed budget process later in the year.

“We are committed to working together to enact the necessary legislation and supplemental appropriations to accomplish these goals.”

Previously, the U.S. Treasury Department and Internal Revenue Service announced that the federal income tax filing due date is also extended from April 15 to July 15. Taxpayers can also defer federal income payments due on April 15, 2020 to July 15, 2020, without penalties and interest, regardless of the amount owed. This deferment applies to all taxpayers, including individuals, trusts and estates, corporations and other non-corporate tax filers as well as those who pay self-employment tax. Taxpayers do not need to file any additional forms or call the IRS to qualify for this automatic federal tax filing and payment relief.

 

Header:  Photo courtesy Governor Phil Murphy’s Facebook page

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Hudson County Partners to a Create a Stepdown Unit for Recovering COVID-19 Homeless Patients


Unit will provide relief to county hospitals so they remain focused on critical care and homeless shelters to lessen spread of the disease in vulnerable populations

Hudson County announced today that it has entered into a partnership with CarePoint Health and Alliance Community Health, a Federally Qualified Health Care Provider (FQHP), to create a step-down unit for recovering COVID-19 patients who are homeless in two currently unoccupied buildings near Christ Hospital in Jersey City, (169 Palisade Avenue) by the end of this week.

The purpose of the unit is to allow hospitals in Hudson County to discharge patients who initially tested positive for COVID-19 and were admitted but now are deemed fit enough for discharge but who are homeless.

Hospitals can only release patients who can demonstrate they have somewhere to go upon discharge. Having homeless shelters provide this for the recovering patient now would expose vulnerable populations with chronic health issues in the shelters to these still recovering individuals who could transmit the virus to them.

This new unit will help ensure that the health care system remains focused on critical care and able to provide the beds required for that mission and protect the shelter network from the spread of the virus.

The target population is homeless individuals demonstrating mild symptoms, who if they had stable housing would simply be released to recover at home.

The Hudson County Improvement Authority (HCIA) will lease the space from CarePoint Health to set up what is known as a Federally Qualified Healthcare Center (FQHC) for the County in partnership with Jersey City-based Alliance Community Health,Inc., in order to provide this step-down unit for an anticipated 100 homeless clients at one time.

The HCIA will be reimbursed by the County Division of Welfare at the rate Welfare pays for shelter services provided by local hotels and motels with funds provided by the State Department of Family Development during this pandemic. The initial estimated cost to operate the unit will be $296,000 a month.

The step down unit for the recovering homeless will provide the following services to these recovering homeless individuals:

  1. 24-hour access to clinical care through a staff of doctors and nurses.
  2. Regular monitoring of inhabitants respiratory function.
  3. Monitor for potential relapse so a proactive decision can be made to re-admit a person into the hospital.
  4. Medically clear those in the homeless shelter population in isolation so that they can enter shelters again without concern that they might infect anyone in the shelter network, staff, volunteers, vulnerable fellow clients.
  5. Professional medical laundry and cleaning services, and medical waste disposal services.

A contractor that provides security at medical facilities in the region will do so for this new unit.

“I believe this is a sensible way to ensure that our hospitals can focus on providing critical care and our homeless shelters remain truly safe havens for those in need of them,” said Hudson County Executive Tom DeGise. “I want to thank the leadership of CarePoint Health, the City of Jersey City and our dedicated team from the Hudson County Department of Family Services and the HCIA who put this together.This unit will help stop the spread of COVID-19. It will save lives.”

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Planning for the Unthinkable: What If COVID-19 Patients Overwhelm Medical Supplies?


Doctors, medical ethicists, and health professionals are crafting decision-making tools to ensure resources are used effectively and fairly

This story was written and produced by NJ Spotlight. It is being republished under a special NJ News Commons content-sharing agreement related to COVID-19 coverage. To read more, visit njspotlight.com.

Full story link – HERE.

By Lilo H. Stainton

Imagine the unthinkable: Doctors at a hospital overwhelmed by the coronavirus outbreak are left with one ventilator but multiple patients unable to breathe without it. Who gets care?

