The Hartford Foundation and CDC leaders hosted a call November 2 outlining details on the $500 million “nursing home strike team” program, highlighting that the primary goal of the funding is to reduce the spread of infection and address long-term care staffing concerns through partnerships between health departments and long-term care providers. The more than 560 participants on the call included federal officials, state health department officials, LeadingAge state partners, AHCA state affiliates, and AMDA representatives.

After a quick review of the American Relief Plan provisions authorizing the program and the CDC guidance on it, CDC officials reported that the funding was distributed in the last week of October to the Epidemiology and Laboratory Capacity (ELC) programs in 64 state and local health departments. They added that today’s meeting sets the stage for collaboration and partnership between the ELCs and long-term care stakeholders in each jurisdiction, including LeadingAge, AHCA, and AMDA representatives among others.

Dr. Nimalie Stone, CDC’s Medical Epidemiologist for Long-Term Care, reinforced the partnership message: “It’s critical to talk to providers about their needs,” she said. Arjun Srinivasan, CDC’s Associate Director for Healthcare-Associated Infection Prevention followed, describing two papers available on the Hartford Foundation website outlining which partners should be at the table on this effort in each jurisdiction, and describing some examples of possible interventions. CDC expects to keep adding examples of interventions and encouraged stakeholders to share examples at either the nursing home strike team email (NHStrikeTeams@cdc.gov) or the healthcare associated infection email (haiar@cdc.gov).

The majority of the meeting featured a panel of speakers from four states, highlighting strike teams and related efforts that relied on health department – LTC partnerships, some featuring LeadingAge state partners and members.

The overarching themes of the panel were:

• Strike teams work well when long-term care providers are part of the team.
• Strike team members must include experts familiar with long-term care environments. Those that are made up of experts who don’t understand LTC are less effective.
• The partnerships that are formed should meet and communicate on an ongoing basis, not just when there is an outbreak.
• The teams work when they listen to the concerns and challenges and respond in a helpful, non-punitive way.

Kristin Henderson of Presbyterian Senior Care Network in Pennsylvania described how the organization hesitated at first to invite the Regional Congregate Care Assistance Teams(RCAT) in during the pandemic. Despite the hesitation, during the height of the pandemic, it turned out the strike team from RCAT was very helpful. They provided competency-based training and served as “boots on the ground” as needed to help with infection control, evaluating the quality of masks, barrier placement, signage, even staffing strategies, “all in a very non-threatening way that our teams found to be very helpful.” Overall, she said, the organization fared better during the pandemic than many others because they had the RCAT help.

Vivien Leunt of the Connecticut Department of Health HAI and Antimicrobial Resistance Program described a partnership her department led that included LeadingAge, AHCA, and AMDA leaders in the state. She talked about the Shift coaching program developed at Brown University. Relying on a structure for regular communication with LTC partners, the program developed and implemented testing, rapid response, and vaccination efforts. The Health Department convened regular ‘huddles” focused on quickly identifying challenges and points of confusion and rapidly finding and implementing solutions.

Leslie Eber, a member of AMDA from Colorado talked about the success of the Colorado Residential Care Strike Team. She said the state has seen LTC staff vaccination rates of over 90% thanks to the “secret sauce” of the strike team. By bringing together state agency and industry leaders, the team was able to create successful interventions and “a truly effective pathway for intervention” by “having the pulse of the front line in post-acute and long-term care.” The team continues to meet weekly to hear new challenges and struggles from people who work in and with nursing homes daily.

Kelly Garner from the Arkansas Department of Health rounded out the panel with a discussion of a highly collaborative effort to ensure that LTC providers had access to and knew how to most effectively use monoclonal antibodies. She described holding nearly 500 conversations with LTC providers and ultimately working with almost 100 of them who used the treatment. She said that she learned that repetition can be helpful in conveying complex concepts. The Health Department also created one email address for all COVID related concerns so that providers don’t have to try to figure out which address to write to. “We created a one-stop shop,” she said.

“Talk with each other and find and talk with all possible partners,” Terry Fulmer of the Hartford Foundation said, concluding the meeting. CDC staff reminded the group to share the resources from the meeting and use the two email contact points at CDC to keep communication open (haiar@cdc.gov) and (NHStrikeTeams@cdc.gov).