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Vaccine clinics could suffer if county forced to take over nursing home efforts

Modesto Bee - 1/22/2021

Jan. 20—Stanislaus County officials said a federal government program is not getting coronavirus vaccine to residents and employees in long-term care facilities quickly enough.

The county is urging the federal government and its program partners, Omnicare CVS and Walgreens, to speed up the vaccinations for this vulnerable population.

If that is not done, it could mean a shift in county energy and resources to long-term care facilities, taking resources away from community vaccine clinics, two top county officials said.

"It should have been taken care of already," Supervisor Terry Withrow said Tuesday.

County Chief Executive Officer Jody Hayes said officials talked with Rep. Josh Harder's office about the sluggish rollout of the vaccine program for care facilities. Harder said he's trying to get answers from federal agencies including the Department of Health and Human Services and the Federal Emergency Management Agency.

"We are doing everything we can to draw attention to this," Hayes said, stressing that the federal government needs to fulfill its commitment.

In an agreement with the Trump administration, CVS and Walgreens are responsible for COVID-19 vaccinations at tens of thousands of care facilities in the 50 states from Alabama to Wyoming. In California, the process began in December. The pharmacies report they've administered vaccine doses to 145,200 residents and staff at facilities, though most of that's been in nursing homes.

The pharmacies' vaccination clinics have reached about 2,000 of 16,380 assisted living and other facilities in the state, according to their data.

Hayes said only 30 of about 250 long-term care facilities in Stanislaus County have received visits for administering the first of two vaccine doses. Another 20 facilities are scheduled for visits from the vaccination teams in the next two weeks.

"That leaves almost 200 facilities that don't have a date with CVS or Walgreens," Hayes said.

If the problem is not addressed this week, the CEO said, the county will have to decide whether to devote its own resources to the vulnerable people in care facilities.

Separately, the county is working on resuming COVID-19 vaccinations at community clinics later this week. It has not made any decision on including long-term facilities in its vaccination program.

"It has been frustrating to say the least," said Lonny Davis, owner of Davis Guest Homes, which has eight residential facilities for adults who have chronic mental illness.

Davis said he began preparing the paperwork after a Dec. 7 letter from the state saying vaccine visits would be scheduled. His largest facility is set for a first round of coronavirus vaccine Wednesday. Monday, he had no idea when a remaining 171 residents at his facilities will have an appointment for the first shots.

Harder criticizes national vaccine rollout

Harder, D-Turlock, said Tuesday the vaccine rollout for long-term care facilities has been too slow nationally.

Harder sent a letter to the Department of Health and Human Services on Tuesday and hopes to get a better idea of the timeline for vaccinations at these facilities.

He's also reaching out to incoming President Joe Biden's team during the transition to a new administration and cabinet. Biden has set a goal of 100 million vaccinations in the first 100 days of his presidency.

"Until we get this pandemic under control, these vaccinations can be life and death for the most vulnerable people in our community," Harder said. "What is unforgivable is facilities have not even received a timeline for when they will be getting the vaccine."

Pharmacies say they're making progress

A CVS spokesperson suggested the program is getting a bad rap. The pharmacy is on pace to complete the first round of vaccinations at almost 500 nursing homes on its list in California, which will satisfy an agreement with the Centers for Disease Control and Prevention.

CVS and Walgreens both report vaccination data, showing they've administered a combined 81,280 doses at 823 nursing homes in California.

The state has 1,230 licensed nursing homes. Los Angeles took on the responsibility of vaccinations for nursing homes in that sprawling county.

CVS didn't have data broken down by county or a direct explanation for the delays in Stanislaus County. In a statement Tuesday, CVS said the state authorized vaccinations to begin at nursing homes Dec 28, followed by assisted living and other long-term care facilities Jan. 11.

"We have vaccinated over 1,900 long-term care facilities, reaching more than 106,800 residents and staff," CVS said. "This next week we're vaccinating nearly 3,300 facilities, including wrapping up first doses for skilled-nursing facilities by Jan. 25."

The statement added: "We continue to work closely with our partner facilities on scheduling and remain on track to meet our program commitments."

Walgreens spokesperson Jessica Masuga said all long-term care facilities that have contracted with Walgreens have been contacted and have their first-dose clinic scheduled. "We've completed all the first doses at skilled nursing facilities," she said. "We've begun vaccinating at all other facilities, which will be completed over the next several weeks."

Facility owners like Davis want to see more action locally. Davis said it appears to him the drugstore chains bit off more than they can chew.

Isolated residents need the vaccine

Davis Guest Homes has mostly avoided outbreaks, but the virus did take hold in a small residential facility, infecting eight of the nine residents. "It is disheartening because these residential care facilities are like petri dishes," Davis said.

Residents of the Modesto-area facilities have been self-isolated for more than nine months and are looking forward to the protection afforded by vaccine, Davis said.

Davis said he has received confirmation that his documentation is complete and has given the program multiple dates for coming in to administer shots. But "here we sit."

The owner said his nursing staff could administer the shots in a short period of time if vaccine was made available.

As of December, almost 1,100 nursing home residents had been infected with the coronavirus since the virus emerged in the county in March 2020, with 134 deaths attributed to COVID-19.

If the county were to focus on long-term care facilities, it would run into the same requirements of consent forms for residents and record-keeping, which can cause delays.

Withrow and Hayes, the county CEO, said it would take county personnel and resources away from operating community clinics for eligible groups.

The community clinics have been heralded as a lifesaver for people 65 and older. When the county postponed clinics this week — over a state alert regarding a lot of Moderna vaccine — some people worried they may be deprived of their second dose if clinics don't resume.

"If we divert our assets to (long-term care) facilities, we will have to see how it affects our clinics," Withrow said. "We would have to figure out a way to make it work."


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