Government officials stress that New Jersey hospitals are not currently facing this moral dilemma. But if that time comes — and COVID-19 patients overburden the state’s health care system — they want clear and ethically sound plans in place to help frontline caregivers navigate these painful choices.

Health care leaders are now working with state officials to create decision-making ethics tools designed to maximize ventilators and other resources, while saving as many lives as possible. An ethics subcommittee of the Medical Society of New Jersey submitted draft guidelines to the state Department of Health on Friday.

“We are — all of us and all of our teams — committed to saving every single life we can in this state,” Gov. Phil Murphy said Friday at the state’s daily media briefing. But “we would be abrogating our responsibilities not to prepare for that awful potentiality” of scarce medical resources, he added.

Refocusing on needs of public

In fact, doctors, nurses and other clinicians are already being forced to rethink how they provide treatment, shifting from their traditional patient-centered focus to a broader approach that must also consider the needs of the public at large. Experts agree this is challenging for medical providers, who are trained to do all they can to save the patient in front of them.

“When the resource is scarce, the goal is to save the most lives with the resources available,” explained Dr. Hannah Lipman, a gerontologist and director of the Center for Bioethics at Hackensack University Medical Center, part of Hackensack Meridian Health. “When resources aren’t scarce, those two goals are not in tension.”

Hospitals around the nation are required to have some form of ethics committee or consultant group, but these entities typically help patients, their families and clinicians with end-of-life decisions specific to one individual, experts said. But with the COVID-19 pandemic — which has now infected more than 16,600 New Jerseyans, including 198 who died — these providers must now wrestle with the potential need to ration some aspects of care, should efforts to slow its spread and ramp up hospital capacity not be enough.

Ethical decisions allocating limited medical resources are highly complex and involve many variables — like age and underlying conditions — but experts said they generally center on survivability. While data on COVID-19 is still limited, patients with respiratory failure may need to remain on a ventilator for 10 days or more, they note.

“When we’re talking about access to that limited resource, the big threshold is survivability. Will this benefit you such that you can go on it, and recover enough so that you can come off it,” said Nancy Berlinger, a research scholar with The Hastings Center, a 50-year-old nonprofit focused on bioethics.

If doctors choose a patient who is unlikely to endure the treatment over one that is stronger, “you create bad outcomes for two people,” Berlinger added. The Hastings Center created a series of slides to help hospitals update their ethics policies in the current crisis.

Dealing with demographic disparities

Medical ethicists acknowledge that this approach raises difficult questions about demographic disparities, given the higher prevalence of certain underlying conditions — like asthma and diabetes — among African Americans. Advocates for disabled individuals also fear these citizens could be passed over when it comes to allocating scare resources.

These disparities are real and worrisome, Berlinger and other experts agree, but they can’t be resolved through ethics policies designed to allocate medical resources in an epidemic.  “We have to be very honest about the inequalities we have tolerated,” she said. “But this is not a great opportunity to make comprehensive social justice.”

That said, ethicists stress that public trust in the health care system is essential and people need to know they won’t be turned away if they are elderly or suffer from underlying health conditions. “The goal of saving the most lives requires consideration of the patient’s prognosis. Considerations of characteristics such as race, ethnicity, religion or sexual orientation are irrelevant,” Hackensack’s Lipman said.

Some decision-making ethics tools, like a model outlined last week in the New England Journal of Medicine, also prioritize treatment for health care professionals. Experts note this makes sense, given the critical role they now play in responding to the outbreak, but underscore the need to think carefully about who is included in this group; doctors, nurses and clinicians alone can’t operate a hospital without those who clean the floors, connect the equipment and transfer patients, for example.

New Jersey’s 71 acute-care hospitals are now required to provide the DOH daily reports on bed space, staffing levels, ventilators and stocks of personal protection equipment, or PPE, the gowns, masks and other critical supplies needed to protect frontline workers. The state is working to add bed space — reopening one closed hospital and setting up temporary facilities at three sites — and seeking to amass more PPE and ventilators from closed surgery centers and a federal stockpile.

