An Hour with CVS/Omnicare - LeadingAge Update on LTCF Pharmacy Partnership Program
Regulation | December 22, 2020 | by Jill Schumann
A team from CVS Omnicare joined LeadingAge members for a 1-hour call to explain the LTCF Pharmacy Partnership in greater detail.
A team from CVS Omnicare joined LeadingAge and more than a thousand callers to explain their role in the Long-Term Care Facility (LTCF) Pharmacy Partnership Program in greater detail. The recording of this call is available here. The CVS team included:
Beth Coryea, Senior Director, Account Management
Jonathan Arletta, Vice President of Sales
Derek Darling, Vice President of Strategy
Ryan Jeanneret, Senior Director, Strategy
David Purdy – Vice President of Operations
The CVS team began with this salient observation, “It is vaccinations, not the vaccine that will lead to recovery from this pandemic.” The first CVS clinics were held last Friday and are continuing as residents, families and staff members embrace this glimmer of hope.
Key program features
Jon Arletta stressed that this is truly a partnership and CVS will work to be a good partner. He acknowledged that this is a huge undertaking and will require communication and flexibility on everyone’s part. His team is conducting facility outreach and he explained key features of the program:
- Each facility needs to complete and return their key contact information to CVS to make sure phone calls and emails are transmitted to the appropriate people at each provider location.
- Everybody receiving an immunization will need to complete a consent form (copy available on their website at www.omnicare.com/covid-19-vaccine-resource). Prior to the date of the first clinic each facility will be sent hard-copy consent forms in triplicate. CVS will also allow electronic and verbal consent and there are specific instructions on how those can be obtained and documented on the hard copy consent forms.
- Providers must also obtain photocopies of insurance cards (front and back) and/ or submit attestation (on the consent form) for individuals who do not have insurance or cards
- Given the pace and breadth of this effort, CVS will pre-select the dates for the clinics. This relates to staffing, supply, geography, state activation plans, logistics, etc. There is not the ability to be flexible about the dates.
- The COVID-19 vaccination effort builds on the Omnicare flu vaccine program that has been a proven approach.
The Clinic Model
These are the basic steps in the CVS Clinic Model:
- Provider community has completed the CDC form expressing desire to participate in the Pharmacy Partnership.
- Clinics are being scheduled. CVS will select the dates and they are currently in the process of scheduling all 3 clinics for each location. They are about a quarter of the way through the scheduling process, so those locations that have not yet been scheduled should be patient.
- Email notification of clinic dates.
- The provider location’s primary contact will receive copies of the triplicate consent forms, as well as posters provided to raise vaccine awareness of residents and staff.
- Locations will receive a phone call to confirm clinic dates and the number of staff and residents to be immunized and clinic details.
- A confirmation email will be sent to the facility. Be sure to save this email.
- Consent forms and copies of insurance cards for each participant are obtained by provider.
- Multi-patient registration is completed by the facility and submitted through the CVS portal.
- The CVS team arrives on site with all supplies and administers vaccines.
- CVS provides documentation to patient and facility. CVS submits required vaccination reporting.
Timing of the Clinics
- One rate-limiter of the speed of scheduling is individual state activation of the plan. To date, all states except WV have opted in, but there are state differences in vaccination prioritization and timing (for example some states have prioritized nursing homes over assisted living).
- CDC has determined that stand-alone independent living buildings are excluded from this clinic program. That is not an Omnicare decision. One nuance is that in multi-level environments such as CCRCS, while residents are excluded, staff members who move across levels of care can be immunized.
Questions from callers:
Q: Must we use the CVS consent forms?
A: Yes. Use the CVS forms. A CVS consent form must be signed. There is an electronic version on the webpage. Documented verbal consent can be used but must be documented on CVS forms. There are specific instructions for this on the website and the person receiving the verbal consent must document and sign using the CVS form. Email consent can also be used in a similar fashion. A consent process document is found on the CVS webpage and provides options and specific steps for each.
Q: Must we have copies of insurance cards?
A: CVS is requiring consent form completed in full which also requests insurance information. CVS is asking for an image of the front and back of the insurance card as they are seeing errors in transcribing numbers on the consent form. So, yes, copies of the cards are needed. If the person does not have insurance, attestation can be completed on the consent form.
Q: Section 202 housing has different rules and restrictions about collecting insurance information, for example. How will the variations for this type of housing be handled?
A: Try to conform as closely to the prescribed process as possible.
Q: What about staff members or residents who enter or exit the organization after the first or second clinic?
A: There are several different scenarios being developed and those will be shared soon and will likely change over time, in part due to vaccine availability. Some examples:
- If they join after 1st clinic – they can get 1st shot at 2nd clinic and booster at clinic 3
- If they join after 2nd clinic - CVS recommends that people do not receive first vaccine at the 3rd clinic.
Q: Will staff be able to sign up to get the vaccine the day of the onsite clinic?
A: That will not be possible. The consent process needs to be completed in advance, in part because it tells CVS how many people are to be immunized and what supplies and doses to bring with them. Because doses are short supply, it is not possible to bring extra.
Q: What if we have COVID-positive residents?
A: It is important to follow the guidance from the drug manufacturers. CVS will conduct clinics onsite if there are positive residents in the facility, but the current guidance is not to vaccinate infected individuals. There are two current recommendations: in one case there should be 14 days of time between the last positive test and vaccination; and the other is to wait 90 days past the last day of symptoms.
Q: Who is responsible for managing serious adverse reactions such as anaphylaxis?
A: Pharmacists will bring Epi-pens and related supplies so they can administer medication if the reaction happens immediately and will do the reporting through VAERS. However, if vaccinations are occurring room-to-room, CVS will not have sufficient staff to leave staff in resident rooms for 15 minutes, so the facility staff will need to monitor. Once the CVS staff leaves the building, the facility will be responsible for observing for, and reporting through VAERS, any adverse reactions.
Q: In which languages will consent forms be available?
A: Currently, only an English version is available on the website. A Spanish version should be available in the next few days. That is all that is anticipated at this time.
Q: What does the facility need to provide for the clinics?
A: There is material on the website regarding clinic preparation. CVS will bring operational materials – PPE, syringes, sharps containers, etc. For those who are needing a room to room approach, the - facility should supply a rolling cart. For more centralized clinics, specifications for tables and chairs on the website in the document above.
Q: Who will pay for staff or residents who don’t have insurance?
A: The Consent form has an attestation for those without insurance and CVS can receive reimbursement for administration from a fund for uninsured people.
Q: Who orders the vaccine – do we need standing physician orders?
A: Standing orders by the facility are not necessary. CVS pharmacists will submit the orders.
For more information:
Visit - www.omnicare.com/covid-19-vaccine-resource
Email - covidvaccineclinicsLTCF@cvshealth.com