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Feb. 19, 2021, 11:55 p.m. EST

Residents of independent-living care facilities left out in cold by federal on-site vaccination program

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Eleanor Laise

Misleading information from the federal government has disrupted and delayed COVID-19 vaccinations for hundreds of thousands of vulnerable seniors nationwide, according to providers of housing for seniors.

After the Trump administration announced in October that a partnership with major pharmacies would deliver on-site vaccinations to residents in long-term-care facilities, communications from the U.S. Department of Health and Human Services said the program would be open to independent-living facilities, which typically provide meals, housekeeping, transportation and other services, as well as assisted-living and skilled-nursing facilities, which provide higher levels of care.

Many independent-living facilities enrolled in the program and waited two months or more for an opportunity to schedule their on-site vaccination clinics, only to learn in late December and January that they had been excluded from the program without notice or explanation, providers and industry groups say.

Caught off-guard by the switch, facility staffs are now spending weekends trying to book off-site vaccine appointments one resident at a time; pleading with local health departments, hospitals and fire departments for help conducting vaccine clinics; and transporting busloads of frail residents to arenas and other mass vaccination sites.

The long wait for on-site clinics that never materialized, followed by the scramble to secure vaccines through other means, has consumed precious months, while COVID outbreaks have continued to threaten the lives of independent-living residents and staff, providers say.

“Our biggest disappointment is that an entire group of the most vulnerable population got left out” of the program, says Karen Sheean, chief people officer at Holiday Retirement, which operates more than 250 independent-living communities with about 30,000 total residents. Residents who are not yet vaccinated are fearful, she says, knowing that they’re at the highest risk living in a congregate setting yet still blocked from the program.

Many independent-living staff members haven’t been able to get the vaccine, either, providers say, because they’re not considered healthcare workers.

The independent-living landscape

There are more than 800,000 independent-living units nationwide, industry groups say, roughly evenly split between free-standing communities and those that are components of campuses, such as continuing-care retirement communities (CCRCs), providing multiple levels of care.

While free-standing independent-living communities have been excluded from the federal pharmacy partnership program, CCRCs and residents of HUD Section 202 housing for the low-income elderly are eligible, according to the Centers for Disease Control and Prevention. Even so, independent-living residents within CCRCs have also in many cases been shut out of on-site vaccination clinics, providers say.

That “has been profoundly distressing and confusing for both the older adults and the staff of these communal-living residences,” LeadingAge, an association of nonprofit senior-care providers, said in a January letter to the CDC and administration officials.

Eligibility for the on-site vaccination program, known as the Pharmacy Partnership for Long-Term Care, “was designed to ensure the program serves those at highest risk of infection and severe illness from COVID-19 who need on-site vaccination services,” says CDC spokeswoman Kate Grusich. “Individuals living in independent-living retirement communities, however, are often highly active and can go offsite to get vaccinated, which is more efficient for vaccine delivery.”

Independent-living providers and industry groups say that’s a misperception. The average age of independent-living residents is 83, compared with 84 for nursing-home residents, and about 70% of independent-living residents have four or more chronic conditions, according to the consulting firm ATI Advisory. Many live with vision and hearing loss and impaired mobility and hire their own in-home caregivers, whose movement in and out of the buildings can further boost viral transmission risk, providers say.

Including independent-living residents in the pharmacy partnership program should have been “a no-brainer,” says David Schless, president of the American Seniors Housing Association. “I just don’t understand why this hasn’t happened.”

See: Want your loved one in a nursing home to get a COVID-19 vaccine? Ask these questions first.

When the on-site vaccination program was announced in October, independent-living providers say that their eligibility seemed certain. HHS communications about the program provided a link at which independent-living facilities could enroll in the program, and, in a late October question-and-answer session, HHS officials stated that both free-standing independent-living communities and those within CCRCs would be eligible, according to multiple industry groups that were represented on the call.

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