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Highlights from Jan. 15th Call with DOH and Governor’s Office

On Fri., Jan. 15th, LeadingAge NY participated in a call with the Department of Health (DOH) and the Governor’s Office. Below are some highlights from that discussion.

Vaccine Updates for Nursing Home and ACF Members

The Department reported that nursing homes should, at this point, have concluded their first vaccination clinic, and many are having their second clinics now. Meanwhile, adult care facility (ACF) clinics are underway. The Department reiterated that standing orders for vaccines are handled by the pharmacy.

DOH is asking that facilities respond to any email from the Department or the pharmacy partner quickly to confirm clinic dates and provide contact information if requested. The Department urges providers not to cancel or try and reschedule clinic dates, as that causes great logistical challenges. The Department is working to ensure that all facilities have clinic dates. If any members do not yet have a clinic date or have a late clinic date, please let us know, and we will work with DOH to resolve.

Members are reminded that staff and residents can get a vaccine in the community as well. This will be critical for those staff not covered in your on-site clinics. Bear in mind, however, that you must still track for the daily Health Emergency Response Data System (HERDS) survey the vaccination status of staff and residents vaccinated outside of your facility, and you should work to ensure that they receive the second dose.

We know that the community sites will not be appropriate for all, and in fact there is very limited availability in the community currently. Thus, we have continually been asking DOH to provide a plan for ACFs and nursing homes for vaccination after the federal program concludes. Some providers may have signed up for the State Vaccination Program to become a vaccinator. Those providers should have received a Memorandum of Understanding (MOU) along with a recent addendum by email on Jan. 11th. LeadingAge NY has continually raised the question regarding New York City providers, who were directed not to enroll in the State Vaccination Program. DOH and the Governor’s Office have taken that issue back for consideration. LeadingAge NY has also advocated for nurses working within ACF settings to be able to provide vaccination to staff and residents, given the extensive list of professionals and paraprofessionals allowed to administer per Executive Order (EO). At this time, we presume that Assisted Living Programs (ALPs) and Enhanced Assisted Living Residences (EALRs) may be able to administer the vaccine following the same logic applied to the influenza vaccination, outlined here. While becoming a vaccinator may be more feasible as new vaccinations become available, not every nursing home or ACF will want or be able to; thus, we continue to press the Department for a plan moving forward.

Vaccination HERDS Questions

The Department noted that providers that just had a vaccination clinic are missing a question on the HERDS survey regarding the total number of people vaccinated for the first and second dose. Those questions must be answered, so be sure to address them.

Abbott BinaxNOW Antigen Tests Being Sent to Nursing Homes

On Jan. 5th, DOH sent an email to nursing homes that stated:

To facilitate the increased testing of nursing home staff in New York State, the New York State Department of Health (Department) will begin distributing Abbott BinaxNow COVID-19 antigen tests directly to nursing homes. These tests are to be used to perform a second weekly test of all staff. The number of tests being provided to each nursing home is based on the total number of staff that was reported to the Department. Tests will be allocated on a monthly basis, with the first delivery occurring within a week. If your facility does not want to receive Abbott BinaxNow COVID-19 antigen tests from the Department at this time, please respond to this email immediately informing us that you do not want to receive these tests. Please use the subject line BinaxNOW tests declined.”

Unless you opted out in response to that email, nursing homes should soon be receiving or should have received over the weekend a month’s supply for all staff based on HERDS reporting. It is unclear how long this supply will last; it is contingent upon the supply from the federal government.

Questions have been raised regarding how the BinaxNOW testing should be documented if you do not have a standard lab test report. It was stated that the provider needs to establish a system that allows them to report test results, whether it be a logbook or a separate form. The mechanism must provide a way to document the results, and that result is then given to the person tested. The documentation must indicate positive, negative, invalid, or any unacceptable result.

POC Test Result Reporting for ACFs and Nursing Homes

In response to concerns regarding the burden of reporting requirements, the director of the Electronic Clinical Laboratory Reporting System (ECLRS) discussed the reporting requirements and some flexibility. Per EO, all point-of-care (POC) tests are required to be reported to the State within 24 hours of test result. ECLRS is the mechanism by which this data is captured. There are a few different ways to report to ECLRS based on your electronic systems capability. You can log into a web application and manually enter individual results, use HL7 messaging, or, most common, do a file upload. ECLRS staff can walk you through this process. It was noted that staff were very busy this past week but seem to have gotten caught up and are available to assist.

There is some complexity in that lab test details, Clinical Laboratory Improvement Amendment (CLIA) details, and file structure have to be accurate. However, you can, for example, save a patient or staff roster and cut and paste to facilitate subsequent reporting.

The federal government developed a way to get lab test results that are reported to the National Healthcare Safety Network (NHSN) sent to states. Nursing homes can report through this mechanism but must check with ECLRS to ensure that they are getting the data. If a nursing home stops reporting to NHSN, they must report to ECLRS. If you do not report this data to NHSN, as would be the case for ACFs, you must report it to ECLRS. To contact ECLRS, use this email and/or phone: eclrs@health.ny.gov, 866-325-7743.

COVID-Only Nursing Homes

The Department reports that there are now 14 COVID-only nursing homes in the state. We have asked for a list of those facilities but to date have not received it. Per EO, these facilities allow for persistently positive, non-infectious, nursing home-eligible people to be discharged to these sites. They can be a standalone building or a building in which a separation can be created where there is no airflow between that and another section of the building. Admissions and discharges follow the same process as non-COVID-only nursing homes.

COVID-only nursing homes can only accept people directly from the hospital. If nursing homes or ACFs are unable to care for or cohort a COVID-positive resident, they may go to another nursing home that has a distinct unit and can manage the person’s care.

The Department reported that there is a need for COVID-only nursing homes in the Mohawk Valley and North Country. If any nursing home is interested in becoming a COVID-only nursing home, the building needs to be fully sprinklered and must have an active call light system and a generator. Interested providers should speak with the Department regarding becoming a COVID-only nursing home.

DOH clarified that residents who are hospitalized and persistently positive but beyond the infectious period still cannot return to their nursing home or ACF until they test negative. LeadingAge NY suggested that the Department provide information to residents and families regarding this policy so they understand the reason they cannot return to the place they call home.

Also within this week’s edition of Intelligence are answers we have received from DOH on frequently asked questions, including some on issues noted above. We recommend that you review that article as well.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, or Karen Lipson, klipson@leadingageny.org. Both can be reached at 518-867-8383.