DOH Commissioner Judith Persichilli said Monday she remains concerned about the supply of PPE and trained staff; the state is also working with professional organizations to expand workforce capacity. But while the impact of the state’s strict social-distancing measures is still being assessed, she remains confident there will be enough beds to accommodate the surge of patients expected to need hospital care in the coming weeks.

Ventilators remain in short supply

But New Jersey does not yet have enough ventilator units, officials said. Federal officials have provided at least 300 units, but Murphy requested 2,300 total and State Police are now working to purchase as many as 2,000 in case the Trump administration doesn’t fill the full order. Persichilli said they are also considering strategies to use one ventilator for multiple patients — an emergency protocol approved by federal officials — or converting anesthesia machines to instead provide breathing support.

“We just want to be prepared,” Persichilli said Monday. “We are preparing for the worst and hoping for the best.”

Berlinger, with The Hastings Center, said putting two patients on a single ventilator is clearly a “workaround” and not a long-standing approved protocol; other workarounds are underway when it comes to the use of PPE, with clinicians re-using some items or opting for less protection than they would normally use, with federal approval. “You see a lot of ingenuity and you see a lot of heroism” in these situations, she said, “but at some point you have to say, ‘What if this doesn’t work’?”

That’s why state officials want a strategy in place to make sure the equipment is used to save as many lives as possible. The DOH declined to say when statewide guidance based on the MSNJ recommendations might be ready for distribution, but it is now working with retired state epidemiologist, Dr. Eddy Bresnitz, on models to help hospitals allocate scare resources and deliver care as safely as possible during the crisis.

“We want to make sure that no matter what we do, that we give safe care,” Persichilli said.

The effort is greatly appreciated by hospital leaders, according to Cathy Bennett, president and CEO of the New Jersey Hospital Association, which has worked closely with the state to assess and allocate resources. “Our healthcare system has a responsibility to plan for all scenarios in a public health emergency like COVID-19,” Bennett, a former state health commissioner, said. “We hope these crisis plans will not be needed, but appreciate that thoughtful and reasoned discussions are under way by medical ethicists.”

Hospitals have already been forced to adjust a host of operational policies in light of the coronavirus epidemic, restricting family visits and rethinking discharge or transfer plans to ensure patients with COVID-19 don’t further spread the disease. But ethicists said it made sense to have statewide guidance, so that public access to care is the same for all New Jerseyans.

“When you have a pandemic, it shouldn’t matter what hospital you go to,” said MSNJ president Larry Downs. “We might not get there, but there’s a chance we could.”

 

Header: Photo courtesy Dr. Tucker Woods

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County Slots Homeless into Motels


Three homeless persons queued up early Tuesday morning outside a mobile trailer in Journal Square for hot showers, meals and personal hygiene kits, all courtesy of the City of Jersey City.

Where needed, they’d also get counseling and shelter related to the coronavirus that has infected the city and the rest of the globe.

Jersey City Mayor Steve Fulop, accompanied by the city’s Public Safety Director James Shea and Health & Human Services Director Stacey Flanagan, welcomed the homeless contingent outside a mobile trailer the city – through its Office of Emergency Management – is using to provide these services.

Some 50 people in Jersey City’s general population, including one homeless person, have thus far tested positive for the virus, which the World Health Organization has labeled a pandemic. Close to 200 county-wide and more than 3,600 in New Jersey are infected, according to reports.

“We have witnessed how COVID-19 has had a devastating impact around the world on all of us,” Fulop said, referring to the WHO’s name for the disease caused by the SARS-CoV-2 virus. “But when you think of those who have the least in society, they are even more vulnerable during this crisis. We are all pulling together to normalize our lives in this unprecedented challenge of our times, but the only way we will succeed is if we look out for those who need help the most and leave no one behind.”

To that end, the city, which the state’s January 2019 “point in time” survey listed as having 420 homeless adults and children combined, is expanding its healthcare outreach to that population from three days per week to five, Monday to Friday, 7 to 11 a.m., with a second trailer on the drawing board.

