ALF Provider Welcome to the - COVID-19 Webinar with LTCR
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Welcome to the
ALF Provider
COVID-19 Webinar
with LTCR
March 10, 2021
Handout
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2
Rescheduling Essential Caregiver Visits
ALFs must accommodate essential
caregiver (EC) visits, which may not be
stopped as a result of a facility
outbreak, county positivity rates, or
facility policy.
ALFs can, with proper documentation
and communication, reschedule an EC
visit.
3
Rescheduling EC Visits
Reschedule means to change a visit time
or date. If rescheduling the date of the
visit, the visit should occur within 48 hours
unless the resident is ill with COVID.
Documentation is required if, at the
request of the facility, a visit is rescheduled
to a different date.
Communication: As soon as possible, a
facility must notify the EC and resident of
the time and/or date the visit is
rescheduled to and the reason it is
necessary.
4
Rescheduling EC Visits –
Examples
A facility experiences a new outbreak
of COVID-19 and chooses to implement
facility-wide testing. EC visits must
continue with the EC wearing full PPE
and the facility may postpone EC visits
for a short period of time during
contact tracing efforts.
5
Rescheduling EC Visits –
Examples (Continued)
The facility has a scheduled training for
a significant number of staff pulling
them away from EC visits.
The facility may work with the resident
and caregiver to reschedule the visit
for later in the day.
6
Rescheduling EC Visits –
Examples (Continued)
The facility scheduled repairs in a
resident’s room and that resident has an
EC visit scheduled while repairs are being
made.
When possible, the facility must
accommodate the visit to occur in a
different area of the facility and notify the
EC prior to the visit.
If there is no area of the facility to
accommodate an EC visit outside of the
resident’s room, a visit may be
rescheduled.
7Rescheduling EC Visits –
Examples (Continued)
The facility has a staffing shortage for
the scheduled timeframe due to staff
illnesses. Rescheduling to another date
may be the best option to consider with
the resident and EC.
Visits should resume as regularly
scheduled as soon as practical for the
facility and resident.
8CDC Guidance for Non-
Healthcare Settings
https://www.cdc.gov/coronavirus/2019
-ncov/vaccines/fully-vaccinated-
guidance.html
NOTE: The CDC recommendations
apply to non-healthcare settings.
9CDC Travel Guidance
Reminder for any staff and residents
considering travel, please review
current CDC Travel Guidance including:
• Traveling during COVID-19
• Know your Travel Risk
• After you Travel
• Travel FAQ
10CDC Travel Guidance
11Save our Seniors
• The state will make a concerted effort to
vaccinate seniors 65+ to ensure Texans
most vulnerable to the consequences of
COVID-19 are vaccinated.
• The state will work with organizations
such as Meals on Wheels and various
nursing groups to identify seniors in
need of the vaccine.
• As part of this, TDEM will focus on
identifying and registering homebound
seniors and visit homes to administer
vaccines.
https://gov.texas.gov/news/post/governor-
abbott-tdem-launch-first-week-of-save-
our-seniors-initiative-in-26-counties
12Infrastructure Workers
Essential critical infrastructure workers
must be admitted to the facility. This
includes utility workers, plumbers,
electricians, persons conducting
maintenance and repairs essential to
safety of residents.
For additional information and guidance
in identifying essential critical
infrastructure workers, please refer to
the following document:
https://www.cisa.gov/sites/default/files/publica
tions/ECIW_4.0_Guidance_on_Essential_Critica
l_Infrastructure_Workers_Final3_508_0.pdf
13Disaster Assistance Online Survey
Texans are urged to fill out the Texas
Division of Emergency Management’s State
of Texas Assessment Tool to help state and
emergency management officials identify
damages that occurred during the recent
winter storm.
Pass this survey on to family, friends and
organizations who live and operate in
counties not currently declared for federal
assistance. Click here to check your
county's status.
Texans who live in current disaster-
declared counties should apply for disaster
assistance at disasterassistance.gov.
14COVID-19 Vaccination Options
HHSC and DSHS have published Long-
term Care COVID-19 Vaccination
Options (PDF).
The resource document provides
COVID-19 vaccination options to ALFs.
