Coachella Valley nursing homes sign-up to partner with pharmacies for COVID-19 vaccine
Coachella Valley skilled nursing and long-term care facilities are preparing to distribute COVID-19 vaccines to staff and residents ahead of the state's initial delivery of doses later this month.
Gov. Gavin Newsom said the state is expected to receive more than 300,000 doses of the COVID-19 vaccine in mid-December, and workers at skilled nursing facilities will be among the first to receive it.
These facilities will be able to receive the vaccine free of charge thanks to the Trump administration, which has tasked pharmacies CVS and Walgreens with distributing doses to the long-term care community.
Scott Gillis, administrator at Rancho Mirage Health and Rehabilitation, said he's now waiting for "when that big old Walgreens bus is going to pull up in our parking lot."
Gillis signed-up for the service online and, because it is nearest to his facility, selected Walgreens as a provider.
Despite his preparedness, though, Gillis still doesn't know if, when or how many of his staff will be able — or willing — to be vaccinated. "You hear different things everyday," he said. Public health officials are "the ones calling the shots, not us," he said.
Newsom has said from the beginning that the state's first round of 327,00 doses will not cover all health care workers. The governor released an updated plan Thursday for the initial phase of distribution:
- Tier 1: Health care workers with direct exposure to patients at acute care, psychiatric and correctional facility hospitals; workers at skilled nursing facilities; paramedics; and workers at dialysis centers
- Tier 2: Workers at intermediate health care facilities, in-home health workers, community health workers, public health field staff and workers at primary care clinics
- Tier 3: Workers at specialty clinics, lab workers, dental offices, and pharmacy staff not included in other tiers.
The state's initial doses are "not a whole lot when you consider health care workers in general, not just in skilled nursing facilities," Gillis said.
To put it in perspective: California's initial doses will allow for vaccinations of 163,500 people since everyone needs two doses. The first dose will be given in mid-December and the second dose will be given three weeks later, Newsom said.
The Inland Empire is included in a region of five California counties slated to receive nearly 60,000 doses of the COVID-19 vaccine in later this month, officials said Thursday. Each region will be responsible for ordering their own vaccines. How vaccine distribution will go within each region is not immediately clear.
Riverside, San Bernardino, Imperial, Inyo and Mono Counties — all part of Region 6 —will receive 59,910 doses. That means, across the five counties, just under 30,000 people will be vaccinated during the mid-December distribution — 0.6% of the region's 4.9 million residents.
Newsom's plan to prioritize skilled nursing facility workers makes sense to Gillis since, he said, it's the staff who goes out into the community, not the residents.
Across the state, health departments have reported 54,020 COVID-19 cases among health care workers and 220 virus-related deaths as of Tuesday. More than 26,000 of those health care workers who tested positive were in skilled nursing facilities.
As of Thursday, 33,279 residents of skilled nursing facilities had tested positive for the virus and 5,123 have died.
"The biggest risk is the staff, that's just the reality," Gillis said.
Whether or not his staff will actually take the vaccine, he added, is another story.
Fear of vaccination lingers for some
Even though health care workers are prioritized in the first tier of the first phase of distribution, Gillis wonders how many of them will be willing to actually take the vaccine.
In his facility, he said, there's been significant fear about the vaccine. Some are worried that the trials were rushed or the side effects may be worse than manufacturers are letting on, he said.
"I am going to get it," Gillis, who just turned 61, said. "I feel I have to lead by example. If I’m not willing to get the vaccine, how can I expect my staff to get the vaccine?"
Staff at Rancho Mirage Health and Rehab won't be required to receive the vaccine in order to continue working, but other protocols, including routine testing, will remain in place, Gillis said.
Gillis' staff isn't required to take a flu shot either, but about 98% of them do, he said.
"It’s so new, of course, it’s frightening — this whole ordeal has been frightening," he said. "I truly never thought it would get this bad."
Gillis has already started reaching out to the families of residents to see if, when the vaccine is available to them, they would want their loved ones to receive it. There's hesitation there, too, he said.
Rancho Mirage Health and Rehab has had sporadic cases of COVID-19 since March, including six staff and five residents, one of whom died of other causes.
