Reducing Barriers to COVID-19 Vaccination: Sub-Provider Agreements

 

To: Residential Care Facilities (nursing homes, assisted living facilities, group homes and intermediate care facilities)   From: CDPHE Residential Care Strike Team and CDPHE Immunization Branch   Body of message:   January 10, 2023,   Dear long-term care partners,   On December 16, 2022, Centers for Disease Control and Prevention (CDC), the U.S. Department of Health and Human Services (HHS), and other partner organizations announced a national effort aimed at reducing barriers to COVID-19 vaccination for residents of long-term care facilities (LTCFs) by providing flexibilities in vaccine administration, increasing communications, and encouraging jurisdictions to use “strike teams” for intensive facility-level efforts. Specific actions under this national initiative include:  COVID-19 vaccine sub-provider agreements allowing LTCFs that are not directly enrolled as providers in the CDC COVID-19 Vaccination Program to access COVID-19 vaccine doses through enrolled pharmacy providers for direct administration by the LTCFs to their residents and staff. See Long Term Care Facilities Enrolling in CDC COVID-19 Vaccination Program | CDC for more information.  Use of single-dose vials: HHS approved the use of single-dose vials of Pfizer COVID-19 vaccine for enrolled LTC pharmacy partners in order to improve access.  Even though HHS is granting a 90-day temporary waiver of data reporting requirements to the state/local immunization information system (IIS), this waiver is not available in Colorado. That’s because Colorado law requires immunizing providers to report all doses administered to the Colorado Immunization Information System (CIIS).   The Colorado Department of Public Health and Environment (CDPHE) has many resources to ensure the success of LTCFs across the state. Read this letter in its entirety to learn how CDPHE can help your facility be successful in protecting your residents and staff from COVID-19.     Educational sessions tailored to LTCFs   CDPHE’s Immunization branch created just-in-time virtual educational sessions that complement existing resources to assist your facilities as you prepare to administer COVID-19 vaccines. Topics include: vaccine storage and handling, temperature excursions, vaccine administration, and reporting to CIIS. To request an educational session for your LTCF, email cdphe_covidvax@state.co.us.    Storage and handling supplies Implementing best practices for vaccine storage and handling is key to ensuring that every dose given is viable and effective. Storing vaccines in pharmaceutical-grade storage units and monitoring temperatures with a certified, calibrated continuous temperature monitoring device or digital data logger (DDL) are best practices for all vaccines. CDPHE can reimburse the purchase of an approved pharmaceutical-grade storage unit and provide free DDLs to facilities that enroll as a CDC sub-provider or as a Colorado COVID-19 vaccine provider.   ●    Pharmaceutical storage unit reimbursement CDPHE offers enrolled COVID-19 vaccine providers a total reimbursement of up to $3,500 to cover the cost of an approved, new pharmaceutical-grade refrigerator. Review the COVID-19 Vaccine Storage Unit Reimbursement Policy for additional information and email the COVID-19 Vaccine Program at cdphe_covidvax@state.co.us for additional information.    ●    Free digital data loggers All units that store COVID-19 vaccines must be monitored with a calibrated DDL that has a buffered probe and the ability to record and store temperature data. If your current data logger does not have the ability to record, store, and print a report of all temperature readings, complete the COVID-19 Program Supply Order Request Form. CDPHE will mail you a compliant data logger, free of charge, to install in your unit immediately upon receipt. The data loggers provided will be a VFC400 or a TRED30-16R model. Order one DDL for each storage unit that will hold COVID- 19 vaccine. If you have any questions about completing the request form, email the COVID-19 Vaccination Program at cdphe_covidvax@state.co.us.   Vaccine data reporting in CIIS All vaccine doses administered must be reported in CIIS within 14 days for manual reporters or within 7 days for electronic reporters to prevent over-vaccination of patients and to assure patient safety if any issues are identified with particular vaccine lot numbers. In addition, all immunizing providers are required by law to report patient-level immunization data to CIIS per §25-4-2403, C.R.S.   There are several ways that a LTCF can report doses administered to CIIS, as required by statute.   ●    Manual entry ○     IZ Quick Add - This is a process by which you can upload information about vaccines administered for multiple patients during a larger clinic within CIIS. The doses are then processed overnight and reflected on patient records in CIIS the next day. ○     Individual Patient - This is a process that you will follow if you are manually reporting a vaccine administered to a patient directly into the CIIS web application one at a time. ○     Historical Entry - This is a process you will follow if you have to add a historical vaccine not given by your facility or for which administrative information like lot number, body site, etc. do not exist to a patient’s record in CIIS.   ●    Electronic reporting ○     Option #1: Develop an electronic interface Organizations using an Electronic Health Record (EHR) that do not currently have an electronic interface with CIIS may be able to develop an electronic interface to report data to CIIS. If you are interested in electronically reporting data to CIIS, email Kim Gulliver at kim.gulliver@state.co.us. ○     Option #2: PrepMod system PrepMod is a mass vaccination scheduling and vaccine administration system that allows staff to set up virtual clinics and track all vaccines administered. Vaccine administration data entered into this system gets sent electronically to CIIS. There is no cost to use it. If you are interested in using this system, email the PrepMod Help Desk at cdphe_prepmod@state.co.us or complete the PrepMod Interest Form. ●    CIIS notification and opt-out requirements CIIS is an opt-out system, which means that patients have the right to not have their immunization information displayed in CIIS. Any organization reporting vaccination information to CIIS is required to have a notification method in place and understand the opt-out procedure. More information is available at the links below. ●    CIIS Notification Information ●    Opt-Out Information If you need assistance with any of the resources above, email the Colorado Immunization Information System Help Desk at cdphe.ciis@state.co.us.   Reminder: Vaccine data reporting in NHSN and EMResource CMS-certified nursing homes are required to report resident and staff vaccination data to CDC’s National Healthcare Safety Network (NHSN) each week. More information related to this reporting can be found at LTCF | Weekly HCP & Resident COVID-19 Vaccination |NHSN | CDC.   Public Health Order 20-20 sets requirements for long-term and residential care facilities to prevent the spread of COVID-19. It requires these facilities to provide COVID-19 testing and vaccinations for their staff and residents. It also requires facilities to make and maintain COVID-19 prevention and response plans. Additionally, the order requires facilities to submit data to CDPHE about their capacity, staffing, personal protective equipment, and other information. Facilities are still required to report all resident and staff COVID-19 vaccine doses to CDPHE through the Juvare/EMResource reporting system. Here’s how: ●    Juvare/EMResource reporting periods are twice monthly. ●    The first report shall occur during the reporting period one, which is defined as the first (1st) day through the fourteenth (14th) day of the month. ●    The second report shall occur during the reporting period two, which is defined as the fifteenth (15th) day through the last day of the month. ●    Multiple reports received during a reporting period shall be counted for that reporting period only. ●    However, facilities are required to report resident and staff vaccine doses into Juvare/EMResource when changes occur and as soon as possible after vaccine doses are completed. ○     The EMResource Access form can be completed here for first- time users in EMResource or for access changes for current users (complete one form for each team member that needs access). ○     Login through the EMResource login page. ○     Retrieve your username. ○     Reset your account password. ○     Training/support materials by facility type is outlined in the EMResource Guidance Document. ○     Access EMResource through Google Chrome and a computer (non-mobile device), if possible. EMResource questions? Email residentialcarestriketeam@state.co.us.