• Enroll as a Texas Vaccine Provider
• Partner with Vaccine Provider
• Contact local/regional health department or
pharmacies
• Reach out to Vaccine.LTCF@dshs.texas.gov
15Monoclonal Antibody Therapy
State Infusion Hotline Now Active to
Request Monoclonal Antibodies
HHSC LTCR and DSHS want to encourage
LTC providers to contact the State Infusion
Hotline at 1-800-742-5990 to request
infusions of monoclonal antibodies and a
medical team at their facility. LTC Providers
set up to provide infusions may also
request immediate delivery of monoclonal
antibody therapeutics to the facility.
Read the letter (PDF) for details and
additional monoclonal antibody resources.
16COVID-19 Vaccination Data
Reporting Emergency Rules
Provider Letter 2021-01 COVID-19
Vaccination Reporting
§553.2004(b) Within 24 hours of
completing a round of vaccinations, an
assisted living facility must accurately
report COVID-19 vaccination data for
staff and residents to HHSC in the
format established by HHSC.
Reminder: Vaccination reporting is a
requirement.
17PL 21-01 COVID-19
Vaccination Reporting
Remember:
• Only report vaccinations occurring
onsite at the facility; do not include
vaccinations that occurred at an off-
site pharmacy, doctor’s office, local
mass vaccination clinic, etc.
• Report vaccinations administered by
the facility or a pharmacy partner.
• Do not provide cumulative numbers -
do not include totals from previous
reports in a new report.
18PL 21-01 COVID-19 Vaccination
Reporting for Staff and Residents
ALFs must report the following data to
HHSC within 24 hours of completing a
round of vaccinations:
• Total number of staff and residents
who received their first dose of a
two-dose vaccine or their only dose
of a single-dose COVID-19 vaccine.
• Total number of staff and residents
who received their second dose of a
two-dose vaccine.
19PL 21-01 COVID-19
Vaccination Reporting
Report vaccination data via Survey
Monkey tool:
• https://www.surveymonkey.com/r/SRD
M2GY
Complete the survey only when you
have information to report.
On days when no vaccines are
administered, you do not need to
complete the survey.
20COVID-19 Vaccination in Texas
DSHS vaccination dashboard:
https://tabexternal.dshs.texas.gov/t/THD/views/COVID-
19VaccineinTexasDashboard/Summary?:origin=card_share
_link&:embed=y&:isGuestRedirectFromVizportal=y
21DSHS Vaccine Resources
Updated COVID-19 Vaccine Information:
• COVID-19 Vaccine Information
• COVID-19 Vaccine Frequently Asked
Questions (FAQs)
• COVID-19 Vaccine Allocations
• COVID-19 Vaccination Hub Providers
Updated Information for COVID-19
Vaccination Providers:
• Information for COVID-19 Vaccination
Providers
• COVID-19 Vaccine Provider Frequently
Asked Questions
• COVID-19 Vaccine Provider Webinars
22Texas Vaccine Rollout
Timeline
Texas continues to receive doses of the Pfizer and
Moderna COVID-19 vaccines, and is distributing
statewide to hospitals, pharmacies, local health
departments, freestanding ERs, and other clinics.
23Who is Eligible to Get
the Vaccine Now?
School and Child Care Personnel Now
Eligible To Be Vaccinated
With the federal directive, the following
education and child care personnel are now
eligible to be vaccinated in Texas:
• Those who work in pre-primary, primary, and
secondary schools;
• Head Start and Early Head Start programs
(including teachers, staff, and bus drivers);
and
• Those who work as or for licensed child care
providers, including center-based and family
care providers.
Additional information for educators and school
staff is available in the Texas Education Agency
(TEA) K-12 COVID-19 Vaccine FAQ.
24Where to Get Vaccinated
If you’re eligible to get vaccinated now, you can
check with a large vaccination hub and/or a local
vaccine provider, like a nearby pharmacy or your
doctor.
Find Vaccine:
1. LARGE VACCINATION HUBS
2. VACCINE AVAILABILITY MAP
3. LIST OF ALL PROVIDERS
When searching for a vaccination site, remember:
• Vaccine supply is limited. Not all local providers
have vaccine each week and hubs may have long
waiting lists.
• Do not show up at a hub or provider looking for a
vaccine.
• Instead, check the provider’s website. Call only if
the website doesn’t answer your questions.
