OPWDD Emergency Meeting with Provider Association
Following the press conference, OPWDD convened an emergency meeting with the Provider Association to discuss the news. OPWDD leadership was joined by representatives from the Governor's Office, including Assistant Secretary for Human Services and Mental Hygiene, Kerri Neifeld and Assistant Secretary of Health, Megan Baldwin. A summary of the meeting follows.
Vaccine Distribution and Availability
People living in any type of OPWDD residence and the staff that support them will be included "Phase 1A" of the distribution plan being developed by The New York State Department of Health (DOH). A key component of this plan involves matching OPWDD residential programs with appropriate vaccine administration sites, such as hospitals or local health centers. Reportedly, individuals and staff in Supervised and Supportive Individualized Residential Alternatives (IRAs), Intermediate Care Facilities (ICFs) or Family Care Homes must receive their vaccine at the designated administration site. DOH will work with OPWDD to maximize distribution, and with The New York City Department of Health and Mental Hygiene (NYCDOHMH) to ensure priority populations are identified across the state. OWPDD and DOH are discussing the potential for broadening the population included in Phase 1A with State Commissioner of Health, Howard Zucker.
Ms. Neifeld noted that DOH is cognizant of individuals who do not reside in certified residential programs. Discussions about how to prioritize vaccination of that population are ongoing. The goal is to get as many people vaccinated as possible. DOH has not developed a clinical profile to help providers prioritize the distribution of the vaccine to people supported, and will not be issuing guidance on sub-prioritizing the population.
Phase 1A does not have a set duration and will continue until everyone included in Phase 1A is vaccinated. The rate of vaccination, uptake, and number of doses available will be important in determining the spacing between Phase 1A and Phase 1B. Most critically, there must be adequate supply available to successfully transition to Phase 1B.
Pfizer received Emergency Use Authorization (EAU) recommendation from the Food and Drug Administration (FDA) committee yesterday, and the full FDA is set to review the recommendation soon. Once EUA approval is granted, the vaccines can be distributed. Another committee meeting is scheduled December 16 to review Moderna's EAU request. Distribution of the Moderna vaccine is anticipated to begin December 21 at the earliest. It is important to note that the EUA does not permit administration of the vaccine to people under the age of 16.
The number of available doses is still being finalized. Weekly vaccine orders are planned, with reorder amounts and future prioritization based on uptake. To maintain prioritization, it is important that the value of vaccination is communicated, and efforts are made to ensure everyone who wants to be vaccinated is identified and supported in that process.
The Pharmacy Partnership for Long-term Care (LTC) Program
414 licensed homes are eligible for the Pharmacy Partnership for Long-term Care (LTC) Program. The Centers for Disease Control and Prevention is partnering with CVS, Walgreens, and a few other pharmacies to offer COVID-19 vaccination services. The Pfizer vaccine will be part of the program. Certified residences were identified as eligible based on serving a majority population of age 65 or older. Notifications to eligible certified residences has not yet occurred. The federal government will be matching pharmacies to the eligible homes over the next two weeks. Providers should expect to be contacted by pharmacies seeking information on resident and employee counts. This information will be critical to ensure adequate vaccine supply is available. Additionally, free clinics will be made available for eligible providers within the program. Ms. Baldwin stated that they recently conducted a presentation with nursing homes detailing the program. We requested the slide deck and will share in a future update.
DOH recognizes the challenges surrounding consent. Vaccine administration cannot be mandated under an EUA. Informed consent must be obtained prior to administering a COVID-19 vaccine. DOH is finalizing a standardized informed consent form that will be made available at all Point of Dispensing (POD) locations. The department is awaiting the FDA's EUA approval and the vaccine fact sheet that will accompany the informed consent form. Once the form is finalized it will be circulated so providers can familiarize themselves with its function and content.
The current plan is to have electronic consent forms available at vaccination sites. DOH recognizes that, while this process will be convenient for staff, it may be difficult for people supported, especially those who need someone else to provide consent. This process remains under discussion, and additional information will be shared when available.
OPWDD is exploring the Title 14 Part 633.11 regulations
to determine who can provide consent under professional medical treatment. That regulation provides a variety of options for people who can step in absent a consent provider. OPWDD is aware of the concern about individuals for whom consent needs to go through the Surrogate Decision-Making Committee (SDMC). SDMC is a small program and lengthy process. OPWDD is considering alternate approaches, including filing emergency regulations amending Part 633.11. Leveraging the existing Informed Consent Committee (ICC) option
already authorized within regulation was discussed. OPWDD envisions the composition would include the same flexibilities that 633.16 currently allows. OPWDD will continue to discuss options to support vaccination of this population over the next week and provide additional updates.
It was recommended that providers reach out to their members to alert them the vaccine is forthcoming, informed consent is necessary, and support in the process will be provided. This is particularly important for those providers who are eligible for the Pharmacy Partnership for Long-term Care (LTC) Program.
Local Health Departments (LHD) have been made aware of the number of people residing in the residential programs within their area. However, their role in the vaccination process is primarily as a partner in reporting. Vaccine distribution is a state exercise, independent of LHD involvement.
OPWDD is developing a reporting mechanism that leverages the Incident Reporting Management Application (IRMA). It will be important to know who was vaccinated and where vaccination occurred. OPWDD recognized the importance of keeping the reporting process simple, given the existing reporting requirements.
Advocacy Efforts & Success
The Arc New York has been advocating for vaccine prioritization on the state and federal level since early September. In addition to ongoing advocacy with OPWDD and DOH, President Jack Kowalcyzk submitted a letter to Governor Cuomo
and other state leaders this week, and advocates from The Arc New York family sent more than 3,300 letters to elected officials calling for all New Yorkers with I/DD living in residential settings and the staff who support them to be prioritized in Phase 1A of New York's vaccination plan.
This advocacy work was largely informed by the collaborative data project undertaken in partnership with Syracuse University and New York Disability Advocates to collect and analyze weekly COVID-19 data from voluntary I/DD providers, including all Chapters of The Arc New York, since March 2020. The resulting studies published by Syracuse University and the Lerner Institute clearly demonstrated the heightened risk of COVID-19 for people with I/DD living in residential programs, and called for appropriate resources and response to protect these high-risk individuals.
Most recently, Dr. Scott Landes from Syracuse University joined three colleagues in submitting public comments to the ACIP, specifically citing the need for vaccine prioritization for the I/DD population and referencing the papers drawn from our data project.
In his conclusion, Dr. Landes stated " . . . evidence is clear that people with IDD are experiencing disproportionate severe COVID-19 outcomes and this population should be taken into account as the ACIP determines the allocation of COVID-19 vaccination. . . . We ask that the committee consider prioritizing all people with IDD for the COVID-19 vaccine."
The full studies and associated coverage of the data project can be found here
We thank all Chapters of The Arc New York for your diligence and dedication in providing this information week after week. Your weekly data has served as an influential advocacy tool, and our success in securing Phase 1 vaccines for the people we support is a definitive result of those efforts.
We will discuss this positive news and the next steps in the process at our weekly Wednesday meeting with the Executive Directors.
Thank you for your continued support and collaboration as we navigate the COVID-19 public health emergency.