"I think we have fared very, very well throughout this," Gillis said.
But the holidays, he said, could be a "game changer."
"My big fear is the staff outside of work, especially outside the holidays," Gillis said. They tell him that they're being careful and, he said, he has to trust them.
Staff at Rancho Mirage Health and Rehab is being tested twice a week and a quarter of the residents are tested each week, ensuring they're all tested each month.
"Things change daily," Gillis said. "I’ll just be glad when I can, truly, spend quality time with my residents again — that’s what I miss the most."
Some ready to receive vaccine
It's a different story at Caleo Bay Assisted Living and Memory Care in La Quinta, where representative Stephen Eatman said most families are excited about the prospect of being able to have close contact with their loved ones again.
"So far the response has been overwhelmingly positive," he said of the vaccine.
Not having that family interaction can be unique for residents at Caleo Bay since most have a diagnosis of dementia or Alzheimer's, and might not be able to understand what's happening or why their families aren't visiting.
"Life is fairly normal on the inside for our residents — it’s that outside interaction which is a huge missing piece," Eatman said.
Though staff wears personal protect equipment, residents aren't required to.
"We can’t just quarantine everyone, it would lead to their functional downfall," Eatman said. "That would be horrible for them."
Window visits or even socially distanced visits just aren't the same, he said. It makes working in memory care more difficult, he said, because so much depends on residents being engaged. "It's very important for us to be able to get back to having family interaction as soon as its safe,"he said.
"Not having their loved ones be able to be there, is heartbreaking every single day," Eatman added.
Even so, Eatman agrees that the most important group to be inoculated is the staff.
They go out in the community, do necessary tasks like go to the grocery store or to pick up their children, he said. Residents, on the other hand, are "in the bubble," Eatman said.
Caleo Bay is working with CVS on its vaccination plan. "What we don’t have yet is a timeline," Eatman said. "We're monitoring it closely with the rest of the world."
Pharmacies tasked with distribution
Gillis believes that, through Walgreens, his staff and residents will be administered the Pfizer/BioNTech vaccine, which is on track to being approved by the Food and Drug Administration as early as next week. Studies show it is up to 95% effective.
That vaccine, which has already been approved for emergency use in the United Kingdom, must be stored at minus 112 degrees.
"Obviously we don’t have the capability to administer the vaccine," Gillis said Wednesday.
As far as Gillis is concerned, Rancho Mirage Health and Rehabis ready. Now, he said, he's just waiting to hear from a Walgreens representative with further instructions or additional information.
Though he doesn't know exactly how the vaccinations will work, he expects that Walgreens will bring a van to the facility and, by appointment, staff and/or residents would get the vaccine just outside the building.
Eatman said he thinks it will be similar to how the flu vaccines are administered — onsite at facilities.
"No one can guarantee exactly how this is going to be distributed," Eatman said.
According to the U.S. Department of Health & Human Services, CVS and Walgreens will schedule and coordinate onsite clinic dates directly with each facility.
"It is anticipated that three total visits over approximately two months are likely to be needed to administer both doses of vaccine (if indicated) to residents and staff," the department said in October. The pharmacies will also:
- Receive and manage vaccines and associated supplies (syringes, needles and PPE)
- Ensure cold-chain management for vaccine
- Provide onsite administration of vaccine
- Report required vaccination data (including who was vaccinated, with what vaccine, and where) to the state, local or territorial, and federal public health authorities within 72 hours of administering each dose
- Adhere to all applicable Centers for Medicare & Medicaid Services (CMS) requirements for COVID-19 testing for long-term care facility staff.
The opt-in process for long-term care facilities began as early as Oct. 19, according to HHS. Facilities also have the option of requesting to use their current pharmacy contracts to support COVID-19 vaccination, the department said.
Nursing homes can sign up via the National Healthcare Safety Network and assisted living facilities can sign up via an online survey they should have already received.
USA Today and Desert Sun reporter Nicole Hayden contributed to this report.
Maria Sestito covers aging and the senior population in Coachella Valley for The Desert Sun. She is also a Report for America corps member and new to the desert. Please say "hello" via firstname.lastname@example.org or @RiaSestito