25FDA Issues Emergency Use Authorization for
Third COVID-19 Vaccine
The FDA has determined that the
Janssen COVID-19 Vaccine has met the
statutory criteria for issuance of an
EUA.
The Janssen COVID-19 Vaccine is
administered as a single dose.
The vaccine was approximately 77%
effective in preventing severe/critical
COVID-19 occurring at least 14 days
after vaccination and 85% effective in
preventing severe/critical COVID-19
occurring at least 28 days after
vaccination.
26Important to Know
Moderna and Pfizer COVID-19 vaccines both
require two doses. It’s best if you get your second
dose from the same brand as your first dose. For
example, if you got a Moderna first dose, it’s best
to get Moderna for your second dose.
27Vaccine 2nd Dose
You can give the 2nd dose up to 4 days
before the recommended 2nd dose
date. If the vaccine is given late, it
should be given as close to the
recommended 2nd dose date as
possible.
No matter how late it is, the series
does not need to be restarted.
https://www.cdc.gov/vaccines/covid-
19/info-by-product/clinical-
considerations.html
28Authorized and
Recommended Vaccines
The CDC provides information on who
is and is not recommended to receive
each vaccine and what to expect after
vaccination, as well as ingredients,
safety, and effectiveness.
Currently, three vaccines are
authorized and recommended to
prevent COVID-19:
• Pfizer
• Moderna
• Janssen
29Vaccine Allergic Reaction
The CDC provides recommendations on
what to do if you experience an allergic
reaction after getting a COVID-19
vaccination. It also provides
recommendations for people who have
had allergic reactions to other vaccines
and for those with other types of
allergies.
https://www.cdc.gov/coronavirus/2019
-ncov/vaccines/safety/allergic-
reaction.html
30Vaccine Allergic Reaction
Observation period following COVID-
19 vaccination
CDC currently recommends that persons
without contraindications to
vaccination who receive an mRNA COVID-
19 vaccine be observed after vaccination
for the following time periods:
• 30 minutes: Persons with a history of an
immediate allergic reaction of any
severity to a vaccine or injectable
therapy and persons with a history of
anaphylaxis due to any cause.
• 15 minutes: All other persons
31Vaccine Allergic Reaction
If you have had a severe allergic
reaction to any ingredient in an mRNA
COVID-19 vaccine, you should
not get either of the currently
available mRNA COVID-19
vaccines.
If you had a severe allergic reaction
after getting the first dose of an mRNA
COVID-19 vaccine, CDC
recommends that you should not
get the second dose.
32Reporting Vaccine Reactions
The Vaccine Adverse Event Reporting
System (VAERS) is co-managed by the
CDC and the FDA. VAERS accepts and
analyzes reports of adverse events
(possible side effects) following
vaccination.
Use VAERS to report adverse reactions
to the COVID vaccine, which are very
rare.
VAERS
33Vaccine Side Effects
Preliminary data from COVID-19 vaccine
trials suggest that most post-vaccination
symptoms are mild to moderate in
severity.
• Most symptoms occur within the first 3
days of vaccination (the day of
vaccination and following 2 days) and
most of the symptoms occur the day
after vaccination.
Symptoms timing:
• typically resolve within 1-2 days of onset
• more frequent and severe following the
second dose
• more frequent and severe in younger
people compared to those that are older
(>55 years)
34What to expect after getting a
COVID-19 Vaccine
Helpful Tips
• To reduce pain and discomfort:
o Apply a clean, cool, wet washcloth
over the area.
o Use or exercise your arm.
• To reduce discomfort from fever:
o Drink plenty of fluids.
o Dress lightly.
https://www.cdc.gov/coronavirus/2019
-ncov/vaccines/expect/after.html
35CDC Post-Vaccine
Considerations for HCP
Do not prevent staff with only post-vaccine
symptoms from coming to work.
