COVID database filled with holes despite law
State lags in meeting new reporting requirements
PASSING A LAW is one thing. Implementing it is another.
On June 7, Gov. Charlie Baker signed a law requiring the Department of Public Health to publish more transparent data about the coronavirus outbreak. The law required DPH to provide more racial and occupational data about caseloads, and to give more detail about outbreaks in long-term care facilities for the elderly.
Although Massachusetts already publishes daily extensive reports on COVID-19, advocates for racial minorities and for older adults had said the state must do better, and the Legislature and governor appeared to agree.
On Thursday, the chairs of the Joint Committee on Elder Affairs – Rep. Ruth Balser and Sen. Pat Jehlen – and nine other committee members sent a letter to Baker expressing concern that the administration was not implementing the law and urging the governor to provide more information about long-term care facilities.
For example, data on long-term care facilities is published weekly, not daily. Case counts in nursing homes are provided only in ranges, rather than with specific numbers. Positive cases in a facility are not separated out between staff and residents. Only cases are reported at assisted living facilities, not deaths. There is no mention of elderly housing in the dashboards, although the law requires reporting from elder housing complexes.
Although cases appear to be abating for now, the lawmakers wrote that in case of a future wave of COVID-19 cases, the elderly population will be at the greatest risk. “Accurate tracking and reporting of the victims of this crisis are essential,” they wrote.
The Department of Public Health, in a July 2 report to the Legislature, explained the barriers to publishing the required data. The report detailed the myriad sources that feed into the state’s database, and said the data are only as good as what is reported to the state.
For example, labs inputting test results rarely have any demographic data about the patients, other than their age, city of residence, and maybe their sex.
Among data inputted into the state’s central database, 47 percent of recent cases list race and ethnicity as missing, unknown, or other; occupation is missing on 87 percent of cases; and primary language is missing on over 90 percent – even though Public Health Commissioner Monica Bharel has asked providers for that information. While the law requires reporting on disability status, the state database does not have a field to input disability status, although state officials are working to create a field.The DPH report, as the Elder Affairs committee lawmakers note, does not directly discuss the lack of data on senior housing.
Baker introduced a bill that would put the obligation on labs and health care providers to provide complete data, with fines for noncompliance. His bill would also eliminate the requirement that senior independent living complexes provide data because Baker says landlords do not know – and have no business knowing – the health status of their residents.