Pharmacy Partnership for Long-Term Care Program for COVID-19 Vaccination-Wisconsin
HHS/CDC partnered with CVS & Walgreens to offer on-site COVID-19 vaccination services for residents of nursing homes and assisted living facilities once vaccination is recommended for them.
The Pharmacy Partnership for Long-term Care (LTC) Program will facilitate safe vaccination of this critical patient population, while reducing the burden on LTC facilities (LTCF) and health departments. The program provides end-to-end management of the COVID-19 vaccination process, including cold chain management, on-site vaccinations, and fulfillment of reporting requirements at no cost to facilities. LTCF staff who have not received COVID-19 vaccine can also be vaccinated as part of the program. This program is being implemented in close coordination with jurisdictions, LTCFs, federal partners, such as the Centers for Medicare and Medicaid Services (CMS), and professional organizations, including the American Health Care Association (AHCA) and Leading Age, with members representing both nursing homes and assisted living facilities.
As part of this program, which is free of charge to facilities, the federal pharmacy partner will:
- Schedule and coordinate on-site clinic dates directly with each Onsite Clinics: CDC has set 3 clinics as a baseline as follows: Clinic 1: 1st dose for everyone in the facility, Clinic 2: 2nd dose for everyone in the facility Clinic 3: 3rd clinic if needed.
- Order vaccines and associated supplies (e.g., syringes, needles, personal protective equipment).
- Ensure cold chain management for
- Provide on-site administration of vaccine to all residents and any staff not already
- Report required vaccination data to the local, state/territorial, and federal jurisdictions within 72 hours of administering each dose.
- Adhere to all applicable CMS COVID-19 testing requirements for LTCF
Federal Program Planning
In November, LTC facilities had the opportunity to sign up for the program and select a pharmacy partner. CDC has worked with jurisdictions to match facilities with their requested pharmacy partner; in some instances, adjustments have been made to reassign facility selections to account for logistics and program needs. Pharmacy partners have started reaching out to participating facilities they were matched with to coordinate vaccination efforts. In Wisconsin, the program began on 12/28/20 for skilled nursing facilities.
CDC expects the program services to continue on-site at participating facilities for approximately two months from the date of the first vaccination clinic. After the initial phase of vaccinations, facilities may continue working with the federal pharmacy partner it was matched with or shift to another pharmacy provider that is enrolled with the state to provide COVID-19 vaccine.
Federal Program: Walgreen’s and CVS Resources
Each pharmacy has developed a website with substantial resources available to facilities. These resources include:
- Webinars describing the process
- Clinic planning guides
- Frequently asked questions
- Consent forms and the consent process for the pharmacies
- Contact information
Please review this material specific to your pharmacy partner and direct questions to your point of contact that each pharmacy assigns to you.
Walgreens: https://www.walgreens.com/topic/findcare/long-term-care-facility-covid-vaccine.jsp#getresources
CVS: https://www.omnicare.com/covid-19-vaccine-resource/
Facilities Opting Out of the Federal Program & Choosing another Pharmacy Partner
Facility Impact
Facilities maintain the right to decline services at any time from the Federal Partnership and Walgreens or CVS. However, when services are declined the facility will need to seek vaccination services from another pharmacy partner. That pharmacy partner must be enrolled with the State of Wisconsin to provide COVID-19 vaccinations. If a facility opts out of the pharmacy partnership program, the facility and the pharmacy provider of their choice are responsible for coordination of and adherence to all vaccine supply chain, storage, handling, administration, and reporting requirements. Pharmacies other than Walgreens and CVS may not know the exact vaccine allocation they may be receiving (the Federal Long Term Care Partnership contract the CDC has with Walgreens and CVS guarantee they will receive vaccine to complete first and second doses of all residents and staff during the program), therefore vaccination of the entire facility may be spread out over a longer period of time.
Pharmacy Impact
When a pharmacy and facility wish to partner, the pharmacy must be completely enrolled as a COVID-19 vaccinator with the State. The pharmacy, like the State, will only know the vaccination allocation one week in advance and the allocation will be variable. A specific vaccine allocation to immediately meet the needs of a specific long term care facility is not guaranteed. Pharmacies and facilities will need to adjust and track vaccination clinics to ensure staff and residents are adequately vaccinated.
