P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e .

Allen Jansen, Senior Deputy DirectorBehavioral Health & Developmental Disabilities

Welcome and Introductions

AFC/HFA COVID Vaccine Update

Heidi Loynes, BSN, RNImmunization Nurse Educator

Division of Immunization

Walgreens and CVS Distribution

An Overview• In Michigan, we have 417 skilled-nursing

facilities enrolled and matched with a CVS or Walgreens pharmacy partner.

• Additionally, we have 4,903 ‘other’ facilities enrolled and matched with a pharmacy partner.

• Approximately 3,700 of these additional other facilities were enrolled in the partnership program by MDHHS.

An Overview cont……• The facilities that were enrolled by MDHHS were identified using a list

provided by CDC of potential LTC facilities that may be eligible for the Pharmacy Partnership program.

• According to CDC, these facilities were identified using publicly available state regulatory agency websites.

• There may be some facilities that were missed or not identified using this process.

• Any unenrolled LTC facilities will need to contact their local health department (LHD) for assistance to get their facility’s residents and staff vaccinated.

Q: How do I know if I am on the list thedepartment submitted to the two pharmacies?

• The list of sites enrolled in the program is available through your LHD and posted online at www.michigan.gov/COVIDvaccine.

• The list of eligible facilities was provided to MDHHS from CDC from publicly available data, therefore it is possible that some facilities may be missing from this list.

http://www.michigan.gov/COVIDvaccine

Q: If not part of this distribution/program or other type, who do they go to?

• Unfortunately, the deadline to enroll facilities into this program has passed

• No other LTC facilities can be enrolled into this program.

• These facilities are still considered top priority for vaccination.

• The facilities should work closely with their LHD to organize clinics and ensure vaccination of LTC staff and residents.

Timeline for Distribution

Going to be somewhat inconsistent but timelines will still be followed

• As of December 12, Michigan has activated PART A of this program, which includes the 417 skilled nursing facilities.

• Once this program is activated, CVS and Walgreens have two weeks to begin scheduling clinics for each assigned facility. (plan to start around December 28th)

• CVS and Walgreens corporate are deciding which individual CVS and Walgreens stores will be responsible for which facilities.

• Currently, Michigan has not yet activated PART B of this program, which includes the other 4,903 eligible facilities.

• Michigan will activate PART B of this program as soon as enough vaccine becomes available in the coming weeks.

Mandatory Vaccinations for Residents & Staff

State’s position on a statewide vaccine mandate

• There is NO plan for the state to mandate that health care workers or the public get the COVID-19 vaccine.

• Under the EUA the vaccine recipient may decide to not receive the vaccine due to it is under the emergency use, thus no mandate.

Vaccine Administration

Q: Who can administer the vaccine?• Within this program the Pharmacy is responsible

for all clinic function.• The Pharmacist and Pharmacy Techs will be

vaccinating the staff and residents through this program.

• The Skilled Nursing Facility will NOT have to supply staff to vaccinate.

***The pharmacy is required to follow all CMS COVID testing requirements and they will be vaccinated.

Signed Consent

Q: What are the requirements and what role does the provider and pharmacy have in obtaining consent?• Consent process can be discussed with specific pharmacy

partner assigned to the LTC facility.• According to CDC, partners supporting the Pharmacy

Partnership for Long-Term Care Program should follow all Emergency Use Authorization Conditions of Use for COVID-19 vaccines when vaccinating LTCF residents, including provision of fact sheets.

• Consent/assent for vaccination should be obtained from the resident or their medical proxy and documented in the resident’s chart per standard practice.

Source: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/LTCF-residents.html

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/LTCF-residents.html

Resources

Q: Will the FAQ and other documents be published?

• Yes, Here is the link: www.michigan.gov/COVIDvaccine

• Plus, all the materials that went out in a recent email will be posted which include:

• List of sites enrolled• FAQ regarding the Federal LTC Partnership Program• CVX COVID-19 Clinic Guide• Walgreens Clinic Tip Sheet

http://www.michigan.gov/COVIDvaccine

Holiday Visitation andVisiting Families

Raymie Postema, DirectorMDHHS Office of Recipient Rights

MDHHS issues Thanksgiving guidance for vulnerable populations

LANSING, Mich. – The Michigan Department of Health and Human Services (MDHHS) today issued Thanksgiving celebration guidance for vulnerable populations to help ensure their health and safety and prevent the spread of COVID-19.“While we are advising everyone to avoid Thanksgiving gatherings beyond their own households, it’s especially critical that residents of nursing homes and other group homes remain in their homes during the holiday,” said MDHHS Director Robert Gordon. “If these individuals' contract COVID while traveling, they run the risk of bringing it back to others who are especially vulnerable to illness and death. This year, please celebrate Thanksgiving by Zoom or by phone, and next year’s Thanksgiving will be better.”