Flanagan said the city opted to locate the trailer in Journal Square (just outside the entrance to a parking garage off Magnolia Avenue) after having identified 50 homeless people congregating in that neighborhood just a short walk to the PATH Transportation Center.

Photo by Jennifer Brown/City of Jersey City

Inside the trailer, individuals can access five private shower stalls and sinks, along with what Flanagan described as “hospital-grade linens” provided by volunteer staff who, she said, would be using gloves and all required gowns and equipment to protect them from getting contaminated by the virus. Flanagan said staff members are trained to comply with federal occupational safety standards and that each shower is cleaned and disinfected after each use.

Shower users will also be offered packages of toilet paper, sanitary wipes, toothpaste, hand sanitizers and towels plus meals for anywhere from four to 14 days depending on whether they need to self-quarantine.

Hudson County also just announced a program to protect the county’s homeless population from COVID19 (albeit one aimed at older adults only). In this initiative, according to Frank Mazza, deputy director of the county’s Department of Family Services, motels along Tonnelle Avenue  will temporarily house chronically homeless persons age 60 as they have been deemed at high risk of infection given their age and living situations. The motels include Travel Lodge, Roadway Inn and Howard Johnson.

For some time, Hudson County has operated a large, dorm-like warming shelter in South Kearny every winter. The idea behind the motel program, Mazza explained, is to thin out the population at this warming shelter and at the same time protect older people and those with underlying health issues from getting sick and also from infecting others.

Mazza said the county will utilize both state block grant general assistance funds and federal block grant temporary assistance for needy families to pay motel room fees. “As it pertains to this crisis, we will provide housing until we are able to get the population safely through and then start again to work to find more prolonged housing solutions,” Mazza indicated.

Reportedly, up to 200 rooms will be available for this purpose. More information about the program is available at any of the county’s several homeless outreach centers or by calling the county’s social services unit at 201-420-3000.

Those who fear having the virus are urged to contact their health care providers or call the city hotline: 201-547-5208.

Photo by Jennifer Brown/City of Jersey City

Header: Photo by Jennifer Brown/City of Jersey City 

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Just the FAQs: What the State DOE Is Telling Schools About COVID-19


The NJ Department of Education has been busy issuing guidance on numerous ways schools need to meet challenges of the coronavirus epidemic

This story was written and produced by NJ Spotlight. It is being republished under a special NJ News Commons content-sharing agreement related to COVID-19 coverage. To read more, visit njspotlight.com.

Full story link – HERE.

By John Mooney

As of March 27:

For New Jersey’s schools, the changes imposed by the coronavirus pandemic are looking increasingly as if they’re here for the long haul.

Gov. Phil Murphy announced yesterday that any decision about how long New Jersey’s schools will remain closed and rely on remote learning will not be made until at least April 17, a month after his initial executive order to shutter schools.

The uncertainty has left open a host of questions about how schools will proceed — questions the state Department of Education has tried to answer in ongoing guidance.

The following are excerpts from that guidance, starting with the latest additions to the department’s FAQs.

It includes guidance about the latest graduation requirements for the class of 2020 after Murphy announced this week that state testing will be suspended. About 10% of students not passing those tests still would require a “portfolio appeals” process to graduate, a process now uncertain. There are also updates for teacher candidates suddenly put on hold.

Q: How can students, who must participate in the portfolio appeals process, meet their graduation assessment requirement if schools are closed?

A: “Portfolio appeals will continue to be reviewed on an ongoing basis. The NJDOE will extend the submission deadline of May 8, 2020, which is the district-submission deadline, to ensure the NJDOE will issue an approval in time for student participation in graduation ceremonies. The NJDOE is developing a process to electronically submit portfolio appeals and will provide additional information as soon as possible.”

“The NJDOE is encouraging districts and schools to develop a process to make Constructed Response Tasks (CRTs) available to students remotely. Some potential options include:

Post CRTs on district/school website.

Create a process and “drop box” for the electronic return to the district/school of completed CRTs.

Students without access to the internet can have CRTs mailed to them, complete them at home, and bring them for submission when school reopens.”

