It’s time. Staff vaccinations required for nursing homes as 10 RI facilities see new COVID cases

Published in Rhode Island News Today on August 24, 2021

With the COVID-19 Delta variant spiking across the country especially among the unvaccinated, last Wednesday, President Joe Biden announced at an afternoon address at the White House that the U.S. Department of Health and Human Services will require nursing homes to require all workers to be fully vaccinated against COVID-19 as a condition for those facilities to continue receiving federal Medicare and Medicaid funding.

According to federal data, of the 1.6 million nursing home workers across the  nation, about 540,000 — 40 percent of the work force — are unvaccinated.  

Since the spread of the Delta variant, there has been a rise in the number of COVID-19 cases, especially in those states that have low rates of vaccinated workers. Both the U.S. Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services (CMS) data confirm a strong relationship between the increase of COVID-19 cases among nursing home residents and the rate of vaccination among nursing home workers.

These new emergency federal regulations, crafted  by CDC and CMS, would apply to nearly 15,000 nursing home facilities, which employ approximately 1.6 million workers and serve approximately 1.3 million nursing home residents.

Rhode Island Gov. Dan J. McKee, along with other states, has already taken a similar step to protect nursing home residents by requiring all staff to be vaccinated and the new federal mandate will ensure consistent and equitable standards throughout the country. 

At a COVID-19 update held at the state the state capitol in early August, McKee called for the new vaccine mandate (as a term of employment) to take effect on Oct. 1st.

On August 23rd, Pfizer’s vaccine was fully approved by the FDA. Approvals of Moderna, Johnson & Johnson and booster shots are expected to follow soon.

According to CMS, the new mandate is a key component of protecting the health and safety of nursing home residents and staff by ensuring that all nursing home staff receive COVID-19 vaccinations. Over the past several months, millions of vaccinations have been administered to nursing home residents and staff, and these vaccines have shown to help prevent COVID-19 and have proven to be effective against the Delta variant.

“Keeping nursing home residents and staff safe is our priority. The data are clear that higher levels of staff vaccination are linked to fewer outbreaks among residents, many of whom are at an increased risk of infection, hospitalization, or death,” said CMS Administrator Chiquita Brooks-LaSure in a statement announcing the new vaccine mandate.  “We will continue to work closely with our partners at the CDC, long-term care associations, unions, and other stakeholders to advance policies that keep residents and staff safe. As we advance these new requirements, we’ll work with nursing homes to address staff and resident concerns with compassion and by following the science,” she said.

CMS says that it’s requiring all nursing home staff to be vaccinated is in keeping with the federal agency’s authority to establish requirements to ensure the health and safety of individuals receiving care from all providers and suppliers participating in the Medicare and Medicaid programs. About 62% of nursing home staff are currently vaccinated as of August 8 nationally, and vaccination among staff at the state level ranges from a high of 88% to a low of 44%. The emergence of the Delta variant in the United States has driven a rise in cases among nursing home residents from a low of 319 cases on June 27, to 2,696 cases on August 8, with many of the recent outbreaks occurring in facilities located in areas of the United States with the lowest staff vaccination rates.

Last May, CMS issued new regulations that require Long-Term Care (LTC) facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) to educate residents, clients, and staff about COVID-19 vaccination and, when available, offer a COVID-19 vaccine to these individuals. These regulations also mandate that LTC facilities report weekly COVID-19 vaccination data for residents and staff to the CDC’s National Healthcare Safety Network (NHSN).

CMS will continue to analyze vaccination data for residents and staff from the CDC’s National Healthcare Safety Network (NHSN) data as an additional method of compliance monitoring and in keeping with current practice, as well as deploy the Quality Improvement Organizations (QIOs)—operated under the Medicare Quality Improvement Program—to educate and engage nursing homes with low rates of vaccinations.

CMS strongly encourages nursing home residents and staff members to get vaccinated as the Agency undergoes the necessary steps in the rule-making process over the course of the next several weeks. CMS expects nursing home operators to act in the best interest of residents and their staff by complying with these new rules, which the Agency expects to issue next month.  CMS also expects nursing home operators to use all available resources to support employees in getting vaccinated, including employee education and vaccination clinics, as they work to meet this staff vaccination requirement.