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MDHHS issues Thanksgiving guidance for vulnerable populations

On Nov. 18, MDHHS issued an epidemic order that limited indoor gatherings to no more than two households. This order does not prohibit residents of the facilities above from leaving a care facility; however, it is recommended that:• Residents be strongly encouraged to stay in place, especially

in light of increasing prevalence of COVID-19 cases.• Providers and direct care staff educate residents and their

family and friends on the associated risk of leaving a care facility and attending gatherings with family and friends as well as the steps they should take to reduce the risk of contracting COVID-19.

• Providers encourage residents to stay connected with loved ones through alternative means of communication, such as phone and video calls.

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MDHHS issues Thanksgiving guidance for vulnerable populations

Care facilities should follow recommended protocols to mitigate the spread of COVID-19 if a resident chooses to leave the care facility even after being provided such counseling:• Limit close contact (maintain physical distancing of six feet or

more), adhere to the gathering restrictions in the Nov. 18 order, and use technology to engage with others remotely.

• Wear a facemask or cloth face covering at all times (including in cars and homes) unless actively eating or drinking, or medical exemptions apply.

• Limit contact with commonly touched surfaces or shared items.• Keep safe around food and drinks. Avoid communal serving

utensils, passing of food and potluck or buffet style food service, and instead opt for individually prepared plates by a single server.

• Wash hands with soap and water or alcohol-based hand sanitizer often.

• Avoid large gatherings, crowded areas and high-risk activities such as singing.

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https://gcc01.safelinks.protection.outlook.com/?url=https%3A%2F%2Flnks.gd%2Fl%2FeyJhbGciOiJIUzI1NiJ9.eyJidWxsZXRpbl9saW5rX2lkIjoxMDIsInVyaSI6ImJwMjpjbGljayIsImJ1bGxldGluX2lkIjoiMjAyMDExMjMuMzEwMDA0NjEiLCJ1cmwiOiJodHRwczovL3d3dy5taWNoaWdhbi5nb3YvY29yb25hdmlydXMvMCw5NzUzLDctNDA2LTk4MTc4Xzk4NDU1LTU0NTEzNi0tLDAwLmh0bWwifQ.O8nc--jrLOGoPZU1oyjxsIBoNvSeQpebGNZa7yd-CrI%2Fs%2F495649657%2Fbr%2F90307388504-l&data=04%7C01%7Cpostemar%40michigan.gov%7C741c47d4cf3c4759d2b508d88ffc6184%7Cd5fb7087377742ad966a892ef47225d1%7C0%7C0%7C637417661414700329%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=GNZ1r9qg5y8eNhlHdyOPxKeotnbm7I9H2WRT4u8b20c%3D&reserved=0

MDHHS issues Thanksgiving guidance for vulnerable populations

• For those attending a gathering, avoid contact with individuals outside of their household for 14 days prior to the gathering if possible and follow MDHHS’s guidance for safe social gatherings.

• Ask anyone who has signs or symptoms of COVID-19 or has been exposed to someone diagnosed with COVID-19, to not attend the gathering.

• If possible, conduct gatherings outdoors. Indoor gatherings should have good ventilation, consider opening windows and doors if possible.

• Verbally greet others instead of shaking hands or giving hugs. Think ahead about how you will manage to prevent physical interactions with loved ones of different ages such as young children.

• All residents who leave the care facility should be screened upon return and if symptomatic, a resident’s health care provider or the local health department should be contacted to determine if quarantine is warranted.

• Strictly adhere to all testing, visitation and re-entry after visitation requirements for care facilities. Wednesday, Oct. 21Epidemic Order or Thursday, Oct. 29 Epidemic Order.

