Residents of independent living care facilities left out in the open by the federal vaccination program in place


Misleading information from the federal government has disrupted and delayed COVID-19 vaccinations for hundreds of thousands of vulnerable seniors across the country, according to providers of senior housing, after the Trump administration announced in October that a partnership with The main pharmacies would deliver the vaccines on the spot. For residents in long-term care facilities, communications from the US Department of Health and Human Services indicated that the program would be open to independent living facilities, which generally provide meals, cleaning, transportation and other services, as well as assisted living services. and skilled nursing facilities, which provide higher levels of care.

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“Caught off guard, facility staff are struggling to book off-site vaccination appointments one resident at a time, overriding local institutions to help establish vaccination clinics and transport residents to mass vaccination sites. . ”

Many independent living facilities signed up for the program and waited two months or more for a chance to schedule their on-site vaccination clinics, only to learn in late December and January that they had been excluded from the program without notice or explanation. , suppliers and industry groups say. Caught off guard by the switch, facility staff now spend weekends trying to book off-site vaccine appointments, one resident at a time; pleading with local health departments, hospitals, and fire departments to help run vaccination clinics; and transporting buses full of frail residents to the arenas and other mass vaccination sites. The long wait for clinics at the site that never materialized, followed by the struggle to secure vaccines by other means, has consumed precious months, while COVID outbreaks have continued to threaten the lives of residents and staff who live. independently, vendors say. “Our biggest disappointment is that an entire group of the most vulnerable population was left out” of the program, says Karen Sheean, chief of staff for Holiday Retirement, which operates more than 250 independent living communities with approximately 30,000 total residents. Residents who are not yet vaccinated are scared, he says, knowing that they are at the highest risk of living in a congregated setting and are still locked out of the program. Many staff members living independently have also been unable to receive the vaccine, providers say, because they are not considered healthcare workers. The Independent Living Landscape There are more than 800,000 independent living units across the country, say industry groups, roughly evenly divided between independent communities and those that are components of campuses, such as retirement communities. Continuing Care (CCRC), which provide multiple levels of care. While autonomous living communities have been excluded from the federal pharmacy association program, CCRCs and HUD Section 202 housing residents for low-income seniors are eligible, according to the Centers for Disease Control and Prevention. Diseases. Still, independent living residents within CCRCs have also been excluded in many cases from on-site vaccination clinics, providers say. That “has been deeply distressing and confusing for both seniors and the staff at these community living residences,” LeadingAge, a nonprofit association of senior care providers, said in a January letter to the CDC. and administration officials. Eligibility for the on-site vaccination program, known as the Pharmacy Partnership for Long-Term Care, “was designed to ensure that the program serves people at increased risk of COVID-19 infection and serious illness who need vaccination services. in the place”. says CDC spokeswoman Kate Grusich. “However, people who live in independent living retirement communities are often very active and may go off-site to get vaccinated, which is more efficient for vaccine delivery.” Independent living providers and industry groups say it‘s a misperception. The median age of independently living residents is 83, compared to 84 for nursing home residents, and about 70% of independently living residents have four or more chronic conditions, according to consultancy ATI Advisory. Many live with vision and hearing loss and reduced mobility and hire their own in-home caregivers, whose movement in and out of buildings can further increase the risk of viral transmission, providers say. Including independent living residents in the pharmacy association program should have been “a no-brainer,” says David Schless, president of the American Senior Housing Association. “I just don’t understand why this hasn’t happened.” See: Do you want your loved one in a nursing home to receive the COVID-19 vaccine? Ask these questions first.

