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  7. » DOH Solicits Comments on Nursing Home PPE Stockpile and Nursing Home/ACF Vaccination Arrangement Regs for Permanent Adoption

DOH Solicits Comments on Nursing Home PPE Stockpile and Nursing Home/ACF Vaccination Arrangement Regs for Permanent Adoption

The Department of Health (DOH) has published two regulations, previously adopted on an emergency basis in response to COVID-19, with the goal of seeking their permanent adoption. The regulations, requiring (i) nursing homes and hospitals to maintain personal protective equipment (PPE) stockpiles, and (ii) nursing homes and adult care facilities (ACFs) to offer or arrange for COVID-19 vaccinations of residents and staff, are open for public comment until July 7, 2022. They are published in the June 8, 2022 edition of the State Register on pages 16-21. LeadingAge NY has submitted comments on these regulations to the Public Health and Health Planning Council (PHHPC) each time they were presented for renewal on an emergency basis. We will be submitting comments again during this public comment period. The most recent comments are available here.

The PPE stockpile regulation requires nursing homes and hospitals to maintain a 60-day supply of PPE. LeadingAge NY is concerned that the formula used to calculate the size of the stockpile relies on an average COVID-19 positivity rate representing the highest positivity rate reached in the facility and its region since the inception of the pandemic. In addition, it applies this rate and specified numerical factors to the nursing home's certified beds, rather than beds in operation. As a result, the required PPE inventory bears little relation to actual or projected need for PPE. In some cases, the formula is requiring facilities to purchase PPE that they will not be able to use prior to its expiration, resulting in wasted resources and negative environmental impacts. Further, the proposed regulation does not include any provision that allows nursing homes to dip into their stockpiles without immediately replenishing them, when faced with widespread PPE shortages. LeadingAge NY members that share these concerns are encouraged to submit comments on this regulation as indicated below.

The nursing home and ACF vaccination arrangement regulation requires facilities to offer (in the case of nursing homes) or arrange for (in the case of ACFs) all consenting, unvaccinated residents and personnel the opportunity to receive any first or recommended next or booster dose of the COVID-19 vaccine. Nursing homes must ensure that each new resident or readmitted resident and all new personnel have an opportunity to receive the vaccine within 14 days of admission, readmission, or hire. ACFs must arrange for all consenting, unvaccinated personnel and residents to register for vaccine appointments, including any recommended booster. ACFs are required to screen residents for vaccination status as part of the pre-admission screening process or on the day of admission or readmission and attempt to schedule the residents for COVID-19 vaccination or booster doses within seven days of admission or readmission. ACFs must screen personnel during the pre-employment process regarding their COVID-19 vaccination status and within seven days of hiring attempt to schedule the new personnel for vaccination. The regulation also requires facilities to maintain records of those who decline vaccination by asking them to sign an affirmation.

LeadingAge NY's comments on this regulation noted that it does not include any provision recognizing that residents or personnel may not be eligible for a vaccine or booster due to recent COVID-19 infection or the timing of their initial vaccination series or booster. Similarly, pediatric nursing facilities may serve individuals under age 5 who are currently ineligible for the vaccine. Thus, it may not make sense for certain employees or residents to be offered an opportunity to receive their vaccination or booster within 14 days (or seven days for ACFs) of admission or hiring. In addition, the comments pointed out that the penalty provisions set forth in the regulation are disproportionately severe, especially given the current staffing crisis.

LeadingAge NY members may submit comments to DOH here by July 7, 2022. Members that would like their feedback incorporated into the association's comments may submit them here by June 21, 2022.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8383