Strategies to minimize impact on staffing due to
post-vaccine symptoms:
https://www.cdc.gov/coronavirus/2019-
ncov/hcp/post-vaccine-considerations-healthcare-
personnel.html
36Vaccine Resources
Questions related to the Pharmacy Partnership
for LTC Program: eocevent494@cdc.gov
CDC webpage for the Pharmacy Partnership for
LTC Program with FAQs for providers:
https://www.cdc.gov/vaccines/covid-19/long-
term-care/pharmacy-partnerships.html
Questions regarding COVID-19 vaccine
registration can be sent to COVID-19
Registration Support:
• Email: COVID19VacEnroll@dshs.texas.gov
• Toll-Free: (877) 835-7750
37CDC Vaccination Toolkit
Long-Term Care Facility Toolkit:
Preparing for COVID-19 Vaccination at
Your Facility
This toolkit outlines the importance of
COVID-19 vaccination in LTCFs,
provides strategies for encouraging
COVID-19 vaccination, and includes
tools a facility may use to monitor
COVID-19 vaccination side effects
among staff and residents.
38CDC Info on COVID-19
Variant Cases
Emerging variants CDC is closely monitoring
have mutations in the virus genome that alter
the characteristics and cause the virus to act
differently in ways significant to public health:
• causes more severe disease,
• spreads more easily between humans,
• requires different treatments,
• changes the effectiveness of current
vaccines.
It’s important to understand that genetic
mutations are expected, and some variants can
spread and become predominant while others
subside.
https://www.cdc.gov/coronavirus/2019-
ncov/transmission/variant-cases.html
39COVID-19 Vaccine FAQ
LTCR Publishes COVID-19 Vaccine
FAQs
HHSC Long-term Care Regulation has
published COVID-19 Vaccine Frequently
Asked Questions (PDF).
The resource document answers
commonly asked questions about the
COVID-19 vaccine.
40Common Vaccine
Questions
Will we ever achieve “herd immunity”
in Texas?
A: Experts are still learning about what
percentage of Texans would need to be
vaccinated to achieve herd immunity. This
term describes when enough people have
protection, either from a previous infection
or from vaccination, that it is unlikely a
virus or bacteria can spread between
people in a community and cause disease.
The percentage needed to reach herd
immunity varies by disease. CDC and
DSHS will keep the public informed as
more information becomes available.
41Common Vaccine
Questions
Will the immunity after getting
COVID-19 last longer than the
protection provided by the vaccine?
A: We are still learning about how long
a recovered person is protected by
“natural immunity.” Early evidence
suggests that immunity after having
COVID-19 may not last very long.
We also don’t know yet how long the
vaccines’ protection lasts, called
“vaccine-induced immunity.” CDC and
DSHS will keep the public informed as
more information becomes available.
42Common Vaccine
Questions
Can I take a COVID vaccine along
with a flu (or another) vaccine?
A: Given the lack of data on the safety
and efficacy of mRNA COVID-19
vaccines administered simultaneously
with other vaccines, the vaccine series
should routinely be administered alone,
with a minimum interval of 14 days
before or after administration with any
other vaccine.
43Essential Caregiver
Vaccination
Essential Caregivers can be given the
vaccine by the facility if all residents
and staff wanting the vaccine have
been vaccinated.
EC must meet criteria to receive
vaccine.
EC vaccination not required to report.
44Entry to ALF
An ALF cannot prohibit a person with
legal authority from entering the
facility unless the person does not pass
COVID-19 screening criteria.
Persons with legal authority to enter
include:
• law enforcement officer
• representatives of the long-term care
ombudsman's office
• government personnel performing
their official duties such as LTCR
surveyors
45Entry to ALF
Providers of essential services:
• Contract doctors, contract nurses,
home health and hospice workers
and mental health specialists whose
services are necessary to ensure
resident health and safety
• Family members and loved ones of
residents at the end-of-life
• Essential caregivers
• Emergency responders
• Essential Critical Infrastructure
Workers (repair people)
46Entry to ALF
COVID-19 screening criteria:
• fever defined as a temperature of 100.4
Fahrenheit and above; or
• signs or symptoms of COVID-19 as
outlined by the CDC; or
• contact in the last 14 days with someone
who has a confirmed diagnosis of
COVID-19, is under investigation for
COVID-19, or is ill with a respiratory
illness, unless the visitor is seeking entry
to provide critical assistance; or
• has a positive COVID-19 test result from
a test performed in the last 10 days.
47Quarantine Reminders
If a resident leaves and returns on the
same day, they do not need to be
quarantined unless they fail the screening
upon return.