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“‘I was never in a conversation where I heard about the exclusion of independent living facilities.’ ”- Paul Mango, former Deputy Chief of Staff for Policy at the Department of Health and Human Services

When the on-site vaccination schedule was announced in October, independent living providers said his eligibility seemed certain. Communications from HHS about the program provided a link where facilities for independent living could enroll in the program and, in a question and answer session in late October, HHS officials stated that both independent communities for the independent living such as those found within the CCRCs be eligible, according to the multiple industrial groups that were represented in the call. A moving target Paul Mango, who was deputy chief of staff for policy at HHS until January and was involved in public communications about the program, says he always understood that the program would cover the entire spectrum of senior facilities. “I was never in a conversation where I heard about the exclusion of independent living facilities,” he says. Grusich, who has served in his public affairs role at the CDC since 2017, says the program’s eligibility criteria were finalized in early December and states received a list of ineligible facilities in their jurisdictions. Independent living providers say they didn’t get the message. Hawthorn Senior Living, which operates more than 60 independent living communities in the United States, enrolled all of its facilities in the program in late October, says Adam Bryan, director of sales and marketing. By mid-January, he says, a handful of Hawthorn assisted living centers had been able to schedule vaccine clinics, but their independent living centers generally hadn’t heard from it. Finally, in response to an inquiry from Hawthorn, the CDC told the company in an email on Jan. 15 that most of its facilities were ineligible. “We were alarmed,” says Bryan. “We immediately started trying to schedule clinics in any way possible.” That has meant taking a bus full of residents to the Bojangles Coliseum, a mass vaccination site in Charlotte, North Carolina, and assembling a team of 18 staff members to spend a Saturday morning trying to book off-site vaccinations for 120 California residents, an effort that yielded only two citations, Bryan says. By mid-February, he says, Hawthorn had been able to secure vaccinations for about two-thirds of its facilities, while at some of the remaining facilities the effort progresses one resident at a time. ‘Doesn’t sound good to me’ Jan Busk, an 85-year-old woman living in a Hawthorn community in Vancouver, Washington, took the bus from the facility to a local clinic to receive her first dose of vaccine in late January. She was “a little surprised,” she says, to learn that she and her neighbors weren’t eligible for the federal pharmacy association program. “We are all of a certain age,” he says. “Doesn’t sound good to me.” The state of independent living residents in CCRCs has been particularly murky, providers and industry groups say. These residents’ access to on-site vaccine clinics has varied by region and the pharmacy running the clinic, says Ruth Katz, senior vice president for public policy and advocacy at LeadingAge. “What we end up with is a patchwork quilt of epic proportions.” Juniper Communities, which enrolled all of its facilities in pharmacy partnership with CVS Health Corp. CVS, + 3.09%, was initially unable to obtain a clinical date for one of its CCRCs, while another obtained a clinical date for skilled nursing residents of the CCRC but not for anyone else, says Lynne Katzmann, Juniper CEO. Ultimately, the company was able to arrange vaccinations for independently living residents through a local hospital and other sources, he says. CVS spokesman Mike DeAngelis did not respond directly to questions about the company’s vaccinations of CCRC residents, but said the CDC “made numerous adjustments to facility allocations and vaccine allocation, and we continue working through vaccination clinics with each facility assigned on a case-by-case basis to meet their needs. ” Industry groups say the CDC should open the pharmacy association program to all residents, regardless of the type of facility. Although the program started months ago, “it is not too late,” says James Balda, president and CEO of Argentum, which represents independent living centers and CCRCs, as well as memory and assisted living providers. . “There is still the possibility of independent living being included, and they should do it and do it quickly.” The CDC says it’s not going to happen. “CDC is not enrolling any additional facilities in this program, which will be closed after the final round of on-site vaccination clinics is completed later this spring,” says Grusich. The Biden White House did not respond to a request for comment on excluding independent living facilities from the vaccination program. Under the Federal Retail Pharmacy Program, launched in mid-February, some retail pharmacies are receiving limited supplies of vaccines targeting priority groups. “As the program expands and the offering becomes more available, residents of the independent living and senior retirement communities will have more opportunities to get vaccinated on site,” says Grusich. Yet now that many states have opened vaccine eligibility to everyone 65 and older, some in the independent living industry say tougher competition for limited doses is putting their residents at a greater disadvantage. “It’s very frustrating,” says Schless. With so many independent living facilities already struggling to secure vaccinations for their residents, “many of us have wondered if this will make it even more difficult.”