COVID-19: Federal Pharmacy Partnership for Long-Term Care Program

Note: The federal Pharmacy Partnership for Long-Term Care Program is different from another federal pharmacy program called the federal Retail Pharmacy Program.

 

The federal Pharmacy Partnership for Long-Term Care Program provides onsite vaccinators for Wisconsin’s long-term care facilities. CVS and Walgreens pharmacies (referred to as the vaccinator) have been contracted to offer onsite COVID-19 vaccination services to residents of nursing homes and assisted living facilities that participate in this program.

This will facilitate safe vaccination of this critical patient population, and reduce the burden on long-term care facilities, skilled nursing facilities, and health departments. This program began vaccinating patients at skilled nursing facilities on December 28.

In the frequently asked questions below:

  • Facility refers to long-term care facilities that are participating in the federal Pharmacy Partnership for Long-Term Care program.
  • Vaccinator or provider refers to the pharmacy (Walgreens or CVS) that will be providing and managing vaccine for the facility.
  • Program refers to the federal Pharmacy Partnership for Long-Term Care.
  • The State refers to the Wisconsin Department of Health Services.

General program information

When did the program start and how long will it last?

Governor Evers announced on Monday, December 14 that the Wisconsin Department of Health Services (DHS) has officially activated the federal Pharmacy Partnership for Long -Term Care Program for COVID-19 Vaccination. The program will utilize the Moderna vaccine. The effort, beginning with skilled nursing facilities, began on Dec. 28, 2020. This program is a partnership between the U.S. Department of Health and Human Services (HHS) and the CDC.

Activation of Part B (vaccination of the remaining facilities enrolled in the program) was announced by DHS on January 7th, 2021 and is effective at the federal level January 25, 2021. However, vaccinators such as pharmacies may begin vaccinating assisted living and other remaining facilities as soon as they have adequate vaccine.

Pharmacy partners completed almost all first clinics at skilled nursing facilities by the end of the third week of January 2021, during which long-term care staff and residents were offered their first dose of COVID-19 vaccine. In most cases, second and third vaccination clinics for skilled nursing facilities should be completed by the end of February 2021.

It is expected that pharmacy partners will complete first clinics in the over 4,000 enrolled assisted living and other enrolled facilities by early March, during which staff and residents will be offered their first dose of COVID-19 vaccine. In most cases, second and third clinics should be completed by mid April 2021.

What types of facilities will be vaccinated through this program?

Enrollment for the Pharmacy Partnership for Long-Term Care Program has closed.

Long-term care facilities eligible to participate in the Pharmacy Partnership for Long-Term Care Program included skilled nursing facilities, nursing homes, assisted living facilities (residential long-term care facilities assisting and supervising primarily elderly residents in daily living activities and independent living skills), continuing care retirement communities, residential care communities/adult family homes, U.S. Department of Housing and Urban Development’s Section 202 Supportive Housing for the Elderly Program, intermediate care facilities for individuals with developmental disabilities, state-run veterans’ homes, and similar congregate living settings where most individuals receiving care/supervision are older than 65 years of age.

Facilities not eligible for the program included adult day care facilities, independent living facilities, facilities exclusively for children or adolescents, psychiatric rehabilitation or behavioral treatment facilities, and drug or alcohol rehabilitation centers. Other ineligible facilities included independent low-income housing (with the exception of the U.S. Department of Housing and Urban Development’s Section 202 Supportive Housing for the Elderly Program, which was included), domestic violence shelters, convents, churches, schools, individual homes (i.e., not a congregate living facility), correctional facilities, and home health programs.

How is it determined which facilities get the vaccine first?

The program is split into two components. Part A includes vaccination of skilled nursing facilities, and Part B includes vaccination of the remaining facilities enrolled in the program.

Part A was activated on December 28, 2020 and is ongoing. Activation of Part B was announced by DHS on January 7, 2021 and is effective at the federal level January 25, 2021. However, pharmacies may begin vaccinating assisted living and other remaining facilities as soon as they have adequate vaccine.

