Home Health & Hospice Week

Vaccine should go straight to home health and hospice providers, trade group suggests.

As COVID-19 vaccinations roll out, the Centers for Disease Control and Prevention is setting guidelines for vaccination of homebound patients.

The guidance is a good step forward, because the homebound population is getting overlooked in the current vaccination process, advocates say. “The 12 million Americans who are homebound and receive care from home health agencies, home care providers, and hospices are not capable of travelling to a local or state health department, a mass immunization site, or the local pharmacy to receive vaccination,” emphasizes the National Association for Home Care & Hospice. “This large population of America’s most vulnerable need the vaccine to come to them or they will likely not receive it,” the trade group warns.

Guidelines the CDC recommends include:

• Map out “travel plans to ensure vaccine is utilized within the approved time frames for use of vaccine at different temperatures, including factoring in pre-vaccination preparation time, and post-vaccination observation time,” the Vaccinating Homebound Persons With COVID-19 Vaccine document instructs.
• “Document the min/max temperatures when transport begins, every time the container is opened, and upon return to the facility. Each temperature reading should be documented on a temperature log,” the CDC offers.
• “A punctured vial may be transported from one home to another by the same health care professional if the cold chain is properly maintained,” the CDC says. “However, a partially used vial cannot be transferred from one provider to another or across state lines.”

The document also addresses topics such as transport with predrawn syringes rather than vials, appropriateness of vaccinating homebound persons’ family members and caregivers, and who qualifies as homebound.

The CDC’s homebound definition may not be quite as tight as Medicare’s. “Homebound persons include those that need the help of another person or medical equipment such as crutches, a walker, or a wheelchair to leave their home, or their medical provider believes that their health or illness could get worse if they leave their home, and they typically do not leave their home,” the federal agency says in the guidance.

While this new guidance is welcome, it’s only the first step, NAHC emphasizes. “These Americans and their families and loved ones would [be] helped enormously if the CDC could address the essential issue as to how home care providers can access the vaccine for their patients,” the trade group maintains. “The recent expansions of access through pharmacies and mass immunization sites is a great improvement in vaccine access, but it does not help the 12 million homebound patients, virtually all of whom fall into a high priority classification.”

What's Needed: “To effectively provide vaccinations to the homebound may require direct supply to the home care and hospice health care companies that care for these patients on a daily basis,” NAHC suggests.

Home Care Workers Fight For Access

Meanwhile, home care providers in certain parts of the country still face big obstacles in obtaining vaccinations for their staff.

Mark Beardslee, a home care worker with Comfort Keepers in northern Michigan, had to call the local health department weekly for months before he could get scheduled for a COVID-19 vaccination, he told Interlochen Public Radio. Beardslee says he’s afraid other home care workers are slipping through the cracks.

Joshua Meyerson, the medical director for two northern Michigan health departments, says they are following state guidance, which is giving priority to seniors, IPR reports.

In Brooklyn, New York, home care worker Marie Deolall is still searching for a way to get the vaccination as she cares for her 101-year-old client, reports Spectrum News NY1. When a local vaccination site opened, Deolall still couldn’t get a slot, the cable channel reports.

In Florida, home care workers continue to face similar obstacles to vaccination, reports Contact 5 at station WFLX in West Palm Beach. When the news program asked Palm Beach County Health Director Dr. Alina Alonso about the problem, she responded “get in line, get in the waiting list, and we will get you vaccinated,” according to the news station.

Note: The CDC guidance is at www.cdc.gov/vaccines/covid-19/clinical-considerations/homebound-persons.html.