An independent team of lawyers and policy experts spent 15 months conducting often emotional interviews: analyzing thousands of pages of laws, emergency plans and government directives: and combing through a daunting amount of data to create the 900-plus-page report on New Jersey’s COVID-19 response released last Monday.

Now it falls to Gov. Phil Murphy and lawmakers to codify the report’s 33 recommendations, which call for better pandemic planning, greater investment in public health and more oversight of the nursing home industry, among other changes. New Jersey — and the nation — were not adequately prepared for the COVID-19 outbreak, the report notes, and both remain at risk today for the next public health crisis.

Putting together a task force

Murphy, a Democrat in his second and final four-year term as governor, acknowledged this ongoing danger and pledged during a radio interview last week to make sure the state is properly protected against the next large-scale emergency when he leaves office in 2026.  He pledged to create a task force to examine the recommendations and develop lasting reforms, with help from lawmakers, noting that “statutes have a permanency to them that will help cement practices and preventions in place.”

Murphy said the task force — to be led by the state health commissioner and the state police colonel, who was a major player in the COVID-19 response — is also charged with ensuring that state officials are trained to implement the response plan if an emergency strikes. According to the report, the state had a pandemic plan and other crisis guidance in place when the virus emerged, but few leaders were aware of its existence.

‘If we ever wish to improve our procedures so this never happens again, we must put politics aside and work together for the betterment of New Jersey.’ — Sen. Anthony Bucco (R-Morris)

“A big part of their remit will be to make sure that there’s a plan, there’s a system and procedures in place that will be there forever and for always,” Murphy told WNYC radio Thursday evening. “When you lose 35,000, 36,000 people there’s no way in hell that you can say you didn’t make mistakes or you didn’t learn from this,” he said.

When NJ Spotlight News asked Murphy’s administration about next steps, the office referred it to his radio interview.

Since the first cases were detected in New Jersey in March 2020, the state recorded more than 3 million positive cases, some 186,000 hospitalizations and nearly 37,000 deaths, when you add fatalities that are considered likely but have yet to be confirmed as COVID-19. That includes more than 3,200 hospitalizations and at least 280 fatalities in 2024 alone, according to state data.

Keeping promises

Murphy pledged early on that there would be an independent assessment of the state’s response. In November 2022 he announced that analysis would be led by attorney Paul Zoubek, a partner with Montgomery McCracken Walker and Rhodes in Cherry Hill, with help from the Boston Consulting Group. The state will pay $9 million for this work, officials said, roughly $5 million for Boston Consulting and the remaining $4 million for Zoubek’s team.

“Look, $9 million is a lot of money, but for 900 pages and 33 recommendations that are very tangible and specific, I think that’s money well spent,” Murphy told WNYC. “It’s a buck a person,” he said, referencing New Jersey’s population of 9 million. “I’d do it again.”

Some Republicans scoffed at the cost, but lawmakers in both parties agreed Zoubek’s report should be used to drive real changes. “Simply accepting the report without further legislative analysis and changes to current practices only hurts our future preparation,” said Sen. Anthony Bucco (R-Morris) in a statement last week. “If we ever wish to improve our procedures so this never happens again, we must put politics aside and work together for the betterment of New Jersey.” Sen. Joe Vitale (D-Middlesex), the longtime health committee chairman, said he is working with Sens. Joe Cryan (D-Union) and Gordon Johnson (D-Bergen) on a potential package of legislation to implement various recommendations.

Sen. Joe Vitale said he is drafting a bill to create an office of veterans advocacy, with the power to hold the state legally accountable.

Vitale is also working with Cryan and others on legislation to reform the structure of the state’s Department of Military and Veterans Affairs, which runs the state’s veterans homes. Two of the three facilities were the subject of scathing government reports for an appalling breakdown in care that allowed COVID-19 to spread quickly, killing dozens of residents; Zoubek echoed these concerns in his own report. Vitale said the goal is to separate the functions so that one agency oversees military programs while another is dedicated to veterans services.

Under the department’s current structure, “Their time and resources are stretched,” Vitale said. “I think we’ve acknowledged and seen the need to have a specific focus on vets’ issues.”

Advocating for vets

In addition, Vitale said he is drafting a bill to create an office of veterans advocacy, with the power to hold the state legally accountable. It would work with other regulatory and investigatory agencies to ensure vets are properly served, he explained. “Like the Office of the Child Advocate, back in the day,” he said, recalling a move former Gov. Jim McGreevey made in 2003 to create a stand-alone agency — since absorbed into the state Department of Children and Families — in the wake of a horrific child-welfare scandal in Newark.

Zoubek’s report underscored problems in nursing homes that exacerbated COVID-19 sickness and death and left New Jersey with the second-highest fatality rate nationwide early in the pandemic. It also highlighted pending legislation to address some of these issues, including a bill sponsored by Vitale to expand transparency around long-term care ownership.

It will ‘take us a while to chop through all these recommendations,’ said Gov. Phil Murphy, who predicted the task force will be at work for the remainder of his term in office.

“It really drills down through all the layers of the onion” related to corporate control, Vitale said. Roughly 90% of the revenue nursing homes here depend on is public money, he added, primarily through Medicaid, the federal and state-funded insurance program for people with low incomes.

Vitale said he is also looking at ways to improve infection control and expand workforce training, two needs also identified in Zoubek’s report and highlighted in other expert analysis of weaknesses in the state’s COVID-19 response.

An April 2021 report from the New Jersey Health Care Quality Institute, a policy collaborative, and BioNJ, which represents the life sciences industry here, provided two dozen recommendations to support public health and clinical care in the wake of the pandemic’s first wave. Among other things, it called for greater investment in public health, more focus on health equity and better data collection, issues that Zoubek touched on too. “There is a lot of overlap between the reports,” said Linda Schwimmer, president and CEO of the Quality Institute.

Workforce shortages

Perhaps the top concern identified by the Quality Institute involved workforce shortages, an issue that has plagued hospitals, nursing homes, home care organizations and others since before the pandemic, but was greatly exacerbated by COVID-19 as frontline caregivers became sick. In July 2022, the group issued a second report focused on creating and retaining a diverse health care workforce. Zoubek also prioritized the need to develop a more robust public health workforce.

“We need to capture the data better on the current workforce and use that for investments and planning,” Schwimmer said, something that Oregon and New York have figured out. “That is a step that the attorney general’s office with (the Department of) Health should start on today,” she said.

Implementing improvements will take time and money, everyone seems to agree. Murphy said it will “take us a while to chop through all these recommendations” and predicted the task force will be at work for the remainder of his term in office.

Vitale, who has pledged to improve veterans care “at any cost,” said the changes will likely require new funding. “It doesn’t mean we should be frivolous,” he said, “but we need to be able to put our money where our mouth is” when it comes to protecting veterans.