Not every facility in the Wisconsin Department of Health Services will receive vaccine on the same day. It is anticipated that facilities will have their first vaccine clinic within several weeks of the start of the program; these clinics will be scheduled by the pharmacies, taking CDC prioritization guidelines and operational efficiency into consideration.

How can I contact the pharmacies?

CVS

Walgreens

Program enrollment

Can facilities still enroll in this program?

No. Enrollment into the Pharmacy Partnership for Long-Term Care Program has closed. Enrollment into this program is non-binding. If your facility is not enrolled or is ineligible for the program, please email dhscovidvaccinator@wi.gov.

Does my facility need to complete the COVID-19 Vaccinator Enrollment process if we are participating in the federal Pharmacy Partnership Program?

A long-term care facility only needs to complete the COVID-19 vaccinator enrollment process if they plan to provide vaccine, either for their staff, and/or for their residents themselves, meaning they will order, store, manage, administer and report doses to the Wisconsin Immunization Registry. Steps for this process are outlined on the COVID-19 Vaccinator webpage. If you are working with a partner to vaccinate your staff and residents, the partner will enroll as a vaccinator.

I signed up to have Walgreens/CVS be our vaccination provider through the Pharmacy Partnership for Long-Term Care Program but have not heard from them. What is the next step?

Walgreens and CVS have received the enrollment data for the Pharmacy Partnership for Long-Term Care Program and are reaching out to facilities. If your facility is enrolled and you have not yet received information from Walgreens or CVS, please contact dhscovidvaccinator@wi.gov.

Walgreens/CVS reached out to us. Can we work with a different pharmacy partner instead?

Walgreens and CVS are reaching out if a facility indicated them either as a preference or contingency option. Enrollment is non-binding and facilities maintain the right to decline services at any time from the federal Partnership and Walgreens or CVS. Facilities should have received an email with more information about this process on January 7th, 2021.

If a facility wishes to opt out of the federal program and work with a different pharmacy the following items must be done:

  1. Pharmacy chosen must ensure they are enrolled with the Wisconsin Department of Health Services as a COVID-19 Vaccinator
    • For pharmacies that completed this process after November 25, 2020, Wisconsin DHS cannot guarantee that they will be eligible to administer vaccine at the initial onset of the Pharmacy Partnership Program for Long-Term Care program. Vaccinator enrollment is ongoing and DHS will work with pharmacy partners to get them enrolled as a vaccinator as soon as possible.
  2. Facility must communicate declination of services to Walgreens or CVS.
  3. Pharmacy or the facility should communicate to the Wisconsin Department of Health Services via dhscovidvaccinator@wi.gov that the facility declined the federal Partnership. This can assist in vaccine allocation planning.

Can facilities update their contact information for the program?

Wisconsin DHS is unable to update contact information. Please visit the website below that corresponds to the pharmacy you are matched with to find out how you can communicate any contact information updates. If pharmacies are unable to reach you, they will let CDC know and they will reach out to the state if necessary.

What if both CVS and Walgreens have reached out to our facility?

In this case, you should choose which pharmacy they would like to work with and inform the pharmacies accordingly so that the appropriate pharmacy can either keep or remove them from their list.

Is my facility able to switch pharmacy partners (between CVS and Walgreens or vice versa)?

Transferring facilities between the federal pharmacy partners will only be possible in limited scenarios. This is a federal program involving multiple organizations and large amounts of data. Making changes to enrollment data at this point is difficult. If enrolled facilities intend to remain enrolled in the federal program, they should plan to work with the pharmacy partner that they are currently matched with.

How can my facility plan for vaccinations after the program ends?

After the initial phase of vaccinations, facilities will have needs for ongoing COVID-19 vaccinations. Facilities can choose to enroll as a COVID-19 vaccinator themselves or facilities can work with a vaccinator of their choice that has enrolled with the state.

Each person getting the COVID-19 vaccine will receive a vaccination record card to make sure they receive the correct vaccine for the second dose. This information will also be recorded in the Wisconsin Immunization Registry (WIR). It is important that the same vaccine is administered for the second dose. In Wisconsin, the Moderna product is being used in long term care facilities that are enrolled in this program.