Q: Can I still apply for my educator certification?

A: “The online Teacher Certification Information System (TCIS) is available but with limited capacity. Candidates can complete an application, a notarized oath of allegiance and pay any fees online. The accompanying documents must still be submitted via mail to the Office of Educator Certification. There will be some delays in uploading the documents into TCIS and the NJDOE staff apologizes for this inconvenience.”

As of March 19:

The state Department of Education has been issuing guidance to New Jersey’s public schools for the past week about dealing with the coronavirus pandemic.

Included is a 15-page FAQ, frequently asked questions that range from the broad (what students must be served?) to the specific — addressing public meetings, for example.

The following are excerpts from the questions and answers included in the full FAQ, as well as other guidance. NJ Spotlight will update this document as more guidance is provided.

Q: How will districts ensure student attendance during the closures and the implementation of remote instruction?

A: “Any day on which all students impacted by a public health-related closure have access to home instruction services provided consistent with the guidance in this memo will count as (an instructional day) … Because such instruction is being provided, all students can be recorded as present for applicable days unless the district knowingly determines a student was not participating in any such instruction during health-related school closures.”

Q: What students must receive instruction?

A: “All students served by the district must be addressed in the plan, including students in preschool if the district has state-funded preschool and/or if the district services preschoolers with disabilities. The plans developed must include age-appropriate strategies and materials to meet the needs of all students. Districts offering preschool should remember to include contracted providers — private preschool providers and Head Start providers — in their planning activities. Each district plan must also include developmentally appropriate strategies and materials to meet the needs of all students with disabilities including those educated in out-of-district placements. Districts are encouraged to consult with the school in which the student is placed to provide continuity of instruction to the maximum extent practicable.”

Q: How might a district be able to administer home instruction remotely if families in our community do not have a device or Internet connectivity?

A: “Equitable access to learning is a critical consideration for any plan and will require that a district understands the limitations each student faces. Districts should consider collecting information on which students have access to a device, how that device is or is not shared, and what access each student has to a network. Schools and districts should take care to collect this information in a manner that avoids stigmatization of any students with varying degrees of access to technology and Internet service at home.”

“Instructional strategies should be varied and designed to meet the needs of the students. Districts should consider various solutions, such as utilizing partnerships with local community-based organizations and businesses, developing worksheets for instruction, or uploading of lessons electronically.”

“Accommodations and multiple means of conducting assignments should be considered for students with disabilities. If students with disabilities do not have access to internet connectivity to participate in remote or online home instruction, the IEP team will need to determine what compensatory instruction a student may require when their school district reopens.”

Q: How should students with disabilities, including students in special class programs, medically fragile students, students with one-to-one paraprofessionals and students receiving related services, be accommodated in the plan?

A: “Home instruction/services shall be consistent with the student’s Individualized Education Plan Program (IEP) to the most appropriate extent possible. Districts should talk to parents, who are key members of the IEP team, and help them consider how they may best ensure that students with disabilities have the necessary supports, including medical supports, in place during a public health-related school closure.”

Federal guidance on serving students with disabilities is available online.

Q: How should districts provide meals to students who receive free and reduced-price lunch during a closure?

A: “All boards of education must develop a school health-related closure-preparedness plan to provide home instruction in the event of such a closure. Each preparedness plan should address the provision of school nutrition benefits or services for eligible students.”

Q: How do COVID-19-related school closures affect statewide testing for school year 2019-2020?

A: “The NJDOE is communicating with the United States Department of Education (ED), other states in similar situations and school districts to develop guidance for long-term testing interruptions. We are currently evaluating all flexibilities and potential schedule changes and will provide guidance as school-reopening dates are confirmed.”

Federal guidance as it has been established thus far is available online.

Q: What options are available to boards of education to conduct business while minimizing the general public’s exposure during this period?