Rhode Island Long Term Care Facilities with new cases in the last 14 days (as of 8/14/2020):

These RI nursing homes are on the RI Dept. of Health list with increased cases –

Alpine – Coventry – 5-9 cases

Avalone – Warwick – less than 5

St. Antoine – North Smithfield – less than 5

Woonsocket Health – Woonsocket – less than 5

All America Assisted Living – Warwick – less than 5

Anchor Bay – Johnston – less than 5

Smithfield Woods – Smithfield – less than 5

Sunrise House – Providence – less than 5

Bridge at Cherry Hill – Johnston – 5-9

Tockwotton – Providence – less than 5

AARP Strongly Supports Biden’s Vaccine Mandate in Nursing Homes 

In response to the Biden Administration directing all nursing homes that receive Medicare or Medicaid funds to require vaccinations for all staff, Nancy A. LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer, stated:  

“The Administration’s announcement today requiring vaccinations for nursing home staff is a significant step in the fight against this pandemic. Around 30% of COVID deaths have been among residents and staff in nursing homes and other long-term care facilities, even though they represent less than 1% of the population. As the new variants are emerging, facilities cannot let preventable problems be repeated. Increasing vaccination rates in nursing homes is one of the most common sense and powerful actions we can take to protect the lives of vulnerable older adults.”

The AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the dashboard to provide snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff, with the goal of identifying specific areas of concern at the national and state levels in a timely manner.

Don’t Just Single Out Nursing Homes 

“We appreciate the Administration’s efforts to increase COVID-19 vaccinations in long term care. Unfortunately, this action does not go far enough. The government should not single out one provider group for mandatory vaccinations. Vaccination mandates for health care personnel should be applied to all health care settings. Without this, nursing homes face a disastrous workforce challenge,” warns Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) 

“Focusing only on nursing homes will cause vaccine hesitant workers to flee to other health care providers and leave many centers without adequate staff to care for residents. It will make an already difficult workforce shortage even worse. The net effect of this action will be the opposite of its intent and will affect the ability to provide quality care to our residents. We look forward to working with the Administration in the coming days to develop solutions to overcome this challenge,” says Parkinson.

The full Nursing Home COVID-19 Dashboard is available at www.aarp.org/nursinghomedashboard. For more information on how COVID is impacting nursing homes and AARP’s advocacy on this issue, visit www.aarp.org/nursinghomes.

AARP: Making Seniors a Priority in Getting COVID-19 Vaccines

Published in Pawtucket Times on January 11, 2021

Last month, a statement the Rhode Island Department of Health (RIDOH) announced recommendations from the Rhode Island COVID-19 Vaccine Subcommittee for hospitals that vaccinations would begin for frontline hospital workers against COVID-19. This recommendation was made at an emergency meeting of the Subcommittee. RIDOH has accepted this recommendation and has communicated to hospitals that they may begin vaccinating these workers, as soon as vaccine arrives.

Two doses will be needed for someone to be fully immunized. Second doses will start arriving in Rhode Island in roughly three weeks. Rhode Island expects to receive approximately 10,000 doses of Pfizer vaccine the first week it is available, and approximately 19,000 doses of Moderna vaccine the first week it is available. Vaccine will come to Rhode Island in weekly allotments over the coming months, says RIDOH.

Epidemiologists, primary care providers, pharmacists, pediatricians, long-term care advocates, ethicists, nonprofit leaders, school leaders, faith leaders serve on Rhode Island’s COVID-19 Vaccine Subcommittee.  This group is responsible for performing an independent review of the process for evaluating the safety and efficacy of the vaccine. The Subcommittee is advising RIDOH on how to prioritize distribution of the vaccine to ensure that it is done equitably, and in a way that best protects the State as a whole.

At press time, the U.S. Food and Drug Administration (FDA) has granted an Emergency Use Authorization for a COVID-19 vaccine developed by Pfizer, and a vaccine made Moderna.

Making COVID-19 Vaccine Available Throughout the Ocean State

“After a rigorous scientific review, we know that COVID-19 vaccine is safe. We also know that it is one of the most effective vaccines ever developed,” announced Director of Health Nicole Alexander-Scott, MD, MPH in the Dec. 14 statement. “In the coming weeks and months, as vaccine becomes more available, getting vaccinated will be one of the most powerful things you can do to keep yourself and the people you love safe from COVID-19. We are going to work to ensure that every person in every community in Rhode Island has access to the vaccine, especially those communities hardest hit by this virus,” she said.

Added, Philip Chan, MD, MS, Consultant Medical Director for RIDOH’s Division of Preparedness, Response, Infectious Disease, and Emergency Medical Services, “We have never had a vaccine that has been – or will be – more closely monitored than the COVID-19 vaccine.”

“Teams of scientists at the national level have been scrutinizing thousands of pages of technical data for weeks, focusing on vaccine effectiveness, safety, and the manufacturing process, and our own local review has happened here in Rhode Island. I absolutely plan on getting vaccinated when it is my turn.,” said Chan.

According to RIDOH, the national vaccine trials for the COVID-19 vaccine involved tens of thousands of people to make sure they meet safety standards and people of different ages, races, and ethnicities. There were no serious safety concerns. (When vaccinated against COVID-19, people do sometimes develop post-vaccination symptoms such as soreness at the spot of the shot and headaches. This is normal, healthy, and expected. It means your immune system is working to develop protection.) Several systems are in place to do ongoing safety monitoring of the vaccine.

As of January 8, the last update on RIDOH’s COVID-19 Data Tracker, out of the 31,541 does administered, 29,743 have been vaccinated with their first of two doses, only 1,798 people were fully vaccinated with two doses.

Don’t look for the roll out of COVID-19 to take days or weeks, it will take months to complete, warns RIDOH officials. Phase 1 of the vaccination program is expected to run through late March.  At press time, the state is currently working its way through the top three tiers of this phase, including hospital staff, healthcare workers, EMS personnel, home health and hospice workers, nursing home staff and residents, high-risk incarcerated persons, first responders, school nurses, and even hard-hit communities.

Finally, those in the final two tiers of Phase 1 to be vaccinated include outpatient providers (Dentists, primary care), Dialysis Center workers and death care professionals, expected to begin Jan. 25, and adults over 75 years of age, expected to start by February.

Phase 2 is expected to kick-in by late March.  A number of factors are being considered to target the distribution of COVID-19 vaccinations a person’s age, high-risk conditions, occupation and geography.  

Make Older Rhode Islanders a Priority in Receiving Vaccines

AARP Rhode Island, representing 132,000 older Rhode Islanders, calls for Governor Gina Raimondo to make the state’s seniors a priority in its time-line for on distributing COVID-19 vaccines.  The Jan. 8 correspondence, cosigned by Kathleen Connell, State Director of AARP Rhode Island and Phil Zarlengo, the group’s State President, called on Raimondo “to increase COVID vaccination transparency,” as it relates to older Rhode Islanders.

AARP Rhode Island asked the Governor to include the numbers of Rhode Islanders vaccinated by age and other criteria on a daily/weekly basis on RIDOH’s COVID-19 Data Tracker.  Specially, the largest state-wide advocacy group called for the state’s website to include:

·         the numbers and percentages of older Rhode Islanders by race and ethnicity, that have been vaccinated:

·         the number of Rhode Islanders vaccinated and their age demographics on a daily/weekly basis;

·         a clear and easy-to-understand schedule of vaccine administration for all populations; and the process by which individuals may seek and obtain a vaccine;

·          the numbers and percentages of long-term care residents, by facility, that have received their first and second doses of vaccines;

·         the numbers and percentages of long-term care staff, by facility, that have received their first and second doses of vaccines.

While acknowledging the many challenges the state officials must tackle in determining how to equitably, safely and effectively distribute COVID-19 vaccines, Connell and Zarlengo call for Rhode Islanders age 50 and older to be made a priority in receiving a vaccine.

“The data clearly show that the older people are, the higher risk they face if they contract COVID-19.  Given that older individuals are at a greater risk of death from COVID-19, we strongly urge you to ensure that Rhode Islanders age 50 and older are prioritized to receive a vaccine.  These individuals must be given priority access to vaccines, in addition to those individuals receiving care in nursing homes and other long-term care facilities,” say Connell and  Zarlengo.

“For years, the long-term care system has been shifting away from institutional care in nursing homes to home and community-based settings (HCBS). Here in Rhode Island, a significant percentage of long-term services and supports are provided in the home or settings such as assisted living facilities, residential care facilities, veterans homes, and in individuals’ own homes,” says Connell and Zarlengo, stressing that this why the state should prioritize seniors, especially those with underlying conditions, receiving care in these additional settings and the staff providing care, to receive a COVID-19 vaccine.