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https://gcc01.safelinks.protection.outlook.com/?url=https%3A%2F%2Flnks.gd%2Fl%2FeyJhbGciOiJIUzI1NiJ9.eyJidWxsZXRpbl9saW5rX2lkIjoxMDMsInVyaSI6ImJwMjpjbGljayIsImJ1bGxldGluX2lkIjoiMjAyMDExMjMuMzEwMDA0NjEiLCJ1cmwiOiJodHRwczovL3d3dy5taWNoaWdhbi5nb3YvY29yb25hdmlydXMvMCw5NzUzLDctNDA2LTk4MTc4Xzk4NDU1LTU0Mjg2MC0tLDAwLmh0bWwifQ.htTjRjm9featK8JVODk_o6GT3AVKeUEW7xCFPUQwmM4%2Fs%2F495649657%2Fbr%2F90307388504-l&data=04%7C01%7Cpostemar%40michigan.gov%7C741c47d4cf3c4759d2b508d88ffc6184%7Cd5fb7087377742ad966a892ef47225d1%7C0%7C1%7C637417661414700329%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=aBKzTT0UJ0m%2BVubMXMyI9GShBySC7Ylx3Odjz1RvQEQ%3D&reserved=0https://gcc01.safelinks.protection.outlook.com/?url=https%3A%2F%2Flnks.gd%2Fl%2FeyJhbGciOiJIUzI1NiJ9.eyJidWxsZXRpbl9saW5rX2lkIjoxMDQsInVyaSI6ImJwMjpjbGljayIsImJ1bGxldGluX2lkIjoiMjAyMDExMjMuMzEwMDA0NjEiLCJ1cmwiOiJodHRwczovL3d3dy5taWNoaWdhbi5nb3YvZG9jdW1lbnRzL2Nvcm9uYXZpcnVzL0VwaWRlbWljX09yZGVyX1RlbXBvcmFyeV9SZXN0cmljdGlvbnNfQ29uZ3JlZ2F0ZV9DYXJlX2FuZF9KdXZlbmlsZV9KdXN0aWNlX0ZhY2lsaXRpZXNfMTAyOTIwMjBfNzA2NjM4XzcucGRmIn0.st4qUuVwX-kq9LQlxn9NXRc1IzyVvFBpj0r3BeB4a6E%2Fs%2F495649657%2Fbr%2F90307388504-l&data=04%7C01%7Cpostemar%40michigan.gov%7C741c47d4cf3c4759d2b508d88ffc6184%7Cd5fb7087377742ad966a892ef47225d1%7C0%7C1%7C637417661414710286%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=5chLJCQQffRpV%2F2jrInCqOkRj6l4mcmtFNQVZg7AyBo%3D&reserved=0

Social Gathering Guidance Pause to Save Lives

COVID-19

Do not share utensils.Keep voices down and avoid shouting or cheering.

Stay six feet apart.Wear a mask – only take it off when you eat or drink,

then put it back on.

Socializing with family or friends may feel safe, but it is risky – especially with COVID everywhere in Michigan today. It’s best to only get together outside. If you must gather indoors, you may only see one other household at a time.

To reduce risk, follow these guidelines:Pick only one other household to see over the next three weeks. Even better, form a consistent social pod.

Choose a household that is also being careful. If anyone in either group feels sick, postpone the gathering.

Limit duration indoors. The longer the visit, the greater the risk.

Follow these rules as much as possible:

After a gathering, monitor yourself for symptoms of COVID-19. If anyone in the group feels sick, get tested.

For more information about social gatherings, visit Michigan.gov/Coronavirus. Questions or concerns can be emailed to COVID19@michigan.gov.

https://www.michigan.gov/documents/coronavirus/11-15_Safe_Social_Pods_v3_707801_7.pdfhttp://michigan.gov/Coronavirusmailto:COVID19@michigan.gov

AFC- HFA FAQ

With the Michigan Supreme Court decision, what requirements are still in effect?

Several orders have been issued by MDHHS Director Gordon that require mask wearing, ban inside visits, limit communal dining, etc. To see a full list of MDHHS Director Gordon’s orders click here. In addition, licensing requires that a home keep residents safe and have policies, procedures, and protocols and implement said policies, procedures, and protocols to prevent disease transmission of any kind, including COVID-19. These policies, procedures, and protocols should be based on CDC guidance and/or another national standard.

https://www.michigan.gov/documents/lara/AFC_HFA_FAQ_Final_685300_7.pdf

https://www.michigan.gov/documents/lara/AFC_HFA_FAQ_Final_685300_7.pdf

P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e .

Testing

Jeffery L. Wieferich, MA, LLPDirector

Bureau of Community Based ServicesBehavioral Health and Developmental Disabilities Administration

Testing Information

Questions of interest:• Testing for small and medium AFCs

• No further action right now to mandate testing• Continue to work with your Local Health

Departments• Testing refusal

• Residents have a right to refuse testing• Staff have a right to refuse testing

Testing Information.