A: “School boards will likely need to hold public meetings to conduct business on various matters, such as developing a budget for the upcoming school year. In accordance with the Open Public Meetings Act (OPMA), public meetings may be held in person or by means of communications equipment, including streaming services and other online meeting platforms. All meetings, including those held using communications equipment, must be noticed in a manner consistent with the requirement of the OPMA, unless the meeting is for emergent circumstances and held in a manner consistent with the requirements set forth at N.J.S.A. 10:4-9(b).”

“Boards of education are reminded that they are required to provide a means of public comment even if a meeting is held remotely. Further, if a board of education currently records the audio or video of its meetings, we recommend that it continue to record a remote meeting.”

 

Header: Image courtesy New Jersey Department of Education Facebook page

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With Census Outreach Stymied by Health Emergency, Advocates Turn to Internet, Social Media


There’s a lot at stake for New Jersey, which was undercounted in the last two censuses

This story was written and produced by NJ Spotlight. It is being republished under a special NJ News Commons content-sharing agreement related to COVID-19 coverage. To read more, visit njspotlight.com.

Full story link – HERE.

By Colleen O’Dea

By now, every New Jersey household should have received an invitation to complete this year’s federal census. While that may be the last thing on people’s minds, advocates say the spreading COVID-19 virus demonstrates the importance of being counted.

“In times of crisis, communities can see the importance of social safety net programs, and these programs depend on an accurate Census for fair funding,” said Peter Chen of Advocates for Children of New Jersey (ACNJ), which is coordinating the census effort of a number of groups and nonprofits in New Jersey.

For more than a year, groups like ACNJ have been preparing for a major push to get New Jerseyans — particularly those in groups considered hard to count — to complete the decennial census.

In addition to efforts by the U.S. Census Bureau itself, New Jersey’s Complete Count Commission plans to spend $3 million on ads in the coming weeks. It has launched a website with information, including a video on how to answer the census online and toll-free numbers to enable a person to fill out the survey in more than a dozen languages. From the outset of census promotion — long before the pandemic struck — the bureau had wanted everyone to fill out the census online.

The state also has given about $5.2 million to counties and community organizations to help get the word out.

No more face-to-face neighborhood meetings

Many of the efforts envisioned by nonprofits had involved holding events or face-to-face neighborhood meetings to explain the importance of getting an accurate population count and convince those who may be reticent, including undocumented residents, that completing the census is safe. There were also plans to help older residents and others without internet access to fill out the survey online or by phone at churches and other gathering places.

None of those can happen now, given the state of emergency and Gov. Phil Murphy’s stay-at-home order meant to limit the spread of the novel coronavirus that had already infected close to 6,900 New Jerseyans and killed ,81 as of Thursday.

As a result, many groups are redirecting their pitches online and to social media. ACNJ has posted a YouTube video that provides salient information about the census and includes a pitch the group had planned to make at in-person trainings: “It’s really important that you know that you can help make sure New Jersey has a complete count in 2020.” The city of Paterson, which has had one of the more robust census promotional efforts in the state, is encouraging people to take a CensusSelfie and upload it to their website.

“Many organizations are now switching to creative solutions to share content through social media and other channels such as phone calls, text messaging, etc.,” Chen of ACNJ said.

The immigrant and worker advocacy group Make the Road New Jersey has livestreamed events explaining the census and how to complete it in Spanish and English on both Facebook and Instagram. The group has also opened a digital kiosk and theater on Monday afternoons and Wednesday evenings where people can get individualized help.

“Make the Road New Jersey moved census outreach and organizing to digital organizing for now,” said Rosa Lopez, a community organizer with the group. “This is how we are assisting folks if they have any doubts or questions navigating census questionnaire.”

There’s a lot at stake for New Jersey, which was undercounted in the last two censuses, in 2010 and 2000, and has areas with some of the largest populations in the nation at risk for not being counted properly.

Billions of dollars at stake

A study released earlier this year estimated that New Jersey got $45.8 billion in census-guided federal funding in the 2017 fiscal year, the ninth highest in the nation. Medicaid and Medicare are the largest beneficiaries of these, but there are more than 300 programs in all that cover a broad range of needs. The Leadership Conference Education Fund notes that a number of the programs people are relying on during the COVID-19 emergency — including aid for dislocated workers, food assistance, and services for senior citizens and the disabled — are apportioned based on census data.