Depending on vaccine supply, facilities may work with a local pharmacy to come and vaccinate, refer residents to their primary care provider, refer residents to the local health system, or arrange for appointments at a local pharmacy. Facilities will need to assess their capabilities and resources, including ability to store vaccine, complete all reporting requirements in WIR, and avoid vaccine wastage.

Facilities may want to work with local hospitals to ensure residents have received their first dose before being discharged.

Staff vaccination

Can staff at my facility get vaccinated via this program?

Yes. Federal pharmacy partners will vaccinate both long-term care facility residents and staff at the same onsite clinics.

What if some long-term care facility staff are not onsite the day of the vaccination clinic? How will they get vaccinated?

Long-term care facility staff are considered health care personnel and are eligible for vaccination in Phase 1A according to the recommendations of the Advisory Committee on Immunization Practices. It is anticipated that pharmacies will schedule three onsite clinics for each facility to accommodate residents and/or staff not present for previous clinics.

Should our staff be prepared to provide their insurance for the administration fee of the vaccinator?

Yes. Walgreens and CVS are asking for insurance information from residents and staff as they can bill insurance for the vaccine administration fee. However, pharmacies cannot deny vaccination should a person not have insurance.

Our long-term care facility employs staff as young as 16 years of age. How will they be vaccinated if Moderna is only approved for individuals 18 and older?

These staff may be vaccinated by another provider according to Wisconsin Department of Health Services plans to vaccinate its healthcare workers. More information is forthcoming.

What staff will the pharmacies vaccinate?

Vaccination plans are based on the roster that facilities will be asked to provide to the pharmacies in advance of clinic scheduling. Direct and ancillary staff who can come in contact with residents who are able to transmit SARS-CoV-2, and/or infectious material containing SARS-CoV-2 virus are eligible for vaccination.

How might facilities address staffing challenges in the event that staff experience post-vaccination symptoms?

These Centers for Disease Control & Prevention resources address these concerns and can help facilities prepare:

Onsite clinics

What happens if a resident or staff member receives their first dose at the third (final) program clinic?

The pharmacy partners will visit facilities for a total of three clinics, with the exception of some smaller facilities where only two clinics may be necessary to vaccinate all residents and staff.

At the third clinic, any facility staff eligible to receive Moderna vaccine that have not yet received their first dose should be vaccinated. If a first dose is administered to a resident on the third clinic, it may be more difficult for them to receive their second dose. In these cases, the facility and pharmacy should work together to determine the best course of action. CVS and Walgreens are not responsible for assuring the second dose in these cases; they will visit facilities for a maximum of three clinics.

What if a person leaves a facility after receiving the first dose but before they are due for the second dose?

People who receive the first dose of COVID-19 vaccine as part of the long-term care program, but are not onsite to receive the second dose should plan to return to the facility when the second clinic takes place. This guarantees that the second dose will be available to them. If a resident has been transferred to a new facility, that individual should provide their vaccination record to the facility to ensure they are set to receive the second dose when a vaccination clinic is held at the new facility.

How will new long-term care facility residents be vaccinated?

After the initial phase of vaccinations, facilities will have needs for ongoing COVID-19 vaccinations. Facilities can choose to enroll as a COVID-19 vaccinator themselves or facilities can work with a vaccinator of their choice that has enrolled with the state.

Each person getting the COVID-19 vaccine will receive a vaccination record card to make sure they receive the correct vaccine for the second dose and this information will be recorded in the Wisconsin Immunization Registry (WIR). It is important that the same vaccine is administered for the second dose. In Wisconsin, the Moderna product is being used in long term care facilities that are enrolled in this program.

Depending on vaccine supply, facilities may work with a local pharmacy to come and vaccinate, refer residents to their primary care provider, refer residents to the local health system, or arrange for appointments at a local pharmacy. Facilities will need to assess their capabilities and resources, including ability to store vaccine, complete all reporting requirements in WIR, and avoid vaccine wastage. Facilities may want to work with local hospitals to ensure residents have received their first dose before being discharged.