Questions of interest:• Holiday testing requirements

• Residents can go on holiday outings with family• Residents must be allowed to return after a holiday

outing• CLIA Waiver payment

• Working on the payment mechanism• Please do not pay the voucher or “coupon” when

you receive it

Emergency Planning andHealthcare Coalitions

Rick Drummer, BS, MBA, MS, CHEPRegion 2 North Healthcare Coalition

Regional CoordinatorServing Macomb, Oakland, and St. Clair Counties

Four Pillars of Emergency Plans

Prev

entio

n an

d M

itiga

tion

Prep

ared

ness

Resp

onse

Reco

very

Emergency Management

Business Continuity

What needs to be considered in Emergency Management Plans

Consider your location, staff, facilities, day-to-day operations, business survival• Prevent or mitigate the impact• Prepare for what is likely to

happen• Know how to respond• Recovery starts at the beginning

CMS Conditions of Participation

These four areas support the emergency plans

Hazards Evolution and Expansion

2002 2020

Terrorism

Anthrax

Power Outage

Katrina

H1N1

Cyber

Pandemic

Zika

Meningitis

Opioids

PoliticalUnrest

Local Floods

Michigan Healthcare Coalitions(HCCs)

HCC Staff:

Regional Staff• Regional Coordinator (Full Time)• Assistant Regional Coordinator (Full Time)• Medical Director

Other Regional Support• Regional Epidemiologist• Regional Trauma Coordinator

HCC Members Include:

• Hospitals• Emergency Medical Services• Emergency Management Organizations• Public Health Agencies• Specialty patient referral centers• Behavioral Health Services and Organizations• Dialysis Centers • Home Health• Primary Care Providers• Skilled nursing and long-term care facilities• Others….

Importance of Healthcare Coalitions:• Coalitions work with local regional and State

partners to prepare hospitals, emergency medical services (EMS), and supporting healthcare organizations to deliver coordinated and effective care to victims of terrorism and other public health/healthcare emergencies.

• Regional Medical Coordination Centers Assist in response as a multiagency coordinating group (MAC)

Coalitions Response to COVID Examples:

• Distributes Strategic National Stockpile Ventilators• Distributes Personal Protection Equipment• Supports Mass Fatality Response for Hospitals• Supports Alternate Care Site Planning• Situational Awareness to Partners• EMResource Daily/Weekly Support• Staffing Issues Communications• Testing Support• Vaccine Communications• Etc.

Region 1 – Matthew Price2123 University Park Dr. Ste. 110Okemos, MI 48864Office: 517-324-4404Fax: 517-324-4406Email: d1rmrc-matt@sbcglobal.netwww.d1rmrc.org

Region 2N – Rick Drummer705 Barclay Circle, Ste 140Rochester Hills, MI 48307Office: 248-759-4748Fax: 248-759-4751Email: rdrummer@region2north.comwww.region2north.com

Region 2S – Amy Shehu6754 Brandt St.Romulus, MI. 48174Office: 734-728-7674Fax: 734-902-6000Email: AShehu@2South.Orgwww.2south.org

Region 3 – Rob Kelly1575 Concentric BlvdSaginaw, MI 48604Office: 989-746-7757Fax: 989-746-7767Email: rob.kelly@cmich.eduwww.Region3HCC.org

Region 5 Robert Christensen1000 Oakland Dr.Kalamazoo, MI 49008Office: 269-337-4286Fax: 269-337-6475Email: Robert.christensn@med.wmich.eduwww.5dmrc.org

Region 6 – Luke Aurner1675 Leahy St., Ste 308BMuskegon, MI 49442Office: 231-728-1967Fax: 231-728-1644Email: laurner@wmrmc.orgwww.miregion6.org

Region 7 – Mark Becmer80 Livingston Blvd, Ste. 106. Gaylord, MI 49735Office: 989-748-4975Fax: 989-748-4980Email: rc@mir7hcc.comwww.MIregion7.com

Region 8 – Ed Unger1202 Wright St. Ste EMarquette, MI 49855Office: 906-273-2125Fax: 906-273-2126Email: ed.unger@region8.orgwww.region8.org

HCC Contacts

mailto:d1rmrc-matt@sbcglobal.nethttp://www.d1rmrc.org/mailto:rdrummer@region2north.comhttp://www.region2north.com/mailto:AShehu@2South.Orghttp://www.2south.org/http://www.region3hcc.org/http://Robert.christensn@med.wmich.eduhttp://www.5dmrc.org/http://www.miregion6.org/mailto:rc@mir7hcc.commailto:jon.stone@region8.orghttp://www.region8.org/