“When households respond to the census on their own, it’s easier for the country to get the complete count we need to support emergency planning and recovery,” said Beth Lynk, the fund’s Census Counts campaign director. “It’s more critical than ever that census advocates work alongside community members to make sure everyone gets counted.”

If not enough New Jerseyans answer the census and the population increase since 2010 is lower than a number of other states,  there is also the potential for New Jersey to lose another seat in the U.S. House of Representatives because those seats are apportioned based on the decennial count; the state lost one in 2010 and now has 12 congressional members. Apportioning representation in the House roughly proportionately among the states was the initial reason the federal Constitution requires a count of the population every 10 years. (The first census was conducted in 1790.)

In 2010, New Jersey’s self-response rate was less than 68%. So far this year according to census officials, 28% of households have filled out the survey. That’s just slightly a fraction less than the national average. Census officials said last week that the rate was on target with what they had expected.

The bureau’s initial plan was to begin in-person follow-ups with householders who do not respond on their own, on April 9. That was also the original date for polling to start at colleges and other “group quarters” like nursing homes and prisons; May 13 was the target date for the rest of the nation. Officials announced last week that they have adjusted the schedule to protect both census workers and residents, delaying college campus visits until at least May 7 and the rest of the nation starting May 28.

Safety first

“First and foremost, we want the public to know that the health and safety of our staff and the public remains of the utmost importance in everything we do,” said Tim Olson, associate director for field operations for the 2020 Census. “We’re also focused on getting a complete and accurate census, even in the midst of these uncertain times. We are carefully monitoring the situation. And we are following the guidance of federal, state, and local authorities.”

Counting college students and other so-called group-quarters residents could be problematic. The census is supposed to be a snapshot of where people are living on April 1. But with many college dorms closed — including virtually all in New Jersey — parents may report their college-age children as living at home, rather than in a dorm where they would normally have been. The distinction is especially important for getting accurate counts in communities with large student populations — including New Brunswick and Princeton. Officials said they are working with college officials to relay that message of where students should be counted.

Because of the later start for those non-response follow-ups, the census bureau is also extending the dates when those will end, with the last now scheduled for mid-August.

That will leave officials with less time than usual to crunch their data to provide population counts to state officials, who need it to redraw congressional and legislative boundary lines to keep the size of districts roughly equal. New Jersey is typically one of the first states to get its census results because it is one of only two states with legislative elections in 2021. The census prioritizes counts for New Jersey and Virginia because these are the only states that need the numbers to redraw legislative boundaries quickly in time for those 2021 elections.

Chen said that the most important message for the public is that the census is continuing despite COVID-19 and people can respond without risking their health.

“Public health and safety are critically important,” he said, “but luckily the 2020 Census can be filled out quickly and easily from the comfort of your home, online, over the phone or by mail. “

 

Header:  Hudson County Census 2020 Facebook page

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Murphy Will ‘Almost Certainly’ Announce State Tax-Filing Extension But Won’t Say When


Governor says delay is due to ‘a number of moving parts,’ such as how state will pay its own bills, amount of federal support

This story was written and produced by NJ Spotlight. It is being republished under a special NJ News Commons content-sharing agreement related to COVID-19 coverage. To read more, visit njspotlight.com.

Full story link – HERE.

By John Reitmeyer

A final decision is still pending, but it sounds like Gov. Phil Murphy may soon be granting New Jersey taxpayers a temporary reprieve from next month’s fast-approaching deadline to file state income taxes.

Over a week ago, state lawmakers sent the governor bipartisan legislation that would put off the April 15 deadline for both filing state income taxes and making payments to settle any tax obligations they still owe, citing concerns about the ongoing novel coronavirus pandemic as a reason to provide more time this year.

That’s something President Donald Trump’s administration has already done at the federal level as many Americans have lost their jobs or have faced other hardships caused by the pandemic. The new deadline for filing federal income taxes and making payments is July 15.

