AHCA/NCAL Urge Administration to Consider Implications of Vaccination Policy

Mary Madison, RN, RAC-CT, CDP 
Clinical Consultant – Briggs Healthcare

On Friday, August 20, 2021, AHCA/NCAL sent this letter to the Secretary of Health and Human Services – Xavier Becerra and the Administrator of CMS – Chiquita Brooks-LaSure.  The letter, signed by Mark Parkinson (President and CEO of the organization) speaks to the mandating of COVID-19 vaccination in SNFs.

The letter provided important background information as well as suggestions for working together.  Here are those suggestions (bolding added by me for emphasis on key points):

1. The President’s order should include a vaccine mandate for all health care workers in all Medicare and Medicaid certified settings. This is the only way to prevent nursing facility employees from leaving to work in other settings such as hospitals or home health.

2. More education must take place to provide information to vaccine hesitant staff. We worked with the CDC on a digital media campaign that targeted facilities and we had success in increasing vaccination rates. Individuals who saw our advertising reported they were more likely to get vaccinated after watching or reading the ads.  Unfortunately, there was only $1 million allocated for that campaign, and we quickly exhausted the funds. We ask that the Administration, either with us or on its own, dedicate $25 million to restart and expand this effort.

3. There should be a federally funded daily testing alternative for staff that won’t take the vaccine. This will give the education efforts time to work and prevent a sudden departure of large numbers of staff. We realize and would support this option being time limited. Currently 16 states and the District of Columbia have implemented vaccine mandates for some or all health care workers. Of these, eight (Delaware, D.C, Hawaii, Maryland, Mississippi, Oregon, Pennsylvania, and Rhode Island) include regular testing for unvaccinated staff as a provision of their mandate.

4. Providers will incur significant expense in agency staff once this policy goes into effect. We encourage the Administration to set aside $3 billion from the Provider Relief Fund to cover the cost of implementing this program including use of agency staff, recruiting replacement staff as well as the cost of testing staff. This could either be in the form of a direct payment on a per bed basis at the start of the program, or an application process with funds set aside to cover these costs.

5. We continue to urge HRSA to open the portal for the additional Provider Relief Funds, both in the general fund and the rural fund. The sector is in crisis and the time to open these funds is now.

6. CMS should modify its visitation guidance to allow providers to ask visitors about their vaccination and test results and require vaccination or negative tests prior to visits. This should also apply to federal and state survey inspectors and ombudsman. The letter is very well-written and speaks to the need for assistance in combating the spread of COVID-19 through vaccination or a reasonable and safe alternative.  I agree with all 6 points, especially #1, #3 and #6.  Involving all healthcare workers, survey teams and ombudsmen as well as visitors to LTC facilities in this mandate is the only way to accomplish the goal at hand.  All of us have a responsibility to protect U.S. citizens in every state.  As I’ve said before in my blogs, our lives depend on us doing the right things to prevent/control infection.  This is a team project that includes all healthcare entities, all healthcare workers, the President and Vice-President as well as Mr. Becerra, Ms. Brooks-LaSure and their teams at HHS and CMS.  We’re all in this together!