Additional Resources

Emergency Planning The following links may be helpful to AFCs/HFAs in creating an emergency plan to address the COVID-19 pandemic and other infectious disease emergencies:

•MIOSHA COVID-19 Workplace Safety Guidance •MIOSHA Emergency Rules •MIOSHA Emergency Rules FAQ •MIOSHA COVID-19 Preparedness & Response Plan Template •MDHHS Long-Term Care COVID-19 Plan

https://asprtracie.hhs.gov

https://www.michigan.gov/leo/0,5863,7-336-100207---,00.htmlhttps://www.michigan.gov/documents/leo/Final_MIOSHA_Rules_705164_7.pdfhttps://www.michigan.gov/leo/0,5863,7-336-100207_103271---,00.htmlhttps://www.michigan.gov/documents/leo/leo_miosha_cet5700_691240_7.dochttps://www.michigan.gov/coronavirus/0,9753,7-406-98178_100722---,00.html

P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e .

Rapid Response Staffing

Nicole HudsonState Assistant Administrator to

Chief Deputy of Health / Chief Medical Executive

Rapid Response Staffing in Long-Term Care Facilities

• The Michigan Department of Health and Human Services is offering Rapid Response Staffing statewide to assist long-term care facilities who may be experiencing a staffing shortage. This includes:

• Skilled Nursing Facilities, Assisted Living Centers, Homes for the Aged, and Adult Foster Care Homes.

• MDHHS’s contracted staffing agencies can provide:• Short term (120 hours or less) of consecutive staffing assistance • Facilities will be able to request of maximum of 5 staff total per shift

• MDHHS cannot guarantee that every facility that meets criteria and request staffing resources will receive staffing support due to the high demand for supplemental staffing

• Detailed program information can be found here: https://www.michigan.gov/documents/coronavirus/RRS_Guidance_for_LTC_Facilities_Program_Updates_Oct_2020_FINAL_706611_7.pdf

https://www.michigan.gov/documents/coronavirus/RRS_Guidance_for_LTC_Facilities_Program_Updates_Oct_2020_FINAL_706611_7.pdf

Steps for Requesting Staffing

Questions

• Please review the program guidance document for Frequently Asked Questions: https://www.michigan.gov/documents/coronavirus/RRS_Guidance_for_LTC_Facilities_Program_Updates_Oct_2020_FINAL_706611_7.pdf

• All other questions can be emailed to: MDHHS-LTCStaffing@michigan.gov

• Please note, requests for staffing assistance cannot be made via this email address.

https://www.michigan.gov/documents/coronavirus/RRS_Guidance_for_LTC_Facilities_Program_Updates_Oct_2020_FINAL_706611_7.pdfmailto:MDHHS-LTCStaffing@michigan.gov

Conclusion: Questions / Comments:

Allen Jansen, Senior Deputy DirectorBehavioral Health and Developmental DisabilitiesMDHHS-COVID-AFC-HFA-Response@michigan.gov

mailto:MDHHS-COVID-AFC-HFA-Response@michigan.gov

Slide Number 1Slide Number 2Walgreens and CVS Distribution�An Overview�An Overview cont……�Q: How do I know if I am on the list the �department submitted to the two pharmacies?��Q: If not part of this distribution/program or �other type, who do they go to? �Timeline for DistributionGoing to be somewhat inconsistent but �timelines will still be followed�Mandatory Vaccinations for Residents & StaffState’s position on a statewide �vaccine mandate��Vaccine AdministrationQ: Who can administer the vaccine?��Signed ConsentQ: What are the requirements and what �role does the provider and pharmacy have �in obtaining consent?�����Resources�Q: Will the FAQ and other documents �be published? Holiday Visitation and�Visiting FamiliesSlide Number 19Slide Number 20Slide Number 21Slide Number 22COVID-19AFC- HFA FAQSlide Number 25Testing InformationTesting Information.Emergency Planning and� Healthcare CoalitionsFour Pillars of Emergency PlansWhat needs to be considered in Emergency Management PlansCMS Conditions of ParticipationThese four areas support the emergency plansHazards Evolution and ExpansionMichigan Healthcare Coalitions�(HCCs)HCC Staff:HCC Members Include:Importance of Healthcare Coalitions:Coalitions Response to COVID Examples:HCC ContactsAdditional ResourcesSlide Number 41Rapid Response Staffing in Long-Term Care FacilitiesSteps for Requesting StaffingQuestions Conclusion: Questions / Comments: