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December 19, 2020


Moderna COVID-19 Vaccine Receives EUA. Late yesterday, the Food and Drug Adminstration (FDA) awarded an Emergency Use Authorization (EUA) to Moderna for its COVID-19 vaccine, following the recommendation of the Vaccine and Related Biologicals Advisory Committee. See FDA's release on this topic, the EUA itself, and the accompanying fact sheet on the Moderna vaccine. Today, the Advisory Committee on Immunization Practices (ACIP) is considering recommending the vaccine for use, which recommendation goes to the Centers for Disease Control and Prevention. ACIP also has on its agenda, for tomorrow, allocation of vaccine supplies to Phases 1B and 1C.

Vaccination Delay for Non-Skilled Settings. Late yesterday, we learned from members that they were notified of delays in their Pharmacy Partnership for Long-Term Care Clinic (PPLTC) clinic dates. Unlike earlier postponements members have reported, this one apparently relates to the Part A/Part B distinction that we reported on Tuesday. Part A of PPLTC, as explained that day by the Health Department's Lance Himes, consists of SNFs enrolled in the program, while Part B is all other enrolled congregate settings. Mr. Himes explained that only Part A was activated, which meant the initial shipment of Pfizer/BioNTech vaccine would go to Part A enrollees only. It seems, however, there was a communication problem with the partner pharmacies, as they scheduled a number of Part B providers for the coming two weeks. This led to the unfortunate need to postpone clinics, although pharmacy staffing concerns also may have contributed in some cases.

As CVS explained to providers scheduled with them:

As I am sure you are aware, the State of Ohio recently adjusted their Pharmacy Partnership program from an all-inclusive Long-Term Care facility program to one that is now prioritizing the Skilled Nursing Facility segment. This has the potential to impact you in four different ways:

  1. Non-skilled customers that have partnered with CVS Health and have clinic dates already scheduled: Your clinics have been postponed. Rescheduling of those clinics will be determined based on the state's reactivation of the non-skilled nursing segment.
  2. Non-skilled nursing facility customers that have partnered with CVS Health and are waiting for clinics to be scheduled will experience delays of clinic dates until reactivation by the state.
  3. Long-Term Care facilities that provide services to skilled nursing patients and senior living residents and have clinic dates already scheduled should adjust vaccination expectations for upcoming clinics to assume that clinics will vaccinate only skilled nursing patients and staff. Additional clinics will be scheduled with non-skilled residents upon state activation.  
  4. Long-Term Care facilities that provide services to skilled nursing patients and senior living residents and are awaiting clinic dates should adjust vaccination expectations for upcoming clinics to assume that clinics will vaccinate only skilled nursing patients and staff. Additional clinics will be scheduled with non-skilled residents upon state activation.  

We apologize for any inconvenience this may cause and appreciate your partnership with CVS Health. For any questions related to the state activation plans please contact the Ohio Department of Health.

OHCA too regrets the disappointment that the delay is causing for those of you who are affected (primarily assisted living and ID/DD members). While it is understandable that early vaccine shipments are limited and not all providers can receive vaccinations immediately, we know the problem is compounded when your expectations are raised and then dashed.

Assisted Living Indeed Going to Weekly Testing (At Least). In yesterday's Assisted Living News Bites, we reported that the Department of Aging (ODA) released a new assisted living testing survey that offered new options for state support and suggested that the testing cadence is increasing from bi-weekly to weekly. ODA's notice for the survey, however, was not clear on this point and seemed to presuppose new testing guidelines that have not appeared. Director Ursel McElroy clarified last night that the testing in fact is moving at least to weekly - and perhaps to twice a week - and apologized that the guidance was not out before the survey. She also confirmed that MAKO will continue to do all laboratory testing for assisted living, but an antigen testing option will be added. Another unclear aspect of the survey is what happens when an assisted living community on a shared campus opts for testing alignment with the co-located SNF. Director McElroy explained that this selection will result in the SNF being assigned to MAKO along with the assisted living, but it will not result in the assisted living going to the SNF's testing frequency.

DD Waiver Funding Amendment Clears General Assembly. Yesterday, the Senate unanimously adopted the conference report on Senate Bill 310, which includes an amendment giving the Department of Developmental Disabilities the necessary spending authority to make another one-time Medicaid payment to waiver providers. The House of Representatives accepted the conference report on Thursday, so the measure is on its way to Governor Mike DeWine for signature. The next step in securing the added funding, which the county boards made possible by contributing all of the state match, is for the state to submit an Appendix K request to the Centers for Medicare and Medicaid Services (CMS).

CMS SNF Stakeholder Call Tuesday on Vaccination. CMS scheduled a SNF stakeholder call for Tuesday, December 22, 1:00-2:00 p.m. The call will focus on vaccination and cover PPLTC, infection control considerations relating to vaccination, communication resources, and reminders for the holiday season. The call-in number is 833-614-0820 and the conference ID is 7979889.

AHCA/NCAL Vaccination Office Hours. With the Moderna EUA out, AHCA/NCAL scheduled another COVID-19 vaccination office hours session for immediately after the CMS call noted above: 2:00 p.m. on Tuesday, December 22. Please use this link to register. Recordings of recent vaccination office hours focused on preparing for the vaccination clinics and promoting high vaccination rates among residents and staff are available here.