Finally, AARP Rhode Island’s correspondence urges the Governor to ensure that all providers are fully complying with established state procedures for vaccine distribution and prioritization. “We urge you to investigate and take swift action against anyone who attempts to commit fraud, including by inappropriately selling the vaccine or intentionally providing vaccines to those who do not meet qualifying criteria in an attempt to circumvent the distribution process.”

From AARP’s National

 “We urge public health officials at the state and local level, as they decide on vaccine allocations, to rely on the evidence and make plans backed by science.  As production is ramping up, AARP is advocating hard to ensure every older American who wants to get the vaccine can get it.  It’s also vital that distribution plans for authorized vaccines are smoothly implemented.  There’s no time to waste: it’s time for full-scale mobilization, and any delays or early bottlenecks in distribution systems need to be addressed urgently,” says AARP Executive Vice President and Chief Advocacy & Engagement Officer Nancy A. LeaMond in a Dec. 28 statement.  

 

AARP Town Hall Gives Its Best to Educate Seniors on COVID-19

Published in the Woonsocket Call on April 5, 2020

With more than 278 Americans now infected with the Coronavirus virus (COVID-19) and at least 7,159 people dying from the deadly virus, according to an April 3 blog article the New York Times, “about 311 million people in at least 41 states, three counties, eight cities, the District of Columbia and Puerto Rico are being urged to stay home.” The Washington, DC-based AARP continues to intensify its efforts to educate seniors about COVID-19 by hosting weekly Coronavirus Information Tele-Town Hall events.

At AARP’s second Coronavirus Information Tele-Town Hall event, held Thursday, March 19, during the 90 minute live event, federal health experts gathered to answer questions about the latest changes to address the health impacts of COVID-19, family caregiving needs, and to give tips on how seniors can stay safe from scams and frauds. AARP’s Vice President Bill Walsh served a host and the panel of experts featured Dr. Jay Butler, M.D., the deputy director for infectious diseases at the Centers for Disease Control and Prevention, (CDC), Lance Robertson, the assistant secretary for aging and administrator of the Administration for Community Living (ACL) and Daniel Kaufman, the deputy director for the Federal Trade Commission’s Bureau of Consumer Protection. AARP’s Jean Setzfand. AARP’s senior vice president served as moderator.

CDC’s Butler called for the public to stay informed and take the coronavirus virus seriously. “As we’ve learned more about COVID-19, it’s very clear that most people who become infected do recover and do very well. But unfortunately, some get very sick. And some even die. And the risk of more severe illness is greatest for those who are older and for persons with underlying health conditions, especially chronic heart, lung or kidney disease, and those with diabetes,” he says.

Juggling Costs and Benefits While Promoting Social Distancing

According to Butler, grocery stores are juggling costs and benefits with promoting social distancing by designating special hours for seniors to shop if they don’t have someone who can make “that run to the grocery store or have delivery services available.”

“We’re at the end of flu season so if you develop symptoms (cough, muscle aches, headache, and temperature) it doesn’t mean that you have COVID-19, says Butler. For those concern, it is important to talk with your health care provider who will determine whether or not you should be evaluated and whether or not a test may be necessary, he adds, noting that COVID-19 testing is now covered by Medicare Part B when it’s ordered by a health care provider.

“Of course, if you suddenly become very ill—and that would be things like shortness of breath, chest pain, difficulty in getting your breath at all or noticing that your face or your lips are turning blue—that’s when you call 911, and get in as quickly as possible,” says Butler.

Butler notes that the primary transmission of the COVID-19 virus (as well as the six other coronaviruses that were previously known to cause disease in humans), is respiratory droplets.

By coughing or sneezing you produce droplets that contain the virus that can spread as far as five or six feet away from you, he says stressing that this is why social-distancing can protect you from catching the virus.

Many express concerns that COVID-19 can be picked up by handling letters and packages. But, says that the likelihood of transmission of is extremely low. So, consider sending a package a loved one in an assisted living facility or nursing home because it can be meaningful, says Butler.

For those over age 75 to age 80, Butler recommends that these individuals practice social distancing by connecting with their children or grandchildren by phone video chat to being exposed to COVID-19.

