Ending 2020 with good news, the Centers for Disease Control and Prevention (CDC) is coordinating distribution of recently approved COVID-19 vaccines through state health departments, networks of independent pharmacies and federal agencies, such as the Indian Health Service. Vaccine distribution is being allocated through a phased approach, with phase one being the most vulnerable recipients and progressing to phase four, which includes all other U.S. residents who did not have access in the earlier phases.
With phases one and two consisting of those with comorbid and underlying conditions, adults living in congregate or crowded settings and older adults, home health, hospice and home care providers administering vaccines need to prepare now.
Steps to Prepare Your Organization for Administrating the COVID-19 Vaccine
This will be a logistical hurdle with some financial considerations. Steps to prepare include:
1. Enroll in your state’s vaccination program. Enroll as a mass immunizer if you are not already enrolled in Medicare as an institutional provider, including skilled facilities, home health and hospice. Contact your state health department to enroll in the vaccination program by searching for “COVID-19 Vaccine Program” on the respective site. The CDC COVID-19 Vaccination Program Provider Agreement must be completed, among other agreement forms. Sign up for email alerts to receive updates and have a go-to resource for the latest information on vaccine management.
2. Designate a vaccination coordinator to identify clinicians who will administer the vaccine, train other staff members and maintain documentation of the training completed. The clinicians who will administer the vaccine will require training in vaccine storage and handling, consents, documentation, administration and monitoring.
- STORAGE and HANDLING: The CDC offers a Vaccine Storage and Handling Toolkit, which has been updated with a COVID-19 Vaccine Addendum. The vaccines must be maintained by a cold chain at a specified temperature range. Not all vaccines will have the same temperature requirements to maintain safety and effectiveness.
- CONSENT: A vaccine information sheet (VIS) is currently not available for the COVID-19 vaccine. Instead, use the COVID-19 Emergency Use Authorization (EUA) by the Food and Drug Administration. Similar to the VIS, providers are required to distribute the EUA to the patient and caregiver prior to vaccination, and must be documented in the patient’s electronic medical record.
- DOCUMENTATION: Documentation must be entered into the medical record within 24 hours of administration and reported to the appropriate system within 72 hours. Record the date the vaccine was administered, the manufacturer and lot number, the vaccination site and route, and the name and title of the person administering the vaccine.
- ADMINISTRATION: Nurses have been trained in injection administration. Using the skills checklist during the training enables the vaccine coordinator to document skills and refresh clinicians who have not recently administered a vaccine. COVID-19 vaccine administrators will need to consider personal protective equipment (PPE): face mask, eye protection, gloves and a clean surface for supplies. The You Call the Shots training module is the recommended resource for administration training.
- REPORTING and MONITORING: Use the Vaccine Adverse Event Reporting System (VAERS), set up by the U.S. Department of Health and Human Services (HHS), to report adverse events post-vaccination or as a resource for questions surrounding the vaccine. The CDC offers a monitoring system, v-safe, an app that provides the recipient or their primary caregiver a check-in system and a reminder for the second vaccination in the two-part dose series. Be familiar with these resources and provide the contact information to your staff.
3. Identify patients who need the vaccine. A majority of the population served in home health, home care and hospice industries, as well as the workers, are recommended to receive the vaccine first.
4. Identify potential reimbursement for administration of the vaccine. Patients will receive the vaccine at no cost. The provider must agree not to charge patients for the vaccination. There is a Provider Relief Fund to help organizations providing vaccinations to uninsured patients. Organizations enrolled in Medicare can obtain reimbursement through roster billing. Those not enrolled in Medicare can participate as mass immunizers. There are specific codes to use for these claims.
The CDC provides many resources to educate providers on the COVID-19 vaccines.
- COVID-19 Vaccination
- The Vaccine Life Cycle: Safety at Every Phase
- COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations
- Vaccine Storage and Handling
- State Vaccination Allocation Plan
Home health providers care for the people who are most vulnerable to this fast-spreading, deadly virus. Thank you for providing this crucial step in the national recovery from COVID-19.