COVID-19 info for Assisted Living Providers

WALA continues to be your advocate in providing resources to work through this public health situation. We are committed to delivering the most up-to-date information as circumstances continue to develop.

Recommendations for TB Testing with COVID-19 Vaccination for Health Care Personnel and Patients Entering Care Facilities

As the U.S. COVID-19 vaccination program continues, some may have questions about the interaction between new COVID-19 mRNA vaccines and tests used for tuberculosis (TB) infection.

There is no immunologic reason to believe that a TST or blood draw for IGRA will impact the effectiveness of COVID-19 mRNA vaccines.

According to the Vaccine Recommendations and Guidelines of the Advisory Committee on Immunization Practices (ACIP), inactive vaccines do not interfere with TB test results. Vaccination with live viruses (such as the MMR vaccine) can cause mild immune system suppression, and may reduce the reactivity of the TST, possibly causing a false-negative reaction.

Although the COVID-19 mRNA vaccine is not a live virus vaccine, not enough is yet known of the potential impact of mRNA vaccines on immune responses to say conclusively whether the COVID-19 mRNA vaccine could have a potential effect on TST or IGRA test results during the first four weeks after COVID-19 vaccination.

Wisconsin Recommendations

Until more is known, Wisconsin recommends following the CDC Dear Colleague Letter regarding timing for TB testing (TST/IGRA) with the COVID-19 vaccine.

For health care personnel (HCP) or patients who require baseline TB testing (at onboarding or for entry/preplacement into facilities) at the same time they are to receive a COVID-19 vaccine:

  • Perform TB risk assessment and symptom evaluation (includes obtaining medical history) on all HCP or patients.
  • If using the interferon gamma release assay (IGRA), draw blood prior to COVID-19 vaccination.
  • If using the tuberculin skin test (TST), place prior to COVID-19 vaccination.
  • If a two-step TST is needed (see Publications P-02382 and P-02382A), place the first TST prior to COVID-19 vaccination and the second TST four weeks after the full COVID-19 vaccination series is complete.

For HCP or patients who require baseline TB testing (at onboarding or for entry/preplacement into facilities) and COVID-19 vaccination has already occurred:

  • Perform TB risk assessment and symptom evaluation (includes obtaining medical history) on all HCP or patients.

For HCP or patients with no risk/history of TB infection and no TB symptoms:

  • Defer TST or IGRA until four weeks after completion of full COVID-19 mRNA vaccination series. TB testing should occur as soon as possible after this time.
  • HCP can be cleared for direct patient care and patients can be admitted to care settings.

For Asymptomatic HCP or patients with risk /history of TB infection:

  • Defer TST or IGRA until four weeks after completion of full COVID-19 mRNA vaccination series. TB testing should occur as soon as possible after this time.
  • Perform chest radiography (CXR) and symptom evaluation for clearance. A clinical decision on direct patient care duties (for HCP) or admission (for patient admission to care settings) should be made based on TB risk assessment, symptom evaluation, CXR and medical history.
  • Per CDC Guidance, a previous CXR less than 6 months old may be used for clearance for asymptomatic HCP/patients.

Resources

DHS COVID-19 Related Infection Prevention Resources

DHS has a number of various infection prevention strategies to assist local health departments and long-term care facilities (LTCFs) with COVID-19.

This includes:

These resources mentioned are available on the DHS assisted living facility pages of the website with more to come.

Wisconsin DHS Regarding Visitation for AL Communities

DHS has released the following updates for Assisted Living visitation during the COVID-19 Pandemic. The following information was provided by DHS. WALA recommends that you carefully read through this updated guidance as well as other provider resources under COVID-19: Long-Term Care Facilities and Services.

Purpose

To provide guidance to assisted living facilities regarding safer visits to residents during COVID-19. This guidance is intended for facilities with no known or suspected COVID-19 cases. The guidance includes preventative measures to reduce the chances of the introduction of COVID-19 into the facility, while mitigating the unintentional consequences of social isolation from family and loved ones. For purposes of this document, facilities include community-based residential facilities, licensed adult family homes, and residential care apartment complexes.

Read this updated DHS guidance in it's entirety: Safer Visits in Assisted Living Facilities

Resources to Support ALFs in Determining Admission Policies during COVID-19 Outbreak

"Resources to Support Assisted Living Facilities in Determining Admission Policies during a COVID-19 Outbreak" has been posted on the Division of Public Health (DPH) Communicable Diseases Memos page. This document serves as a decision support tool for Assisted Living Facilities, and is a companion document to BCD 2020-27, "Prevention and Control of Acute Respiratory Illness Outbreaks in Long-Term Care Facilities."

DPH Communicable Diseases memos can be found here.

New Information Available on HHS Pharmacy Partnership

Update: The deadline to opt-in to HHS’ pharmacy partnership program for vaccine management has been extended to Friday, November 6. Please don't wait to register.

This program is intended to help long-term care communities, at no cost, with complete vaccination management through a retail pharmacy partnership with CVS and Walgreens. You can read the program overview here. Long-term care communities are not mandated to participate in this program and can request to use their current pharmacy contracts to support COVID-19 vaccination. However, providers should ensure that their long-term care pharmacy is a registered provider with their state. It is also important to note that if communities opt-in to the HHS program, the decision on how to receive vaccines can be changed at any time before vaccines are distributed.

HHS has clarified that independent living residents are included for prioritization in the vaccination program and as such, should be included in vaccination clinics in partnership with CVS/Walgreens or qualified long-term care pharmacies. This would include standalone independent living communities and CCRCs, as well as previously recognized assisted living communities. You are encouraged to register for the HHS Pharmacy Partnership for Long-Term Care Program. And be sure you adequately account for all residents, staff, volunteers, and vendors in providing census counts. Read more here.

Guidance for Health Care Professionals and Residential Care Facilities

Read the entire guidance regarding COVID-19 Long-Term Care Facilities and Services. Facilities should also follow sections for visitors to facilities, guidance for all facilities, and resources.

Sign up for email updates from DHS here

WALA Part of the "Stop the COVID Spread!" Coalition

WALA is proud to be one of the more than 100 organizations that have joined in this effort to combat the growing public health crisis in the Badger State.

“Stop the Covid Spread!” is a coalition of Wisconsin’s leading health care, business, education, and advocacy organizations--and now all three of our professional sports teams--who have all joined in the team effort to urge the public to get in the game and take preventative measures seriously so that we can all continue to safely participate in Wisconsin’s economy. Learn more about the Coalition here.

For the latest information on Coronavirus (COVID-19), please visit the links below:

General Information on COVID-19
Video and Webinar Resources
Assisted Living Specific Resources
Other Links and Resources on COVID-19
Personal Protective Equipment (PPE) Resources

Currently, all PPE requests will go through county or tribal emergency management. Each county or tribe will develop its own process and timeline for accepting these requests. You do not have to have a COVID-19 positive individual to request PPE from your county or tribal emergency manager.

Locate Your Local Health Department 

  Locate Your County Emergency Management Director

Providers should contact the State's Emergency Function Line at 608-888-5318 with any questions.

If you are a facility that is currently treating one or more COVID-19 positive individuals, however, please continue to follow the PPE Reserve Request Process listed below:

Employment Resources