One long-term care sector advocate on Monday likened securing COVID, RSV and flu vaccines to a survivalist book and movie series, even as the White House says it is making a push to boost coverage rates among seniors.
“In New Hampshire, it’s clear that the Biden administration has abandoned nursing home residents when it comes to COVID-19 vaccine access,” Brendan Williams, president of the New Hampshire Health Care Association, told McKnight’s Long-Term Care News on Monday.
Williams’ comments came in response to an in-person meeting hosted by the White House last Wednesday with little fanfare. It included national long-term care advocates and a host of administration heavyweights such as Secretary of Health and Human Services Xavier Becerra; Maj. Gen. (ret) Paul Friedrichs, MD, director of pandemic preparedness and response policy for the White House; and Jonathan Blum, principal deputy administrator for the Centers for Medicare & Medicaid Services.
“The dialogue focused on efforts to partner to increase vaccination uptake in long-term care settings during the fall and winter respiratory virus season, particularly given the shift of COVID-19 vaccines to the commercial market,” the White House stated in a meeting summary issued late in the day Friday. “In the meeting, participants discussed operational challenges they are facing, including workforce shortages and opportunities to improve communication about access to Federal resources. They also highlighted successes and challenges during the initial phase of the transition of COVID-19 vaccines to the commercial market.”
The White House readout of the meeting did not list participants other than government officials, though LeadingAge confirmed its attendance.
Ruth Katz, LeadingAge’s senior vice president for policy and advocacy, and Janine Finck-Boyle, vice president of health policy, discussed the high cost of vaccine clinics for facilities, which can run as high as $1,000.
“We were glad to hear administration officials assure us that COVID vaccine supply is more than sufficient,” Katz said in a statement provided to McKnight’s on Monday. “Still, we shared with them that to date, we’ve heard of inconsistency in vaccine availability and access around the country. … What’s more, we’ve heard of confusion between pharmacy partners, providers and the CMS itself on payment coverage and process details.”
According to Williams, many providers are facing major vaccine administration challenges because the White House has been unsupportive of efforts in nursing homes to get vaccines into the arms of residents.
“As chaotic as the Trump administration response to the pandemic was, it at least set up a program that worked really well,” Williams said, referring to the Pharmacy Partnership for Long-Term Care Program. “Yet here we are, over three years into the pandemic, with a president that regularly demagogues about COVID-19 deaths to justify an unfunded staffing mandate, and we’re playing ‘The Hunger Games’ in trying to access vaccines.”
Williams recently told WMUR, a New Hampshire ABC affiliate, that the pharmacies through which facilities order vaccines are short on supplies. One facility ordered 100 shots in late September but was able to get only 20, while some nursing homes are suggesting that family members take residents to off-site clinics or pharmacies, he said.
One challenge is that Medicare covers the cost of the vaccine but not providers’ costs, such as billing and administering vaccines. The American Health Care Association recently announced a new tool to help providers maximize reimbursement and cover the costs of providing vaccines.
In December 2022, the White House announced an initiative called “All Hands on Deck” to increase booster shots among seniors. One of the significant changes made at that time was to allow facility staff to administer the shots. Katz’s statement noted that LeadingAge members “outperformed all other groups in resident update.” From the program’s announcement through February 2023, 65% of LeadingAge members reported residents being up-to-date with vaccines and boosters compared to 51% of all nursing homes.
Things have changed, though.
Katz’s statement said that miscommunication between federal and state governments and providers is causing unnecessary delays in getting the vaccines to nursing homes. In the meeting, she and Finck-Boyle advised that CDC, HHS, and CMS need to prioritize vaccines for facilities, identify areas where there is limited access, and be clear on who can administer the shots and how providers will be reimbursed.
“Nursing homes must not be made the scapegoats for logistical, supply chain or other bureaucratic problems,” Katz said. “Older Americans living in nursing homes in every corner of this country deserve reliable access to the vaccinations they need to stay safe.”