But Murphy has yet to take similar action at the state level, sowing some confusion among taxpayers as the April 15 deadline — at least for state income taxes — draws nearer.

When a reporter asked Murphy about the issue on Thursday during the governor’s daily press briefing on the state’s ongoing response to the pandemic, Murphy said he will “almost certainly” be granting state taxpayers an extension. But he stopped short of saying how soon there will be an announcement, and exactly how long of a delay will be granted.

‘Trying to figure out where to land’

“We’re just trying to figure out where to land,” Murphy said. “There are a number of moving parts associated with it.”

One of the moving parts the governor was likely referring to was exactly how to delay the collection of state income-tax payments without making it impossible for state government to pay its own bills — especially since the income tax is the state budget’s largest single source of tax revenue. The fate and size of any federal support for the state budget that would come from a massive relief package moving through the U.S. Congress this week is also another important factor.

Among the economic-relief bills that state lawmakers rushed to Murphy’s desk last week was the measure calling for an extension of the state deadlines for filing both gross-income and corporate-business taxes. While the legislation was drafted prior to the federal government taking final action, it allowed for the state deadlines to be extended to June 30. That’s an important date for the state budget because it is the last day of New Jersey’s fiscal year, and the state constitution does not allow for a deficit to be carried forward.

A conditional veto

But in the wake of the Trump administration’s decision to move the federal deadline all the way back to July 15, most tax filers and accountants would probably like to see the governor issue a conditional veto or some other executive action to make the state’s deadline line up with the federal cutoff.

“Needless to say, it is a big concern for our members,” said Ralph Albert Thomas, the executive director and chief executive officer of the New Jersey Society of Certified Public Accountants, during an interview with NJ Spotlight.

In addition to simplifying the tax-filing process, many have also suggested a longer extension could help lessen the burden for those struggling with serious illness, a job loss, or some other difficult situation that has put a strain on their personal finances.

New Jersey has reported a total of 6,876 positive cases of COVID-19, as of Thursday’s press briefing, making the state one of the hardest hit so far. The state also processed a record-high 155,815 new claims for unemployment benefits last week, according to the state Department of Labor and Workforce Development. That surge in jobless claims comes as Murphy has enacted a series of social-distancing measures in recent weeks that are designed to slow down the spread of COVID-19 infections, including the closure of all nonessential businesses indefinitely.

“People are trying to prioritize what do I pay when I’m sitting on the sidelines,” said Thomas, whose organization is seeking an extension of the state deadline to July 15.

“Having the additional time would give folks some breathing room,” he said.

April 15 is fast approaching

Meanwhile, several Republican lawmakers have been raising concerns about the governor’s delay in action, noting the April 15 filing deadline is now just a few weeks away.

“Extending the state deadline gives filers more time to complete their returns, and more importantly, it provides additional time for those that will have a balance due,” said Sen. Anthony Bucco (R-Morris), who was a primary sponsor of the extension bill.

“I call on the governor to announce this filing deadline delay as soon as possible to provide some good financial news for hard-hit New Jerseyans,” said Assemblyman Ryan Peters (R-Burlington).

But Murphy, a first-term Democrat, suggested during Thursday’s briefing that he wants to see exactly what New Jersey ends up getting in the federal economic-stabilization measure that could get final approval as early as Friday before making a final decision on any state tax-filing extension.

For fiscal year 2020, the governor and lawmakers boosted state budget reserves in the $38.7 billion spending bill that was signed into law last June to over $1 billion. But that still represents a small percentage of overall spending, and it is much less than what many other states had in their reserve balances heading into this potential downturn, according to a recent state-by-state analysis by the Pew Charitable Trusts.

To help provide more of a cushion, the Murphy administration put nearly $1 billion in FY2020 discretionary spending in reserve late last week. But Murphy has also said repeatedly that federal aid will be necessary to help his administration navigate significant revenue losses expected in the final months of the current fiscal year.

“Knowing what’s in the federal bill, and knowing that it’s actually been signed into law, gives us a little bit firmer footing to look at what the next sort of 30 days looks like,” Murphy said on Thursday.

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