COVID-19 UPDATE #116
December 18, 2020
COVID-19 MEDICAID RATE ADD-ONS FOR ALFs AND SNFs
We have learned that the COVID-19 Medicaid add-ons for ALFs and SNFs are being extended. The add-ons for SNFs will be $8.30/ppd. The add-ons for ALFs will be $4.79/ppd. Currently, we are being told that the add-ons will be provided through March 2021, and possibly beyond that date. Since the early days of the crisis, WHCA has worked hard to secure much-needed relief for its members. While these rate add-ons are not enough to cover the true cost of COVID-19, they are needed and appreciated.
CVS AND WALGREENS UPDATE WEBSITES WITH VACCINE CONSENT INFORMATION
As we prepare for the vaccine rollout here in Washington, many providers have been seeking written confirmation that CVS and Walgreens will accept verbal or email consent. Both CVS and Walgreens have updated their websites, forms, and FAQs to reflect they can accept verbal or email consent. Below are the links for each site to help you find the updated information.

Walgreens

The Walgreens FAQs can be confusing because they reference signed consent. What they are saying is that facility staff will have to sign to affirm they confirmed verbal or email consent.

CVS
SITE PREPARATION FOR VACCINE CLINICS
Due to a report of an anaphylactic reaction following a COVID vaccine injection, it is important for your site to be prepared. The Department of Health (DOH) is sharing Interim Considerations for Preparing for the Potential Management of Anaphylaxis at COVID-19 Vaccination Sites issued by the Centers for Disease Control and Prevention (CDC). Appropriate medical treatment for severe allergic reactions must be immediately available in the event that an acute anaphylactic reaction occurs following administration of Pfizer-BioNTech COVID-19 Vaccine.

Vaccination providers are also reminded to review, implement, and consult CDC’s Interim Clinical Considerations for Use of Pfizer-BioNTech COVID-19 Vaccine. All Advisory Committee on Immunization Practices (ACIP) recommendations related to COVID-19 vaccine can be found here. Pfizer’s Standing Orders for Administering Vaccine to Persons 16 Years of Age and Older are also a helpful tool when preparing to administer the COVID-19 vaccine.
CDC RECOMMENDS UNIVERSAL USE OF EYE PROTECTION DURING PATIENT CARE ENCOUNTERS
The Centers for Disease Control and Prevention (CDC) is recommending universal use of eye protection (face shield or goggles) and face masks during patient care encounters (updated December 14, 2020). The Department of Health (DOH) notes there have been many cases of staff-to-staff transmission, so they encourage staff to wear face shields and masks for all staff or patient encounters. The minimal transmission is generally interpreted as <25 cases per 100,000. Current Washington rate of confirmed cases is 264 per 100,000.

Healthcare personnel (HCP) working in facilities located in areas with moderate to substantial community transmission are more likely to encounter asymptomatic or pre-symptomatic patients with SARS-CoV-2 infection. If SARS-CoV-2 infection is not suspected in a patient presenting for care (based on symptom and exposure history), HCP should follow standard precautions. They should follow transmission-based precautions if there is a suspected SARS-CoV-2 diagnosis. In addition, they should also wear eye protection in addition to their facemask to ensure the eyes, nose, and mouth area are all protected from exposure to respiratory secretions during patient care encounters.
DSHS CITING LIMITED/POOR SCREENING OF STAFF AND VISITORS
Residential Care Services shared concerns observed during onsite infection control visits resulting in failed practice specific to facility screening practices. All staff and visitors entering the facility must be actively screened upon entry. Any symptoms indicative of COVID-19 must warrant the staff/visitor leave the building immediately. The screening process should occur immediately after arriving in the building and should not require the person walk through the facility to be screened.
DEAR ADMINISTRATOR LETTER ADDRESSES CLIA CERTIFICATE OF WAIVER FOR AL PROVIDERS
In a Dear Administrator letter dated December 15, 2020, assisted living providers are informed that facilities administering point-of-care (POC) testing for COVID-19 must report all their COVID-19 testing results to the Department of Health (DOH) or local health jurisdiction (LHJ). To perform SARS-CoV-2 POC testing and report patient-specific results, a facility must be a Clinical Laboratory Improvement Amendments (CLIA) certified laboratory or testing site that meets applicable regulatory requirements.

The letter explains the Washington State Medical Test Site Program is temporarily exercising enforcement discretion under the state Medical Test Site rules for SARS-CoV-2 POC testing when a facility submits a CLIA Certificate of Waiver Medical Test Site Application but has not yet been assigned a state medical test site license. The letter also provides instruction on where to email completed applications. Finally, the letter provides the following links to help providers:

Providers are encouraged to email DOH Quality Assurance or call them at (253) 395-6746 if they have questions.
ALTSA SHARES COVID-19 VACCINE INFORMATIONAL RESOURCES
There are many information resources being developed and shared to assist providers in their efforts to understand and promote the COVID-19 vaccine. In an email from Aging and Long-Term Support Administration dated December 17, 2020, the following resources are shared:

WHCA has also added a section to our COVID-19 resource page specific to the COVID-19 vaccine. WHCA will continue to post links to resources and information about the vaccine.
WA-PALTC COVID-19 VACCINE WEBINAR RECORDING NOW AVAILABLE
The Washington Society of Post-Acute and Long Term Care Medicine (WA-PALTC) hosted a webinar on December 16 focused on the COVID-19 vaccine. The information shared is both compelling and informational. If you were not able to participate during the live presentation, you may watch the recorded version of the webinar here. The webinar, COVID-19 Vaccine: How Will it Work? A Talk with the Experts, included Dr. Mike Miynt, ID Specialist at Multicare, Kathy Bay, DOH Vaccine Advisory Group, Dr. Leslie Eber, AMDA State Chapter President (Colorado), and Dr. Sabine von Preyss-Friedman, WA-PALTC, moderating. 
PROJECT ECHO NURSING HOME NETWORK FEEDBACK AND REGISTRATION
The American Health Care Association (AHCA) has partnered with Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), and Project ECHO to help with the National Nursing Home COVID-19 Action Network for Best Practices on Coronavirus Control. All skilled nursing facility providers are encouraged to participate in the 16-week virtual training and mentoring program, and the project leaders are looking for feedback from those already participating.

For those already registered, the Network would appreciate your feedback by completing this brief five-question survey. If your center is not registered, you will find more information on this free program and you can register here.
ADDITIONAL RESOURCES
WHCA continues to post resources and information as it becomes available on our website. If you have questions or need additional information, please call the WHCA office at (800) 562-6170.