Is there a consent form?

There is no special federal or state requirement for consent forms for COVID-19 vaccines, so CDC and DHS are not intending to provide templates. Walgreens and CVS will be providing and requiring consent forms. Vaccinating entities are free to use a consent form they have developed for their own needs in addition to the form used by the pharmacies.

There is a requirement to provide the Emergency Use Authorization Fact Sheet for the specific COVID-19 vaccine to each person administered the COVID-19 vaccine.

Do residents and staff need to complete a second consent form prior to receiving their second dose?

Yes. Both CVS and Walgreens are requiring residents and staff to complete separate consent forms for both doses. Please plan accordingly. Forms should be completed for all staff and residents prior to the clinic day, with the exception of any screening questions that ask individuals about how they are feeling on the day that they receive vaccine.

When pharmacies go on site will they have an emergency kit including Epi, Benadryl, etc. or are facilities responsible for being prepared for that?

Yes, both CVS and Walgreens vaccinators will bring these materials to the onsite clinics.

If a non-skilled nursing facility is connected to or in the same building as a skilled nursing facility, would that facility be vaccinated at the same time as the skilled nursing facility?

Now that part B of the program has been activated, DHS has authorized CVS and Walgreens to include attached independent living facility residents and staff who are on the same campus as the skilled nursing facility or assisted living facility when those vaccination clinics are scheduled.

Due to the size of some independent living settings that are attached to skilled and assisted living facilities, the pharmacies may not be able to adjust the schedule for those scheduled over the next two weeks to include the independent facilities, but will work to schedule them for future clinics.

Non-SNF facilities, including Independent living facilities, attached to skilled nursing and assisted living facilities are being vaccinated due to resident and staff intermingling across the campus setting and for operational efficiency since the pharmacies will be on the campus to administer vaccine. Residents in unattached independent living facilities are not eligible for the federal program and will receive vaccine in other phases of the vaccine rollout as set by the State Disaster Medical Advisory Committee (SDMAC).

Where can I get more information about the onsite clinics or the consent process for my pharmacy partner?

CVS

Walgreens

Costs/Billing

What costs are we responsible for if we choose to participate in the pharmacy partnership program?

The federal Pharmacy Partnership for Long -Term Care program is free of charge to facilities. CVS or Walgreens will bill private and public insurance for the vaccine administration fee. Get additional information regarding COVID-19 vaccination costs.

If the facility chooses its own pharmacy provider, will that pharmacy provider receive a payment for administering the vaccine?

Yes, it is anticipated that pharmacy providers will bill public and private insurance for the vaccine administration fees.

Regulations/Reporting

Will there be any changes to mitigation measures in facilities once residents at long-term care facilities have been vaccinated?

At this time, there has been no change in guidance for long term care facilities related to mitigation measures. Long-term care facilities should continue to follow best practices as they have been. At this moment, it is unclear what level of community immunity or amount of the population vaccinated is needed for the CDC to stop recommending the use of masks and physical distancing. Experts need to understand more about the protection that COVID-19 vaccines provide.

How should facilities report possible adverse events after COVID-19 vaccination?

Facility administrators should work with staff to report any health problems that occur after vaccination to the Vaccine Adverse Event Reporting System (VAERS), even if unsure the vaccine caused the health problem. VAERS is a national vaccine safety monitoring system that helps CDC and FDA monitor health problems after vaccination.

In addition, all vaccinated long-term care facility staff and residents who have a smartphone can participate in v-safe. V-safe is a new smartphone-based, after-vaccination health checker for people who receive COVID-19 vaccines.

Please review CDC resources for more information.

Is Centers for Medicare and Medicaid Services (CMS) mandating residents to be vaccinated with COVID-19 vaccine?

Not at this time. Please refer to CMS directly for requirements around COVID-19 vaccine in long-term care facilities.

Last Revised: February 22, 2021