Butler gave simple tips for residents of senior living complexes to protect themselves from COVID-19. When you come back into your apartment after taking out trash to the chute or dumpster, “wash your hands,” he says. “And that means about 20 seconds with soap and water.

It seems like a long time but it’s the same amount of time it usually takes getting through the alphabet or to sing Happy Birthday twice,” adds Butler. Or just use a hand sanitizer with at least 60 percent alcohol as an alternative to hand washing.

ACL Administrator Robertson provided tips to unpaid caregivers who cannot visit their loved ones in nursing homes due to the necessary visiting restrictions. He says, get the facility’s up-to-date contact information along with details as to ways as how to make virtual visits, video chats and regular phone calls. He says, don’t forget to send cards and notes, not only to your loved one, but to other residents even to staff to say thank you.

Communicating with Your Loved Ones

Enhance your verbal communication by asking the facility staff to schedule the time for your call. “If your mom is most alert in the morning, pick a morning time, think about what music they might like and play that in the background or sing along or sing directly to your loved one,” recommends Robertson.

Robertson notes, “If you find the conversation struggling a bit, maybe play a game of trivia, reminisce, work on a crossword puzzle together, sing songs, read poetry or other materials.

Watch a TV show at the same time and just discuss. Again, throw in some creativity and you can help prevent both boredom and isolation.”

For those more technically savvy, face-to-face interaction through FaceTime, Messenger, Facebook, Zoom, can enhance your contact, says, Robertson.

Adds Robertson, make sure you ask the facility staff to keep the scheduled time of the care conference, holding it over the phone. “We know they’re busy, but it’s imperative that you remain linked as a caregiver,” he says.

For those caregivers seeking resources to take care of their loved one at home, call ACL’s Eldercare Locator, recommends Robertson. It’s toll-free 1-800-677-1116.

During this COVID-19 emergency FTC’s Daniel Kaufman warned that you will see “unscrupulous marketers” trying to take advantage of senior’s fears by selling them bogus treatments. In early March, he told the listeners that the FTC and the U.S. Food and Drug Administration (FDA) sent out warning letters to seven companies that were claiming products (such as cheese, essential oils and colloidal silver) could treat or prevent the coronavirus. He quipped, these companies are not making these claims anymore and urged seniors to report any scams they come across by going to ftc.gov/complaint.

Kaufman says that seniors can also go to ftc.gov/coronavirus or just go to ftc.gov to see a very prominent link for coronavirus scams. If you want to receive consumer alerts directly from the FTC, you can go to ftc.gov/subscribe.

Skyrocketing of COVID-19 Related Scams

According to Kaufman, FTC is seeing an increase in scams, from phishing emails, charity and stock scams, to robocalls selling cleaning supplies and masks.

“We are seeing a lot of bogus emails that are going out to consumers, that use headers about coronavirus to get people to open them. You know, these are fake emails that are purporting to come from legitimate and important organizations like the World Health Organization or the CDC,” says Kaufman. “Don’t click on links when you get those emails. Don’t open those emails. They will download viruses or be harmful to software onto your computer, or they will try to get your private information or credit card information,” he adds.

Watch out for charity scams, too, warns Kaufman. “You know, this is a difficult time and we all want to help. But we want to make sure we’re helping charities and not scammers who are pretending to be charities, he says, suggesting that you do your homework to protect your pocketbooks.

With COVID-19 spreading across the nation you are now seeing more robocalls touting products and services to protect you from being exposed to virus. “Just hang up. Keep in mind that anyone who’s robocalling you, if they’re trying to sell you a product, they’re already doing something that’s unlawful,” he says.

Kaufman also recommends that seniors use a credit card when purchasing products, whether it’s cleaning supplies or masks, on websites. “It’s pretty easy to set up a website that’s purporting to provide, to sell these kinds of products. And they’re taking consumers’ payment information but not delivering, he notes.

Finally, Kaufman urges seniors to watch out for watch out for fraudsters who are touting that a certain company’s stock that is certainly going to explode because they have products that can treat coronavirus. Don’t fall for this stock scam and buy this stock.

For the latest coronavirus news and advice, go to http://www.AARP.org/coronavirus.

To see transcript, go to http://www.aarp.org/health/conditions-treatments/info-2020/tele-town-hall-coronavirus-03-19.html.