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December 24, 2020

A short one today - we wish you a Merry Christmas!

CDC Vaccine Toolkit; Ohio Discussion. 'Tis the season to release toolkits directed at overcoming COVID-19 vaccine hesitancy. First we saw AHCA/NCAL's toolkit. Today we highlight a toolkit from the Centers for Disease Control and Prevention (CDC). The CDC materials include separate sections on preparing staff and residents for vaccination, vaccine safety monitoring and reporting, frequently-asked questions, and additional resources. Nothing is more important at this stage of the battle against COVID-19 than educating staff and residents about being vaccinated. Anecdotally, we hear members are achieving vaccination rates of around 90% of residents but only 30-50% of staff. We recommend reviewing both toolkits, as well as other materials that are available, for ideas to help improve vaccination rates.

A group of SNF operators, including several members of the OHCA Board of Directors, spoke this morning with Governor Mike DeWine and other state officials on the same topic. Governor DeWine's concern, like ours, is the low rate of vaccine uptake among facility staff members. He asked for ideas from the operators. A hearty discussion ensued, with the main areas of agreement being the following:

  • The vaccination rate for residents is even more important than for staff because it is residents who we primarily seek to protect. The uptake among residents is much better than with staff, but the state needs to define an effective approach for vaccinating new admissions after the pharmacy program ends.
  • Facilities need to prepare extensively for the educational effort and need to devote the time necessary to address people's concerns individually. Short videos and peer-to-peer communications are most effective, particularly from peers who choose to be vaccinated. The wording should be about becoming immune and the benefits of immunity, not about getting vaccinated, which can be fear-inducing.
  • The second clinic is critically important because it is the last chance for staff members and residents to participate in the Pharmacy Partnership for Long-Term Care, if they chose not to be vaccinated at the first clinic. Providers should redouble their efforts to educate hesitant individuals in the lead-up to the second clinic.
  • There were mixed opinions among providers about the value of monetary incentives, but everyone agreed that reducing testing based on vaccination would be a powerful motivator. Most of the providers were not in favor of a state vaccination mandate, nor was Governor DeWine.

OPHAS Map a Mixed Bag. As usual on Thursday, the state unveiled an updated Ohio Public Health Advisory System (OPHAS) map. The good news is there no longer are any purple counties. The bad news is everywhere in Ohio is red except for four Applachian counties. While OPHAS is irrelevant for SNF testing and visitation, which are controlled by the latest Department of Aging guidelines and the Centers for Medicare and Medicaid Services positivity rates, respectively, it is a consideration for assisted living communities and ICFs/IID relative to whether to allow visitation.

Stimulus Impasse Continues. The way forward for Congress' bipartisan stimulus/government funding bill remains murky following President Donald Trump's surprising rejection of the measure. Today Congress sent the massive bill to the President at his Mar-A-Lago resort, but there is no indication if he will sign it or veto it. House Democrats attempted to amend the bill today to increase the individual stimulus payments from the $600 level in the legislation to the $2,000 amount President Trump demanded. House Republicans nixed that plan and instead proposed reducing foreign aid spending, which the President also decried.