Quarantine the resident if:
• Upon return screening, the resident has
fever or other COVID-19 symptoms,
• The resident spent one or more nights
away,
• The resident had close contact with
someone who is COVID-19 positive or
has symptoms of the virus, or
• Upon return screening, it is determined
that during the visit they weren’t able to
follow all infection control protocol.
48Staff Return to Work
Follow the CDC’s Return to Work
Criteria when an employee has
confirmed or suspected COVID-19
infection and requires isolation.
49Review Emergency
Preparedness Plan
Review Emergency Preparedness Plan
post winter storm:
• Did you follow the plan?
• What worked?
• What didn’t work?
• What can you do better?
• Provider Letter 2021-06 LTCR
Waivers During Severe Winter
Weather (PDF).
50Allergies vs COVID-19
Similarities and the differences between
allergies and COVID-19.
51DSHS Training Video
DSHS Video on Long-term Care
Facilities COVID-19 Infection
Prevention and Control Now
Available
The Department of State Health
Services has published a recorded
training for long-term care providers on
COVID-19 precautions to take and how
to accomplish them.
View the video training.
52COVID-19 Resources
Available resources and tools for ALFs:
• COVID-19 Response Plan
• COVID-19 Emergency Rules
• §553.2001
• §553.2003
• §553.2004
• Frequently Asked Questions
• ALF FAQ
• Provider Letters
• Texas Division of Emergency
Management - interactive map for
finding testing resources
53Public Health Regions
Map and contact info for all of the
state’s Public Health Regions.
https://www.dshs.texas.gov/regions/default.shtm
54Provider Letters
• PL 20-37 Reporting Guidance for Long-Term
Care Providers (Revised)
• PL 20-42 COVID-19 Response – Expansion
of Reopening Visitation
• PL 20-46 Reporting Guidance for Long-Term
Care Providers – Point-of-Care Antigen
Testing (Revised)
• PL 20-48 Transferring COVID-19 Positive
Residents
• PL 20-49 Process to Request Free COVID-19
Point of Care Antigen Test Kits (Revised)
55Provider Letters
• PL 20-50 Influenza (Flu) Vaccine Guidance
during COVID-19
• PL 20-53 Guidance for Activities, Dining, and
Volunteers
• PL 21-01 COVID-19 Vaccination Reporting
• PL 21-04 HHSC COVID-19 Reporting Process
• PL 21-06 LTCR Waivers During Severe Winter
Weather
56Webinar Recordings and PDFs
Access recordings and PDFs of previous
ALF webinars from the ALF Portal.
Click on COVID-19 Resources to
expand the accordion to access
resources and webinars.
March 3, 2021 ALF webinar:
• Listen to the webinar recording here.
• Read the webinar slide presentation
(PDF).
57Webinar: Creating a Culture of
Normalcy within COVID-19 Regulations
This webinar is designed to provide LTC
providers with clarification of COVID-19
Emergency Visitation Rules. It will
highlight the importance of maintaining
as much normalcy as possible during
the pandemic in the interest of
resident’s psychosocial well-being.
March 11
3:30–5 p.m.
Register for the COVID-19 webinar.
March 12
10–11:30 a.m.
Register for the COVID-19 webinar.
58GovDelivery
To sign-up for Alerts:
• Go to:
https://service.govdelivery.com/account
s/TXHHSC/subscriber/new
• Enter your email address.
• Confirm your email address, select your
delivery preference, and submit a
password if you want one.
• Select your topics.
• When done click “Submit.”
59LTC Ombudsman Patty Ducayet State Long-term Care Ombudsman Telework Phone: (737) 704-9075 https://apps.hhs.texas.gov/news_info/ombudsman/ Statewide Contact for an LTC Ombudsman: Phone: (800) 252-2412 or Email: ltc.ombudsman@hhs.texas.gov Facebook Live Events Weekly Facebook Live Q&A for Families of LTC Residents: Every Wednesday, 12:15 to 12:45 https://www.facebook.com/texasltcombudsman?fref=ts
FAQ
How to Contact
Jennifer Morrison, Manager
Jennifer.morrison@hhs.texas.gov
LTCR Policy Mailbox
LTCRPolicy@hhs.texas.gov
COVID-19 Page
https://hhs.texas.gov/services/health/coronavirus-covid-19
ALF Provider Portal
https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-
providers/assisted-living-facilities-alf
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