Facility and Pharmacy Action Items
If a facility wishes to opt out of the federal program and work with a different pharmacy the following items must be done:
- Pharmacy chosen must ensure they are enrolled with the State as a COVID-19 Vaccinator.
- Facility must communicate declination of services to Walgreens or CVS.
- Pharmacy or the facility should communicate to the State that the facility declined the Federal Partnership by emailing DHSCOVIDVACCINATOR@dhs.wisconsin.gov
Opt Out Frequently Asked Questions
1. Will choosing a preferred local partner pharmacy delay COVID-19 vaccination for my residents and staff?
The State has begun the Federal Partnership for skilled nursing facilities. That means that Walgreens and CVS are guaranteed to receive vaccine to administer to residents and staff of skilled nursing facilities. Other pharmacies that are not part of the federal program will receive vaccine directly from the State. When the pharmacy receives the State’s weekly allocation survey they should indicate how many doses are needed to vaccinate long term residents and staff during the upcoming week.
2. Can an alternate pharmacy begin to administer vaccine to assisted living residents and staff as soon as the pharmacy receives vaccine?
The Federal Partnership has two phases: Phase A for skilled nursing and Phase B for all other long term care facilities for the elderly. CVS and Walgreens are the only pharmacy partners for the federal program. For other Phase 1a vaccinators including other pharmacies, the vaccinating entity should follow the same process and start with skilled nursing facilities, with vaccination of other long term care facilities beginning when that part of the program is activated by the state.
3. What if some LTCF staff are not onsite the day of the vaccination clinic? How will they get vaccinated?
LTCF staff are considered healthcare personnel and are eligible for vaccination in Phase 1a according to the recommendations of the Advisory Committee on Immunization Practices. LTCF staff who are not present for onsite vaccination clinics may get vaccinated by another provider serving Phase 1A populations. LTCF staff that received their first dose at the facility and happen to leave a facility after receiving the first dose but before they are due for the second dose can return to the same facility to get their second dose.
4. Is written consent required in a long term care facility?
There is no special Federal or State requirement for consent forms for COVID-19 vaccines, so the CDC and DHS are not providing templates. Vaccinating entities are free to use a consent form they have developed for their own needs.
There is a requirement to provide the Emergency Use Authorization Fact Sheet for the specific COVID-19 vaccine to each person administered the COVID-19 vaccine.
The pharmacies in the federal partnership will be using a Vaccination Administration Record or a consent form for the pharmacies’ needs. The pharmacies’ policies on consent can be found at the following webpages:
These are the pharmacies’ policies and the pharmacies are open to multiple ways to document the vaccination administration record. If a facility has another mechanism where they also need to have documented consent, the facility should maintain that process. Other pharmacies that a facility partners with may have their own procedures for consent.
5. Which vaccine is designated for this program?
Wisconsin chose to use the Moderna vaccine for the federal pharmacy partnership. Walgreens and CVS will be using this vaccine. Other pharmacies may be allocated Pfizer or Moderna vaccine to be used for phase 1a vaccinations for long term care facilities.
6. What if a person leaves a facility after receiving the first dose but before they are due for the second dose?
Walgreens and CVS are working with facilities to allow these people to come to the facility location during subsequent clinics to receive vaccine (i.e., plans to have drive-up vaccination so the person receiving vaccine would not need to enter the actual facility). Offering this option will vary across facilities.
Residents that happen to leave a facility after receiving the first dose but before they are due for the second dose should plan to return to the same facility to get their second dose. Notifying the residents who have left about the details of the second dose clinic is the responsibility of the facility. Ideally a resident or staff person who have left the facility could receive their second dose at another location of their choice. However, in the next few months vaccine will be limited and not readily accessible at many locations. Since the second dose is imperative, the follow-up clinic at the facility is a guaranteed option for individuals to receive the second dose and therefore individuals should plan for that.
|
